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Flashcards in neuro post midterm Deck (73):
1

Atenolol

B1 adrenergic antagonist. Tx HTN

2

Salbutamol

B2 adrenergic agonist. Tx asthma (bronchodilator)

3

Atropine

Muscarinic antagonist. Mydriatic, reduction of drooling in Parkinson's dz, antidote in poisoning with insecticide

4

Amyotropic lateral sclerosis (ALS)

Degeneration of anterior horn cells and V, VII, X, XII, parts of pyramidal tract, and primary motor area. Affects LMNs. Flaccid and spastic paralysis. Affects UEs. Decreased cough reflex -> aspiration pneumonia, respiratory insufficiency

5

Anterior spinal artery (ASA) syndrome

Flaccid paralysis, spastic paresis. Positive Babinski (UMN), lose pain and temp

6

Central medullary syndrome

I.e. syringomyelia d/t tumors. Lose pain and temp, get flaccid paralysis (no spastic paralysis). Common in cervical spine

7

Posterior parietal cortex

Brodmann 5+7, integrate sensory info for motor planning in concert w/premotor areas

8

Lateral corticospinal tract

Mainly flexor. Alpha and gamma. Cortical input. Mainly excitatory

9

Rubrospinal tract

Flexor. Alpha and gamma. Cortical input. Excitatory

10

Medullary/lateral reticulospinal tract

Flexor, bilateral innervation. Alpha and gamma via interneuron. Cortical input. Excitatory

11

Pontine/medial reticulospinal tract

Extensor. Gamma ONLY, via interneuron. Cortical input. Excitatory. Mostly involuntary

12

Lateral vestibulospinal tract

Extensor. Alpha ONLY, via interneuron. NO CORTICAL INPUT. Vestibular organ - excitatory. Cerebellum - inhibitory

13

Medial vestibulospinal tract

Extensor. Alpha ONLY. NO CORTICAL INPUT. Inhibition of alpha (glycine). Vestibular organ - excitatory. Cerebellum - inhibitory

14

Type I motor unit

Slow-twitch; low-tension; fatigue-resistant, aerobic; small motor neuron and axon

15

Type IIA motor unit

Fast; relatively fatigue-resistant; large tension; some aerobic; relatively large motor neurons

16

Type II B motor unit

Fast; fatigue-susceptible; large tension; anaerobic; large motor neurons

17

Dx and tx for myasthenia gravis

Dx - Tensilon test. Tx - azathioprine and corticosteroids - immunosuppressants

18

Myotonia congenita

Defect in gene encoding Cl- channels, can't bring Em close to Ecl to recover from AP when K+ is accumulating in TTS -> spontaneous firing of muscles after nerve end stimulation. Prolonged relaxation phase

19

Ballismus

Due to lesions of subthalamic nucleus. Decreased excitation of GPi -> disinhibition of thalamus and cerebral cortex -> increased contralateral movement

20

Tardive dyskinesia

D/t antipsychotic drugs (dopamine receptor antagonists), can become permanent

21

Dopa-induced dyskinesia

Occurs in txt of Parkinson's w/DOPA -> chorea

22

Drug-induced Parkinson's disease

Antipsychotics, depletors of DA stores (ex reserpine), toxic contaminants (MPTP)

23

Striatal neuronal degeneration and Huntington's disease

Destruction of striatal neurons expressing D2 receptors -> decreased thalamic inhibition -> increased cortical activity. HYPERKINESIS, CHOREA

24

Sydenham disease

Chorea d/t autoimmune ABs against striatum resulting from childhood rheumatic fever

25

Mech of L-DOPA and carbidopa

L-dopa -> increased dopamine synthesis in surviving SNc. Carbidopa -> decreased peripheral metabolism of L-DOPA. Txt w/L-DOPA and carbidopa becomes less effective over several years

26

Bromocriptine

Stimulates D2 receptors

27

Pergolide

Stimulates both D1 and D2 receptors

28

Amantadine

Antiviral drug, may benefit some manifestations of Parkinson's (akinesia, rigidity) -> ma promote release of dopamine and/or block ACh receptors (also weakly blocks NMDA receptors). Psychiatric SE's!

29

Selegiline (deprenyl)

Irreversibly binds MAO B -> may improve responses to or delay need for other therapies

30

Entacapone and tolcapone

Inhibit COMT -> prolong synaptic longevity of dopamine

31

Benztropine

Muscarinic antagonist. Block ACh (which has opposite effect of DA on D2) excitation of striatum -> tx resting tremor.

32

Huntington's disease

Tx with D2 receptor antagonists -> antichoreic if there's still surviving D2 striatal neurons or use VMAT inhibitors -> more free dopamine, less stored in vesicles

33

Louis-Bar syndrome

Widespread degeneration of cerebellar Purkinje cells and compromised immune fxn -> delayed development of motor skills, increased vulnerability to infxn, increased sensitivity to ionizing radiation, bloodshot eyes

34

Cerebellar cognitive affective syndrome (CCAS)

Cognitive and emotional systems dysfunction resulting from cerebellar injury

35

Guillain-Barre syndrome

After respiratory or GI infection. Demyelination of peripheral axons. Good recovery, demyelination. Lumbar puncture -> increased protein in CSF. Tx - immunoglobulin

36

Leprosy (Hansen's disease)

Prefers unmyelinated axons (pain and temperature). Bacterial multiplication -> compression and ischemia of all peripheral axons. Tx w/multiple abx

37

Lead poisoning

Focal weakness of extensor muscles of fingers, wrists, and arms. Bilateral arm weakness and wasting in chronic situations. No sensory symptoms. Motor neuropathy in adults and encephalopathy in infants

38

Alcoholic peripheral neuropathy

First sensory loss, then motor loss (both symmetric). Vit B1 deficiency

39

Vitamin B1 deficiency

Affects rostral vermis and adjacent parts of anterior lobe. Affects cortical Purkinje cells -> reactive gliosis

40

DM

Sensory loss (symmetric), motor loss (asymmetric), and autonomic neuropathy. Vasculopathy

41

Cheyne-Stokes respiration

Lesion in forebrain

42

Hyperventilation

Lesion in midbrain

43

Apneusis (inspiratory cramps)

Lesion in pons

44

Ataxic breathing

Lesion in lower pons/upper medulla

45

Respiratory arrest

Lesion in medulla (bilateral)

46

Diencephalic lesion

Small, reactive pupils

47

Uncal herniation

One dilated, one constricted

48

Midbrain lesion

Midposition, fixed pupils

49

Diffuse effects of drugs, metabolic encephalopathy

Small, reactive

50

Pretectal lesion

Larged, fixed, unreactive

51

Pontine lesion

Pinpoint pupils

52

Alexia

Inability to read the left visual field due to dmg in splenium of corpus callosum

53

Phenytoin, carbamazepine

Tx epilepsy. Block excitation: reduce flow of Na+ and Ca2+ ions into neurons, increase level of GABA, and suppress the release of glutamate -> less excitability

54

GABAergic, benzodiazepines, barbiturates

Tx epilepsy. Enhance inhibition: potentiate inhibitory GABAa recs and inhibit excitatory AMPA recs

55

Levetiracetam

Decreases voltage-operated delayed rectifier K+ current w/o effect on Na+ and A-type K+ potassium currents -> reduced repetitive AP generation

Reduction of N-type and P/Q type Ca2+ currents -> decreased NT release

Binds to synaptic vesicle protein, SV2A, which is believed to impede conduction across synapses

56

Thalamocortical transmission part of ARAS

Cholinergic structures, monoaminergic systems

57

Lateral hypothalamus, basal forebrain, and cerebral cortex part of ARAS

NA, serotonin, histamine, orexin/hypocretin, ACh, GABA

VLPO in hypothalamus - inhibitory (GABA, galanin), promotes sleep by inhibiting activity in the brain's arousal centers

58

Adenosine

Extracellular conc of adenosine rises during waking hours -> inhibits ARAS. During sleep, conc slowly declines. Administration ->NREM sleep

59

Melatonin

Extracellular conc reaches a max at about2-3am, and declines to low value by 7am. Synthesis: tryptophan->serotonin->melatonin

60

IL-1

Produced during infections. Conc increases in CSF during NREM. Intraventricular injection -> NREM sleep

61

Muramyl peptides

From bacterial cell walls. Inject into lateral ventricles of mammals -> NREM sleep

62

Delta sleep-inducing peptide

Intraventricular injection -> NREM sleep

63

REM-on cells

Maximally active in REM sleep. Use NTs GABA, glycine, ACh, or glutamate

64

REM-off cells

Minimally active in REM sleep. Use NTs NE, epi, serotonin, and histamine

65

Storage areas for procedural, non-declarative memory

Supplementary and premotor cortex, striatum in BG, cerebellum

66

Late onset Alzheimer's

Chromosome 19 (ApoE/ApoE4) -> failure in Abeta clearance -> gradual increase in Abeta 42

67

Familial Alzheimer's

Chromosone 1 (presenilin 2)
Chromosome 14 (presenilin 1)
Chromosome 21 (APP)

Cause constant production of Abeta 42 (Abeta 43)

68

Histology of Parkinson's dz

Lewy bodies in substantia nigra, locus ceruleus, basal nucleus of Meynert, raphe nucleus, cerebral cortex

69

Histology of Huntington's chorea

Intranuclear and cytoplasmic inclusions/Huntington protein, striatum, frontal cerebral cortex

70

Histology of amyotrophic lateral sclerosis

Bunina bodies/SOD1; UMN, LMN, lateral corticospinal tract

71

Pick's dz

Cytoplasmic inclusions, Tau+ Pick bodies composed of densely packed neurofilaments; atrophy in frontal or temporal lobe, cholinergic neuronal loss especially in basal nucleus of Meynert

72

Progressive supranuclear palsy, corticobasal degeneration, frontotemporal dementia

Neurofibrillary tangles/tau

73

Progeria

LMNA gene normally encodes prelamin A protein. Mutation in LMNA -> production of abnormal form of prelamin A (progerin) -> blebbing and disorganization of nuclear envelope -> impaired signal transduction, nuclear compartmentalization, and gene regulation