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Neurology > Neuro3 - Mark > Flashcards

Neuro3 - Mark Flashcards

1
Q

is caused by obstruction of the upper airway. It is characterized by repetitive pauses in breathing during sleep, despite the effort to breathe, and is usually associated with a reduction in blood oxygen saturation. These pauses in breathing, called “apneas” (literally, “without breath”), typically last 20 to 40 seconds ; Symptoms may be present for years or even decades without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance. ; snoring, apneic episodes, chocking, gasping, nocturia, tiredness upon awakening

A

Obstructive Sleep Apnea Syndrome

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2
Q

characterized by excessive sleepiness that typically is associated with cataplexy and other REM sleep phenomena such as sleep paralysis and hypnagogic hallucinations ; may be seen in children ; may be cataplectic ; HLA-A1 ; may be genetic

A

Narcolepsy

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3
Q

a sudden and transient episode of loss of muscle tone, often triggered by emotions such as laughing, crying, terror, etc. ; occurs without the co-occurrence of narcolepsy ; cause is unknown, but the condition is strongly linked to experiencing intense emotions and reduced levels of the neurochemical hypocretin ; associated with narcolepsy

A

Cataplexy

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4
Q

s the experience of the transitional states to and from sleep: the hypnagogic and the hypnopompic states of consciousness.

A

Hypnagogic Hallucinations

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5
Q

secreted by tubulomammary bodies ; lack of this neurotransmitter is thought to be a cause for narcolepsy

A

Hypocretin

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6
Q

stimulants (dopaminergic agents, noradrenergic agents, adenosine recepter agents) ; used to treat narcolepsy

A

Somnolytics

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7
Q

catacholamine re-uptake blockers, serotonin re-uptake blockers, centrally acating cholinergic antagonists, sodium oxybate ; used to treat cataplexy

A

anticataplectic

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8
Q

protriptylene, clomipramine, venlafaxine, fluozetine, sodium oxybate ; used to treat cataplexy/narcolepsy

A

REM suppressants

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9
Q

dopaminergic agents (amphetamine, methylphenidate), noradrenergic agents (amphetamine), adenosine receptor agents (methylxanthines - caffeine, theophyline), are treatments for this condition

A

Tx for sleepiness

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10
Q

catecholamine reuptake blockers, SSRIs, centrally actinc cholinergic antagonists, REM sleep inhibitors (protriptyline, clompramine, venlafaxine, floxetine,) sodium oxybate (mech unknown) are all treatments for this condition

A

Tx for cataplexy

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11
Q

disorders of arousal, and sleep stage transition problems ;

A

Parasomnias

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12
Q

sleep terrors, sleepwalking - arousal disorders

A

Confusional arousals

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13
Q

a type of confusional arousal - arousal disorder ; generally occurs during delta sleep - sudden arousal from slow wave sleep with a piercing scream or cry accompanied by autonomic and behavioural manifestations of intense fear ; usually in kids but if continued during adult life may be very dangerous ; may use a benzodiazepam to tx

A

Sleep Terrors

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14
Q

characterized by mental confusion, automatic behaviour, relative non-reactivity to external stimuli, poor response to provoke behavioral wakefulness, retrograde amnesia fro many intercurrent events, only fragmentary or no recall of dream mentation ; in adults can be very dangerous

A

Sleep wakling

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15
Q

loss of muscle ationa during REM sleep causing people to act out their dreams ; may put pt at risk for development of parkinsons later in life ;

A

REM sleep behaviour disorders

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16
Q

transient conscious state of involuntary immobility occurin in transitions between sleeping and waking ; unable to make gross bodily movements during sleep paralysis but often able to open eyes ; aware of the surroundings and capable of later providing accurate reports on events occurred during the episode ; during paralysis individuals may atempt to cry out and sometimes produce moaning sounds ; frightening hypnagogic hallucinoid experiences often accompany this

A

Sleep paralysis

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17
Q

are characterized by recurrent awakenings from sleep with recall of intensely disturbing dream mentation usually involving fear or anxiety but also anger sadnes, disgust and other dysphoric emotions ; occationally nightmares are very common experience (70-90%) ; unpleasant dreams that do not wake the dreamer ;

A

Nightmare disorder

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18
Q

patients engage in a variety of behaviours that may be elaborate and bizarre lasting minutes to an hour or longer often with marked agitation percieved dreaming that is acutally a dissociated wakeful moment of a past abuse, and can include nocturnal fuge state

A

Sleep related dissociative disorder

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19
Q

anhedonia, loss of appetite, socialy withdrawn, loss of libido, sleep disturbances (hypersomnia or insomnia), worselesness, guilt, feel that they and everyone else would be better off if they were dead -> suicidal ; symptoms every day for at least two week ; difficulty problem solving, memory, speudodementia ; TSH, GH, FSH, LH are inhibited during this disorder ; can be caused by parkinsons, myxedema, hypothyroidism, post-partum ;

A

Major Depressive Disorder

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20
Q

depression that happens in winter months - lack of light

A

Seasonal affective disorder

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21
Q

chronic depression ; down, not fun to be around, but FUNCTIONAL ; part of their life for at least 2 years

A

Dysthymic disorder

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22
Q

pressured speach, flight of ideas, dysforic mania ; can be recurrent if not treated ; very high sense of self esteem -> may even be delusional ; prefrontal cortex is affected ; pleasure driven kind of behavior -> impulsive (persistent for 1-2 weeks) ; off the charts

A

Bipolar 1

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23
Q

more energetic, more creative etc -> alternating with periods of depression ; at least 4 days of feeling better but they are functional ; no pressured speach ; distractable ; not as extreme

A

Bipolar 2

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24
Q

a type of chronic mood disorder widely considered to be a milder or subthreshold form of bipolar disorder ; characterized by numerous extreme mood disturbances, with periods of hypomanic symptoms alternating with periods of mild or moderate depression ; present just about every day for 2 years ;

A

cyclothymic personality

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25
Q

8th leading cause of death in USA ; very common in mood disorders especially depressive disorders

A

Suicide

26
Q

a mental disorder characterized by symptoms that suggest physical illness or injury – symptoms that cannot be explained fully by a general medical condition or by the direct effect of a substance, and are not attributable to another mental disorder ; medical test results are either normal or do not explain the person’s symptoms, and history and physical examination do not indicate the presence of a medical condition that could cause them. Patients with this disorder often become worried about their health because doctors are unable to find a cause for their symptoms ; MUST HAVE - sx before age 30, 4 distinct pain sx at different sites (2 GI sx, 1 sexual sx, 1 pseudoneurological sx),

A

Somatoform disorders

27
Q

causes patients to suffer apparently neurological symptoms, such as numbness, blindness, paralysis, or fits, but without a neurological cause. It is thought that these problems arise in response to difficulties in the patient’s life, and conversion is considered a psychiatric disorder ; may lead to depression

A

Conversion disorder

28
Q

is physical pain that is caused, increased, or prolonged by mental, emotional, or behavioral factors ; Headache, back pain, or stomach pain are some of the most common types of psychogenic pain. It may occur, rarely, in persons with a mental disorder, but more commonly it accompanies or is induced by social rejection, broken heart, grief, love sickness, or other such emotional events

A

Psychogenic pain disorder

29
Q

refers to excessive preoccupancy or worry about having a serious illness. This debilitating condition is the result of an inaccurate perception of the body’s condition despite the absence of an actual medical condition

A

hypochondriasis

30
Q

a type of mental illness, a somatoform disorder, wherein the affected person is concerned with body image, manifested as excessive concern about and preoccupation with a perceived defect of their physical features ; The person thinks they have a defect in either one feature or several features of their body, which causes psychological distress that causes clinically significant distress or impairs occupational or social functioning

A

body dysmorphic disorder

31
Q

need to be a patient ; all physical and psychological sx are under voluntary control of the patient ; munchousins disorder

A

facticious disorder

32
Q

is a psychiatric factitious disorder wherein those affected feign disease, illness, or psychological trauma to draw attention or sympathy to themselves. It is also sometimes known as hospital addiction syndrome, thick chart syndrome, or hospital hopper syndrome ;

A

Munchousins Disorder

33
Q

is a condition in which a person deliberately produces, feigns, or exaggerates symptoms in a person in their care.

A

Munchousens disorder by proxy

34
Q

fabricating or exaggerating the symptoms of mental or physical disorders for a variety of “secondary gain” motives, which may include financial compensation (often tied to fraud); avoiding school, work or military service; obtaining drugs; getting lighter criminal sentences; or simply to attract attention or sympathy.

A

malingerer

35
Q

active process, governed by homeostatic and circadian processes ; characterized by total or partial unconsciousness and the nearly complete inactivity of voluntary muscles ; easily reversible, self-regulating, essential for survival ; purpose is for restoration, memory, immune, energy conservation, circadian homeostasis, preservation ; cycles about every 90 mins between Stage 1, 2, 3, REM

A

Sleep - Definition

36
Q

EEG - mixed frequency and fast ; EMG - voluntary motor activity is paralized (only eyes, diaphragm, and sphincters are active) ; Autonomics - Variable ; nocturnal penile tumescence ; altered control of tumescense

A

REM Sleep

37
Q

EEG - spindles, K-complexes, Delta waves ; EMG - present muscle movement, but lower ; eye movement is absent ; Autonomics - regular ; absent penile tumescence ; respiration control is normal ; GROWTH hormone is released during this type of sleep ; N1 first stage ; N2 second stage ; N3 deep sleep third stage

A

Non-REM sleep

38
Q

length of time since last sleep (homeostasis), body temperature drop, low light,

A

Factors that drive Sleepiness

39
Q

older pts will have a drop in Delta sleep, REM is virtually unchanged, they have less difficulty falling asleep but wake more times throughout the night, they also take more naps throughout the day ;

A

Age and sleep

40
Q

study of biological rhytms - ultradian rhythms, circadian rhythms, and infradian rhythms ;

A

Chronobiology

41
Q

is the process by which external time cues (light-dark) influence the timing and periodicity of biological rhythms ; sleep is coordinated by these processes

A

Entrainment

42
Q

when animals are isolated from all external time cues, they are in a state termed free-running with respect to their biological rhythms ; the periodicity of circadian rhythms lengthens or shortens during free-running to 23-26 hours, depending on the species ; this phenomenon suggests that an endogenous mechanism, no an environmental cue, is responsible for circadian rhythms ; HOWEVER two or more rhythms may become dysinchronized

A

Free running rhythms

43
Q

are external time cues that regulated and synchronize circadian rhythms with the environment ; falls into tow categories - photic (light-dark cycle) and non photic (food, social interaciton, exercise)

A

Zeitgeber

44
Q

sunlight serves as a photic cue, determining the timing and level of some physiological variables -> light reaches the suprachiasmatic nucleus of the brain primarily via te retinohypothalamic tract -> affects periodicity of rythm ; light intensity is a major factor in synchronizing circaiand rhythms to the environmental light-dark cycle -> light of 2500 lux has a major effect that suppresses melatonin secretion from pineal but once light has less than 1200 lux -> shift to endogenous cicadian pacemaker

A

Photic cues

45
Q

photic inputs via: a) retinohypothalamic tract, b) geniculohypothalamic tract, and nonphotic input mainly from the: c) midbrain raphe nuclei, neuropeptide Y containing projections from the intergeniculate leaflet of the thalamus and serotogenic brainstem median raphe nuclei ; the main control on the SCN is from melatonin ; also may recieve some control from the TGF-alpha

A

Suprachiasmatic nucleus (SCN) inputs

46
Q

may function as a feedback means to regulate circadian rhythms at the level of the Suprachiasmatic nucleus (SCN) via melatonin ;

A

Pineal gland

47
Q

melatonin receptors modulate neuronal firing, arterial, vasoconstriction, cell membrane proliferation in cancer cells, and reproductive and metabolic functions ; thought to be responsible for inhibition of suprachiasmatic nuclei arousal function

A

Melatonin 1 receptor

48
Q

melatonin receptors phase shift circadian rhythms of neuronal firing in the suprochiasmatic nucleus

A

Melatonin 2 receptor

49
Q

hormones typically have a rhythmic pattern of secretion ; endocrine system also plays an important role in the regulation of circaidan rhythms, endocrine secretions, communicate with pacemaker to influence rhythms and periodicity

A

Endocrine Rhythms

50
Q

endocrine secretion most closely linked to circadian system ; the pineal gland secretes this during darkness and is regulated by light from SCN pathways hence the name hormone of darkenss ; SCN holds a high density of affinity of receptors for this

A

Melatonin rhythm

51
Q

is a steroid hormone released from the adrenal gland in response to stimulation by ACTH from the pituitary gland ; it is needed for metabolism ; secretion peaks early in the morning soon after awakening -> declines as the day continues with a nadir in late evening ;

A

Cortisol

52
Q

is regulated by sleep itself and not by circaian rhythms about 80% of total daily secretion occurs in a large pulse during slow wayve sleep (stage 3-4)

A

Growth hormone

53
Q

is modulated by and increases with sleep ; circadian rhythms have little effect on the secretion of this

A

Prolactin

54
Q

endogenous depression mood is commonly poor in the mornings but improves as the day continues

A

Mood and Sleep

55
Q

refers to the desynchronization of circadian rhythms with the external environment due to travel across three or more time zones ; syndrome is due to the inability of endogenous clocks to adjust quickly to shifted zeitgebers in a new location

A

Jet Lag

56
Q

demands the constant adjustment and readjustment of sleep patterns and circadian rhythms to the changing sleep-wake pattern ; difficulties in aligning one’s own clock with ligh, sleep, work and social cues, lead to circadian rhythm disorder and predispose to accidents in the work place

A

Shift Work

57
Q

disorder characterized by the inability to fall asleep at night until early morning that results in the desire to awaken in the late morning or early afternoon ; sleep is delayed and attempts to realign the sleep pattern fails, causing sleep onset insomnia and daytime sleepiness when required to rise at 7-8am ; treated with chronotherapy

A

Delayed sleep phase syndrome

58
Q

disorder characterized by the onset of sleep at an inconvenient, early time in the evening and consequently awakening in the early morning ; sx include inability to stay awake in the evening, early morning awakenings, and daytime sleepiness ; Tx - high intensity light at night to delay sleep

A

Advanced sleep phase disorder

59
Q

irregular sleep-wake pattern is the second most commonly diagnosed circadian rhythm sleep disorder ; it is marked by the complete loss of circadian rhythms and a persistently changing and disorganized sleep-wake schedule

A

Irregular sleep-wake pattern

60
Q

characterized by a sleep-wake cycle that has a periodicity of more than 24 hours ; occurs mostly in young adults and blind individual or schizoid personalities ; pattern is usually present for many years ; sx include sleep onset insomnia, fatigue, cognitive disturbance, daytime sleepiness ; treated with melatonin at the same time every night

A

Hypernycthermeral Syndrome (non-24-hour sleep wake syndrome

61
Q

allergic rhinitis, arthritis, asthma, myocardial infarction, stroke, peptic ulcer disease (increased severity in the MORNING) ; bronchial asthma, chronic obstructive lung disease (increased nocturnal severity)

A

Disorders influenced by circadian effects

Neurology (6 decks)

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