Clinical Nervous system > Revise > Flashcards

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1
Q

بسم الله الرحمن الرحيم
_________________
“تبارك الذي نزل الفرقان علي عبده ليكون للعالمين نذيرا الذي له ملك السماوات والأرض ولم يتخذ ولدا ولم يكن له شريك في الملك وخلق كل شئ فقدره تقديرا “
_____________________________________
Obsessive comulsive disorder =

A

Obssession + compulsion

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2
Q

Recurrent unexpected crescendo attacks of intense fear

A

Panic attacks

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3
Q

Unpleasant feeling of fear & apprehension accompanied by somatic symptoms

A

Anxiety disorders

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4
Q

Causes of anxiety disorders

A

Learning congitive - catastaophization - underestimation
Neurotransmitters diosorder
Genetics

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5
Q

Neurotransmitters disorders in anxiety ?

A

-Increased Serotinin in ? Panic +OCD
Decreased in social anxiety
-Increased NE - B agonist + a blocker perciptate anxiety
-Increased dopaime + glutatme + decreased Serotinin + GABA =OCD

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6
Q

Mention symtomps of anxiety

A

Depersonalization + Derealization
Sucide + Insomnia + Irritability
__________________________________
Lumb in thorat + Papitations + Muscle tension

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7
Q

Agarophobia

A

Fear from being outside the home, in crowd, public transportation

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8
Q

Selective mutism

A

Failure to speak in specific situations e.g. at school

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9
Q

differnetial of anxiety

A

1- Pheochromocytoma
2- Hyperthyroidism
3- Hypoparathyroidism
4-  Vit B12
5- TTT with Bronchodilators
6- Toxicity of caffeine, cocaine, amphetamine
7- Withdrawal of Alcohol & BZD

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10
Q

ttt of Anxiety ?

A

BZDs for rapid relief
alprazolam short + Bromazepam long
BB blockers for somatic
Anti depressants :
TCA + SSRI better for chronic anxiety no antichoilergic effect
Psychotherapy

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11
Q

side effect Anxiety at the start of TTT
in ?

A

SSRI Fluoxetine, Citalopram

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12
Q

Chronic disorder of Thoughts c.c. by
acute psychotic episodes that come & go

A

Schizphrenia

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13
Q

can’t determine what is real & what is unreal

A

Psychosis

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14
Q

Mention causes of schizophrenia

A

1-Gentic
2-Substance abuse
3-Neurotrasnmitters :-
A-dopaine :-
1-Mesocortical increased dopamine cause + symptops as : Behavior and speech disorganized
+ delusions + hallucinations
2-Mesolimbic decreased dopamine casue - symptoms as : Agloia anhedonia avolition
______________________
B-serotonin working on 5HT2 then causing both + and - symptoms

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15
Q

TTT of schizophernia

A

Typical antipsychotics :
Incisce : Halopridol with :
Nigrostiatal s.e :
Tuberinfindibular : Increased prolactin causing ammenorhea galactohrea + gnycomastia
Basal : Chlorpromazine
______________________
Atypical antipsychotic :
olanzopine - quitapine
Dopamine + serotonin = Respirdone
________________________
Hospitalization ( electro-convulsive therapy ) + Psychotherapy

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16
Q

DD pshycosis

A

Encephalitis - dementia
Renal failure -hepatic encephalopahty
Drugs - cortisone coccanie cannabis+amphetamine

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17
Q

1ry headache

A

Tension
migarane
hemicrania
cluster
paroxysma

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18
Q

1ry headache

A

Tension
migarane
hemicrania
cluster
paroxysmal

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19
Q
  • New onset headache
  • e.g. Brain tumor, head trauma, vascular ds, infection,
    Medication over use headache
A

2ry headache

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20
Q

regular analgesic use
* Continues until medication is stopped
* Often responsible for “transformation” of
episodic into chronic headache

A

Medication overuse Headache

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21
Q
A

New onset ,increased at morning, increased by leaning forward
Poor response to analgesics
Associated with projectile vomiting & blurring of vision,
Fever, Neck stiffness or L.N. ++
If begins after head trauma

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22
Q

Headache which is
Bilateral Fronto Temporal parietal
Band like
Radiating to Neck and Shoulders
for 30 minutes to 7days
increased in late night decreased at morninig
not associated with vomiting
Not aggervated by activites ?

A

Tension type headache
more in females

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23
Q

Heaches which is
unilateral
pulstaile
radiating to Neck
Increasd by bright light + stress decreased by sleep
Causing Photophobia + Nasuea + Vomiting

A

Migarane
4h - 3 days

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24
Q

Headache
Unilateral around eye with focal pain
1-3 hours
Reptitive headache 3-8 /day for weeks
Red eye + lacrimation + rhinorrhea

A

Cluster headache
sucide headache

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25
TTT of migarane
NSAIDS +Paracetamol Serotonin agonists sumatriptans BB -TCA - antiepilipetic
26
Common, chronic unilateral headache, starts after neck movement & up to the head
Cervicogenic Headache
27
Indomethacin sensitive
Paroxysmal hemicranias
28
- Responsible for jet lag & Seasonal affective disorder
Melatonin
29
Dopamine and sleep
Dopamine= Wakefulness so, Dopamine Blockers (Phenothiazines) =Sleep
30
Little decrease REM & N4 & Little rebound but Chronic usec ause decrease in Sleep latency (insomnia)
BZD
31
Early onset of sleep but INCREASE Wakefulness in 2nd half of sleep
Moderate alcohol
32
Alcohol intoxication & Barbiturates
Decrease REM
33
Alcholol + Barbiturate withdrawal = ":?
REM nightmares
34
decrease N3 & 4 + decrease REM Latency (45 mins) +increases REM duration
Major depression
35
Mention imp of REM sleep ?
Long term consolidation Cleans out brain Dampens excitement
36
REM deprivation cause ?
Inability to do complex tasks Loss of Attention
37
Sleep attacks without warning e.g. middle of talking Pts go to REM sleep with paralysis & dreams directly Excessive daytime sleep
Narcolepsy مهم فيها cataplexy due to decreased hypocretin
38
signs of Narcolepsy ?>
Cataplexy paralysis Hallucinations : hypagnoic hypopompic
39
ttt of nacrolepsy
CNS +++ modafinil TCA impiramine for cataplexy
40
Breathing temporarily stops during sleep = leading to many awakening each hour+snoring risk of sudden death
Sleep apnea
41
ttt of sleep apnea ?
Weight loss CPAP Adenoidectomy
42
Insomia causes and ttt
Anxeity + depession Drug withdrawal as sedatives +Alcohol Poor sleep Conditions ________________ BZD Trizolam non BZD: Zolpeidum z durgs
43
Compare between Night terrors and Night mares
Night terrors :- N4 Arousal No recall Nightmares : no arousal REM Recall
44
Enurisis
n3+n4 impairamine
45
Bruxism
N2 Oral prothesis
46
Somnambulism
N4 Sleep walking
47
Working memory 1 Verbal memory 2 Visual memory 3
1-Ach in Frontal lobe 2-GABA in temporal lobe 3-Serotonin Occipital lobe
48
Progressive degenration in nerve cells due to decreased Ach and increased Glutamate
Alzhemier's disease causing Cognitive + Functional + Behavioral Impairment
49
TTT of Ach
Donepezil + Rivastigmine Choilinesterase inhibitors Memantine NMDA receptor antagonist
50
Reward system :-
From Mid-Brain (Ventral Tegmental Area) to : 1- Nucleus accumbens in ventral striatum (Basal ganglia) = Meso-Limbic pathway 2- Pre-frontal cortex = Meso-cortical pathway
51
Shifting from impulsivity to compulsivity
Drug abuse
52
1- Drug pre-occupation (thinking) 2- Craving (desire) 3- Excess search for the drug symptoms of ?
Addiction All drugs abuse result in more dopamine in mesolimbic system  Causing changes in the reward circuit
53
Most common pathogen for Menigitis
Strep.penmoniae Gram+ dipolococci RFs: DM +Asplenia + OM+Pnemonia
54
Triad of Menignits
1-Fever 2-Headache 3-Neck stifness
55
Menigism is ? what are comlications of Menigits
Nucal Rigidity Kernig's test Brudzinski test _______________ Disrubted consciousness + Sezuiers +cranial palsy 367 + hemiparesis + dysphasia
56
Compare CSF results in pathogens of Menigits
Bacterial : turbid + PMNs + Inc proteins + Dec glucose + increased pressure TB: Cob wheel + lymphocytes + Inc proteins + Dec glucose +cl normal pressure Viral : clear + Lymphocytes + Inc proteins + normal glucose and cl normal pressure
57
Gluscose must be measured within ,,,,,,Minutes why ? in meningitis dIagnosis
20minutes otherwise false low glucose levels will be assessed due to inflamatory cells and bacetria nutirion on glucose CT scan for exclusion of Subarachnoid Hge
58
TTT of menigits
Emprical !! before CSF results:- Ceftriaxone + Vancomycin + Acyclovir Steroids to avoid inflammatory reactions
59
Pathogens of aspetic menigits ?
Non polio : Coxacke - Echoviruses HIV seroconversion
60
Investigations for aseptic meningits ?+Treatment
CSF : Lymphocytosis + Serology for prevelant viruses as Herpes Serum AB: for non prevelant virsues PCR ________________________ Acyclovir for 1-2 weeks + Vaccination
61
Investigations for TB menigits
1-Quantiferon TB gold in tube 2-Dot immune blinding assay + PC R + Direct film 3-skin tubeclin test
62
Mass occupying lesion , Hydrocephalus, Hgic infarction & Chronic meningitis
Fungal meningitis Cryptococcus neformants Aspergillus Rhinocerebral mucor mycosis
63
Pathotgens of Encephalitis
HSV1 Most common Congenital HSV 2 Summer Arbovirus Winter Mumps Immnuocompression CMV
64
iNCREASDE pessure + proteins +lymphocytes Xanthocrhormia Negative culture = ?
Encephalitis so PCR is done for HSV1
65
Investigation and treamtent for susppected herpes encephlaitis ?
PCR MRI tempral + orbitofrontal edema ttt= acyclovir
66
اللَّهُ الَّذِي جَعَلَ لَكُمُ اللَّيْلَ لِتَسْكُنُوا فِيهِ وَالنَّهَارَ مُبْصِرًا ۚ إِنَّ اللَّهَ لَذُو فَضْلٍ عَلَى النَّاسِ وَلَٰكِنَّ أَكْثَرَ النَّاسِ لَا يَشْكُرُونَ (61) ذَٰلِكُمُ اللَّهُ رَبُّكُمْ خَالِقُ كُلِّ شَيْءٍ لَّا إِلَٰهَ إِلَّا هُوَ ۖ فَأَنَّىٰ تُؤْفَكُونَ

Clinical Nervous system (3 decks)

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