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HSC2008 Pathology & Pharmacology > Week 7 > Flashcards

Week 7 Flashcards

(93 cards)

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1
Q

sensory afferent pathways

A

spinothalamic, posterior column, spinocerebellar

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2
Q

spinothalamic afferent pathway transmits __

A

pain & temperature to cerebrum via thalamus

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3
Q

posterior column afferent pathway transmits __

A

touch, pressure, vibrations to cerebral cortex

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4
Q

spinocerebellar afferent pathway transmits __

A

kinesthesia / proprioception to cerebellum

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5
Q

descending efferent pathways

A

corticospinal & corticobulbar tracts

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6
Q

TIA

A

transient ischemic attack

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7
Q

TIA is defined as __

A

transient neurological dysfunction by focal brain, spinal cord or retinal ischemia without acute infarction under 24 hours

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8
Q

Amaurosis fugax

A

Transient one-sided visual loss due to atherothrombotic disease in ICA proximal to the ophthalmic artery

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9
Q

causes of Amaurosis fugax

A

carotic dissection
aortic embolism
atherothrombotic disease in ICA

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10
Q

risk of recurrent stroke after TIA is done via __

A

ABCD2 score to identify patient at high risk of ischemic stroke in first 7 days after TIA

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11
Q

stroke is defined as when __

A

interrupted blood flow to an area of the brain, resulting
in permanent neurological damage

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12
Q

types of strokes

A

ischemic (80%)
- embolism
- thrombosis

hemorrhagic (20%)

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13
Q

ischemic stroke pathophysiology

A

lack of sufficient blood flow to perfuse cerebral tissue due to narrowed/blocked arteries

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14
Q

significance of ischemic penumbra

A

potential to reverse neurological impairment with post stroke therapy as ischemic core is unsalvageable whereas the penumbra is

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15
Q

functioning brain is dependent on __

A

continuous blood supply for oxygen & glucose & remove end product metabolism

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16
Q

ATP is needed to __

A
  • maintain neuronal integrity
  • keep Ca2+ & Na+ outside cell, K+ inside cell
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17
Q

clinical syndromes of anterior stroke

A

lacunar & hemispheric syndrome

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18
Q

clinical syndromes of posterior stroke

A

lacunar
medullary
pontine
cerebellar
top of basilar
lock in

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19
Q

neuroanatomy ascending tract pathways

A

dorsal column-medial lemniscal pathway, anterolateral, spinocerebellar

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20
Q

cortical signs

A

aphasia
apraxia
gaze preference
homonymous hemianopia
visual extinction
agnosia
acalculia

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21
Q

hemispheric syndrome clinical symptoms

A
  • presence of higher cortical dysfunction
  • lateralization = label on side of lesion
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22
Q

aphasia & right sided weakness =

A

left hemispheric syndrome

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23
Q

left sided weakness, numbness & left visual neglect =

A

right hemispheric syndrome

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24
Q

lacunar syndrome clinical symptoms

A
  • absence of higher cortical dysfunction
  • lateralization = label on side of deficit
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25
lacunar syndrome mainly affects
basal ganglia, internal capsule, thalamus, pons
26
cincinnati stroke scale includes identifying ___
FAS = face, arms, speech prehospital notification done if stroke discovery time is less than 6 hrs
27
blood investigation of stroke includes
- blood glucose level - bilateral blood pressure differential - pulse oximetry - ECG - brain imaging
28
assessment tool for stroke monitoring is ___
NIHSS monitoring
29
what is the neuro imaging exam ordered for stroke
CT brain + angiography MRI/MRA Doppler carotid / transcranial doppler US DSA
30
decompressive craniectomy
surgical removal of skull portion to allow outward herniation of infarcted brain tissue before compression of healthy brain tissue occurs decreased intracranial P & improve cerebral perfusion
31
hemorrhagic stroke pathophysiology
blood vessel rupture leading to compressed brain tissue from expanding hematoma leading to loss of blood supply to affected tissue
32
types of hemorrhagic stroke
intracerebral & subarachnoid hemorrhage
33
primary cause of hemorrhagic stroke
uncontrolled hypertension & cerebral amyloid angiopathy
34
secondary cause of hemorrhagic stroke
vascular abnormalities, aneurysm rupture, neoplasms
35
volume of ICH formula
longest axis (A) x longest axis perpendicular to A (B) x number of slices x slice thickness (C) (A x B x C) / 2
36
spontaneous IVH + obstructive hydrocephalus intervention is __
EVD
37
spontaneous ICH < 30 mL, GCS > 3, IVH requiring EVD intervention is __
EVD + thrombolytic
38
spontaneous ICH < 30 mL, IVH requiring EVD intervention is __
neuroendoscopy + EVD + thrombolytic
39
FLAIR can be used to detect __
edema a few hours after onset; not routine in stroke imaging
40
DWI-FLAIR mismatch
infraction visible on DWI but not FLAIR
41
DWI-FLAIR used to estimate __
onset time in wake-up / unwitnessed strokes
42
rTPA
recombinant tissue plasminogen activator
43
each hour where treatment fails, brain loses __
3.6 years of normal aging
44
each minute where treatment fails, ___ neurons die
1.9 million
45
keep SBP ___ mmHg post rTPA
< 180/105
46
stroke unit care closely monitors for __ complications
pneumonia, deep vein thrombosis, pulmonary embolism, urinary tract infection
47
large artery artherosclerosis
brief & recurrent obstructive vascular process in extracranial / intracranial arteries associated with stenotic atherosclerotic lesion
48
what antiplatelets are given for stroke
aspirin, dipyridamole, clopidogrel, ticlodipine
49
what is given with aspirin
dipyridamole
50
clopidogrel AKA __
plavix
51
anticoagulants given for stroke are __
NOACS = apixaban, rivaroxaban, dabigatran warfarin
52
LDL lower agents
anything that ends with "-statin" & ezemtimibe
53
indications for LDL lowering agents
stabilize plaque & keep bad cholesterol < 1.8 mmol/L improve endothelial dysfunction
54
antihypertensive meds
ACE = angiotensin converting enzyme angiotensin II receptor blocker beta blocker Ca2+ channel blocker
55
early rehab within 24 hrs of acute stroke must be done __
with caution who are severely affected or had ICH
56
medical guidelines to drive vocationally with TIA
single TIA = only once free of TIA for 6 months multiple TIA = " for > 1 year
57
medical guidelines to drive privaltey with TIA
single TIA = only once free of TIA for 1 months multiple TIA = " for > 6 months
58
seizure definition
transient occurrence of signs or symptoms due to abnormal excessive neuronal activity in the brain
59
neurons in a seizure may be __
abnormally developed, damaged, functioning abnormally due to environmental factors
60
typical signs of seizure
loss of awareness, abnormal movement & sensations
61
most seizures self abort after __
several seconds to mins
62
types of partial seizures
simple, complex, with secondary generalization
63
types of generalized seizures
generalized tonic clonic seizure, absence, myoclonic
64
status epilepticus is when __
seizure >5 mins & risk of neuronal injury is high; emergency situation
65
epilepsy vs seizure
Epilepsy is a disease with a tendency to have recurrent unprovoked seizures seizure is 1 event
66
seizure 1st aid is done by putting patient in __
recovery position
67
how to prevent seizure recurrence
anti-epileptic drug & lifestyle modification
68
what drugs alter neuronal excitability
Na+ channels, GABA, Receptors
69
common side effects of AEDs
fatigue, toxicity, rash, weight gain, hair fall, low platelets,
70
Broca's area
expressive speech area
71
Wernicke's area
comprehensive area for both written & spoken language
72
left hemisphere of brain
responsible for mathematical, problem solving & logical reasoning
73
right hemisphere of brain
artistic ability, creativity, spatial relationship, emotional and behavioural characteristics
74
limbic system
emotional reactions & feelings
75
functions of cerebral spinal fluid
1) provides a cushion for the brain & spinal cord; 2) supplies nutrient to nervous system tissue; and 3) removes waste products from cerebral metabolism
76
brain excitatory molecules
dopamine, serotonin
77
brain inhibitory molecules
gamma-aminobutyric acid (GABA)
78
spinal cord inhibitory molecules
glycine
79
ischemic stroke
total occlusion of a cerebral blood vessel by atheroma (thrombus) or embolus
80
hemorrhagic stroke
Ruptured cerebral vessels leading to compression of brain tissues from an expanding haemotoma
81
5 mins of ischemia leads to __
irreversible nerve cell damage
82
classic signs of acute stroke
FAST - facial droop - arm weakness - slurred speech - time (call 995)
83
pharmacotherapy for ischemic stroke
- IV rTPA within 4.5 hours of stroke onset - antiplatelet therapy for non-cardioembolic stroke - anticoagulation therapy for cardioembolic stroke - statins to stabilize plaque & improve endothelial dysfunction
84
Endovascular therapy for large vessel occlusion with symptoms onset within __
6 hours
85
pharmacotherapy for long term CVRF control
- antiplatelets - anticoagulants - statin according to SPARCL trial
86
Convulsive status epilepticus
recurrent or continuous seizures without recovery of consciousness. Impaired respiration and intense muscle activity can lead to severe hypoxia, hypoglycemia, acidosis and decreased blood pressure
87
EEG use in seizures
determine type & location
88
routine blood study in seizures
identify metabolic causes
89
neuroimaging study in seizures
identify structural abnormalities
90
seizures managed using __
pharmacotherapy = anti-epileptic drugs & sedatives vagus nerve stimulation
91
cerebellum function
movement, posture, equilibrium
92
medulla function
respiratory & cardiovascular control center
93
grey matter parts
- anterior horns = motor neurons - lateral horns = visceral motor neurons - posterior horns = receives sensory info

HSC2008 Pathology & Pharmacology (14 decks)

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