Sigs Unit 8 Cases 1-7 | Baamboozle - Baamboozle | The Most Fun Classroom Games!

List the advantages and disadvantages of the drug therapies used to manage PD. (SIGS 8.2b)

some drugs can only be used for short periods due to adverse effects; others if used for a long time have increasing undesired effects/ decreased effectiveness

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Describe the effects of dopamine depletion in PD. (SIGS 8.2a)

pars compacta in substantia nigra not making dopamine-> cannot act to stimulate D1 excitatory pathway-> unable to inhibit GPi-> incr inhibition of thalamus

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Describe the RACE score and NIH Stroke Score and how they are used for CVA management. (Sigs 8.1a)

RACE is a pre-hospital assessment to assess possible stroke- EMT; NIHSS is more specific- used by physicians to quantify severity of stroke in acute setting

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Describe the vascular and neurogenic migraine hypotheses. (Sigs 8.4b)

V: ischemia due to intracranial vasoconstriction-> aura&rebound vasodilation->perivascular nociceptive activation; N: neuronal hyperactivity occipital cortex

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Define status epilepticus and discuss nonpharmacologic management of it. (Sigs 8.4a)

seizure that lasts greater/equal to 5 min OR a series of seizures in rapid succession w/o interictal period; airway clear (O2),BP&pulse, EEG

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Describe the motor and sensory areas of the cerebral cortex that get their blood supply from the MCA, relating to specific MCA stroke signs/symptoms (Sigs 8.1a)

Motor: broca's area--> expressive aphasia, unilateral motor area--> contralateral hemiparesis; sensory: wernicke's--> receptive aphasia, unilateral sensory area

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Identify a physiologic rationale for the declining efficacy of carbidopa-levodopa treatment over time in PD. (SIGS 8.2b)

dependency on exogenous levodopa vs endogenous + disease progression-> dose dependence-> side effects worsen(dyskinesia)--> discontinue

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Discuss the MOA and use of diazepam and levetiracetam for treatment of seizures. (Sigs 8.4a)

D: incr. GABAa action-> calms neuroactivity in brain; L: SV2A receptor blocker-> slows electrical signals in brain

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Identify neural pathways affected in AD. (SIGS 8.2b)

memory 1st (hippocampus), then reasoning/language/behavior (frontal &temporal lobes), in later stages motor is affected (motor cortex)

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Distinguish abortive and preventative pharmacotherapies for migraine headache. (SIGS 8.4b)

Prev:Amytriptyline(TCA antidepress-> block reuptake norepi&serotonin),Prochlorperzine(antipsychotic-> block D2r); abort: Ketorolac(NSAID-nonsel), Sumatriptan

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Discuss the mechanisms of action of the six different drug therapies used to manage PD symptoms. (SIGS 8.2b)

dopamine precursor, decarboxylase inhibitors, dopamine agonists, COMT inhibitors, NMDA antagonists, MAO-B inhibitors, anticholinergic (muscarinic antagonists)

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Explain the rationale for using methylprednisone in an acute MS exacerbation. (SIGS 8.1b)

decr vasodilation & permeability of capillaries + decrease leukocytes + mediate change gene express + inhibit phospholipase A2 & NF-kappa B--> decr. inflam

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Describe the clinical presentation of benign paroxysmal positional vertigo (BPPV) and labyrinthitis. (SIGS 8.3a)

BPPV= abnormal sensation of motion elicited by certain provocative positions--> nystagmus; Labyrinthitis: inflamm disorder-> poor balance & hearing

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