Skip to main content

Posts

Neuropathology of Alzheimer's Disease

Neuropathology of Alzheimer's Disease Gross Brain Changes The following are the gross changes in the brains of the people with Alzheimer’s disease: Reduced weight of the brain Reduced cortical volume Dilated ventricles Deepening of sulci Magnetic Resonance Imaging On magnetic resonance imaging, the diagnostically most important finding is atrophy , especially of the medial temporal lobe. It affects the entorhinal cortex the earliest but then it spreads to other regions of the temporal lobe and limbic lobe for example hippocampus, amygdala, and parahippocampus. Later, the pathology extends to parietal lobe and eventually global atrophy. It spares frontal lobes until the late stage. The progression of atrophy occurs in a similar pattern as the progression of the neuropathology. Dilated ventricles can show global atrophy, but the most reliable method is a direct measurement of volume. Expansion of the fissures is the indirect, and less reliable way to measure the atrophy. For Alzheime

Neurobiology of Panic Disorder

Neurobiology of Panic Disorder "There is most evidence for changes in Gamma-aminobutyric acid , with lowered cortical Gamma-aminobutyric acid type  levels measured by magnetic resonance spectroscopy, and diminished benzodiazepine -receptor binding in the parietotemporal regions in unmedicated patients with panic disorder (Hasler et al., 2008)." This happens in panic disorder. Gamma-aminobutyric acid is the major  inhibitory  neurotransmitter in the brain. Benzodiazepine also binds to Gamma-aminobutyric acid type A receptors and increases its firing rate, thus resulting in hyperpolarisation of the cell because of increased chloride influx. So, specific regions in the brain are hyperexcitable in patients with panic disorder. Summary of Hasler et al.  Context Studies have implicated the benzodiazepine receptor system in the pathophysiologic mechanism of panic disorder  by indirect evidence from pharmacological challenge studies and by direct evidence from single-photon emission

APRIL 2017 Previous (solved) Paper IMM

APRIL 2017 Previous (solved) Paper IMM Q11 A 45-year male patient with several years history of mental illness was seen replying to some person abusing him when nobody was around. At the same time, he also reports that he can see a young girl skipping a rope behind his back. During the conversation, he recalled events related to his father's accidental death & burial that occurred two months back but was mostly smiling while mentioning it. He was convinced that his wife is not faithful to him and is having an illicit relationship with one of his friends, although no evidence suggesting, this is available. During his assessment, he was found constantly imitating the actions performed by his doctor and believed that a cart carrying armed personnel will land in his room by making a hole in the roof and will take away all his valuables to another planet. Name the psychological disturbances present in phenomenological terms. Q12 Outline the neurobiology of neglect and abuse in child

Summary of Treatment Guidelines for ADHD

Summary of Treatment Guidelines   for ADHD       AAP Treatment Recommendations Nov 2019         First-line    Second line    Preschool children (4-5 years)    Behaviour therapy    Methylphenidate        Methylphenidate, if no significant improvement and moderate-to- severe functional impairment    Elementary school (6–11 years)    Behaviour therapy or medication, preferably both .     Evidence      stimulants > atomoxetine > guanfacine ER > Clonidine ER    Summary, NICE Treatment Recommendations 2018        First-line    Second line    Children under 5 years    Discussion    Group parent-training program    (ADHD-Focused)    Medication     (Only a specialist can start)    Start medications only after seeking advice from ADHD specialist services    Children over 5 years    Discussion and ADHD-focused Support     Medication    Support     Offer a minimum of 1 or 2 sessions of support, can be    group-based        education on the causes and impact of ADHD    advice on parenting