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PRITE - High Yield Exam 2024/2025 Questions With Completed & Verified Solutions.
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PRITE - High Yield Exam 2024/2025 Questions With Completed & Verified Solutions.
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PRITE - High Yieldinternal carotid artery - ANS Name this artery.
anterior cerebral artery - top is A2, bottom is A1
A1 - supplies internal capsule, limbic system; may have minimal Sx d/t collateral flow from ACoA
A2 - contralateral paresis and anesthesia of lower limb - ANS Name this artery and its
segments.
Name the stroke symptoms associated with occlusion of each segment.
middle cerebral artery - M1 is proximal to the early cortical branches and M2 is distal to the early
cortical branches
either segment - contralateral hemiplegia, hemianesthesia, homonymous hemianopia
Dominant hemisphere = Dysarthria (actually aphasia)
Nondominant = Neglect - ANS Name this artery and its segments.
Name the stroke symptoms associated with occlusion of each segment.
posterior cerebral artery - P1 is proximal to PCoA, P2 is distal to PCoA.
P1 Syndrome - affects midbrain, thalamus, hypothalamus. Claude syndrome - third nerve palsy
and contralateral ataxia (red nucleus of midbrain); Weber's syndrome - third nerve palsy and
hemiplegia (cerebral peduncle)
P2 Syndrome - affects medial temporal and occipital lobes. Contralateral homonymous
hemianopia with macular sparing. - ANS Name this artery and its segments.
Name the stroke symptoms associated with occlusion of each segment.
basilar artery
"Locked in" syndrome - quadreplegia, cranial nerve signs, preserved consciousness (lower
midbrain) - ANS Name this artery. Name the stroke symptoms associated with occlusion of this
artery.
pontine arteries - ANS #11 - name the arteries
superior cerebellar artery - ANS #10 - name the artery
anterior inferior cerebellar artery - ipsilateral limb Ataxia, contralateral loss of pain and
temperature
Lateral pontine syndrome (fACIAl): loss of taste, lacrimation, salivation, hyperaucusis ipsilateral;
ipsilateral paralysis of face - ANS #14 - name the artery. Name the stroke symptoms associated
with occlusion of this artery.
posterior inferior cerebellar artery - lateral medullary / Wallenberg syndrome
,PIC - Pain and temperature, Ipsilateral loss on face, Contralateral loss on body. Horner
syndrome (small pupil, ptosis, decreased sweating; "pH = PICA/Horner"). - ANS #16 - name the
artery. Name the stroke symptoms associated with occlusion of this artery.
vertebral artery - ANS Name this artery.
posterior limb of the internal capsule - ANS A lacunar stroke of what area would cause a pure
motor stroke, or lower extremity ataxia?
ventroposterolateral nucleus of thalamus - ANS A lacunar stroke of what area would cause a
pure sensory stroke?
basilar pons - ANS A lacunar stroke of what area would cause dysarthria/clumsy hand
syndrome?
Mechanism of action: NRT binding induces Na influx or Cl influx
Outcome effect: excitation or inhibition of membrane
Receptor / NRT: nicotinic AChR (ACh), NMDA (glutamate), 5HT-3 (serotonin), GABA-A (GABA)
# transmembrane receptors: 4 transmembrane receptors on each of 5 subunits within one
receptor - ANS For the ionotropic receptor subtype, give the mechanism of action, outcome
effect, example receptor/ neurotransmitter pairs within this subtype, and the number of
transmembrane receptor units.
Mechanism of action: NRT binding induces physical transformation of receptor, G protein
activation, adenylyl cyclase enzyme activation, formation of second messenger (cAMP or IP3),
activation of protein kinase, phosphorylation of transcription factor
Outcome effect: gene transcription
Receptor / NRT: muscarinic AChR (ACh), alpha, beta (NE, E), mu (endorphins, enkaphalins),
5HT other than 3 (serotonin), D1, D2 (DA)
# transmembrane receptors: 7 - ANS For the G-protein coupled receptor subtype, give the
mechanism of action, outcome effect, example receptor/ neurotransmitter pairs within this
subtype, and the number of transmembrane receptor units.
Mechanism of action: dimerization of 2 monomer subunits, phosphorylation of tyrosine, enzyme
activation, gene transcription
Outcome effect: neurogenesis
Receptor / NRT: VEGF, FGFR (BDNR, other neurotrophic factors) - ANS For the receptor
tyrosine kinase receptor subtype, give the mechanism of action, outcome effect, and example
receptor/ neurotransmitter pairs within this subtype.
Mechanism of action: hormone diffuses across cell membrane, hormone-receptor complex
enters nucleus and binds DNA
Outcome effect: gene transcription
, Receptor / NRT: thyroid hormone, estogen, progesterone, androgens (testosterone), cortisol,
aldosterone - ANS For the nuclear receptor subtype, give the mechanism of action, outcome
effect, and example receptor/ neurotransmitter pairs within this subtype.
Autoreceptors are receptors for regulation of NRT release, bound by the same NRT which they
release.
Somatodenditic receptors - presynaptic GPCR, cause opening of K channels and decreased
cAMP levels. Regulate neuron firing rate, ex inhibitory 5HT-1A.
Nerve terminal receptors - postsynaptic GPCR, cause closing of Ca channels. Ex alpha-2 inhibit
NE release (MOA of clonidine) - ANS Define autoreceptors. Describe the two types of
autoreceptors and provide an example of each.
alpha-2 agonist; agonism of this nerve terminal receptor inhibits NE release. Tx for ADHD,
nightmares in PTSD - ANS Give the mechanism of action of clonidine and the clinical use.
Heteroreceptors are receptors for regulation of NRT release, but they are bound by a NRT other
than the one they regulate.
5HT (serotonin) binds DA presynaptic neuron and decreases DA release d/t decreased firing
rate.
NE binds alpha-1 receptors on 5HT neurons and increase the firing rate. - ANS Define
heteroreceptors and give two examples.
desensitization - chronic activation of a receptor causes it to be overphosphorylated and
signaling cascade is blocked
down-regulation - chronic desensitization causes degradation of receptor
SSRIs chronically activate 5HT-1A autoreceptors, which down-regulate and result in less
inhibition of 5HT action - ANS Describe receptor desensitization and down-regulation. Give an
example.
Chronic antagonism of a receptor causes increased receptor synthesis, resulting in increased
NRT sensitivity.
Ex: chronic antipsychotic use (D2 blockade) increases sensitivity to DA and causes tardive
dyskinesia - ANS Describe the mechanism of receptor upregulation. Give an example.
1) allosterically bind and inhibit the 5HT reuptake transporter so more 5HT is available in the
synapse
2) chronically activate 5HT-1A autoreceptors, which down-regulate and result in less inhibition of
5HT action - ANS Give two main mechanisms of action for SSRIs.
tryptophan -tryptophan hydroxylase-> 5HTP -decarboxylase->5HT
dorsal raphe nucleus in the pons and medulla - ANS Give the synthesis pathway for 5HT
(serotonin). Give the primary location of 5HT synthesis.
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