1 Neuro T Flashcards
1
Q
ankle-jerk reflex
A
S1-S2
2
Q
NTD will show what in CSF
A
alpha fetoprotein and AChE
3
Q
Botulisim has what kind of blockade
A
nicotinic and muscarinic
4
Q
Symptoms of ataxia-telangectasia
A
cerebellar atrophy leading to ataxia - recurrent sinopulmonary infections - cancer risk as they can’t repair DNA well
5
Q
Tx restless leg syndrome w/
A
dopamine agonist
6
Q
Tx acute dystonic reaction w/
A
dopamine agonist
7
Q
P450 inducers
A
carbamazapine, phenobarbital, phenytoin, rifampin, griseofulvin
8
Q
P450 inhibitors
A
cimetidine, ciprofloxacin, erythromycin, azoles, grapefruit juice, isoniazid, ritenovir
9
Q
craniopharyngeoma histology
A
cyst filled with brown-yellow cholesterol fluid
10
Q
incidence calculation
A
newly infected each year / at risk (pop - affected)
11
Q
CN3 arises b/w
A
Sup cerebellar artery and post cerebral artery
12
Q
Post 1/3 of int capsule contains
A
sensory
13
Q
Median nerve pathway in the forearm
A
b/w two heads of pronator and then b/w digitorum superficially/profundus
14
Q
What is a dopamine and NE repute inhibitor
A
buproprion - Tx smoking cessation and depression
15
Q
Venlafaxine MOA
A
serotonin AND NE reuptake inhibitor
16
Q
Neurofibromatosis cells derive from
A
neural crest
17
Q
thyroid follicular cells derive from
A
endoderm (base of tongue)
18
Q
kidneys and ureturs derive from
A
mesoderm
19
Q
nucleus pulposis derives from
A
notochord
20
Q
Prader Willie is cause by
A
paternal deletion of ch 15
21
Q
Tall stature with lens displacement
A
Marfan syndrome
22
Q
blotchy mm fibers on Gomori stain
A
mitochondrial myopathy
23
Q
Fredrich ataxia often has ataxia plus..
A
hypertrophic cardiomyopathy (gait ataxia, foot abnormality, kyphoscoliosis, DM)
24
Q
Tx Wilson’s disease
A
penicillamine
25
3x mm innervated by CN5 mandibular branch
pterygoids masseter temporalis
26
the only CN to decussate before innervating target
CN4 trochlear - S.O.
27
Tx of organophosphate poisioning
atropine or pralidoxime (reactivates AChE)
28
Acute vs chronic cryptococcus Tx
ampho B - acute
| fluconazole - chronic
29
HIV with multiple ring enhancing lesions: first thought and if it doesn't respond to therapy
think toxo first and if doesn't respond to treatment think primary central nervous system lymphoma, esp. B cell lymphoma from EBV infection
30
longstanding HTN or DM causing lacunar strokes can cause what damage/symptoms
subthalmic nuclei damage causing hemiballismus
31
Isoniazid neuropathy
paresthesias due to lack of B6
32
Wernicke's encephalopathy includes
confusion, opthalmoplegia, and ataxia
33
Benzos are
anxiolytic, anticonvulsant. mm relaxant, sedative-hypnotic
34
carbamazapine MOA and toxicity
blocks Na channels; can cause hepatotoxicity, bone marrow suppression, SIADH
35
deep perennial nerve innervates what
ant. compartment of the lower leg (dorsiflex) (superficial does eversion)
36
tibial nerve innervates what
post. compartment of the lower leg (planter flex and inversion)
37
ALS Tx and MOA
riluzole - decreases glutamate release
38
TCA's have what type of side effects
urinary retention, constipation (anti cholinergic)
39
1st line to Tx tic douloureux
carbamazapine
40
what type of amine can cross the BBB
tertiary
41
ankle jerk reflex spinal lvl
S1
42
patellar reflex spinal lvl
L4
43
POMC gives rise to
beta endorphins, ACTH, MSH
44
mesolimbic-mesocortical pathway does what
regulates behavior, hyperactive in schizophrenia, antipsychotics block dopamine in this pathway
45
homovanillic acid is breakdown product of
dopamine
46
nigrostriatal pathway does what
substantia nigrum to basal ganglio to regulate movement
47
tuberoinfundibular pathway does what
regulatates dopamines inhibitory effects on prolactin
48
DBS in parkinson targets what
subthalmic nucleus
49
signs of NMS
Fever Encephalopathy Vitals Enzymes Rigidity
50
Tx of NMS and MOA
dantrolene direct mm relaxant (ryanodine antagonist)
51
NF-1 is what inheritance
AD
52
Describe Wallerian degenration and axonal reaction
destruction distal to injury; cell body swells, nissle substance moves to periphery, nucleus moves to periphery
53
carbomyl phosphate synthetase (1st step in urea cycle) depends on what
N-acetylglutamate
54
diplopia while looking down is lesion of
CN4
55
thalmic nuclei responsible for diurnal rhythm
suprachismatic
56
Vit A toxicity
cirrhosis, pseudotumor, teratogen
57
What enzyme activity is unregulated and down regulated in Lesch-Nyhan
HGPRT is deficient (salvage purine)
| PRPP is upregulated (de novo purine)
58
12-24 hr post infarct brain histology
Red Neurons, eosinophilic w/ loss of Nissle substance
59
Cremasteric reflex in what nerve
genitofemoral
60
Focal complex/simple
| General myotonic/TC/absence
One Lobe unconscious/conscious
| Both Lobes conscious & jerking/unconscious & contraction followed by jerking/unconscious
61
Meyer's Loops lesion
pie in the sky (upper quarter of opposite visual field) into the temporal lobe
62
direct D2 agonsts
bromocriptine (ergot) and pramipexole/ropinirole (nonergot)
63
What is selegiline
MAO-B inhibitor, stops dopamine degredation; Tx PD
64
what is entacapone/tolcapone
COMT inhibitors, stops levadopa breakdown in periphery; Tx PD
65
thiopental and barbiturates method of distribution
lipid soluble; rapidly fill the brain then tissue redistribution
66
conversion disorder
neuro symptoms not explained by physical/mental health illness
67
somatic symptom disorder
excessive anxiety about 1 or more unexplained symptom
68
Ritodrine and Terbutaline do what
Beta agonists to stop uterine contractions (tocolysis)
69
Gingival hyperplasia with antiepileptic
phenytoin (P450 inducer)
70
Anesthetic side effects
cardiac depression, respiratory depression, increased intracranial pressure, decrease GFR/renal plasma flow (increase renal vascular resistance), decrease hepatic blood flow
71
What can cause a scotoma
DM, Multiple sclerosis, retinitis pigmentosa (rod degeneration)
72
What is Refsum syndrome an explain
lack of peroxisomes; can't alpha oxidize very long chain fatty acids and branched chain fatty acids
73
What is Zellweger syndrome
can't make myelin; peroxisome disorder
74
what canal does obturator nerve pass through and what are it's actions
obturator canal; adduct the thigh/sensory in medial thigh
75
Vit B12 deficiency causes
vacuolization and axonal degeneration of the lateral corticospinal tracts and dorsal column
76
B1 is required in what enzymatic reactions
transketolase, alpha-ketoglutarate dehydrogenase, pyruvate dehydrogenase
77
erythrocyte transketolase activity gauges levels of what vitamin
B1 thiamine
78
What do metastatic brain tumors look like?
well circumscribed and at the junction of the grey and white matter
79
butterfly appearance with a brain tumor is a...
glioblastoma; necrotic and hemorrhagic
80
Damage below the red nucleus leads to what
decerebrate rigidity (extensors predominate)
81
Damage above the red nucleus leads to
decorticate rigidity (extensors from vestibular nuclei predominate)
82
CNS tumor with whorled cells and psamomma bodies
meningioma
83
CNS tumor, small blue cells with homer-wright rosettes
medulloblastoma
84
Inability to release doorknob, sustained mm contraction
myotonic dystrophy; cataracts are common
85
myesthenia gravis antibodies originate where
thymus
86
proximal mm weakness improve with use
lambert-eaton
87
shaken baby syndrome results in what
breaking of bridging veins i.e. subdural bleeds; retinal hemorrhages; post rib fractures
88
Serotonin, dopamine, and catecholamines require what for synthesis
tetrahydrobiopterin
89
transtentorial herniation crushes
CN3
90
subfalcine herniation crushes
ACA
91
tonsillar herniation crushes
medulla
92
Clinical findings in Wernicke-Korsakoff
ataxia, memory loss (permanent), oculomotor dysfunction,
93
status epilepticus, describe and Tx
sustained T/C seizure w/o regain of consciousness; Tx benzo due to rapid onset; then hit with Na channel blocker i.e. phenytoin
94
High blood/gas coefficient means...
greater blood solubility and slower onset of action
95
Atropine acts on which receptors
muscarinic, not nicotinic; so patients can still have mm paralysis
96
What is needed for carbomoyl synthase I?
n-actyleglutamate
97
phenytoin and carbamazepine block what channel
Na; stop axonal propagation of AP
98
cyrptococcus morphology
while round, be sure you don't pick spherule (coccidiodies) and instead 'budding yeast'
99
what nerve runs through coracobrachialis
musculocutaneous
100
what drug blocks NMDA and K+ channels
valproate
101
surgery/pelvic trauma/butt shots w/ dropped hip to L
R sup. gluteal nerve; Trendelenburg sign (drop to unaffected sign)
102
Difficulty in rising from chair or taking stairs
inf. gluteal nerve
103
Skeletal mm in inner ear and innvervation
1)tensor tympani V3 dampen sound 2)stapedius CN7 pt complain of hyperacuity
104
What aa can be reduced in treating leukemia
asparagine via L-asparaginase (reduces plasma levels)
105
What forms proprionyl Co-A
isoleucine, valine, threonine, methionine
106
1st area of brain damaged in global ischemia
hippocampus
107
HIV dementia activates what cell type
microglial cells
108
intranuclear acidophilic inclusions; intranuclear basophilic inclusions
HSV/CMV
109
charcot-bouchard vs penetrating vessels
CB is deep brain structures; penetrating vessels are int capsule
110
pyelocytic astrocytoma vs medulloblastoma
PA - rosenthral fibers; medulloblastoma - many mitotic figures (small blue cells)
111
thiopental PKs... explain
rapidly gets into brain, then redistributes to skeletal mm (causing brain levels to fall off) therefore its used to induce anesthesia but not really throughout procedures
112
explain fragile X
CGG repeats (over 200) leading to hypermethylation
113
Baclofen MOA and Tx
GABA B agonist Tx spasticity
114
rocker bottom feet, VSD, big occiput, small jaw, clenched hands with overlapping fingers
trisomy 18 - edwards
115
sensation to lateral forearm from
musculocutaneous nerve
