3/22 neuro Flashcards

1
Q

Short acting benzos?

-mnemonic?

A

TOM acts fast

  • triazolam
  • oxazepam
  • midazolam

*also alprazolam. AL bundy has a short fuse.

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2
Q

Essential tremor

-Tx:

A

propanolol

-2nd line = primidone.

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3
Q

3 major types of glial cells

A

astrocytes, oligodendrocytes, microglia

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4
Q

astrocytes & oligodendros

-derived from what tissue?

A

neuroectoderm

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5
Q

which hypoT nucleus maintains circadian rhythm?

-mnemonic?

A

suprachiasmatic nucleus

-hard to be “super charismatic” when you have jet lag.

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6
Q

All sensory information goes through thalamus except:

A

olfaction

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7
Q

When a pt needs IV ABxs, can oral ABxs be a good enough substitute?

A

no

-oral ABxs do not adequately penetrate the CSF.

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8
Q

heroin withdrawal

-key Sxs:

A

dilated pupils
yawning
lacrimation

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9
Q

Alcohol & benzo withdrawal

-key Sxs:

A

tachy

seizures

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10
Q

nicotine withdrawal

-key Sxs:

A

inc. appetite

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11
Q

Seizures

-opioid or alcohol withdrawal?

A

alcohol withdrawal can produce seizures, opioid withdrawal does NOT.

*benzo withdrawal can also lead to seizures.

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12
Q

nicotinic receptor

-how many ACh need to bind for channel to open?

A

2

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13
Q

chlorpromazine

-high or low potency?

A

low potency antipsychotic

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14
Q

fluphenazine

-high or low potency?

A

high potency antipsychotic

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15
Q

entacapone

-mech?

A

peripheral COMT inhibitors, prevent L-DOPA degradation, increased dopamine availability.

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16
Q

entacapone vs tolcapone

-difference?

A

Entacapone inhibits peripheral COMT while tolcapone inhibits both central & peripheral COMT.

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17
Q

MAO-B

-degrades what?

A

dopamine

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18
Q

MAO-A

-degrades what?

A

NE & serotonin

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19
Q

Which receptor causes mydriasis?

A

alpha1

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20
Q

What nerve inn. all the muscles of mastication?

A

V3 (mandibular) of the trigeminal

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21
Q

which muscle opens the jaw?

A

lateral pterygoid

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22
Q

Mandibular n. (V3, trigeminal)

-exits skull through which foramen?

A

foramen ovale

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23
Q

Maxillary n. (V2, trigeminal)

-exits skull through which foramen?

A

foramen rotundum

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24
Q

TCAs

-blockade of what leads to arrythmias?

A

cardiac fast sodium channels

*also keep in mind, blockade of muscarinic receptors can also cause tachy.

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25
TCAs have inhibitory effects on what receptors?
- NE & serotonin reuptake - muscarinic - alpha-1 - histamine - cardiac fast Na channels
26
Whats the most common cause of death in pts w/anti-depressant toxicity?
TCAs inhibit cardiac fast sodium channels resulting in arrythmias.
27
ant pit | -derived from what tissue?
rathke pouch = surface ectoderm
28
post pit. | -derived from what tissue?
neural tube (which is from ectoderm).
29
Alar plate - ventral or dorsal? - motor or sensory?
(dorsal): sensory
30
Basal plate - ventral or dorsal? - motor or sensory?
(ventral): motor
31
Brainstem | -components:
midbrain + pons + medulla = brainstem.
32
Forebrain - aka? - what does it develop into?
- AKA: prosencephalon - telencephalon => cerebral hemispheres - diencephalon => thalamus
33
Midbrain - aka? - what does it develop into?
- AKA: mesencephalon | - midbrain
34
Hindbrain - aka? - what does it develop into?
- AKA: rhombencephalon - Metencephalon => pons + cerebellum - Myelencephalon => medulla
35
3rd ventricle | -which part of brain?
thalamus
36
aqueduct of sylvius | -which part of brain?
midbrain
37
Neural crest | -origin of what nervous system structures?
PNS neurons, Schwann cells.
38
whats the resident macrophage of the CNS and what layer does it derive from?
microglia | -from mesoderm like macrophages.
39
Order of closing of neural tube: | -rostal, middle, caudal: order?
-neural tube first closes in the middle. Then the rostal | end, then the caudal end.
40
Neuropores | -fuse during which week?
4th week
41
Failure of neuropores to close | -persistent connection btwn what two areas?
amniotic cavity & spinal canal.
42
Whats the marker for neural tube defect? - and where can you measure it? - whats a confirmatory test?
inc. AFP - amniotic fluid & maternal serum - inc. AChE in amniotic fluid = confirmatory test.
43
Spina bifida occulta | -is dura intact?
yes | -only spina bifida lesion w/intact dura.
44
Anencephaly - what part of brain is missing? - associated w/what maternal problem?
- No forebrain. | - maternal DM 1.
45
Holoprosencephaly - what is it? - which signaling pathway is fucked up?
- Failure of left and right hemispheres to separate, usually occurs during weeks 5-6. - sonic hedgehog
46
Holoprosencephaly - presentation? - associated w/what genetic disease?
- Moderate form has cleft lip/palate, most severe form results in cyclopia. - patau (trisomy 13)
47
Chiari II (Arnold-Chiari malformation) - what is it? - whats it cause?
- Significant herniation of cerebellar tonsils and vermis through foramen magnum - Aqueductal stenosis and hydrocephalus
48
``` Chiari II (Arnold-Chiari malformation) -how does it present? ```
-Often presents with lumbosacral myelomeningocele and paralysis below the defect.
49
Dandy-Walker - what is it? - associated w/what comorbidities?
- Agenesis of cerebellar vermis with cystic enlargement of 4th ventricle. - Associated with hydrocephalus and spina bifida.
50
Syringomyelia - what is it? - what cells are usually damaged first?
-Cystic cavity (syrinx) within the spinal cord. -Crossing anterior spinal commissural fibers are typically damaged first.
51
Syringomyelia - Sxs: - most common location?
- Results in a “cape-like” bilateral loss of pain and temperature sensation in upper extremities (fine touch sensation is preserved). - Most common at C8–T1.
52
Ant. 2/3 of tongue | -which branchial arches?
-1st and 2nd branchial arches.
53
Post. 1/3 of tongue | -which branchial arches?
-3rd and 4th branchial arches
54
Post. 1/3 of tongue - somatosensation via? - taste via?
-CN 9 for both.
55
Which CNs carry taste sensation? | -what nucleus do they deliver this to?
CN VII, IX, X | -solitary nucleus
56
Ant. 2/3 of tongue - somatosensation via? - taste via?
- sensation = V3 | - taste = CN 7
57
Astrocyte | -handles metabolism of what?
potassium
58
HIV-infected microglia: appearance?
-fuse to form multinucleated giant cells in the CNS.
59
Oligodendrocyte | -how many axons can it myelinate?
A lot (~30)
60
Oligodendrocyte - how many axons can it myelinate? - injured in which diseases?
- ~30. | - Injured in multiple sclerosis, progressive multifocal leukoencephalopathy (PML), and leukodystrophies.
61
Schwann cells - how many axons can it myelinate? - mnemonic?
- can only myelinate 1 PNS axon. | - Schwann bike only fits one person.
62
Schwann cells - derived from? - destroyed in what disease(s)?
- neural crest | - Destroyed in Guillain-Barré syndrome.
63
Most common sign of initial periph. neuropathy in DM pts is loss of what? -caused by damage to what?
Loss of vibration sense | -pacinian corpuscles
64
4 cell types in epidermis:
-langerhan dendritic cells, keratinocytes, melanocytes, merkel cells.
65
Endoneurium - surrounds what? - inflammatory infiltrate here signals what disease?
- single nerve fiber | - inflammatory infiltrate in Guillain-Barré syndrome.
66
Perineurium | -surrounds what?
- surrounds a fascicle of nerve fibers. | - Must be rejoined in microsurgery for limb reattachment.
67
Epineurium | -surrounds what?
-dense connective tissue that surrounds entire nerve (fascicles and blood vessels).
68
Dopamine | -location of synthesis
- Ventral tegmentum and SNc (midbrain) | * SNc = substantia nigra pars compact
69
Serotonin - inc or dec in anxiety? - inc or dec. in parkinsons?
- dec. in anxiety | - inc. in parkinsons
70
Serotonin | -where is it made?
Raphe nucleus (pons, medulla, midbrain)
71
ACh | -where is it made?
Basal nucleus of Meynert
72
ACh - inc or dec in parkinsons - inc or dec in Alzheimers - inc or dec in Huntingtons
- inc. in Parkinson disease - dec. in Alzheimer disease - dec. in Huntington disease
73
GABA | -inc or dec. in anxiety?
-dec. in anxiety
74
GABA | -where is it made?
- Nucleus accumbens | * strong association w/addiction.
75
Tight junctions aka:
-zonula occludens.
76
vasogenic edema | -what is it?
-cerebral edema due to infarction and/or neoplasm destroying endothelial cell tight junctions of the BBB.
77
Areas of hypoT not protected by BBB:
- OVLT (organum vasculosum of the lamina terminalis) senses change in osmolarity. - area postrema (responds to emetics)
78
Supraoptic nucleus makes:
ADH.
79
Paraventricular nucleus makes:
oxytocin.
80
HypoT: lateral area - function? - mnemonic? - inhibited by what?
- "Lat makes you Fat" - controls hunger - destruction => anorexia - inhibited by leptin
81
HypoT: Ventromedial area - function? - mnemonic? - stimulated by what?
- If you zap your ventromedial area, you grow ventrally & medially. - satiety center - destruction => hyperphagia - stimulated by leptin.
82
Anterior hypothalamus - function? - mnemonic? - stimulated by what?
- cooling - A/C = anterior cooling. - parasympatheticaly stimulated.
83
Posterior hypothalamus - function? - stimulated by what?
- heating | - sympathetically stimulated
84
Suprachiasmatic nucleus - function? - mnemonic
- Circadian rhythm. | - "Hard to be "super charismatic" when you have jet lag".
85
Suprachiasmatic nucleus - how does it stimulate pineal gland? - what does pineal gland release when stimulated?
-Suprachiasmatic nucleus squirts NE onto pineal gland which then releases melatonin.
86
Two stages of sleep:
-rapid-eye movement (REM) and non-REM.
87
Extraocular movements during REM sleep due to activity of:
-PPRF (paramedian pontine reticular formation/conjugate gaze center).
88
How often does REM sleep occur?
Every 90 minutes, and duration increases through the night.
89
What decreases REM & delta wave sleep?
-Alcohol, benzodiazepines, barbiturates, & norepinephrine.
90
Bedwetting: Tx:
Oral desmopressin acetate (DDAVP). | -preferred over imipramine.
91
Night terrors and sleepwalking: Tx:
Benzodiazepines
92
What stage of sleep does sleepwalking, night terrors, and | bedwetting occur?
Non-REM: stage N3 | -delta wave sleep
93
What stage of sleep does bruxism occur?
Non-REM: stage N2 | -Sleep spindles and K complexes
94
Thalamus: VPL nucleus | -inputs?
Spinothalamic & DC/ML
95
Thalamus: VPM nucleus - inputs? - mnemonic?
- inputs: trigeminal and gustatory pathway | - "M"akeup goes on the face (vp"M")
96
Thalamus: LGN nucleus - inputs? - destination? - mnemonic?
- input: CN2 - Calcarine sulcus (visual cortex) - Lateral = Light
97
Thalamus: MGN nucleus - inputs? - destination? - mnemonic?
- input: Superior olive and inferior colliculus of tectum. - Auditory cortex of temporal lobe. - "M"edial = "M"usic
98
Thalamus: VL nucleus - inputs? - destination?
- inputs: Basal ganglia, cerebellum. | - Motor cortex
99
Limbic system | -involves which sense?
olfaction
100
Cerebellum | -output nerves?
Purkinje cells | -the only output cells of the cerebellum.
101
Which cells in cerebellum are very vulnerable to ischemia?
Purkinje cells
102
Striatum =
= putamen (motor) + caudate (cognitive).
103
Lentiform =
= putamen + globus pallidus.
104
Is amygdala part of basal ganglia?
No, its part of limbic system.
105
Sertraline | -what is it?
SSRI
106
precentral gyrus
primary motor cortex
107
Which vitamin inc. peripheral metabolism of levodopa?
B6
108
Cimetidine | -s/e:
- p450 inhibitor - anti-androgenic effects - gynecomastia - prolactin release - impotence - dec. libido - dec. renal excretion of creatinine
109
What type of drugs are usually more addictive, shorter or longer acting?
shorter acting