6/14 UWorld Flashcards
What causes autosplenectomy in sickle cell patients
Vaso-occlusion
Why might you see macrocytic anemia is sickle cell patients
Hemolytic anemia leads to increased erythrocyte turnover and increased folic acid requirement
So patients are prone to developing relative folic acid deficiency
Functional units of cerebellum and their corresponding deep nuclei
- REMEMBER:
- Lateral to medial = Don’t Eat Greasy Foods
- Dentate
- Emboliform
- Emboliform + Globose = Interposed
- Globose
- Fastigial
- Lateral to medial = Don’t Eat Greasy Foods
- Vestibulocerebellum
- Vermis + flocculonodular (most medial)
- = Fastigial deep nucleus
- Spinocerebellum
- Vermis + paravermis
- = Interposed (Emboliform + Globose) deep nucleus
- Cerebrocerebellum
- Lateral hemisphere
- = Dentate deep nucleus
What is the presentation and cause of hemiballismus
Sudden, wild flailing of half of body (1 arm +/- ipsilateral leg)
Seen in lesion of contralateral subthalamic nucleus
What are the layers that you go through during a spinal tap?
Skin - superficial fascia - supraspinous ligament - interspinous ligament - ligamentum flavum - epidural space - dura mater - subdural space - arachnoid membrane - subarachnoid space (this is where CSF is)

Define athetosis and it’s cause
Slow, writhing movements, especially seen in the fingers
Due to lesion of basal ganglia (Huntington’s)
Define chorea and its cause
- Sudden, jerky, purposeless movements
- Due to lesion of basal ganglia (e.g. Huntington’s)
- Sydenham chorea seen in acute rheumatic fever
Define dystonia
Sustained, involuntary muscle contractions
Due to Writer’s cramp, blepharospasm, torticollis
Define akathisia and its cause
- Dancing in place (voluntary) / Restlessness
- THINK: Anthony saying “Ayy, Kayla” when she is drunk and dancing in place
- Compulsion to move
- Seen with neuroleptic use or in Parkinson’s
Define asterixis and its cause
- Extension of wrists causes “flapping” motion
- Associated with hepatic encephalopathy, Wilson disease, and other metabolic derangements
What part of the brain is affected in Huntington’s
- Atrophy of caudate and putamen with hydrocephalus ex vacuo (ventricles appear dilated due to loss of surrounding brain tissue)
- Symptoms:
- Chorea, athetosis, aggression, depression, dementia
Identify the location of the following in the spinal cord:
Dorsal column
Spinothalamic tract
Corticospinal tract (lateral and anterior)

What part of the spinal cord is damaged in Werdnig-Hoffman disease
Anterior motor horn - LMN deficit with SYMMETRIC weakness
(vs. poliomyelitis which is LMN deficit with ASYMMETRIC weakness)
Floppy baby
THINK: Hoff = hop, so you know it is associated with polio (hopping on one leg)
What part of the spinal cord is affected/presentation of complete occlusion of the anterior spinal artery
- Damage to everything except dorsal column
- Spinothalamic damage = loss of bilateral pain and temperature below the lesion
- Corticospinal damage = UMN below the lesion
- Anterior horn damage = LMN deficit at the level of the lesion
What part of the spinal cord is damaged/presentation of ALS
- Aka Lou Gehrig disease
- Damage to anterior motor horn and lateral corticospinal tract
- Presents with both UMN and LMN deficits
- Lack of sensory impairment distinguishes from syringomyelia
- Caused by defect in superoxide dismutase (O2- à H2O2)
Describe the findings in Brown-Sequard syndrome
(is each spinal pathway affected ipsilaterally or contralaterally)
- Ipsilateral UMN signs below level of lesion (corticospinal tract damage)
- Ipsilateral loss of tactile, vibration, proprioception sense below level of lesion (dorsal column)
- Contralateral pain and temp loss 2-3 segments below level of lesion (spinothalamic tract)
- 2-3 segments below because remember info travelled up 2-3 segments via Lissaur’s tract
- Ipsilateral pain and temp loss at level of lesion
- Ipsilateral LMN signs at level of lesion
Presentation of multiple sclerosis
- Charcot triad of symptoms = SIN:
- Scanning speech
- Intention tremor, Incontinence, Internuclear ophthalmoplegia
- Nystagmus
- Hemiparesis, hemisensory symptoms
Describe MRI and lumbar puncture of MS
- MRI = gold standard
- Periventricular plaques (areas of oligodendrocyte loss and reactive gliosis)
- Lumbar puncture
- Increased protein
- Oligoclonal IgG bands
Presentation of Friedrich ataxia
- Degeneration of cerebellum and spinal cord
- Ataxia, muscle weakness, loss of vibratory sense and proprioception, diabetes mellitus, hypertrophic cardiomyopathy
- Presents in childood with kyphoscoliosis
- THINK: Friedreich is fratastic (frataxin): he’s your favorite frat brother, always staggering and falling but has a sweet, big heart
What are Osler nodes and what disease are they associated with
Painful red nodules on finger and toe pads
Associated with bacterial endocarditis
What are the painless macules on palms and soles associated with bacterial endocarditis
Janeway lesions
Derivatives of the aortic arches (1, 2, 3, 4, 6)
- 1st:
- Will degenerate
- Part of maxillary artery
- 2nd:
- Will degenerate
- Stapedial artery and hyoid artery
- 3rd:
- Common carotid artery and proximal part of internal carotids
- 4th:
- On left – aortic arch
- On right – proximal part of R subclavian
- 6th:
- Proximal part of pulmonary arteries
- On left – ductus arteriosus

Describe the transition from fetal circulation to adult circulation (e.g. closure of shunts)
When the infant takes a breath, this decreases intrathoracic pressure, thus decreasing resistance in pulmonary vasculature
Decreased resistance leads to more blood entering the pulmonary artery (less leaving through ductus arteriosus), and thus more blood entering the LA
Increased LA pressure causes closure of the foramen ovale
Highly oxygenated blood in the aorta causes closure of ductus arteriosus
Cardiac abnormalities associated with:
- DiGeorge
- Turner syndrome
- Down syndrome
- Turner syndrome:
- Coarctation of aorta
- Bicuspid aortic valve
- Down syndrome
- Endocardial cushion defect (ASD and VSD)
- Complete atrioventricular canal defect
- Endocardial cushion defect (ASD and VSD)
- DiGeorge syndrome
- Tetralogy of Fallot
- Truncus arteriosus