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UworldSUN > CNS > Flashcards

CNS Flashcards

1
Q

patient recently started on schizo meds, has torticolis, what is mechanism?

A

D2 antagonism leads to acute dystonic reaction

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2
Q

demyelinating disease causes decrease in what in the neuron?

A

length (space) constant. velocity equals length/time. length constant is how far impulse can travel- because myelin creates high resistance in membrane, impulse can travel farther

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3
Q

cystic degeneration of putamen is commonly caused by

A

wilson’s

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4
Q

21 yo with impaired balance, tremor and difficulty speaking, sibling who has progressive neurological disease, dx and pathognomonic sign?

A

wilson’s- keyser-fleischer rings, slit lamp examination

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5
Q

HIV dementia, histology?

A

microglial nodules and multinucleated giant cells

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6
Q

patient with RA given anesthetic then develops quadriparesis, dx and mechanism?

A

vertebral sublaxation. RA involves atlantoaxial joint and then anesthetic worsens this sublaxation causing compression of vertebral arteries/spinal cord

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7
Q

rural farmer in penn, has splinter injury, and develops lockjaw and difficulty swallowing, cannot turn neck, dx?

A

tetanus- clinical diagnosis.

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8
Q

hyperkalemia after anestehtic? which one?

A

succinylcholine- dont give in burn, myopathy, quadreplegic patients

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9
Q

post herpetic neuralgia given topical capsaicin, whcih substance does it regulate?

A

substance P, not NPY

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10
Q

boy with papilledema, unable to look up, eyelid retraction, blurry vision. dx?

A

parinaud syndrome due to midbrain compression, by pineal gland

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11
Q

HIV patient, has meningitis symptoms, organism and what would you see?

A

cryptococcus, on india ink you would see budding yeasts. can also do a latex agglutination test for the polysaccharide capsule

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12
Q

isoflurane anestehtic side effect

A

increased cerebral blood flow

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13
Q

upon looking right, the left eye does not adduct, dx and lesion?

A

internuclear opthalmoplegia, due to damage to MLF commonly due to lacunar stroke

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14
Q

agraphia, acalculia, left-right disorientation

A

gerstmann syndrome in angular gyrus in dominant parietal lobe

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15
Q

RTA, fracture at pterion (where three bones meet), what artery is damaged and what can it lead to?

A

maxillary artery branch- middle meningeal artery- epidural hematoma

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16
Q

equilibrium potential given and permeability to the ion… at resting membrane potential, at ligand gated channel and voltage gated channel

A

potassium sodium chloride

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17
Q

face and arm weakness, leg spared. which artery?

A

middle cerebral

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18
Q

needs anesthesia for anterior thigh muscles, where should you inject?

A

inguinal crease

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19
Q

brain tumor, positive for synaptophysin, negative for GFAP. what is the origin of this tumor?

A

neurons

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20
Q

course of median nerve?

A

brachial plexus, between ulnar and humeral heads of pronator teres, then between FDP and FDS

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21
Q

man dies with alcohol related vomitus aspiration on the sidewalk. hemorrhage of mamillary bodies. what enzyme is low?

A

transketolase - thiamine deficiency in wernicke’s. thiamine is essential for PPP, which uses transketolase

22
Q

meningitic symptoms, fever, biopsy shows clear cells, dx?

A

cryptococcus

23
Q

nerve conduction study shows delayed action potential after stimulus, what is wrong with neuron?

A

schwann cells due to compression and apoptosis. axon damage would cause decrease in amplitude

24
Q

old woman with headache with left lower limb paralysis, and tremor of hand, csf shows lymphocytic pleocytosis and RNA from virus. dx?

A

west nile virus infection

25
Q

person with diffuse muscle rigidity, hyperthermia and altered sensorium and dysautonomia on haloperidol and sertraline, dx, rx, and mecahnism?

A

neuroleptic malignant, dantrolene, blocks ryanodine receptor to inhibit Ca release from sarcoplasmic reticulum

26
Q

cherry red macula, startle reflex, macrocephaly, developmental delay in 8 month old, abdo exam normal. dx and enzyme missing and what accumulates?

A

tay sachs, hexosaminidase A, GM2 ganglioside. contrast with niemann-pick has hepatosplenomegaly (sphingomyelinase deficiency)

27
Q

fragile X syndrome baby, what is genetic abnormality?

A

hypermethylation of FMR1 gene

28
Q

male patient has myclonic epilepsy, muscle biopsy shows blotchy red appearance, what is probability that offspring will get disease?

A

0% because mitochondrial inheritance. MERRF, LHON, MELAS

29
Q

posterior triangle dissection, shoulder abduction weakness later. what muscle is affected?

A

trapezius. posterior triangle dissection led to spinal accessory nerve injury

30
Q

MS patient with painful spasticity of muscles, rx?

A

baclofen- GABA-B agonist and tizanidine alpha 2 agonist can also be used

31
Q

SAH, 5 days later, new FND. what is dx? and Rx?

A

vasospasm causing infarct. can give CCB

32
Q

high levels of acetylcholinesterase in amniocentesis of week 18 baby, dx?

A

neural tube defect

33
Q

4 yo patient w difficulty walking, frequent respi infections, high rate of radiation induced genetic mutation, dx?

A

ataxia-telangiectasia. cerebellar atrophy

34
Q

japanese restaurant eating fish, neurotoxicity, where in action potential?

A

binds to voltage gated sodium channels, prevents depolarization

35
Q

battle sign, racoon eyes/orbital floor fracture?

A

basilar skull fracture, infraorbital nerve damaged

36
Q

orninthine cannot get into mitochondria, what should be restricted in the diet?

A

protein; because urea cycle is defective

37
Q

retinoic acid inhibits what in fetus?

A

hox pathway- face, thymus, cartilage

38
Q

endorphins are structurally similar to what normal hormone?

A

ACTH. both made from POMC

39
Q

treatment for cryptococcal meningitis?

A

Ampho B and flucytosine, then long-term fluconazole

40
Q

hydrocephalus, intracranial calcification and chorioretinitis?

A

toxoplasmosis, from cat droppings, in-utero infection TORCHES

41
Q

long term parkinsons patient on levodopa carbidopa treatment. why on-off?

A

because of nigrostriatial destruction

42
Q

why, in mitochondrial diseases, is there such varaibility in phenotype?

A

heteroplasmy because mitochondria are unequally distributed

43
Q

anestehtic has increased arteriovenous concentration gradient which means that it has a _______; how about high blood gas coefficient

A

slower onset of action; because peripheral tissue is taking up the anesthetic a lot, must be replaced; this means that more is being solubilized so more needs to be given

44
Q

what does adding carvidopa to levodopa do?

A

dopa decarboxylase inhibitor so it can go into brain more. peripheral side effects of dopamine such as postural hypotension and hot flashes and vomitng/nausea are reduced, but brain activity increases so anxiety and agitation might get worse

45
Q

SVT ablation at RA, crysta terminalis. what nerve can be injured?

A

R phrenic nerve, elevation of diaphragm will show it

46
Q

camping trip to new mexico, torticolis, mydriasis, drooling, painful esophageal spasms, cannot eat or drink, dx and where is the entry point?

A

rabies encephalitis, muscle ACh receptor

47
Q

perivenular inflammatory infiltrates in brain and astrocyte hyperplasia -glial scarring, dx?

A

MS

48
Q

what anesthetics lead to liver failures?

A

halogenated- esoflurane etc

49
Q

trendelenburg sign nerve

A

superior gluteal nerve

50
Q

sponteaneous local recurrent lobar hemorrhage in elderly , dx?

A

cerebral amyloid angiopathy

51
Q

TMJ dysfunction and hearing issues, what nerve?

A

mandibular (V3)

UworldSUN (11 decks)

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