Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nervous System > CNS Pathology > Flashcards

CNS Pathology Flashcards

1
Q

What are Down syndrome pt. more at risk for?

A

1) Early onset dementia presenting with senile plaques and neurofibrillary tangles
2) Acute leukemias
3) Congential heart disease
4) GI defects (duodenal atresai and Hirschsprung dx)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Spontaneous contractions of a single lower motor unit; occur at rest

A

Fasiculations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How can you differentiate between a benign positional vertigo and a posterior fossa disease using the Baranay maneuver?

A

1) Latency will be immediate with posterior fossa dx; 2-20 seconds for benign positional vertigo
2) Duration will be persistent with a posterior fossa dx; < 1 min for a benign positional vertigo
3) Adaptation with benign positional vertigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Treatment for tension headache?

A

1) NSAID
2) NSAID + Caffeine
3) NSAID + Barbiturate
4) All together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the barbiturate used for tension headaches? What are its effects?

A

1) Butalbital
2) Causes sedation by facilitating GABA neurotransmission
3) Can become dependent and will have rebound headaches after removal of substance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why is caffeine used in the treatment of tensions headaches?

A

Caffeine is a competitive antagonist at the adenosine receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Headache that has abrupt onset, occurs bilaterally, PE and all other tests are normal; most common cause of headache

A

Tension Headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are aura symptoms?

A

1) Presence of Zig-zag lines that flash
2) Occur before migraine
3) May also have olfactory hallucinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the difference between communicating and non-communicating hydrocephalus?

A

1) Communicating = symmetric enlargement of ventricular system
2) Non-communicating = asymmetric enlargement of ventricular system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Herniation that occurs when unilateral expansion of a cerebral hemisphere displaces the cingulate gyrus under the falx cerebri

A

Subfalcine herniation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Herniation that occurs at the medial aspect of the temporal lobe where it is compressed against the tentorium

A

Transtentorial herniation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Displacement of the cerebellar tonsils through the foramen magnum

A

Tonsillar herniation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the complications of Transtentorail herniation?

A

1) Compromise of CN III
2) Compression of posterior cerebral artery
3) Kernohan’s notch- contralateral cerebral peduncle compression (causes ipsilateral paresis)
4) Secondary brainstem (Duret) hemorrhages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a complication of a tonsillar hernation?

A

1) Death due to compression of essential components of the medulla oblongota

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does the presence of alpha-fetoprotein in maternal serum indicate

A

Neural tube defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Absence of cortical gyri

A

Lissencephaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Small, numerous and irregularly formed cerebral convolutions

A

Polymicrogyria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Spectrum of malformations characterized by incomplete separation of the cerebral hemispheres across the midline

A

Holoprosencephaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What occurs in Dandy-Walker Malformation

A

1) Agenesis of cerebellar vermis

2) Cystic enlargement of 4th ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Small posteiror fossa with downward extension of the vermis through the foramen magnum

A

Arnold Chiari malformation (Chiari II malformation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Low lying cerebellar tonsils that extend down into the vertebral canal

A

Chiari I malformation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Vertigo caused by free-floating otoconia that have been dislodged form the utricular macula and have been moved into one of the semicircular canal

A

Benign positional vertigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the location of an acoustic neuroma?

A

1) Cerebellopontine angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Headache that presents in young males, is unilateral, and usually retro-orbital, autonomic dysfunctions; duration of 30 min to 2 hours

A

Cluster Headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Headache with unilateral lightning bolt pain; 2-20 episodes dilay; normal neurologic exam

A

Trigeminal Neuralgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What must occur in order to classify a headache as a migraine?

A

At least four attack must have occured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What time period in someone’s life are they more likely to get a migraine?

A

In the first four decades of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Unilateral throbbing pain associated with photophobia and phonophobia; usually associated with nausea and vomitting; duration: 4-72 hours

A

Migraine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the main cause of an epidural hematoma?

A

1) Rupture of middle meningeal artery
2) Generally occurs in children with temporal bone displacement
3) Neurosurgical emergency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Main cause of subdural hematoma?

A

1) Tearing of the bridging veins in elderly or infants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What region of the brain is at greatest risk of a border zone infarct in a hypotensive state?

A

1) edges of the cerebral vascular supply that mainly receives adequate supply due to overlap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the stages of global cerebral ischemia?

A

1) Presentation of red neurons (12-24 hrs)
2) Infiltration of neutrophils (1-3 days)
3) Influx of macrophages (3-5 days)
4) Reactive gliosis (1-2 weeks)
5) Scar formation/repair (months)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How does hypertension affect the brain?

A

1) Lacunar infarcts
2) Slit Hemorrhages
3) Hypertensive Encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the two major causes of intracranial hemorrhage?

A

1) Hypertension

2) Cerebral amyloid angiopathy (CAA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What mendelian disorders are at greater risk for a berry aneurysm?

A

1) Autosomal dominant polycystic kidney disease
2) Ehlers-Danlos syndrome
3) Neurofibromatosis type 1
4) Marfan syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Extension of only the meninges herniating into the spinal canal defect

A

Meningocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Meninges and spinal cord herniate through the spinal canal defect

A

Meningomyelocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Malformation of the anterior neural tube resulting in no forebrain and an open calvarium; polyhydramnios and frog-like appearance

A

Anencephaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Lake-like spaces that occur in the lenticular nucleus, thalamus, internal capsule, caudate nucleus, and pons? What is the most common cause?

A

1) Lacunar Infarct

2) Caused by hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Most common location of a berry aneursym?

A

1) Bifuraction of the anterior communciating artery and anterior cerebral artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Describe the bacterial cause of meningitis according to age. Neonate (0-6 mos)? Children (6mos-6years)?
6 years to 60 years? Elderly (>60 years)?

A

1) Group B streptococcus agalactae, E. coli, Listeria
2) Streptococcus pneumonaie, Neisseria meningitidis, Haemophilus influenzae type B
3) Streptococcus pneumoniae, Neisseria meningitidis
4) Streptococcus pneumoniae and Listeria monocytogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the findings of CSF for an acute purulent meningitis?

A

1) Increased neutrophils (>90,000)
2) Increased protein
3) Decreased glucose
4) Findings on gram stain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are the findings of CSF for an acute aseptic meningitis?

A

1) Lymphocytosis
2) Moderately increased protein
3) Normal glucose level
4) No findings on gram stain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Describe the progression of an infarct in the brain.

A

1) At 12 hours red neurons with cytotoxic and vasogenic edema
2) After 24 hours the tissue appears pale, soft and swollen
3) 1-3 days infiltration of neutrophils
4) 3-7 days infiltration of macrophages (microglia)
5) Liquefaction occurs at 2-3 weeks
6) After several months there is separation from the cavity forming a gliotic cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Dilation of the ventricular system with a compensatory increase in CSF volume due to loss of a brain parenchyma

A

Hydrocephalus ex vacuo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What are the causes of Hydrocephalus ex vacuo?

A

1) Parkinson’s

2) Alzheimer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What are Duret Hemorrhages caused by? What is their appearance?

A

1) Transtenorail (uncal) hernia

2) Linear, flame shaped lesions caused by tearing of arteries supplying the upper brain stem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Failure of bony spinal canal to close, but no structural herniation

A

Spina Bifida Occulta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Diverticulum of malformed CNS tissue extending through a defect in the cranium

A

Encephalocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Collection of neurons in inapporpirate locations. How does this present?

A

1) Neuronal heterotopias

2) epilepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Infarct at the supratentorial periventricular white matter that consists of a chalky yellow plaque

A

Periventricular Leukomalacia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What are Charcot-Bouchard microaneurysm associated with?

A

1) Intracerebral hemorrhage

2) Caused by hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Sensory loss of pain and temperature with sparing of fine touch and position in the upper extremities in a cape like distribution

A

Syringomyelia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Formation of a fluid filled cleft-like cavity in the inner portion of the cord that occurs from C8-T1

A

Syringomyelia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Discontinuous multi-segmental expansion of the ependymal lined central canal of the cord

A

Hydromyelia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is the difference between Creutzfeldt-Jakob Disease and vCJD?

A

1) vCJD has behavioral changes early in onset
2) vCJD has plaques in the cortical regions with surrounding spongiform change
3) No alterations in PRNG gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What has been found to be connected genetically to CJD?

A

1) Homozygous state at the 129 codon of the PRNG gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What are the two microscopic findings in CJD?

A

1) Spongiform transformation

2) Presence of uniform empty vacuoles within the neuropil and perikaryon of neurons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Autoimmune attack on the myelin sheath; results in plaques within the white matter; characterized by distinct episodes of neurologic deficits separated in time

A

Multiple Sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is HLA-DR2 associated with?

A

Multiple Sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What is used to diagnose MS?

A

1) MRI - shows plaques in white matter

2) Lumbar puncture- shows increased lymphocytes and oligoclonal IgG bands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Bilateral optic neuritis and spinal cord demyelination

A

Neuromyelitis Optica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Diffuse, monophasic demylinating disease that follows a viral infection; there is myelin loss with relative preservation of axons

A

Acute Disseminated Encephalomyelitis (ADEM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Fulminant syndrome of CNS demyelination affecting younger adults and children; preceded by a URI

A

Acute necrotizing hemorrhagic encephalomyelitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Spherical collections of dilated, neuritic processes around a central amyloid core; found in Alzhemier disease

A

Neuritic plaque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is the abnormal protein found within the amyloid core of a neurtic plaque?

A

1) A-beta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What are the two major microscopic findings in Alzheimer disease?

A

1) Neuritic plaques

2) Neurofibrillary tangles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Bundles of filaments in the cytoplasm of the neurons that displaces the nucleus; elongated flame shape

A

Neurofibrillary tangles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Elongated, glassy, eosinophilic bodies consisting of paracrystaline arrays of beaded filaments; what is this associated with?

A

1) Hirano bodies

2) Alzheimer disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is the major protein deposited in Alzheimer disease derived from? How does it come about?

A

1) Aβ is derived from Amyloid precursor protein (APP)

2) Aβ is only formed when APP undergoes beta cleavage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What cleave must APP undergo to make Aβ?

A

Beta cleavage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What chromosome is APP found on?

A

Chromosome 21

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is another complication of the abundant amyloid protein found in Alzheimers?

A

1)Cerebral amyloid angiopathy which could cause intracerebral hemorrhage due to weakening of the wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What protein is hyperphosphorylated in the neurofibrillary tangles found in Alzheimer

A

1) Tau protein is hyperphosphorylated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Group of disorders that have progressive degeneration of temporal and frontal lobes resulting in deterioration of language and changes in personality

A

Frontotemporal Dementias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Frontotemporal dementia that occurs progressively; Atrophy is so severe that it causes wafer thin gyri; presence of cytoplasmic round filamentous inclusions that are weakly basophilic

A

Pick Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Dementia caused by multifocal infarction and injury due to hypertension, atherosclerosis, or vascultis; step by step decline

A

Vascular dementia

78
Q

What are the clinical features of Parkinsonism?

A

Think: your body becomes a TRAP

1) Tremors (pill rolling tremor)
2) Rigidity (Diminished facial expression)
3) Akinesia (slowness of voluntary movment ie bradykinesia)
4) Posutral instability (Stooped posture and festinating gait)

79
Q

With a microsopic finding of neurons that have a single or multiple, cytoplasmic, eosinophilic inclusions with a dense core and a pale halo you should think what? What is the disease?

A

1) Lewy bodies

2) Parkinson disease

80
Q

What are the filaments in Lewy bodies made up of?

A

Alpha-synuclein

81
Q

focal demyelination of the pons; presents as acute bilateral paralysis “locked in syndrome”; due to overly rapid correction of Na levels

A

Central Pontine Myelinolysis

82
Q

Deposition of alpha-synuclein inclusions found in oligodendrocytes

A

Multiple System Atrophy

83
Q

Degeneration of dopaminergic neurons? Degeneration of GABAnergic neurons?

A

1) Parkinson Disease

2) Huntington Disease

84
Q

Atrophy of GABAnergic neurons in the Caudate nucleus of the basal ganglia?

A

Huntington Disease

85
Q

What is the cause of Huntington disease?

A

1) Autosomal dominant expansion of a trinucleotide repeat in the huntingtin gene

86
Q

Autosomal recessive spinocerebellar, dorsal root ganglion, posterior column, and th distal positions of the corticospinal tract degenaration

A

Friederic Ataxia

87
Q

What are findings in Friederic ataxia?

A

1) Loss of position and vibratory sense
2) DTRs are absent
3) Pes Cavus develops
4) Enlarged heart
5) Intentional tremor

88
Q

Autosomal recessive disorder causing ataxia and the development of telangiectasia in the conjunctiva and skin; immunodeficiency also observed

A

Ataxia-Telangiectasia

89
Q

Degenerative disorder of both the lower and upper motor neurons of the corticospinal tract; degeneration of the anterior horn neurons and the precentral gyrus

A

Amyotrophic Lateral Sclerosis

90
Q

Mutation of SOD1 gene on chromsome 21 results in what disease? What is characteristic of this disease?

A

1) Amyotrophic Lateral Sclerosis

2) Degeneration of both the upper and lower corticospinal tract

91
Q

PAS positive cytoplasmic inclusions in remaining neurons found in Amyotrophic Lateral Sclerosis? What are they remnants of?

A

1) Bunina bodies

2) Remnants of autophagic vacuoles

92
Q

X-linked adult onset due to an expanding trinucleotide in the androgen receptor; results in lower motor neuron loss and androgen insensitivity/gynecomastia/ testicular atrophy

A

Bulbospinal Atrophy (kennedy syndrome)

93
Q

Autosomal recessive deficiency of galactocerebroside β-galactosidase ; what is the pathologic result of this deficiency?

A

1) Krabbe Disease

2) Increase in alternative catabolic pathway producing galactosylsphingosine and loss of myelin and oligodendrocytes

94
Q

What is pathognomonic for Krabbe disease?

A

Globoid cell

95
Q

Engorged macrophages that aggregate in the parenchyma and blood vessels

A

Globoid cell

96
Q

How does fat embolism classically present in the brain?

A

1) Petechial hemorrhage throughout the white matter

97
Q

What should you think wit a pure motor stroke?

A

Lacunar infarct

98
Q

Development of psychotic symptoms or ophthalmoplegia due to thiamine deficiency

A

Wernicke encephalopathy

99
Q

Development of memory distrubances and confabulation due to deficiency of thiamine deficinecy

A

Korsakoff syndrome

Course is off syndrome = memory and confabulation

100
Q

Non-progressive neurologic motor defiicit characterized by combinations of spasticity, dystonia, and paresis

A

Cerebral palsy

101
Q

Inherited mutations in enzymes involved with the maintenance or production of myelin

A

Leukodystrophies

102
Q

Deficiency in the lysosomal enzyme arylsulfatase A? What is the result?

A

1) Metachromatic leukodystrophy

2) Demeylination due to increased cerebroside sulfate

103
Q

How does metachromatic leukodystrophy get its name?

A

1) It gets its name from its metochromasia property which occurs when toluidine blue has its dye absorbance changed

104
Q

In ability to catabolize very long chain fatty acids resulting in myelin loss and adrenal insufficiency? What gene is mutated?

A

1) Adrenoleukodystrophy

2) Mutation of ALD gene on X chromosome

105
Q

X linked mutation for myeling proteins resulting in fatal leukodystrophy and complete loss of meylin in cerebral hemispheres; occurs early in life and is fatal

A

Pelizaeus-Merzbacher disease

106
Q

Disease characterized by megalocephaly, severe mental deficits, blindness, and white matter injury in infancy; due to mutation in aspartoacylase

A

Canavan disease

107
Q

Disease characterized by megalocephaly, seizures, progressive psychomotor retardation; due to GFAP mutaitons

A

Alexander disease

108
Q

Most common nuerological syndrome caused by mitochondrial abnormality; presents with neurologic deficits, muscle involvement with lactic acidosis, and stroke like episodes

A

Mitochondrial Encephalomyopathy with Lactic Acidosis and Stroke like episodes (MELAS)

109
Q

Maternally inherited mitochondrial disease that results in myoclonus and myopathy

A

Myoclonic Epilepsy and Ragged Red Fibers (MERRF)

110
Q

What causes foci hemorrhage and necrosis in the mamillary bodies and the walls of the third and fourth ventricles?

A

1) Thiamine deficiency

111
Q

Subacute combined degeneration of the spinal cord?

A

B12 deficinecy

112
Q

Charcot’s triad of MS

A

(MS is a SIIN)

1) Scanning speech
2) Intention tremor and Incontinence
3) Internuclear opthalmoplegia
4) Nystagmus

113
Q

What structures are at greatest risk for damage with focal cerebral ischemia? Why?

A

1) Thalamus, basal ganglia, and deep with matter

2) There is not high collateral flow as seen in Watershed areas (less affected)

114
Q

What is the most common location for a thromboembolism?

A

1) Middle cerebral artery

115
Q

Cerebral hemorrhagic infarcts are caused by? non-hemorrhagic?

A

1) Emboli and CAA

2) Thrombi

116
Q

What is the gross progression of a non-hemorrhagic infarct?

A

1) No change during first 6 hours
2) After 48 hrs brain becomes pale, soft, and swollen
3) By 2-10 days brain becomes gelatinous
4) 10 days- 3 weeks tissue liquefies
5) Results in the formation of a fluid filled cystic space surrounded by gliosis

117
Q

Edge of infarction

A

Penumbra

118
Q

What is Cerebral Amyloid Angiopathy? What causes it?

A

1) Weakening of of vessel walls creating an increased risk for hemorrhage
2) Caused by a deposition of Abeta protein (found in Alzheimer)

119
Q

Causes of intracerebral hemorrhage

A

1) Hypertension –> Charcot-Bouchard microaneurysm

2) Cerebral Amyloid Angiopathy

120
Q

Focal neurologic deficit due to a temporary reduction in blood flow to a part of the brain that lasts less than 24 hours

A

Transient Ischemic Attack

121
Q

What are the three types of pathological tremors?

A

1) Resting tremors
2) Postural tremors
3) Intentional Tremors

122
Q

Tremor associated with rigidity and slowness

A

Resting tremor

123
Q

Tremor with normal neuro exam; treated with beta blockers and benzodiazopine

A

Postural tremor

124
Q

Tremor with signs of cerebellar dysfunction

A

Intentional tremor

125
Q

How can you tell the difference between Parkinson and Progressive supranuclear palsy?

A

1) Progressive supranuclear palsy has rigidity on extension

2) SPS also has speech and swallowing distrubances and difficulty with eye movements

126
Q

Random, irresistible, asynchronous movements

A

Tics

127
Q

Tics with corprolallia

A

Tourettes syndrome

128
Q
  • Absent DTRs
  • Impaired joint position and vibratory sense
  • Ataxia
A

Friederich ataxia

129
Q

Dementia, gait disturbance, and urinary incontinence

A

Normal Pressure Hydrocephalus

130
Q

What protein is low in Friedreich ataxia?

A

Friedreich is Fratastic

1) Frataxin
2) Primary symptoms are staggering and falling

131
Q

What are the symptoms of normal pressure hydrocephalus

A

Think: wild, wobbly and wet

1) Dementia
2) Gait disturbances
3) Urinary incontinence

132
Q

Disturbances of muscle tone

A

Dystonia

133
Q

What is the most common cause of dystonia?

A

1) Idiopathic

2) Iatrogenic (dopaminergic treatment)

134
Q

Constant headache with visual disturbances; found in obese females; elevated opening LP; normal CT; papilledema present

A

Idiopathic intracranial hypertension (pseudotumor cerebri)

135
Q

Gait instability, dysphagia and swallowing disturbances, difficulty with eye movements (espc. vertical); rigidity with extension

A

Progressive Supranuclear Palsy (PSP)

136
Q

Loss of pain and temperature sensation in the right leg; loss of vibratory sense and sensation on the left; hyper activity DTRs on the left

A

Brown sequard syndrome on the left

137
Q

What does Horner’s syndrome consist of? What is the cause?

A

1) Ptosis (drooping eyelid), miosis (pupil constriction, anhidrosis (absence of sweating)
2) Lesion in spinal cord above T1

138
Q

What is the most common cause of a thoracic radiculopathy

A

Infarction, atherocsclerosis, or vasculitis of the nerve root

139
Q

Numbness of ipsilateral face, contralateral in body; Horner syndrome on ipsilateral side, ataxia ipsilateral side

A

Wallenberg’s syndrome

140
Q

What is the cause of Wallenberg syndrome?

A

Caused by rupture of the posterior inferior cerebral artery

141
Q

What is the results of a Thalamic syndrome?

A

Contralateral numbness and pain sensation with no motor deficits

142
Q

What nerve acts as the efferent pathway for the pupillary reflex?

A

CN III

143
Q

What is the pathway for the pupillary reflex?

A

1) Receptor (retina)
2) Afferent = CN II
3) Synapes = Edinger-Westphal in midbrain
4) Efferent = CN III
5) Pupil constrictor muscle

144
Q

Pt. has abnormal horizontal gaze. Eyes deviate to the right. Where is the lesion?

A

1) Right FEF

2) Pons on the Left

145
Q

Pt. has abnormal horizontal gaze. Eyes move right normally, however the right eye does not move left. Where is the lesion?

A

1) Right MLF (Right INO)

146
Q

How do you differentiate between a simple and a complex partial seizure?

A

1) Simple partial maintains consciousness, complex partial does not

147
Q

Pt. seems to disengage from current activity and “stare into space” then returns to activity feeling absent minded; often confused with day dreaming. What is this seizure type?

A

Absence seizure

148
Q

What are the different types of primary generalized epilepsy?

A

1) Absence
2) Myoclonic
3) Clonic
4) Tonic
5) Tonic-clonic
6) Atonic

149
Q

Musculature jerking of the limbs and body for at least 30 seconds; incontinence, eyes roll, involuntary contraction/relaxation

A

Clonic seizure

150
Q

Pt. becomes rigid with loss of consciousness, vocalizations; skeletal muscles tense

A

Tonic seizure

151
Q

Impairment of consciousness with seizure; epileptic discharge is from the temporal lobe

A

Complex partial (focal) epilepsy

152
Q

Prolonged, sustained, unconsciousness with persistent convulsive activity in a seizing pt.

A

Status epilepticus

153
Q

Acute episode of delirium associated with severe form of alcohol withdrawal?

A

Delirium tremens (DT)

154
Q

Stroke syndrome that results in stupor with hemiplegia and sensory loss contralaterally, and monocular blindness ipsilaterally

A

Occlusions of the internal carotid

155
Q

Stroke syndrome that results in paralysis of contralateral LE, lesser degree of paralysis to contralateral UE; urinary incontinence

A

Occlusions of the anterior cerebral artery

156
Q

Stroke syndrome that results in paralysis of contralateral face and body; motor and conduction aphasia; paralysis of conjugate gaze to ipsilateral side

A

Occlusions of the middle cerebral artery

157
Q

Stroke syndrome that results in loss of vision; thalamic syndrome

A

Occlusions of the posterior cerebral artery

158
Q

Stroke syndrome that results in vertigo and CN dysfunction

A

Occlusions of the vertebro-basilar arterial system

159
Q

What is the definition of Orthostatic Hypotension?

A

1) Drop in systolic bp >20 OR drop in Diastolic >10 within 3 min of standing

160
Q

Most common cause of meningitis in the 6-60 age group?

A

Streptococcus pneumonia!

161
Q

What tests can be done to determine if there is a neural tube defect during pregnancy?

A

1) Amniotic fluid and maternal serum for alpha fetoprotein (elevated)
2) Look for elevated acetycholine essterase in amniotic fluid

162
Q

What neurotransmitters are low in Huntington’s disease?

A

Think: CAG (Caudate loses ACh and GABA)

1. Degeneration of GABAnergic nuerons in the caudate nucleus

163
Q

Sudden wild flailing of 1 arm

A

1) Hemiballismus

2) Lacunar stroke of the subthalamic nucleus on contralateral side

164
Q

Name what occurs if a lesion were in the following areas:

1) Amygdala
2) Frontal lobe
3) Right Parietal lobe
4) Reticular activating system
5) Mammillary bodies
6) Basal ganglia
7) Cerebellar vermis
8) Cerebellar hemisphere
9) Hippocampus
10) Paramedian pontine reticular formation
11) Frontal eye field

A

1) Kluver Bucy syndrome (hypersexuality, disinhibited behavior, hyperorality)
2) Behavioral changes and loss of judgment
3) Spatial neglect syndrome
4) Coma
5) Wernicke-Korsakoff syndrome
6) Ataxia
7) Truncal ataxia, dysarthria
8) Intention tremor, limb ataxia on ipsilateral side
9) Memory loss (anterograde)
10) Eyes deviated away from lesion
11) Eyes deviated toward lesion

165
Q

Contralateral hemiparesis
Decreased contralateral proprioception
Ipsilateral hypoglossal dysfunction (tongue deviates ipsilateral)

A

1) medial medullary syndrome

2) Caused by occlusion of the anterior superior artery

166
Q

Vomiting, vertigo, nystagmus
Dysphagia, hoarseness
Ipsilateral Horner’s sydnrome
Ataxia

A

Think: don’t PICA Hoarse that can’t eat (dysphagia)

1) Lateral medullary (Wallenberg’s) syndrome
2) Occlusion of the Posterior inferior cerebral artery

167
Q 
Vomiting, vertgio, nystagmus
Paralysis of the entire face
Decreased lacrimation
Decreased taste on anterior 2/3 of tongue
Decreased corneal reflex
Ipsilateral horner's
A

1) Lateral pontine syndrome

2) Occlusion of the AICA (anterior inferior cerberal artery

168
Q

Pt. comes in with extremely bad headace. Spinal tap is blood and xanthochromic. What should you think?

A

Suarachnoid hematoma

169
Q

How do you differentiate cerebral amyloid angiopathy from Charcot-Bouchard pseudoaneurysm?

A

1) CAA causes lobar parenchymal hemorrhage

2) Charcot bouchard is more common in the basal ganglia and internal capsule

170
Q

What causes the neurological symptoms of Normal Pressure Hydrocephalus?

A

1) Stretching of the corona radiata

171
Q

Treatment for trigeminal nueralgia?

A

Carbamazepine

172
Q

Neuron with shrunken nuclei, no detectable Nissl substance, and intensely eosinophilic cytoplasm; What happened?

A

1) Red neuron

2) Ischemia

173
Q

Gram positive rod with tumbling motility that can causes meningitis

A

Listeria monocytogenes

174
Q

What does Vitamin E deficiency cause?

A

Degeneration of spinocrebellar tracts, dorsal column and peripheral nerves

175
Q

First area of damage during global cerebral ischemia

A

Hippocampus

176
Q

Cause of hemiballism

A

Damage to the subthalamic nucleus

177
Q

Where is the defect for impaired ability to oxidize very long chain fatty acids occur?

A

Peroxisome

178
Q

Complete destruction of the facial nucleus itself; Ipsilateral facial paralysis of entire face

A

Bell’s palsy

179
Q

Demyelination of CNS due to destruction of oligodendrocytes. What is the cause?

A

1) Progressive multifocal leukoencephalopathy (PML)
2) JC virus infection
3) Fatal

180
Q

Horner-Wright Rosettes; poorly differentiated tumor in the posterior fossa; highly mitotic

A

Medulloblastoma

181
Q

Pseudorossetes with GFAP positive

A

Ependymoma

182
Q

What is pathognuemonic for a neuroblastoma? Where are these tumors located?

A

1) Neuropil; small blue cells; elevated HVA and/or VMA

2) Adrenal gland

183
Q

Paralysis of upward gaze

A

Parinaud syndrome (dorsal midbrain syndrome)

184
Q

What test would a patient with frontotemporal dementia have difficulty performing?

A

1) Pt. naming more than 12 animals in one minute

185
Q

What disease has an increased startle response and startle myoclonus; patients have rapidly progressive dementia

A

Creutzfeldt-Jakob disease

186
Q

What tests differentiate Alzheimer’s from frontotemporal dementia?

A

1) Alzheimer’s generally has short term memory loss and frontotemporal does not
2) Frontotemporal has personality changes

187
Q

Neurologic scale that provides an objective assesment for the conscious state of a patient with head injury

A

Glascow coma scale

188
Q

What are the three aspects of the Glascow coma scale?

A

1) Eye response (4 grades)
2) Verbal response (5 grades)
3) Motor response (6 grades)

189
Q

What is the graded eye response in glascow scale?

A

1) no eye movement
2) eye movement to pain
3) eye movement to verbal response
4) spontaneous

190
Q

What is the graded verbal response in glascow scale?

A

1) no response
2) Incomprehensible
3) Inappropriate
4) Confused
5) Orientated

191
Q

What is the motor response in glascow scale?

A

1) no response
2) Extension to pain
3) Flexion to pain
4) Flexion and withdrawal
5) Localize pain
6) Obeys command

Nervous System (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions