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Boards DIT > DIT Neuro 2 > Flashcards

DIT Neuro 2 Flashcards

1
Q

Lower motor neuron lesion symptom vs upper?

A

Lower: flaccid paralysis, atrophy and fasciculations (b/c anticipate signal) (hyporeflexive b/c no ark)

Upper lesions: spastic paralysis and hyperreflexive

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2
Q

How does signal get to the deep cerebellar nuclei?

A

inputs from Mossy and Climbing fibers

to other stuff

To PURKINJE (know those three cells)

To deep nuclei of cerebellum

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3
Q

Where is the major output pathway of cerebellum going?

A

Ventral Lateral nucleus of thalamus (via superior cerebellar peduncle)

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4
Q

What side of body is affected by left side of cerebellum?

A

Left side (ipsilateral)

path is to right thalamus, cortex, corticospinal tract which decussates to the left body again

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5
Q

What does Romberg test?

A

Proprioception (Tabes dorsalis)

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6
Q

What are the three input to cerebellum? What nuclei do they go through?

A

Nuclei: D E G F (F is in middle)

Vestibulocerebellum is F (middle)
Spinocerebellum is EG and F
Cerebroccerebellum is D

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7
Q

Vermis and peravermis issue causes what?

A

Postural instability (core of body affected), slurred and slow speech

Spinocerebellum

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8
Q

3 kinds of tremors? Cause for each?

A

Essential (fam history and always tremor)

Resting: parkinsons and gone with movement

Intention: cerebellar damage with involuntary movement (cerbrocerebellum issue (lateral hemisphere)

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9
Q

Lesion of substantia pars compact?

Lesion of subthalamic nucleus?

A

Parkinsons

Hemibalismus

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10
Q

Mnemnoic for parkinson drugs?

A

BALSA

Bromocriptine (ergot, vasoconstrict) pramiproxal and ropinerol

Amantadine more dopa release
Levadopa/carbidopa

Selegiline: stopes monoamine oxidase (pref dopamine)

Antimuscarinic (Benztropine Park my Benz)

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11
Q

Huntington mnemonic? 2 of them

A

CAG. Caudate loses ACh and GABA

C’s

CAG repeat
Chromsome Cuatro
Chorea
Cognitive decline
Caudate
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12
Q

Huntington Tx? 2 types of drugs

A

tetrabenazine and reserpine (inhibit monoamine transport)

Haloperidol and clozapine

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13
Q

What causes:

Hemiballismus?

Chorea

Athetosis?

A

Hemiballismus: one half body jerks out: contralateral subthal nucleus (lacunar stroke, its a contralateral lesion)

Chorea: huntington

Athetosis: slow writhing movements in hands and fingers: Huntington again

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14
Q

What does polio hit? What is werdnig hoffmann disease?

A

LMN b/c destroy anterior horns

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15
Q

What does MS affect in spinal cord?

A

Random demyelination.

Scanning speech, inanition tremor, internuclear opthalgia (MLF lesion: adduction paralysis ipsilateral and abduction nystagmus)

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16
Q

What does amyotrophic lateral sclerosis affect on spinal cord?

Cause?

Tx?

A

ALS is upper and motor neuron lesion.

IN TACT sensory and not dumb

Lateral spinal tract
Anterior horn

So lots of symptoms: eventually can’t breath.

Caused by superoxide Dismutase 1 defect.

Tx is riLOUzole for Lou Gerig (not curative, but dampens affect)

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17
Q

Describe Friedrich ataxia?

A

trinucleotide repeat

Freidriech is Fratastic (fratazxin): FRAT bro always STAGGERINg, FALLINg, but has BIG HEART

Sensory loss b/c iron binding issues in mitochondria. Presents in kids. Chromosome 9

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18
Q

Mnemonic for Ataxia telangiectasia?

A 
A disease
ATM gene (double strand break repair)

Ataxia, Angiomas, igA deficiency Afp is high

Ataxia from cerebellar defect

19
Q

Erb duchenne palsy?

A

Erber (upper trunk: C5-6) from babies being born who are too big and stretches roots.

Waiter tip.

suprascapular, musculocutaneous, axillary

Will get function back if just distocia.

20
Q

Klumpke palsy?

A

KLumpke cause KLaw hand

21
Q

Look at more brachial plexus

A

ok

22
Q

How do you injure femoral nerve? What is consequence?

A

Pelvic fracture (L2-4)

Loww of hip flexion and extension (loss of sensation to anterior thigh and medial leg)

23
Q

How do you injure obturator? What is consequence?

A

Anteriorhip displasion, loss of

Medial thigh sensation
loss of adduction

24
Q

How do you injure superior gluteal nerve?

Consequence?

A

Posterior dislocation
Hip abduction and medial rotation of thigh

Polio can do it
Tradelenberg gate (Teri Ache) and hip drop when standing on injured leg (THE NONINJURED SIDE DROPS b/c gluts can't keep body level)
25
Q

How do you hurt inferior gluteal nerve?

What do you see?

A

Gluteus maximus is out, so can’t stand up or extend hip

26
Q

Sciatic is lost? what happens?

How does it happen?

A

Intervertebral disc herniation, spinal stenosis, spondylolisthesis

Hammis out

Sensation to posterior thigh and lower leg

27
Q

How do you diagnose which nerves are out for branches of sciatic?

A

PED: Perioneal Everts and Dorsiflexes, if injured, foot is dropPED (deep perioneal)

TIP: Tibial Inverts and Plantarflexes; if injured: can’t stand on TIPtoes

28
Q

Type 1 muscle vs type 2? mnemonic

A

Type 1: 1 slow red ox
slow twitch are red and lots of mitochondria so great at ox phosph

Type2 is fast twitch, white muscle building muscle

29
Q

Bilateral facial paralysis: consider what?

CSF findings with one of the diseases? (nothing was mentioned for the other disease)

A

Guillain barre: Elevated CSF protein with normal cell count

Lyme disease

30
Q

What is progressive multifocal leukoenephalopathy presentation?

any associations?

A

Demylenation b/c oligodendrocyte destruction

JC virus association (AIDs) and usually rapidly progressive and fatal

31
Q

What is metachromatic leukodystrophy?

Findings?

A

Autosomal rec lysosomal storage from arylsulfatase A def.

Sulfatides build up and impair myelin sheath production.

Central and peripheral demyelination with ataxia/dementia

32
Q

What is charcot marie tooth disease?

Findings?

A

hereditary motor and sensory neuropathy b/c defective protein production or sheath production.

Autosomal dominant

Various parts of body affected but LOOK FOR HIGH or FLAT foot arches

33
Q

If you have a pic on the test of a retina with an optic disk having a big ring in it, what is it showing?

A

Optic cup >50% of optic disk diameter is glaucoma

34
Q

What are the two kinds of macular degeneration? What happens?

How do you treat it?

A

Loss of macula vision (central fields)

Dry: STOP FUCKING SMOKING deposition of drusen in eye. Multivitamin and antioxidants slow progression

Wet: rapid loses from vascularization and treat with antiVEGF

35
Q

Glaucoma tx? 5 classes

A

Increase outflow:
Alpha agonists
Prostaglindins
Cholinergic agonists

Reduce production:
beta blockers
acetazolamide

36
Q

What is a risk of chronic middle ear infection? How do you treat what we are worried about?

A

Cholestatoma. Overgrowth of keratin debris that erodes ossicles and mastoid air cells.

Gray white pearly lesion behind TM and remove it!!!

37
Q

WHAT IS MENIERE DISEASE? (ACCIDENTAL CAPS LOCK, SORY)

A

ENDOLYMPHATIC HYDROPS. IMBALANCE OF FLUID AND ELECTROLYTE COMP IN ENDOLYMPH CAUSE TRIAD OF:

INTERMITTENT VERTIGO
HEARING LOSS
TINITIS

38
Q

What are findings of alzheimer intracellularilyh and extracellularily?

A

intracellular tau proteins

Extracellular beta amyloid

Neurofibrillary tangles have intracellular tau

Depletion of acetylcholine

39
Q

Why are down syndrome higher risk for dimensia?

A

Extra chromosome 21

Code for amyloid precursor protein

40
Q

Alzheimer tx?

A

Cholinest inhib: Donepezil, galantamine, rivastigmine

Memantine: NMDA (NMDgay) receptor antag (glutamate receptor which would otherwise be overstim)

41
Q

What is dementia with Lewy bodies?

A

VISUAL hallucinations, parkinsonian features, repeated syncope

Lew bodies are in the cortex instead of substantial nigra

42
Q

What do you see with pick disease?

A

Pick bodies are spherical tau protein aggregates. They may PICK ON YOU b/c personality change

Frontotemporal atrophy

dimentia, aphasia, parkinsoinan aspects with change in personality. THEY GET CRABBY.

Pariatal lobe is spared and superior 2/3 of temporal features.

43
Q

Rapid on course of dementia with change in personality?

A

Creutzfeldt jakob. May have startle clonus

Prion disease (beta pleated sheets)

Brain starts to make vacuoles (spongioform encephalopathy)

44
Q

Intracellular spherical aggregates of tau on silver stain?

A

Silver means Pick.

Boards DIT (43 decks)

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