Extra Stephens Flashcards
Dysesthesia (a tingling sensation, like ants crawling) over one side of the body is likely due to ____ syndrome
The presentation is due to a lesion of proprioception/2pt tactile, and pain/temp on the ____lateral side of the body aka the _____ and ____ are lesioned since they run through the thalamus (VPL)
^** Note this is different from an internal capsule lesion, since in that case, you would also lose the CST aka motor loss whereas the CST does NOT run through the thalamus
Thalamic (Dejerine-Roussey syndrome)
Contralateral, SL and ML
Excess alcoholics can develop cerebellar degeneration, like we talked about, and due to the deficiency of _____, they can also develop ___ syndrome
Vitamine B1 (Thiamine), Korsakoff
For frontal lobe syndrome
Anosmia = Loss of ____ would cause a lesion to be localized to the _____
Monocular blindness = Loss of vision would cause it to localize to the ____
Paracentral lobule deficit = Cotralateral loss of motor in leg = Localized to the Telenceohalon
Smell, Telencephalon
Diencephalon
A left superior homonymous quadrantanopia means that a lesion must have occurred in the _____ lobe, more specifically, the RIGHT _____ from a tumor
Anterior Temporal lobe, Loop of meyer
Frontal lobe syndrome can often occur due to a ____ aneurysm
Also remember, the para-central lobule is supplied via the ____
ACA (Anterior communicating artery)
ACA
If a patient loses memory for only a period of time, without any problems, it is called ____
Around 3-5 hours, occurs once, characterized by amnesia aka don’t know where they are, don’t know why they are there, and then they ASK YOU AGAIN, but they know who you are***
Transient global amnesia
Consciousness is the total awareness of ___ and ____
Requires Arousal AND awareness
Self and environment (surroundings)
AD vs LBD
In AD, you get ____ short term memory loss, some word finding difficulty, not able to name objects, etc….
Forget where they put things, etc….
Not able to draw a clock on MMS, and get a bad score on mini mental status exam
As diseases progresses, since it occurs later, they may think spouse is cheating, getting money stolen from, etc….
EARLY
If a patient comes in dementia, words said wrong, focal problems like weakness on one side, homonomyous hemianopsia, facial weakness, etc…. It is most likely NOT dementia, and instead ____
If this is the case, and they continue to get dementia, what type of dementia is it? ***
Ischemic stroke
Vascular dementia
What is a classic CN abnormality you will see with a patient who has a ____ aneurysm?
LUMBAR PUNCTURE if CT scan doesn’t show the subarachnoid hemorrhage
3rd nerve palsy (ptosis, eyes down and out, mydriasis)
Cluster headaches tend to be seasonal
Need a serum ceruloplsamin level for ___ disease
Is BOTH a Brady kinetic and hyperkinetic movements
Wilsons
If a patient is rigid, slow (bradykinesia) and PRONOUNCED orthostasis and dysautonomia, they have ____
MSA (Multiple systems atrophy)
____ is characterized by exacerbations and remissions
Interferens, Acetate, Teriflunomide are ALL disease modifying agents
Corticosteroids like Solumedrol shorten the exacerbations, but are not modifying the disease
MS
Which 3 drugs can be used for primary generalized seizures, and focal or partial onset
Valporate, Lamatrogine, and Levetiracetam
Migraine, seizure with postictal state, hepatic abnormalities, hyper/hypoglycemia can ALL mimic ____
A patient with ischemic stroke will present with HYPODENSITY aka ____ if its ischemic and if its hemorrhagic it is _____ due to blood
Stroke
Dark, bright
____ (a short acting opioid full agonist) will cause pupil diameter constriction
Remember, oPioids = PinPoint Pupils
Sufentanil
Anything that ends in FANTANYL
Acetazolamide lowers intra-ocular pressure via inhibiting ____ secretion
Apraclonidine lowers intra-ocular pressure via ____
Timolol decreases the aqueous humor secretion from ciliary epithelium, lowering the intra-ocular pressure as well, via ____ adrenergic receptor ____
Aqueous humor
Alpha 2 adrenergic receptor agonists
Beta1 adrenergic receptor antagonists
Epinephrine on ____ cause mydriasis (dilation)
Epinephrine on ____ cause miosis (constriction)
****Atropine is a Muscarinic receptor M3 ___nist, that causes pupil dilation
Agonists at M3 receptors (like Ach, pilocarpine, carbachol, etc) cause pupil constriction due to their effects on the ___ muscle of the eye *****
Alpha 1
Beta 2
ANTAGONIST, radial
Sphincter
INFLOW SUPPRESSION:
Brimonidine is an ____ adrenergic ____nist that inhibits aqueous humor secretion and possibly increases uveoscleral outflow
Timolol is a ____ adrenergic _____nist that lowers intraocular pressure via attenuating aqueous humor formation
Acetazolamide is a carbonic anhydrase inhibitor that also inhibits aqueous humor secretion
Alpha 2 agonist
Beta 1 antagonist
OUTFLOW ENHANCEMENT:
Pilocarpine increases aqueous humor outflow via ____ receptor mediated contraction of the ___ muscle
^** But remember, ACh causes pupil ____, so this is a annoying side effect with this drug
Bimatroprost is a prostaglanding F2alpha drug
M3 (muscarinic ACh), ciliary
Constriction
Just to recap, B1 (antagonists), A2 (agonists), and Carbonic anhydrase inhibitors all decrease intraocular pressure via decreasing secretion
Muscarinic ACh receptor agonists decrease IP via increasing outflow
…
The hippocampus and amygdala are involved in anxiety and stress, and there seems to be a high density of _____ receptors and their neuropeptides in these locations
So if you can block these receptors, (BB2) you might be able to present anxiety
Bombesin
