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General Neuro Questions Flashcards

1
Q

criteria when comparing different states of consciousness

A

awareness, wakefulness, brainstem/respirations, motor

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2
Q

5 neurological levels assessed in comatose patients

A

LOC, respiration, pupils, oculomotor/vestibular, and motor

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3
Q

cheyne-stokes happens when what level of CNS is affected

A

lower diencephalon/ upper mesencephalon

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4
Q

central neurogenic hyperventilation happens when what level of CNS is affected

A

midbrain

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5
Q

Apneustic breathing (ie long arrest after inhalation) occurs when what level of the CNS is affected

A

pon

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6
Q

Ataxic breathing occurs when what level of the CNS is affected

A

pons/medulla

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7
Q

Apnea occurs when what level of the CNS is affected

A

medulla

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8
Q

decorticate posturing occurs when what level of the CNS is affected

A

upper midbrain

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9
Q

decerebate occurs when what level of the CNS is affected

A

upper pontine

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10
Q

are arms extended in decorticate or decerebrate posturing

A

decerebrate

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11
Q

4 criteria for brain death

A

deep coma, lack of response to stimulus, lack of pupillary response, ventilator dependence

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12
Q

level I brain death

A

lack of awareness, no voluntary behavioral response, no language

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13
Q

level 2 brain death

A

present sleep wake cycles, preserved autonomic/hypothalamic fxn, preserved CN reflexes

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14
Q

wakefulness

definition and part of CNS that is responsible

A

arousal and ability and readiness to respond to environment and stimuli
provided by reticular brainstem and its thalamic and forebrain projections

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15
Q

awareness definition and part of CNS that is responsible

A

understanding of relationship to self and environment provided by thalamocortical and corticocortical circuits

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16
Q

how does locked in syndrome happen?

A

large infarction/ hemorrhage in pontine tegmentum and base

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17
Q

what is used to treat minimally conscious state?

A

rehab, levodopa, SSRIs, stimulants, DBS

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18
Q

is wakefulness a prerequisite for awareness or is awareness a prerequisite for wakefulness

A

wakefulness is a prereq for awareness

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19
Q

which areas of the brain are most sensitive to anoxia

A

hippocampus, 3rd lamina in cortex, and purkinje cells of cerebellum

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20
Q

which area of the brain is sensitive to methyl alcohol

A

putamen

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21
Q

which area of the brain is sensitive to mercury poisoning

A

cerebellum

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22
Q

which area of the brain is sensitive to B1/ thiamine

A

Wernicke’s and mammillary bodies

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23
Q

which area of the brain is sensitive to B12 deficiency

A

white matter in lateral and dorsal columns

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24
Q

which area of the brain is sensitive to Wilson’s disease/ copper accumulation

A

striatum

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25
Q

Bunina bodies are associated w/ which disease

A

ALS

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26
Q

Wallerian degeneration

A

degeneration of axon distal to injury. At area of transection neuron tries to regenerate and sends out multiple endings. Myelin sheath will start to fragment as secondry effect

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27
Q

What is dying back of a neuron

A

degeneration of distal segments of axon due to inability of cell body to maintain adequate axoplasmic flow or provide nutrition

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28
Q

What are axonal spheroids

A

swellings of axons usually from sublethal injury

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29
Q

what happens to Nissl substance when motor neurons get sick

A

it disappears or move to the side

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30
Q

Alzheimer’s type II glia occurs how?

A

elevated ammonia or serum electrolyte abnormalities

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31
Q

what is dysarthria

A

trouble speaking

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32
Q

Brown sequard

A

hemitransection: hemiplegia and loss of DC-ML modalities on ipsilateral side of injury , loss of ALS modalities on contralteral side

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33
Q

Which dermatome is dorsal to great toe

A

L5

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34
Q

Which dermatome is at lateral heel

A

s1

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35
Q

Which dermatome is below medial knee

A

L4

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36
Q

Which dermatome is near thumb

A

c6

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37
Q

Which dermatome is near middle finger

A

c7

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38
Q

Which dermatome is by pinky

A

c8

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39
Q

what is scale used for muscle strength

A

0-5

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40
Q

how is Babinksi reported

A

absent or present

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41
Q

what is paratonia

A

involuntary variable resistance during passive movement

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42
Q

flaccidity is a sign up upper or lower motor neuron disease

A

lower

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43
Q

a waddling gait is a sign of what

A

gluteal weakness

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44
Q

what does a hemiplegic gait look like

A

circumducting

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45
Q

what is romberg sign

A

tests balance/proprioception. Has person try to stand still with eyes closed

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46
Q

sympathetics come from which spinal levels

A

T1- L2

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47
Q

does nerve damage cause proximal or distal weakness

A

distal

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48
Q

does myopathic process cause proximal or distal weakness

A

proximal

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49
Q

What is horner’s syndrom

A

lesions in sympathetic

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50
Q

radial nerve injury causes what kind of weakness

A

weakness of wrist extension

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51
Q

how is mononeuropahty multiplex treated

A

steroids and IVIG

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52
Q

most common cause of polyneuropathy

A

diabetes

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53
Q

what are fibrillations

A

spontaneous depolarizations which are marker of active denervation

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54
Q

Riluzole is used to treat what disease

A

ALS

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55
Q

does Charcot Marie Tooth/ hereditary motor sensory neuropathy affect the proximal or distal muscles more?

A

distal

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56
Q

charcot marie tooth/ hereditary motor sensory neuropathy is what kind of neuromuscular diseae

A

hereditary neuropathy

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57
Q

pathology of CMT/ HMSN

A

demyelination or axonal damage

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58
Q

myotonic dystrophy pathology/ inheritance

A

trinucleotide repeats / AD/ Anticipation

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59
Q

type I myotonic dystrophy affects more proximal or distal muscles

A

distal

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60
Q

type II myotonic dystrophy affects more proximal or distal muscles

A

proximal

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61
Q

which muscles are most affected by mitochondiral disease

A

EOM

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62
Q

polymyositis treatment

A

prednisone, IVIG

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63
Q

Polymotositis presentation

A

insidious onset of proximal muscle weakness w muscle sorness

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64
Q

polymyositis etiology

A

autoimmune

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65
Q

dermatomyositis presentation

A

insidious onset of proximal muscle weakness, red/purple rash over eye lids and extensor part of joints

66
Q

polymyositis typical onset

67
Q

dermatomyositis typical onset

A

5-15 and 50-60

68
Q

dermatomyositis can be an indicator of

A

malignancy

69
Q

Lambert Eaton pathology

A

Abs directed against voltage gated calcium channels leads to reduced NT relase

70
Q

does weakness w/ Lambert Eaton get worse or better w/ exercise

71
Q

biceps reflex involves which nerve root and nerve

A

c6 musculocutaneous

72
Q

brachioradialis reflex involves which nerve root

73
Q

triceps reflex involves which nerve root and nerve

74
Q

finger flexor reflex involves which nerve root and nerve

75
Q

patellar reflex involves which nerve root and nerve

A

L4 femoral

76
Q

ankle reflex involves which nerve root and nerve

A

s1 sciatic

77
Q

categories in Glasgow Coma scale

A

eye response, verbal response, best motor response

78
Q

Time course in DAI

A
  • 4-5 hours: accumulation of beta APP
  • 12-24 hours: axonal varicosities
  • 24hr - 2 months: axonal swelling and microglial nodules
  • long term: wallerian degernation, atrophy
79
Q

most DAI occurs where

A

mesencephalon and high pons

80
Q

acceleration force from blow causes coup or contrecoup injury?

81
Q

acceleration force from fall causes coup or contrecoup injury?

A

countrecoup

82
Q

medication overuse headaches usually present where?

83
Q

which kind of hemorrhage can present w/ chemical meningitis and stiff neck?

A

subarachnoid

84
Q

what do you see on LP of subarachnoid hemorrhage?

A

rbcs and xanthochromia

85
Q

2 things that can cause thunderclap headache

A

SAH and cerebral venous sinus thrombosis

86
Q

what is distinct diagnostic marker of arterial dissection

A

horner’s

87
Q

giant cell arteritis treated with what

88
Q

classic patient w/ idiopathic/benign intracranial HTN

A

young obese women w/ polycystic ovary disease

89
Q

mneumonic for red flags for headaches

A 
S: systemic symptoms
N: neurologic symptoms
O: onset
O: older new onset/ rogressive
P: previous HA history if HA is first, different, or changing
90
Q

what is meniere’s disease caused by

A

increased pressure in endolymph of inner ear causes small ruptures in membranes and leads to mixing of endo and perilymph

91
Q

myelin has more or less lipid and proteins than regular plasma membrane

A

lipid: more
protein: less

92
Q

areas most commonly affected in MS

A

lateral ventricles, optic nerves, optic chiasm, along floor of 4th ventricle and adjacent to pial surface of spinal cord

93
Q

which type of MS has conentric lesions on MRI

94
Q

adrenoleukodystrophy inheritance

95
Q

ADL pathology

A

defect in peroxisomes so very long chain fatty acids accumulate

96
Q

Globoid cell leukodystrophy/ Krabbe’s disease pathology

A

deficiency of galactocerebroside B galactosidase

97
Q

Globoid cell leukodystrophy/ Krabbe’s disease inheritance

98
Q

Metachromatic Leukodystrophy inheritance

99
Q

metachromatic leukodystrophy pathology

A

low/ absent levels of arylsulfatase leads to accumulation of galactolipids/ sulfatides

100
Q

which gene is involved in Pelizaeus-merzbacher disease

101
Q

are Th1 or Th2 anti-inflammatory/ protective

102
Q

In TNF or TGF anti-inflammatory/ protective

103
Q

What Risk category is CIS

104
Q

what % of people w/ CIS progress?

105
Q

where do most lesions in MS appear

A

periventricular: dawson’s
juxtcortical
infratentorial
spinal cord

106
Q

in MS T1 is used to look for

A

black holes/ atrophy

107
Q

in MS T2/ Flair is used to look for

A

disease burden

108
Q

in MS T1+ gad is used to look for

A

disruption of BBB

109
Q

how does Glatiramer acetate work?

A

altered peptide ligand for MHC that acts as decoy for overactive immune cells

110
Q

what is Ab used to treat MS and why is it second line

A

Natalizumab, PML

111
Q

how do oligodendrogliomas often present

112
Q

seizures in posterior pituitary cause what

A

diabetes insipidus

113
Q

which tumor causes gigantism/ acromegaly

A

eosinophilic adenoma

114
Q

which tumor causes cushing’s hyperadrenalism

A

basophilic adenoma

115
Q

ependymoma usually affect which age gruop

116
Q

parietal lobe = what kind of visual field deficit

A

inferior quadrantanopia from damage of optic raiations

117
Q

temporal lobe damage = what kind of visual field deficit

A

superior quadrantanopia from damage to meyer’s loops

118
Q

what do astrocytoma cells look like histolgoically

A

naked nuclei, pilocytic, GFAP +

119
Q

rosenthal material is characteristic of what kind of tumor

A

low grade astrocytic process

120
Q

What is characteristic feature of oligodengolioma histology

A

fried egg appearance

121
Q

What is characteristic feature of ependymoma histolgy

A

nuclear free zone around capillaries

122
Q

What is characteristic feature of medulloblastoma/ primary neuroectodermal tumor?

A

cells w/ very little cytoplasm

and rosettes

123
Q

which type of rosette has a central lumen

A

Flexer-Witnersteiner

124
Q

what kind of tumor has association w/ von Hippel Lindau

A

cerebellar hemangioblastoma

125
Q

What is characteristic feature of meningioma histology

A

Psammoma bodies and whorling

126
Q

What is characteristic feature of schwanomma histology

A

stream, spindle shaped cells w/ cigar shaped nuclei

Verocay bodies

127
Q

cafe au lait spots are associated w/

A

neurofibromatosis

128
Q

hypopigmented ash leaf spots are associated w/

A

tuberous sclerosis

129
Q

port wine stains are assoicated w/

A

Sturge Weber

130
Q

what is most important part of pedi neuro exam

A

tone in motor portion

131
Q

what is tone defined as

A

resistance to passive movement

132
Q

what is moro reflex, when should it disappear

A

startle reflex, should disappear by 4 months

133
Q

what is asymmetric tonic neck reflex ATNR, when should it disappear

A

fencer’s posture appears around 6 weeks and persists until 6 months

134
Q

when should lateral prop reflex appear

135
Q

when should forward parachute appear

A

10-11 months

136
Q

which epilepsy type is associated w/ SUDEP and SCN1A mutation

137
Q

spinal muscular atrophy inheritance

138
Q

What is a new, novel treatment for muscular dystrophy and how does it work

A

Eteplirsen = stop codon skipper

139
Q

FT Dementia ia caused by an accumulation of what protein

140
Q

Pick’s disease is caused by an accumulation of what protein

141
Q

where does degenration occur in Pick’s disease

A

anterior frontal lobe and anterior superior temporal gyrus

142
Q

Parkinson’s is caused by an accumulation of which protein

143
Q

lewy bodies are associated w/ what

A

parkinsons

144
Q

Multiple System Atrophy is caused by an accumulation of hwat portein

A

synnuclien

145
Q

what is characteristic histo finding of multiple system atrophy

A

glial cytoplasmic inclusions

146
Q

progressive supranuclear palsy is associated w/ an accumulation of which protein

147
Q

multiple system atrophy is associated w/ atrophy in which section of the brain and which specific structure

A

midbrain

putamen

148
Q

what is histo finding in progressive supranuclear palsy

A

globose tangles in basal ganglia, brain stem

149
Q

corticobasal degeneration is associated w/ accumulation of which protein

150
Q

what is difference b/w corticobasal degeneration and PSP

A

PSP has less tau

151
Q

corticobasal degeneration affects which part of the brain

A

frontoparietal

152
Q

presentation of PSP

A

multisystem degeneratin characterized by parkinsonism and supranuclear opthalmoplegia

153
Q

tFDP-U is associated w/ accumulation of which protein

154
Q

ALS is associated w/ accumulation of which protein

155
Q

Huntington’s affects which area of the brain

A

caudate nucelus

156
Q

spinocerebellar ataxia inheritance

157
Q

what kind of repeat for friedreich’s ataxis

158
Q

diagnosis of Parkinsons requries which 3 features

A

tremor, rigidity, bradykinesia

159
Q

how are Parkinsons and Essential tremor different?

  • when does it occur
  • symmetry
  • waht areas does it affect
A 
parkinson= resting tremor
essential= action tremor
parkinsons= asymmetrical, unilateral at onset
essential= bilateral
parkinsons= hands/legs
essential= face, hands upper extremity more affected
160
Q

list cns cells in sensitiveity to ischemia

A 
neurons
oligos
astrocytes
endothelial
gial
161
Q

3 major sites where hypertensive hemorrhages occur

A

basal ganglia, cereballar white matter, pons

Neuro Path (2nd Year) (6 decks)

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