Gustafson Flashcards
GPCR
- use 2nd messengers
- in the CNS they are from RHODOPSIN family
GABAa
-IONOTROPIC -> FAST transmission
GABAb
-METABOTROPIC -> SLOW transmission
stroke
- CLINICAL event
- SUDDEN onset of neuro deficits
- TIA not a stroke
- don’t need complete loss of blood flow to get infarction
penumbra
- blood flow 10-17 ml/min -> reversible damage w/ recirculation
- blood flow <7.7-14 -> irreversible damage
most sensitive neurons to ischemia
- pyramidal cell layer of hippocampus
- cerebellar Purkinje cells
- pyramidal neurons in cerebral cortex (neocortex)
focal ischemia due to hypo perfusion
- causes watershed infarcts
- border b/w ACA and MCA highest risk***
most common cause of embolic thrombi
- CARDIOGENIC: A-fib***, calcified heart valves, mural thrombus after MI, paradoxical emboli due to ASD, coronary artery bypass
- need to anticoagulate
epidural hematoma
- cause: traumatic skull fracture -> middle meningeal arteries
- younger ptx
- NOT cross suture lines
subdural hematoma
- cause: blunt trauma -> bridging veins
- elderly
- CAN cross suture lines
subarachnoid hemorrhage
-cause: trauma or rupture of aneurysm (saccular/berry)
basal ganglia hemorrhage
-cause: HTN -> rupture of Charcot-Bouchard aneurysms (lenticulostriate arteries)
lobar hemorrhage
-cause: OLD AGE or cerebral amyloid angiopathy (CAA)
main symptoms of meningitis
- HEADACHE
- NUCHAL RIGIDITY
- FEVER
- +Brudzinskis and +Kernigs
SUPPURATIVE meningitis
- ACUTE inflammation -> granulocytes
- hyperacute, rapid worsening, SEPSIS
- DEADLY and FAST progression
ASEPTIC meningitis
- CHRONIC inflammation -> lymphocytes
- rapid onset but slower than suppurative
is a CT or MRI better at looking for meningitis?
T2 MRI -> leptomeningeal enhancement
-T2 MRI also better for encephalitis
CSF meningitis
- pleocytosis (> 5 WBCs per hpf***) 4=normal
- ELEVATED OP (>250mmH2O)
- NO RBCs
CSF encephalitis
- pleocytosis
- NORMAL OP (<240mmH2O)
- ELEVATED RBCs
main symptoms of encephalitis
- DELIRIUM
- SEIZURES
- FEVER
which lobe is affected when HSV causes encephalitis
-temporal lobe
cerebral abscess
- clinical: mass effect, FOCAL deficit, fever, SEIZURES
- SLOW onset
- surrounding capsule w/ edema
- image w/ T1 MRI
subdural empyema
- PUS under the dura -> deadly
- emergency surgery
edema surrounding cerebral abscess
-TREATABLE
edema from ischemia
-cytotoxic (NON-TREATABLE)
Multiple Sclerosis (MS)
- MULTIPLE lesions and >1 episode
- REPEATED ATTACKS
- lose myelin but PRESERVE axons
- damage OPTIC nerves
- lymphocytes attack myelin basic protein and myelin associated glycotprotein -> PERIVENOUS inflammation
- CSF: high IgG, OLIGOCLONAL BANDS
- image: PERIVENTRICULAR PLAQUES
Neuromyelitis Optica (NMO)
- longer lesions than MS
- Anti-Aquaporin 4 Ab***
- NECROSIS
- affect eyes (optic neuritis) and spinal cord
- Tx: Rituximab
Acute Disseminated Encephalomyelitis (ADEM)
- MONOPHASIC (single attack)
- NO relapsing or progressive course
- affects brain and spinal cord
- Tx: steroids
Acute Transverse Myelitis (ATM)
- MONOPHASIC (single attack)
- NO relapsing or progressive course
- affects spinal cord only
- Tx: steroids…more likely for chronic deficit
Parkinson’s disease
- loss of SN dopaminergic neurons
- histo: alpha-synuclein Lewy bodies
- idiopathic -> ABNORMAL dopamine SPECT
- iatrogenic -> NORMAL dopamine SPECT
Huntington’s Chorea
- autosomal DOMINANT
- CAG repeats
- atrophy of Caudate nucleus and Putamen
Friedrich Ataxia
- aut. recessive
- ataxia, spastic, weak, sensory neuropathy, Cardiomyopathy
Ataxia-Telangiectasia
- aut. recessive
- ataxia-dyskinetic syndrome + telangiectasias + IMMUNODEFICIENCY
ALS
- UMN/LMN loss
- sporadic
- bulbar WORSE prognosis than manual
- RESPIRATORY FAILURE
Progressive Muscular Atrophy
- subtype of ALS
- lose LMN
Primary Lateral Sclerosis
- subtype of ALS
- lose UMN
Spinal Muscular Atrophy (SMA)
-lose LMN in spinal cord
SMA type 1
Werdnig-Hoffman - fatal in neonate
- “floppy baby”
- tongue fasciculations
SMA type 3
Kugelber-Welander - child/adolescent
SMA type 4
adult
what shows a seizure on a EEG?
SUDDEN change
-inter-ictal spike
epilepsy
syndrome of REPEATED seizures
can normal brains have seizures?
YES
-most common cause are single, unprovoked seizures
what can a diseased brain cause
-BOTH seizures and cognitive impairment
what creates the electrical amplitude recorded on EEG?
MANY neurons firing SYNCHRONOUSLY together
symptoms of seizures
- clonus -> fast contraction, slow relaxation (oscillating)
- myoclonus -> irregular, sudden jerks (no rhythm)
- tonic -> sustained contraction
simple partial seizures
-RETAIN consciousness
complex partial seizures
-LOSE consciousness
secondary generalized focal seizures
-more common than primary generalized seizures
