HY PAQs Flashcards by Joshua Punsalan

Name the ganglion and location:

CNV

Gasserian Ganglion

Meckel’s Cave

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Name the ganglion and location:

CN VII

Geniculate Ganglion

CNVII Genu

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Name the ganglion and location:

CN VIII : Cochlear

Spinal Ganglion

Cochlea, modiolus

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Name the ganglion and location:

CN VIII, Vestibular

Scarpa’s Ganglion

IAM

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Name the phylogenic and functional counterparts of:

Flocculonodular lobe
Anterior lobe
Posterior lobe

FLOCCULONODULAR
Archicerebellum
Vestibullocerebellum

ANTERIOR
Paleocerebellum
Spinocerebellum

POSTERIOR
Neocerebellum
Cerebrocerebellum

FAV ni APS si PNC

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What is responsible for detection of:

ANGULAR acceleration?
LINEAR acceleration?

Angular: Semicircular canals

Linear: Utricle and Saccule

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What is responsible for detection of:

Horizontal head movement?
Vertical head movement?

Horizontal: Utricle

Vertical: Saccule

HUVS

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Which nucleus of CNV is responsible for proprioception?

a) Mesencephalic Nucleus
b) Spinal Nucleus
c) Main sensory nucleus

a) Mesencephalic Nucleus

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What are the three subnuclei of the spinal tract of CNV? Their functions?

ORAL
tactile, oral mucosa

INTERPOLAR
Dental pain - trigeminothalamic also

CAUDAL
pain and temp, face

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Globus pallidus lesions in encephalopathy due to? (2)

Carbon Monoxide

Hepatic Encephalopathy (MANGANESE) deposition

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Physiologic counterpart of the afterslow wave in the EEG?

Hyperpolarization

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Astrocytoma variants?

Fibrillary / Protoplasmic (MC)
Gemistocytic
Pilocytic
Mixed (astro-odg)

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Location on the fourth ventricle:

Medullo vs ependymoma

ROOF: Medulloblastoma

FLOOR: Ependymoma

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Cowdry Type A inclusions seen in?

CMV
Herpes
Measles
Polio

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N-Type and P/Q type Ca channel inhibitor?

Lamotrigine

T-TYPE
Ethosuximide, Zonisamide, Valproate

N-TYPE
Lamotrigine, Levetiracetam

P/Q TYPE
Lamotrigine

ALPHA2-DELTA1
Pregabalin, Gabapentin

HVA-OTHERS
Phenobarbital, Felbamate, Topiramate

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Utilizes SLOW inactivation NA channels

Lacosamide

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Decrease dabigatran levels (2)

Carbamazepine

Pheny/Fosphenytoin

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What are found in the stages of sleep?

N1 - Theta at least 50%
N2 - Theta, Sleep spindles, K-comp
N3 - Delta at least 20%
REM - desynchronized, low volt, high freq

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Duration of sleep cycle

Newborn
Adults

NB: 60 mins
Adult: 90-100 mins

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Longest duration among sleep stages in adults?

N2 (50-60%)

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Damage -> pathologic wakefulness, virtual absence of sleep

Awake state maintained by monoaminergic activity (locus ceruleus, tuberomamillary nucleus, and raphe nuclei) that inhibits ____

Ventrolateral Preoptic Nucleus, Hypothalamus

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What do orexin neurons do?

Prevent rapid transitions (awake -> sleep)

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What ions/ionic channels do the following receptors influence?

NMDA receptor
GABA-A receptor
GABA-B receptor

NMDA receptor - CALCIUM

GABAa - CHLORIDE

GABAb - POTASSIUM

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Binding of these two are needed for opening of the NMDA receptor

Glutamate

Glycine

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Derivation of the following NTs ``` GABA Glutamate Monoamines (NE, Ep, DA) Serotonin Acetylcholine ```

``` GABA - Glutamate (Vit B6 dependent) Glutamate - a-ketoglutarate (via Krebs) Monoamines - Tyrosine Serotonin - Tryptophan Acetylcholine - acetyl CoA + Choline ```

Proteins in CSF: Lumbar Spine Basal Cisterns Ventricles

In mg/dL: Lumbar spine: 45-50 Basal cisterns: 10-25 Ventricles: 5-15

Traumatic tap: WBC/RBC ratio

1-2 WBC / 1,000 RBCs

Detected only in CSF

Beta 2 transferrin - Tau | Most sensitive test to determine CSF leak!

Elevated 14-3-3 protein is indicative of?

Prion disease

MRS proteins indicative of A) Neuronal integrity B) Membrane turnover

A) Neuronal integrity - NAA | B) Membrane turnover - Cho

Adams: Appearance of alpha rhythm Reaching of adult frequency

Alpha: 6 years Adult frequency: 10-12 yo

Duration Spike Sharp

Spike: 20-70 ms Sharp: 70-200 ms

Primary NTs PREganglionic synapses a) Sympathetic b) Parasympathetic

Primary NTs PREganglionic synapses a) Sympathetic - ACh b) Parasympathetic - ACh

Primary NTs POSTganglionic synapses a) Sympathetic b) Parasympathetic

Primary NTs POSTganglionic synapses a) Sympathetic - NE * * Except sweat glands: ACh b) Parasympathetic - ACh

MC site of vertebral artery dissection

C1-C2 or V2-V3 segment of the VA V1 Origin - C6 V2 C6-C2 V3 Atlantic V4 Intradural

DSA phase where you can visualize the AVM nidus

Late arterial phase ** Early arterial - feeding arteries Late arterial - nidus Capillary - draining veins and sinuses

[SSP] Treatment for AVMs: a) SM I-II b) SM III c) SM IV-V

SM I-II Excision SM III Microsurgery/SRS + embo SM IV-V Conservative

Complete lissencephaly / Miller-Dieker syndrome: a) LIS1 gene b) DCX gene, double cortin protein c) A/w walker-warburg, muscle-eye-brain disease, FKMD

ANS: a) LIS1 gene * DCX gene, double cortin protein - X-linked * A/w walker-warburg, muscle-eye-brain disease, FKMD - Type II/ Cobblestone

Few or no gyri a) Schizencephaly b) Lissencephaly c) Pachygyria d) Polymicrogyria e) Heterotopias

b) Lissencephaly

Clefts bet. Ventricles and SA space lined w/ gray matter a) Schizencephaly b) Lissencephaly c) Pachygyria d) Polymicrogyria e) Heterotopias

a) Schizencephaly

Few broad, thick gyri a) Schizencephaly b) Lissencephaly c) Pachygyria d) Polymicrogyria e) Heterotopias

c) Pachygyria

Rests of neurons in WM 2/2 arrested radial migration a) Schizencephaly b) Lissencephaly c) Pachygyria d) Polymicrogyria e) Heterotopias

e) Heterotopias

Small gyri a) Schizencephaly b) Lissencephaly c) Pachygyria d) Polymicrogyria e) Heterotopias

d) Polymicrogyria

Paroxysmal NON-kinesigenic dyskinesia Genetics?

DYT 8, 20 MR1

Paroxysmal KINESIgenic dyskinesia Genetics?

DYT 10 PRRT2

Most sensitive and specific for Wegener's Granulomatosis

cANCA

ANCA-associated Vasculitis, granuloma, (+) asthma and eosinophilia

Churg-Strauss Wegener's: NO asthma and eosinophilia Microscopic polyangitis: NO granuloma, asthma, and eosinophilia

Adenopathy Optic neuritis, focal vasculitis a) M. Pneumoniae b) Listeria c) Melioidosis d) Legionella e) Bartonella f) Anthrax g) Brucellosis h) Whipple

e) Bartonella

Osteomyelitis a) M. Pneumoniae b) Listeria c) Melioidosis d) Legionella e) Bartonella f) Anthrax g) Brucellosis h) Whipple

g) Brucellosis

Oculomasticatory myorhythmia Supranuclear ophthalmoplegia Subacute dementia a) M. Pneumoniae b) Listeria c) Melioidosis d) Legionella e) Bartonella f) Anthrax g) Brucellosis h) Whipple

h) Whipple

GBS, Hurst, Reye a) M. Pneumoniae b) Listeria c) Melioidosis d) Legionella e) Bartonella f) Anthrax g) Brucellosis h) Whipple

a) M. Pneumoniae

Transverse myelitis a) M. Pneumoniae b) Listeria c) Melioidosis d) Legionella e) Bartonella f) Anthrax g) Brucellosis h) Whipple

d) Legionella

Rhombencephalitis a) M. Pneumoniae b) Listeria c) Melioidosis d) Legionella e) Bartonella f) Anthrax g) Brucellosis h) Whipple

b) Listeria

Multiple small abscesses India, SEA Diabetics a) M. Pneumoniae b) Listeria c) Melioidosis d) Legionella e) Bartonella f) Anthrax g) Brucellosis h) Whipple

c) Melioidosis

SAH a) M. Pneumoniae b) Listeria c) Melioidosis d) Legionella e) Bartonella f) Anthrax g) Brucellosis h) Whipple

f) Anthrax | * Hemorrhagic + Inflammatory CSF

Most common neurologic presentation of Sarcoidosis

Mononeuritis multiplex

Pathologic correlate of convulsions in bacterial meningitis?

Subpial encephalopathy

Pathologic correlate of headache, stiff neck, meningeal signs in bacterial meningitis?

Pia arachnoiditis

Pathologic correlate of focal seizures, focal cerebral deficits, most often after the first week in bacterial meningitis

Thrombosis of meningeal veins

LP findings in Cerebral Malaria

Increased pressure Few WBCs Normal glucose

HTLV-1 Routes of transmission Symptoms Tx

ROUTES Placenta, breast milk IV drugs, transfusions, organ transplant Sexual contact SYMPTOMS Spastic gait, early sphincter sx Later, proprioceptive loss TX Mogamulizumab (anti-CCR4 antibody)

Which parasitic infections cause seizures?

NO SEIZURES - sikat lang na walang sz: TAE (Trichinosis, Astrongyloidiasis, Echinococcus) ``` Echinococcus (hydatid) Trichinosis Astrongyloidiasis Gnathostomoiasis Balyisascariasis Toxocaria ``` (+) SEIZURES - all S and C, then PETT Strongyloidiasis Schistosomiasis Sparganosis Cysticercosis Paragonimiasis E.histolytica, N. fowleri, B. mandrallis Toxoplasmosis Tuberculoma

Genetic abnormalities and key findings of NF1 and NF2?

NF1 Chromosome 17, Neurofibromin Cafe au lait spots, lisch nodules (IRIS hamartomas) Optic gliomas ``` NF2 Chromosome 22, Merlin/Schwannomin Bilateral vestibular schwannomas Meningiomas RETINAL hamartomas ```

ALS genes

SOD1 C9orf72 FUS/TLS TARDBP

Which clinical finding in Sturge-Weber was found to have cerebral lesions in all their cases?

Involvement of upper eyelid

Sturge-Weber a) GNAQ b) Endoglin, Novel Kinase, Activin c) Chromosome 3 d) TSC

Ans: GNAQ b) Endoglin, Novel Kinase, Activin - HHT, Osler-R-W c) Chromosome 3, VHL gene d) TSC1 - hamartin C9, TSC2 tuberin C16

* Cerebellar tumor with nodule within a cyst * Retinal hemangioblastomas * Renal cell CA * Pheochromo, pancreatic, cystadenomas * Polycythemia vera

Von-Hippel Lindau

``` • AVMs: skin, mucous membranes, GI, GU, lungs, NS • Hemorrhagic tendency, spider-like • Repeated epistaxis, GI, GU bleeding • Iron-deficiency anemia Pulmonary fistulas ```

Hereditary Hemorrhagic Telangiectasia Osler-Rendu-Weber

Tramline calcification

Sturge-Weber

``` • Ash-leaf lesions • Hypomelanotic skin macules • Shagreen patch • Subepidermal fibrotic lesion MC found in the LS region ``` * MC primary presemntation: Sz, psychomotor devt delay * Sz change pattern * Flexion spasms w/ hypsarrhythmia * GTC, atypical absence * Focal abnormalities are uncomomon * Gradual deterioration of cognitive function * Most useful laboratory measures: CT and MRI

Tuberous Sclerosis

Pathognomonic of TS

Adenomas of Pringle

Earliest manifestation of TS

Mild erythema over cheeks and forehead intensified by crying

Genetic abnormality in Adrenoleukodystrophy

ABCD1 mutation X-linked Peroxisomal oxidation of VLCFAs

Toxicity Children: sensorial and gi sx, then increased ICP 70 mcg/dl: minimal sx Adults: Colic, anemia, peripheral neuropathy (bilateral wrist drop) ``` Children: Lead lines, metaphyses of long bones Basophilic stippling of red cells Inc urinary UCP and ALA Wood lamp ZOO ```

Lead

MC cause: suicidal, accidental ingestion of herbicides, insecticides, rodenticides Encephalopathy, peripheral neruopathy (distal axonopathy) Punctate hemorrhages in WM Mees lines (fingernails)

Arsenic

Initial: enceph Later: extrapyramidal (odd gait, dystonia, rigidity of trunk, postural instability, cogwheeling

Manganese

``` • Tremor • Confusion • Cerebellar syndrome • Choreoath, parkinsonian facies Mood, behavioral changes prominent ```

Mercury

Toxicity Concentric constriction of visual fields Hearing loss, cerebellar ataxia, tremors, sensory impairment

Minamata Disease Mercury

Toxicity: Immediate anticholinesterase effect Delayed: polyneuropathy -> atrophy Intermediate: paralysis including respiratory muscles

Phosphorous, Organophosphate

Toxicity: Neuropathy, optic atrophy, ophthalmoplegia, alopecia

Thallium

Toxic levels of lithium

Therapeutic: 0.6 - 1.2 mEq/L Above 1.5-2 mEq/L Intoxication, cerebellar, myoclonic, nephrogenic DI Above 3.5 mEq/L Stupor, coma, convulsion

In AD, there's marked reduction in chAT in these two regions

Hippocampus | Neocortex

Huntington's Chorea vs Sydenham

Slower More muscles involved Stereotyped Athetoid or dystonic

Dose of Magnesium Sulfate in Eclampsia

IM: 10g IM, then 5g IM Q4 IV: 4g IV then 5g IM Q4 1-2g / hour IV

Schizophrenia subtype: * Striking incoherence of ideas and grossly inappropriate affect * Hallucinations and delusions are frequent * Motor symptoms: grimacing, stereotyped mannerism, and other oddities of behavior a) Simple b) Catatonic c) Disorganized or Hebephrenic d) Paranoid

c) Disorganized or Hebephrenic