Immunology, Neuro, and Renal Day Flashcards
What inervates the diaphragm
C3- C5 keeps the diagphragm alive
What does the corticospinal tract carry
Motor stuff
What nerve is injured in foot drop
Common peroneal
weak dorsiflexion and eversion and steppage gait
Sensory loss over lateral leg and dorsum of foot
What nerve damage results in wrist drop
Radial ~c7
The “M” of the brachial plexus is
Upper
Musculocutaneous
Median
Ulnar
lower
What cute nerve split is directly above the brachial plexus M
The ~C7 cord splits into axillary and radial
What are the 2 classes of dopamine agonists
Ergot- bromocriptine
Non-ergot- Pramipexole, ropinirole
Both directly stimulate Da receptors
How does Phenoytoin work and what is the major side effect
Blocks Voltage gated Na channels- treats SZ
s/e: gingival hyperplasia from ↑ platelet derived growth factor–> ↑ Macs–> proliferation of gums
other s/e: CNS stuff, ataxia and nystagmus
What is the precursor AA for serotonin
Tryptophan
How do you treat SSRI overdose
Cycproheptadine - an antihistamine and anti- 5ht
What is the treatment for benzo overdose
Flumazenil
What is parkinsons deep brain stimulation targeted against
Basil Ganglia type stuff
exactly: globul palidus internus
Subthalmic nucleus
Why does deep brain stimulation at globus palidus internus or subthalmic nucleaus help
basically the Da movement pathways are directed here
GPe–> STN–> GPi–> thalmus–> cortex–> movement
This seizure is no LOC + brief jerking movements
Myoclonic
rx: broad spectrum, is valproic acid
This SZ has LOC and diffuse muscle contraction
Tonic Clonic
rx: broad spectrum, ie Valporic acid
This SZ has a sorta LOC (blank stare) with NO postictal state
Absence
rx: ethosuximide
What is / When do you use a narrow spectrum SZ drug
Simple or complex SZ
Rx: Phenytoin, phenobarb, Gabapentin, etc
Compare simple and complex SZ
Both: Focal
simple: NO LOC
Complex: HAS LOC
What CNS tumor is asc. w/ EBV
Primary CNS Lymphoma
Aids defining illness
What is cerebral amyloid angiopathy like
- Most common reason for spontaneous hemorrhage seen in elderly
- usually seen in occipital and parietal lobe
What is a aneurysm rupture due to HTN involving deep brain structures
Charcot Bouchard aneurysm
Usually involves the basil ganglia
This is the most common cause of brain hemorrhage in children
Brain AVM
What is the prefered combo therapy for parkinson’s
BALSA
Bromocriptine or Pramipexole Amantadine (↑ Da) Levodopa(with Carbidopa) Selegiline- COMT inhibitor Antimuscarinic
How does selegiline work and what do we use it for
Inhibits MAO type B, helps in Parkinsons
How does Amantadine work
invented vs flu
BUT
HAs dopaminergic activity, and anticholinergic therefore helps in parkinson’s
What is the most common reason for the hook “worst headache of my life”
Worst HA of life= Subarachnoid
Most common cause of subarachnoid= Saccular (berry) aneurysm
Could also be an AVM
Where do saccular (berry) aneurysms tend to occur and who usually has them
In the circle of willis
seen often in ehlos danlos and AD-PCKD
What does CSF look like in subarachnoid hemorrhage
Xanthochromia- aka yellowish
Stroking out this area will lead to wild involuntary large amplitude movements
Subthalamic nuc (part of basil ganglia)
often seen in setting of lacunar stroke from chronic DM and HTN
How does ethosuximide work
blocks T type Ca channel
What do T type Ca channels do
trigger rhythmic pulsed discharges in thalamic neurons
How does a meningioma present
Often asympt, may have Sz
Forms psammoma body on histology
What nerve mediates larynx muscles
Vagus
What mediates taste on anterior 2/3 of tongue
Chorda tympani of facial
*also mediates saliva
Which Chiari malformation is the most common
Type 1- benign and more common. s/s: ataxia, dizzy
Type 2- severe. usually has myelomeningocele and noncommunicating hydrocephalus
What generally causes Vertigo
dysfx in the vestibular system
ex: inner ear
What nerves are in the cavernous sinus
CN 3- 6
(minus V3)
Also some internal caratoid
This is a vascular malformation in the brain that has an increased risk for intracerebral hemorrhage
Cavernous hemangioma
pts often have sz as well
How does atropine work
reversible cholinergic antagonist selective for M
How do you reverse atropine
Cholinesterase inhibitor ex: physostigmine
b/c atropine is reversible anti-M, just load them up with Ach to out compete and let M work again
What are the primary childhood brain cancers
#1- Pilocytic # 2- Medulblastoma #3- Ependymoma
cranipharyngioma, pinealoma
This disease will show UMN and LMN lesions
ALS
loss of anterior horn
Demylination of lateral corticospinal tract
Paralysis of the _______ m (innervated by 7) leads to hyperacusis
Stapedius M on middle ear (attaches to stapes)
hyperacusis: increased sensitivity to sound
Myotonic dystrophy is
Trinuc repeat of CTG
baldness testicle atrophy cataracts muscle dystrophy arrhythmias
What neurotransmitter is missing in huntington
GABA
How do you treat neuromalignant syndrome
Dantrolene
Where is most water in kidney absorbed regardless of anything (hydration, etc)
Proximal tube- passive water absorption
What parts of the kidney never absorb water
Ascending loop of henle
Early DCT
Why do we conjugate polysaccharide vaccines
Polysac alone= b cell response
Polysach + protein conjugate= B and T cell (has memory, lasts longer)
What type of cell is a juxtaglomerular cell
A modified smooth muscle cell with renin containing zymogen granules
How does ↑ aldosterone present
Hypertension
Muscle Weakness
Hypokalemia
What are the 3 ways to treat CMV
Gancyclovir
Foscarnet
Cidofovir
This anti CMV drug is a pyrophosphate analog
Foscarnet
What are the side effects of foscarnet
Nephrotoxicity electrolyte abnormalities ↑ or ↓ of Ca and Phos hypokalemia hypomagnesemia
If you break your humorous, and damage the radial nerve, what artery did you also hurt
Deep Brachial
Runs with the radial
What choromosome is messed up in wilms tumors
11
What chromo is messed up in RB
13
What chromo is messed up in Nf-1
17
Where is c-myc
chrmo 8
