Kaplan- Neuro 2 Flashcards
2/12/14
tricyclic antidepressants act on what receptor and what effect does this have on cAMP
TCA’s antagonize D2 receptors leading to increased cAMP
normal D2 receptor activity downregulates cAMP
what part of the brainstem controls vertical eye movements and eyelid elevation (hint: this is why it is spared in locked-in syndrome)
rostral midbrain (rostral interstitial nucleus of MLF and interstitial nucleus of Cajal)
what are intracytoplasmic eosinophilic inclusions in neurons called
Lewy bodies
what are Pick bodies
round intracytoplasmic bodies that contain altered tau, ubiquitin and neurofilament
what do Lewy bodies contain
alpha-synuclein or ubiquitin
disruption of what brainstem structure will cause extrapyramidal symptoms
substantia nigra
what hormone levels should you make sure to check in a patient on lithium?
TSH (Lithium causes decreased TSH and thereby decreased thyroid hormones)
name the two streams of higher-order visual processing
dorsal pathway (parieto-occipital association cortex) (hair=where) relays visiospatial information
ventral pathway (temporo-occipital association cortex) (gut=what) relays information about colors, faces, symbols
what is the most common cause of ring-enhancing lesions in HIV patients
toxoplasmosis
what does CNS toxoplasmosis present like and what is seen on histology
CNS toxoplasmosis presents as AMS, seizures, or focal neurologic deficits;
on histology: necrotic, hemorrhagic lesions with round encysted bradyzoites (inactive) or crescent-shaped tachyzoites
central necrosis surrounded by granulation tissue and gliosis suggests what kind of infection?
bacterial abscess
what nerve provides sensation for the anatomical snuffbox
radial nerve
a patient with acute onset right homonomous hemianopia and intact visual acuity most likely has an infarct in which vessel
left PCA (macular sparing suggests the lesion is in the occipital lobe rather than one of the nerve tracts)
what vision defect does occlusion of the ophthalmic artery cause
monocular blindness
what is the most common cause of viral encephalitis in the U.S. and what region of the brain does it most commonly affect
HSV-1;
temporal lobe
what are the preferred benzos (name 3) for a patient with liver disease (i.e. alcoholics) and why are they preferred
“LOT” lorazepam, oxazepam and temazepam
better for patients with unhealthy livers because their metabolism is phase II rather than phase I, which starts to fail in liver disease; they also have less active metabolites
a central scotoma is likely due to a lesion where
the macula
what is the visual toxicity of ethambutol
optic neuropathy
a decline in cognitive function and gait as well as hypertonicity and dysarthria and abnormal EEG waves, all of which develop over the course of several months would likely involve what pathognomonic finding on autopsy
spongiform change in gray matter (CJD)
-rapidly progressing dementia with abnormal EEG findings suggests CJD
what nerve provides sensory innervation to the mucosa above the vocal cords?
below the vocal cords?
the internal branch of the superior laryngeal nerve supplies the mucosa above the vocal cords while the recurrent laryngeal nerve supplies the mucosa below the vocal cords
what is Werdnig-Hoffman disease and what part of the nervous system does it affect
spinal muscle atrophy due to perinatal programmed cell death that continues postnatally
anterior horn is affected
neuons of the spinal cord are myelinated by what kind of cell
oligodendrocytes, NOT Schwann cells (even though it’s not the brain the spinal cord is still CNS)
which drugs tend to predispose to or cause acute angle glaucoma
anticholingergics and drugs with anticholinergic effects like amitryptiline, topiramate, cyclobenzaprine,
what are some key signs and symptoms of acute angle glaucoma
headache, seeing halos around lights, nausea/ vomiting, severe ocular pain, corneal edema and high IOP
what is the name of the condition in which a patient cannot recognize faces
and what kind of lesion produces this deficit
prosopagnosia; caused by bilateral lesion of the visual association cortex
what is anosognosia and what lesion produces this condition
a lack of awareness or understanding the one is suffering from a condition; usually caused by large lesion of nondominant parietal lobe producing lack of awareness of sensory or motor deficits
what serum marker can be used to test for myelomeningocele (either in maternal serum or amniotic fluid)
alfa-fetoprotein
name all of the ventricles of the brain and their origins
lateral ventricles (telencephalon), third ventricle (diencephalon), cerebral aqueduct (mesencephalon), upper half of 4th ventricle (metencephalon), lower half of 4th ventricle (myelencephalon)
what is albuminocytologic dissociation and what disease is it characteristic for
albuminocytologic dissociation is when there is an increase in CSF protein, but no increase in CSF cell count; characteristic of Guillan Barre syndrome (an autoimmune demyelinating disorder that causes ascending polyneuropathy, usually following GI or upper respiratory infection. It spontaneously resolves.)
Flexner-Wintersteiner rosettes (cuboidal-to-columnar cells surrounding a central lumen) found in a tumor of a child’s eye suggests what disease and what chromosome association
retinoblastoma; chromosome 13
mutation on what chromosome is associated with Wilm’s tumor
chromosome 11
what chromosome is p53 on
chromosome 17
what chromosomes are associated with BRCA-1 and BRCA-2
BRCA-1 is on chromosome 17
BRCA-2 is on chromosome 13
what chromosomes are associated with NF-1 and NF-2
NF-1 is on chromosome 17
NF-2 is on chromosome 22
what nerve is found along the upper border of the greater sciatic foramen above the piriformis muscle and what muscles does this nerve innervate
superior gluteal nerve;
it innervates the gluteus medius, gluteus minimus, tensor fascia latae muscles
what does the inferior gluteal nerve innervate and where does it exit the pelvis
the inferior gluteal nerve innervates the gluteus maximus and it exits the pelvis at the inferior border of the greater sciatic foramen below the piriformis muscle
what three nerves pass through the inferior border of the greater sciatic foramen and what nerve passes through the superior border
inferior gluteal, pudendal and sciatic nerves pass through the inferior border
superior gluteal passes through the superior border
what symptom can help differentiate amphetamine use from PCP use
nystagmus; both drugs cause hypertension, tachycardia and diaphoresis, but PCP causes vertical and horizontal nystagmus while amphetamines do not
what are the symptoms of PCP use
mental: disorientation, detachment, distortions of body image, reckless behavior, impaired judgment
somatic: horizontal and vertical nystagmus, hypertension, tachycardia, diaphoresis, lack of motor coordination and numbness
what pathology is associated with dry beri beri
what pathology is associated with wet beri beri
dry beri beri involves polyneuropathy
wet beri beri involes dilated cardiomyopathy
what visual deficit do patients with Wernicke’s aphasia commonly present with and why
upper quadrantanopia because Meyer’s loop (the more inferior of the optic radiations) passes near Wernicke’s area in the superior temporal lobe
what nerve innervates the parotid glands
glossopharyngeal
what nerve provides sensory input for the thoracic viscera
vagus
what nerve provides taste sensation to the epiglottis
vagus
how do you differentiate acute meningitis from chronic meningitis
acute and chronic meningitis can be differentiated by the cellular findings in the CSF
acute: either increased neutrophils (pyogenic) or increased lymphocytes (lymphocytic)
chronic: increased lymphocytes, plasma cells, macrophages and fibroblasts
name some causes of chronic meningitis and name some causes of acute meningitis
chronic meningitis: TB, syphilis, brucellosis, fungal
acute meningitis: strep pneumo, neisseria meningitidis
what disease is characterized by ophthalmoplegia, pseudobulbar palsy (difficulty chewing and speaking), axial dystonia and bradykinesia, (normal cognition)
progressive supranuclear palsy: a neurodegenerative condition with widespread neuron loss and gliosis in subcortical sites with sparing of cerebral and cerebellar cortices
what are common tumors in von Hippel Lindau
retinal angiomas, hemangioblastomas (often of the cerebellar area), renal carcionoma, cystic or angiomatous lesions of various organs (epididymus, pancreas, lungs, liver)
name two characteristic cancers found in Sturge-Weber disease
port-wine nevus of the head; leptomeningeal angiomatosis
what does subacute sclerosing panencephalitis cause in a patient and what infection is it the result of
SSPE results from measles infection (usually in childhood)
patients experience cognitive decline, behavioral changes, seizures, ataxia and focal neurologic deficits leading to eventual death
