NEURO Flashcards
1
Q
Neurotransmitter that is Used in the neuromuscular junction, and both sympathetic and parasympathetic nervous system; triggers REMsleep
A
2
Q
NT secreted by postganglionic sympathetic neurons
A
3
Q
NT mainly secreted by the adrenal medulla; has greater B2effect than NE
A
4
Q
NT Secreted by substantia nigra to fine tune movement and by the hypothalamus to decrease prolactin
A
5
Q
NT that comes from tryptophan; low levels are associated with depression
A
6
Q
Permeant gas, inhibitory NT, vasodilator
A
7
Q
- Main inhibitory NT of the spinal cord;
- increases Cl· influx
A
8
Q
- Main inhibitory NT of the brain;
- increases Cl· influx or K* efflux
A
9
Q
Main excitatory NT of the brain; formed from reactive amination of alpha ketoglutarate
A
10
Q
NT involved in slow VS fast pain
A
11
Q
Cranial nerve for opening of eyelids, contraction of most EOMs, accommodation and pupillary constriction (miosis)
A
12
Q
Cranial nerve for special sensation (taste) of the anterior 2/3 of the tongue
A
13
Q
Cranial nerve for general sensation (e.g. pain) of the anterior 2/3 of the tongue
A
14
Q
Cranial nerve for facial muscles
A
CN VII (Facial nerve)
15
Q
Cranial nerve for facial sensation and muscles of mastication
A
CN V (Trigeminal nerve)
16
Q
Headache pattern that is Highly characteristic of posterior fossa brain tumors
A
Vomiting that precedes headache
17
Q
Dominant symptom in temporal (giant cell) arteritis
A
headache
18
Q
Key pathway for pain in migraine
A
Trigeminovascular input from the meningeal vessels
19
Q
Most disabling headache
A
migraine
20
Q
Most effective drug classes in the treatment of migraine (3)
A
- Anti-inflammatory agents,
- 5-HT 1B/ 10 receptor agonists (triptans),
- and dopamine receptor antagonists
21
Q
Most efficacious of the triptans (2)
A
Rizatriptan and eletriptan
22
Q
Core feature of cluster headache
A
Periodicity
23
Q
Most satisfactory treatment in cluster headache
A
Administration of drugs to prevent cluster attacks until the bout is over
24
Q
Most serious cause of secondary headache
A
Subarachnoid hemorrhage
25
Classic headache associated with a brain tumor
Most evident in the morning and improves during the day
26
Preferred diagnostic test for any patient suspected of having a brain tumor, and should be performed with gadolinium contrast administration
cranial MRI
27
Glucocorticoid of choice for brain tumors because of its relatively low mineralocorticoid activity
Dexamethasone
28
Established risk factor for primary CNS lymphoma
29
exposure to ionizing radiation is the established risk factor for these 3 primary brain tumors
30
True or False. Primary brain tumors..
In adults: usually supratentorial
In children: usually infratentorial
True
31
Most common primary brain tumor of childhood
vs
Most common orimarv brain tumor overall
Grade I astrocytomas: pilocytic astrocytomas (WHO grade I)
vs
Meningiomas
32
This virus frequently plays an important role in the pathogenesis of HIV related primary CNS lymphoma
EBV
33
Most common malignant brain tumor of childhood
vs
Most common malignant brain tumor overall
Medulloblastomas
vs
Grade IV astrocytoma (Glioblastoma)
34
Meningiomas are most commonly located over the
Cerebral convexities
35
Main differential diagnosis for meningioma
dural metastasis
36
Most common schwannomas
Vestibular schwannomas or acoustic neuromas
36
Most common site of brain metastases
Gray matter-white matter junction
37
85% of all brain metastases are supratentorial. True or False
True
38
Most common sources of brain metastases
(2)
* lung cancer
* breast cancer
39
Malignancy with greatest propensity for brain metastasis, found in 80% of patients at autopsy
vs
Malignancies with propensity to metastasize to the dura and can mimic meningioma
melanoma
vs
prostate and breast cancer
40
Definitive method and often considered the gold standard to diagnose leptomeningeal metastases
Demonstration of tumor cells in CSF
41
Part of the spine affected most commonly in epidural metastasis
Thoracic spine, followed by the lumbar and then cervical spine
42
Presenting symptom of epidural metastasis in virtually all patients
back pain
43
Best test for epidural metastasis
MRI of the complete spine
44
Surgical procedure of choice for epidural metastasis
Complete removal of the mass, typically anterior to the spinal canal
45
Primary radiation oncology approach to brain metastases
Stereotactic radiosurgery
46
Most serious toxicity from radiotherapy as they are often irreversible
Late delayed toxicity
47
Second only to myelosuppression as dose-limiting toxicity of chemotherapeutic agents
neurotoxicity
48
Classic clinical triad of meningitis
* Fever,
* headache,
* and nuchal rigidity
49
Classic clinical triad of brain abscess
* Headache,
* fever,
* focal neurologic deficit (present 50%)
50
other term for non-encapsulated brain abscess
cerebritis
51
Pathognomonic sign of meningeal irritation and is present when neck resists passive flexion
Nuchal rigidity ("stiff neck")
52
Most common form of suppurative CNS infection
bacterial meningitis
53
Most common cause of meningitis in adults >20 years
Strep pneumoniae
54
Important clue to diagnosis of meningococcal infection
Petechial or purpuric skin lesions
55
Most common etiologic organisms of community acquired bacterial meningitis (2)
* Streptococcus pneumoniae
* and Neisseria meningitidis
56
Most common agents in acute viral meningitis
enteroviruses
56
viruses that cause the ff:
* temporal encephalitis
* thalamic encephalitis
* subacute sclerosing panencephalitis
57
Most common symptom of brain abscess
headache
58
Optimal therapy for brain abscess
combination of high dose parenteral antibiotics and surgical drainage
59
Triad of Lennox-Gastaut Syndrome
60
First clue of typical absence seizures
Daydreaming and a decline in school performance recognized by the teacher
60
Electrophysiologic hallmark of typical absence seizures
61
Main seizure type in 10% of all persons with epilepsy
GTCS
62
Most common seizure type resulting from metabolic derangements
GTCS
63
Most common syndrome associated with focal seizures with dyscognitive features
Mesial Temporal Lobe Epilepsy Syndrome
64
Most common seizures arising in late infancy and early childhood
febrile seizures
65
First goal in the approach to seizure
Determine if event was truly a seizure
66
Drugs of choice approved for the initial treatment of focal seizures (4)
* Carbamazepine (or a related drug, oxcarbazepine),
* lamotrigine,
* phenytoin,
* and levetiracetam
67
Best initial choice for the treatment of primary generalized tonic-clonic seizures (3 )
* Valproic acid
* Lamotrigine
* Levetiracetam
68
Most recurrences of seizure occur when
First 3 months after discontinuing therapy
69
Refers to infarction following atherothrombotic lipohyalinotic occlusion of a small artery
Lacunar Infarction
70
Decrease in cerebral blood flow to zero causes death of brain tissue within how many minutes
4-10 mins
71
Most common cause of cerebral embolism overall
Nonrheumatic atrial fibrillation
72
Most common source of artery to artery embolism
Carotid bifurcation atherosclerosis
73
Most significant risk factor of stroke and TIA
hypertension
74
Principal side effect of dipyridamole
headache
74
Only antiplatelet agent that has proven effective for the acute treatment of ischemic stroke
aspirin
75
Hallmark of top of the basilar artery occlusion
Sudden onset of bilateral signs, including ptosis, papillary asymmetry or lack of reaction to light and somnolence
76
Endarterectomy for carotid is most beneficial atherosclerosis when performed within ____ weeks of symptom onset
Within 2 weeks of symptom onset (benefit is more pronounced in men>75 years)
77
Gold standard for identifying and quantifying atherosclerotic stenoses of cerebral arteries
Conventional x-ray cerebral angiography
78
Bleeding into subdural and epidural spaces is principally produced by
trauma
79
Most common sites of hypertensive intraparenchymal hemorrhage (4)
* Basal ganglia (especially putamen},
* thalamus,
* cerebellum,
* pons
80
Most common cause of lobar hemorrhage in the elderly
Cerebral amyloid angiopathy
81
Most cerebellar hematomas of this diameter will require surgical evacuation
>3 cm diameter
82
Most common cause of peripheral neuropathy
DM
83
Most common diabetic mononeuropathies
Median neuropatby at the wrist and ulnar neuropathy at the elbow
84
Most common cranial mononeuropathies in DM
Seventh nerve palsy,
followed by third nerve, sixth nerve, and, less frequently, fourth nerve palsies
85
Most common cranial mononeuropathies in scleroderma
Trigeminal nerve
86
Most common cranial nerve involved in sarcoidosis
Seventh nerve
87
Most common mononeuropathies in uremia
Carpal tunnel syndrome
88
Most common form of peripheral neuropathy associated with HIV infection & usually seen in patients with AIDS
Distal symmetric polyneuropatby
89
Most common associated malignancy with neuropathies
lung cancer
90
Manifests as a rapidly evolving symmetric, ascending. areflexic motor paralysis with or without sensory disturbance, associated with Campylobacter jejuni found in undercooked chicken
Guillain Barre Syndrome (GBS)
91
GBS is associated with what bacteria
Campylobacter jejuni
92
Neuromuscular disorder characterized by weakness and fatigability of skeletal muscles, caused by a decrease in the number of available acetylcholine receptors (AChRs) at neuromuscular junctions due to an antibody-mediated autoimmune attack, associated with diplopia
Myasthenia Gravis (MG)
93
Most common form of Parkinsonism
Parkinson's Disease (PD)
94
Most common cause of Familial PD
Mutations of the LRRK2 gene
95
Most common cause of secondary Parkinsonism
Dopamine blocking agents
96
Most significant pathogenic mechanism in Parkinsonisrn
Protein misfolding and accumulation and mitochondrial dysfunction
97
Mainstay of therapy for PD
Levodopa-carbidopa
98
Major clinical effect of central-acting anticholinergic drugs
tremors
99
Most widely used antidyskinesia agent in patients with advanced PD and the only oral agent that has been demonstrated in controlled studies to reduce dyskinesia
amantadine
100
Most common cause of nursing home placement in Parkinson disease patients
dementia
101
Most common movement disorder
essential tremor
102
Standard drug therapies for essential tremors (2)
beta blockers or
primidone
103
Most common forms of dystonia
focal dystonia
104
Most commonly seen dystonia with neuroleptic drugs or after chronic levodopa treatment in PD patients
Drug-induced dystonia
105
Most common systemic disorder that causes chorea
SLE
106
Most common acute hyperkinetic drug reaction
vs
Most common subacute drug reaction
dystonia
vs
akathisia
107
Gold standard for diagnosis of Wilson's disease
liver biopsy
108
Most common psychogenic movement disorder
Tremor affecting tbe upper limbs
109
Date-rape drug
flunitrazepam
110
Antidote to benzodiazepine overdose
flumazenil
111
Most frequently abused drug, causes Wernicke-Korsakoff syndrome in overdose and delirium tremens in withdrawal
ethanol
112
Used for prevention of Wernicke-Korsakoff syndrome
thiamine
113
first line drugs for GTCS (2)
113
Used for treatment of alcohol withdrawal
Diazepam
114
first line drugs for focal seizures (5)
115
first line drugs for Typical Absence Seizures(3)
vs
Atypical Absence (3)
116
117
