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EBSE > Neuro > Flashcards

Neuro Flashcards

1
Q

what does the notochord become?

A

nucleus pulposus of intervertebral disc

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2
Q

markers for neural tube defect during pregnancy

A

elevated AFP in amniotic fluid and maternal serum

inc acetylcholinesterase in amniotic fluid to confirm

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3
Q

risk factor for anencephaly

A

maternal type 1 DM

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4
Q

Arnold Chiari malformation

A

herniation of cerebellar tonsils and vermis through foramen magnum > hydrocephalus and impaired coordination. Can be assoc w/ throaco-lumbar myelomeningocele

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5
Q

Dandy Walker malformation

A

agenesis of cerebellar vermis, cystic enlargement of 4th ventricle
assoc w/ hydrocephalus and spina bifida

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6
Q

syringomelia

A

cystic enlargement of central canal of spinal cord

crossing fibers of STT damaged first

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7
Q

nerves providing taste and pain sensation in parts of the tongue

A

anterior - taste is 7, pain is V3
post - both are 9
extreme posterior - both are 10

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8
Q

Wallerian degeneration

A

degeneration of neurons - allows for axonal regeneration in PNS
degen distal to injury and axonal retraction proximally

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9
Q

C fibers vs Adelta fibers

A

C - slow, unmyelinated

Adelta - fast, myelinated

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10
Q

Meissner’s corpuscles vs Pacinian corpuscles vs Merkel’s discs - where are they and what do they sense

A

Meissner - hairless skin, fine/light touch (adapt quickly)
Pacinian - deep skin, vibration/pressure
Merkel’s - hair follicles, pressure / static touch

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11
Q

function of perineurium

A

permeability barrier around nerve

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12
Q

where is ACh synth in CNS?

A

basal nucleus of Meynert

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13
Q

3 structures that form BBB

A

tight jxns of endothelial cells
basement membrane
astrocyte foot processes

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14
Q

2 hypothalamic input areas not contained by BBB

A

OVLT - senses osmolarity

area postrema - senses emetics

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15
Q

where are ADH and oxytocin made in brain?

A

ADH - supraoptic nucleus

oxytocin - paraventricular nucleus

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16
Q

lateral and ventromedial hypothal - fns

A

lateral - hunger

ventromedial - satiety

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17
Q

anterior and posterior hypotha - fns

A

ant - cooling (AC), PSNS

post - heating, SYNS

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18
Q

what do these thalamic nuclei connect (input/output)?

VPL, VPM, LGN, MGN, VL

A

VPL - STT/DC > primary somatosensory
VPM - trigeminal and gustatory pathway > primary somatosensory
LGN - CN2 > calcarine sulcus
MGN - superior olive and inf colliuclus > auditory
VL - basal ganglia > motor cortex

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19
Q

3 cerebellar peduncles and what they carry

A

superior - output to contra motor cortex
middle - input from contra cortex
inferior - input from ipsi proprioceptive pathways

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20
Q

cerebellar deep nuclei from lateral > medial, and what does lateral do vs medial?

A

Dentate, Emboliform, Globose, Fastigial (don’t eat greasy foods)
lateral - voluntary mvmt
medial - balance/coordination

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21
Q

what composes striatum and lentiform nucleus?

A

striatum - putamen + caudate

lentiform nucleus - putamen + globus pallidus

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22
Q

direct and indirect pathway in basal ganglia

A

direct - putamen (D1) > inhib GPi > disinhibition of thalamus > inc motion

indirect - putamen (D2) > inhib GPe > disinhibition of STN > stimulation of GPi > inhibition of thalamus > dec motion

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23
Q

result of dopamine in basal ganglia pathways

A

dopamine always inc motion
direct - D1 stimulates excitatory pathway
indirect - D2 inhibits inhibitory pathway

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24
Q

Parkinson’s dz - protein accumulations

A

Lewy bodies - composed of alpha synuclein

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25
Q

where is the lesion causing hemiballismus?

A

contra STN

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26
Q

tx of essential tremor

A

beta blockers, primidone

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27
Q

Kluver-Bucy syndrome

A

bilat amygdala lesions, assoc w/ HSV1

hyperorality, hypersexuality, disinhibited behavior

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28
Q

Wernicke-Korsakoff syndrome - sx, cause

A

confusion, ophthalmoplegia, ataxia, memory loss, confabulation, personality change
assoc w/ thiamine (B1) def and excessive ETOH, precipitated by giving glucose w/o B1 to B1 def pt

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29
Q

how to tell side of lesion based on eye direction for PPRF and FEF lesions

A

PPRF - eyes look away from lesion

FEF - eyes look toward lesion

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30
Q

conduction aphasia - what is it and what is the lesion

A

poor repetition but fluent and can comprehend

dmg to arcuate fasciculus

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31
Q

what is the primary driver behind cerebral perfusion and how can this be used to your advantage?

A

PCO2

therapeutic hyperventilation - dec PCO2 to dec ICP in acute cerebral edema

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32
Q

sx of MCA stroke

A

contra paralysis/loss of sensation to upper limb and face

aphasia or hemineglect based on what side (dominant/nondominant)

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33
Q

sx of ACA stroke

A

contra paralysis/ loss of sensation of lower limb

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34
Q

sx of lateral striate artery stroke and what usually causes it

A

contra hemiparesis/hemiplegia

lacunar infarcts 2/2 HTN

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35
Q

sx of ASA stroke

A

contra hemiparesis of lower limbs
dec contra proprioception
tongue deviates ipsi

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36
Q

sx of PICA stroke

A 
vestibular - vomiting vertigo nystagmus 
cerebellar - ataxia dysmetria
STT - dec pain/temp sensation in face/limbs
dysphagia** hoarseness
ipsi Horner's

**lateral medullary (wallenberg’s syndrome)

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37
Q

sx of AICA stroke

A

vestibular - vomiting, vertigo, nystagmus
paralysis of face** dec pain/temp sensation in face
ipsi Horner’s and dec hearing
ataxia dysmetria

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38
Q

sx of PCA stroke

A

contra hemianopsia w/ macular sparing

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39
Q

sx of AComm stroke

A

visual field defects (usually a berry aneurysm, not a stroke)

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40
Q

sx of PComm stroke

A

CN III palsy - eye down and out, ptosis, pupil dilation

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41
Q

MC site of berry aneuryism

A

AComm artery

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42
Q

Charcot bouchard microaneurysm - assoc w/? where?

A

chronic HTN

small vessel - basal ganglia, thalamus

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43
Q

where do hypertensive hemorrhages tend to occur?

A

basal ganglia and internal capsule

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44
Q

flow of CSF

A

lateral ventricles > intraventricular foramina of Monro > 3rd ventricle > cerebral aqueduct of sylvius > 4th ventricle > go to subarachnoid space via Lateral foramina of Luschka or Medial Foramen of Magendie

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45
Q

sx of normal pressure hydrocephalus

A

“wet wobbly and wacky”

urinary incontinence, ataxia, cog dysfn

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46
Q

2 causes of isolated LMN lesions

A

poliomyelitis and Wednig-Hoffman dz

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47
Q

genetic cause of ALS

A

defect in superoxide dismutase 1

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48
Q

Werdnig Hoffman dz

A

AR
congenital degernation of anterior horn of SC
floppy baby w/ marked hypotonia and tongue fasciculations, die at 7 mo

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49
Q

Friedreich’s ataxia - inheritance, gene, sx

A

AR triplet repeat
frataxin
staggering gait, frequent falling, nystagmus, dysarthria, pes cavus (high arch), hammer toe, kyphoscoliosis, hypertrophic cardiomyopathy (cause of death)

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50
Q

sx of Horner’s syndrome and what location of lesion causes it

A

ptosis, anhidrosis, miosis

lesion of SC above T1

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51
Q

dermatomes of - nipple, umbilicus, inguinal ligament, kneecaps

A

nipple T4
umbilicus T10
inguinal ligament L1
kneecap L4

52
Q

myotomes of biceps, tricepss, patellar, and achilles reflexes

A

biceps - C5,6
triceps - C7,8
patellar - L3,4
achilles - S1,2

53
Q

Parinaud syndrome

A

paralysis of conjugate vertical gaze due to lesion in superior colliculi like a pinealoma

54
Q

nucleus where PSNS neurons synapse to cause pupillary constriction

A

Edinger Westphal nucleus

55
Q

CN IV controls

A

superior oblique

56
Q

where are the CN 3-12 nuclei located (which part of brainstem) and mnemonic for where they are lateral vs medial

A

midbrain - 3,4
pons - 5,6,7,8
medulla - 9,10,12
SC - 11

lateral - sensory
medial - motor (both M’s)

57
Q

vagal nuclei fns

A

nucleus solitarius - visceral sensory info
nucleus ambiguus - motor innervation of pharynx/larynx/upper esophagus
dorsal motor nucleus - autonomic fibers to heart lungs upper GI

58
Q

which CN pass through cavernous sinus?

A

3,4,V1,V2,6

59
Q

with a CN V motor lesion, does jaw deviate toward or away from lesion?

A

toward side of lesion

60
Q

which muscles open vs close the jaw?

A

open - lateral pterygoid

closed - masseter, temporalis, medial pterygoid

61
Q

retina whitening w/ cherry red spot on fundoscopic exam

A

central retinal artery occlusion

62
Q

Marcus gunn pupil

A

afferent pupillary defect - bilat dec in pupil constriction when light is shone in affected eye

63
Q

in CN III, what type of nerve fibers are more vulnerable to vascular damage vs compression?

A

vascular - motor fibers

compression - PSNS fibers

64
Q

drusen assoc w/

A

dry macular degeneration

65
Q

Meyer’s loop

A

carries inf retina information, loops around inferior horn of lateral ventricle (temporal loop)

66
Q

internuclear ophthalmoplegia - lesion to what structure? what does it cause?

A

MLF

impaired horizontal conjugate gaze beyond midline, convergence is spared

67
Q

protein accumulations in alzheimer’s

A

extracellular amyloid plaques

intracellular tau tangles

68
Q

protein accumulation in Pick’s disease

A

pick bodies - spherical tau protein aggregates

69
Q

Lewy body dementia - unique symptom and what protein is in Lewy bodies

A

hallucinations

alpha synuclein

70
Q

2 MC causes of dementia in elderly

A

1 - alzheimer’s

2 - multi-infarcts

71
Q

Charcot’s classic triad of MS sx

A

scanning speech
intention tremor
nystagmus

72
Q

other name for Guillain Barre

A

acute inflammatory demyelinating polyradiculopathy

73
Q

CSF findings in Guillain Barre

A

inc protein w/ nl cell count

74
Q

metachromatic leukodystrophy - what is it generally, inheritance, cause

A

lysosomal storage dz > impaired production of myelin
AR
arylsulfatase A def

75
Q

Charcot Marie Tooth disease - what kind of disease does it cause, general pathophys

A

motor and sensory neuropathy

defective production of proteins needed to make myelin sheath

76
Q

Krabbe’s disease - inheritance, type of disorder, protein cause > what general problem

A

AR
lysosomal storage disorder
galactocerebrosidase def > destroys myelin sheath

77
Q

MC site of partial seizure

A

medial temporal lobe

78
Q

MC causes of seizures in kids, adults, and elderly

A

kids - genetic
adults - tumors
elderly - stroke

79
Q

Sturge Weber syndrome

A

neurocutaneous disorder

port wine stains in V1 distribution, leptomeningeal angiomas, pheochromocytomas, glaucoma, seizures, hemiparesis, MR

80
Q

3 MC primary brain tumors

A

1 - glioblastoma
2 - meningioma
3 - schwannoma

81
Q

brain tumor w/ “pseudopalisading” pleomorphic tumor cells. central areas of necrosis w/ hemorrhage

A

glioblastoma

82
Q

brain tumor w/ spindle cells in a whorled pattern, psammoma bodies

A

meningioma

83
Q

MC type of pituitary adenoma

A

prolactinoma

84
Q

Rosenthal fibers assoc w/

A

pilocytic astrocytoma (benign childhood brain tumor)

85
Q

Homer-Wright rosettes assoc w/

A

medulloblastoma

86
Q

craniopharyngioma is derived from what?

A

remnants of Rathke’s pouch

87
Q

MC childhood supratentorial tumor

A

craniopharyngioma

88
Q

5 types of drugs used for glaucoma

A

alpha agonists - epi, brimonidine
beta blockers - timolol, betaxolol, carteolol
diuretics (CA inhibs) - acetazolamide
cholinomimetics - pilocarpine, carbachol, physostigmine, echothiophate
prostaglandins - PGF2alpha - latanoprost

89
Q

mechanism of opioids

A

open K channels, close Ca channels > dec synaptic transmission > inhibit NT release

90
Q

butorphanol

A

mu opioid receptor partial agonist and kappa opioid agonist > produces analgesia w/ less respiratory depression

91
Q

tramadol

A

weak opioid agonist. also inhib serotonin and NE reuptake. used for chronic pain

92
Q

1st line drug for partial seizures

A

carbamazepine

93
Q

1st line for absense seizures

A

ethosuximide

94
Q

1st line for status epilepticus (acute vs prophylaxis)

A

acute - benzos

prophylaxis - phenytoin

95
Q

1st line seizure med in kids

A

phenobarbital

96
Q

tox of carbamazepine

A

diplopia, ataxia, blood dyscrasias (agranulocytosis, aplastic anemia), liver tox, SIADH, Stevens Johnson syndrome, teratogen

97
Q

tox of ethosuximide

A

GI distress, fatigue, HA, urticaria, Stevens Johnson

98
Q

tox of phenytoin

A

nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, megaloblastic anemia, teratogen, drug induced lupus, LAN, Stevens Johnson, osteopenia

99
Q

tox of valproic acid

A

GI distress, fulminant hepatotox (rare), neural tube defects, tremor, wt gain

100
Q

mech of phenytoin

A

blockade of Na channels > inhib glutamate release

101
Q

mech of barbiturates

A

facilitate GABAa action by inc duration of Cl channel opening

102
Q

barbiturates are contraindiated in what condition

A

porphyrias

103
Q

benzos mech

A

facilitate GABAa action by inc frequency of Cl channel opening

104
Q

what do you treat benzo OD w/?

A

flumazenil

105
Q

zolpidem, zaleplon, eszopiclone - mech, use

A

nonbenzo hypnotics - act via BZI subtype of GABA receptor

tx insomnia

106
Q

MAC as it relates to anesthetics

A

minimum alveolar conc at which 50% of population is anesthetized
inversely related to potency

107
Q

which drugs can cause malignant hyperthermia?

A

all inhaled anesthetics except nitrous oxide

108
Q

thiopental - class, use

A

barbiturate

IV anesthesia - used for induction and short procedures

109
Q

midazoloam - class, use

A

benzo

IV anesthesia - MC drug used for endoscopy

110
Q

arylcyclohexamines - ex, mech

A

ketamine

PCP analog - block NMDA receptors

111
Q

propofol - mech, use

A

potentiates GABAa

sedation in ICU and short procedures

112
Q

how to tell esters from amides in local anesthetics

A

amides have 2 i’s in the name, esters just have 1

113
Q

tricks w/ local anesthetics - how to increase local action? using in infected areas?

A

local action increased by vasoconstrictors like epi

infected tissue is more acidic > anesthetics stay charged > can’t penetrate membranes > need more anesthetic

114
Q

order of sensation loss w/ local anesthetics

A

pain > temp > touch > pressure

115
Q

which type of local anesthetic tends to have allergic reactions?

A

esters

116
Q

succinylcholine - mech and tox

A

depolarizing NMJ blocker

hyperCA, hyperK, malignant hyperthermia

117
Q

nondepolarizing NMJ blockers naming

A

-cur- (ex vecuronium)

118
Q

reversing NMJ blockers

A

use cholinesterase inhibs like neostigmine

119
Q

dantrolene - mech, use

A

prevent release of Ca from sarcoplasmic retic

tx malignant hyperthermia and neuroleptic malignant syndrome

120
Q

tx of malignant hyperthermia

A

dantrolene

121
Q

tx modalities for parkinson’s dz

A 
DA agonists (bromocriptine -ergot, non ergots: pramipexole, ropinirole)
inc DA - carbidopa, amantadine (inc DA release)
prevent DA breakdown - selegiline (MAOb inhib), entacapone/tolcapone (COMT inhib)
curb excess cholinergic activity - benztropine (helps w/ tremor and rigidity but not bradykinesia)
122
Q

selegiline - mech, use

A 
MAOb inhib (preferentially reduce breakdown of DA over NE / 5-HT)
parkinson's
123
Q

memantine - mech, use

A

NMDA receptor antagonist - prevent excitotox

alzheimer’s

124
Q

donepezil / galantamine / rivastigmine - mech, use

A

AChE inhibs

alzheimer’s

125
Q

tetrabenazine / reserpine - mech, use

A

inhibit VMAT - limit DA vesicle packaging and release

huntington’s

126
Q

tx for Huntington’s

A

tetrabenazine and reserpine

haloperidol

127
Q

sumatriptan - mech, use, tox

A

5HT 1b/1d agonist, inhib trigeminal nerve activation, induce vasoconstriction
acute migraine, cluster HA
tox - coronary vasospasm

EBSE (18 decks)

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