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USMLE 1 > NEURO > Flashcards

NEURO Flashcards

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USMLE® Step 1 flashcards
1
Q

autopsy of a homeless man shows foci of hemorrhage and necrosis in the mamillary bodies and gray matter surrounding the third and fourth ventricles. Could have been dx measuring

A

erythrocyte transketolase activity

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2
Q

chronic thiamine (b1) deficiency leads to

A

diminished ability of cerebral cells to utilize glucose

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3
Q

mechanism of b1 deficiency

A

decreased function of enzymes that use B1 as a cofactor:
pyruvate DH
a-kg DH
transketolase

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4
Q

cultured fibroblasts from an infant w hypotonia and seizures shows an impaired ability to oxidize VLCFA and phytanic acid. defect localized to

A

peroxisomes

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5
Q

cannot undergo mitochondrial beta oxidation

A

vlcfa, phytanic acid

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6
Q

peroxisome takes vlcfa and phytanic acid and metabolizes them via

A

special beta ox or alpha ox

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7
Q

Zellweger syndrome

A

infants are unable to properly form myelin in the CNS

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8
Q

Refsum disease

A

results from a defect in peroxismal alpha ox and leads to accum of phytanic acid in body;

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9
Q

Decreases morbidity and mortality due to cerebral vasopasm ff SAH

A

Nimodipine

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10
Q

threat ff SAH

A

vasospasm in 20-30% of patients; altered mental status and focal neuro deficits

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11
Q

sx of vasopasm occur ___ days ff SAH

A

3-8 days

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12
Q

unable to tolerate everyday sounds. injury of CN ___

A

facial nerve; stapedius muscle allows wider oscillation of stapes and increased sensitivity to sound (hyperacusis)

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13
Q

synringomelia PP

A

csf flled cavities enlarge over time and destroy adjacent portions of the cord;

commonly ventral white commissure and ventral horn

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14
Q

synringomelia presentation

A

bilateral loss of pain and temp

destruction of motor neurons causes
flaccid paralysis and
atrophy of intrinsic hand ms

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15
Q

GABA A and C are

A

ion channels

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16
Q

GABA b receptor is linked to a

A

G-protein

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17
Q

benzos, barbs, and alc MOA

A

bind to diff components of the GABA A receptor and facilitate the inhibitory action of GABA in the CNS

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18
Q

21 y/o with weakness and gait disturbance. difficulty releasing the doorknob. cataracts, frontal baldness, gonadal atrophy. biopsy shows muscle atrophy involving type 1 fibers

A

myotonic dystrophy

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19
Q

antipsychotics can cause

A

EPS sx!

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20
Q

tx for drug-induced parkinsonism

A

benztropine and trihexyphenidyl

[(EPS) centrally acting antimuscarinic agents]

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21
Q

sciatica mostly involved

A

L5 or S1

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22
Q

a strong non-specific muscarinic agonist has been developed. this would ML

A

release endothelium-derived relaxation factor

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23
Q

In ischemic brain infarcts, red neurons appear…

A

12-24 hours later

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24
Q

55 y/o w severe confusion and hallucinations. Mouth is dry and face is flushed. Low bp, tachycardeic. QRS prolongation and premature ventricular beats. what is this?

A

TCA-associated cardiac abnormalities

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25
Q

How to correct cardiac abn caused by TCA

A

sodium bicarbonate

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26
Q

5 y/p recent onset gait instability and ataxia. midline posterior fossa mass. biopsy: sheets of primitive cells and many mitotic figures

A

medulloblastoma

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27
Q

cerebellar tumors

A

pilocytic astrocytoma, medulloblastoma

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28
Q

MR, large ears, long face, prom mandible, large testes. Hand joints are hyperextensible. ML dx?

A

fragile X syndrome

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29
Q

short acting hypnotic that’s not BZD

A

zolpidem

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30
Q

tx resistant depression and insomnia. painful erection. what med is this?

A

trazodone

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31
Q

prog gait instability and dysarthria, degeneration of post col and SCB tracts.

A

freidrich’s ataxia

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32
Q

Freidrich’s ataxia is closely mimicked by

A

vitamin E deficiency

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33
Q

headaches and vomiting, papilledema, dry skin, hepatosplenomegaly. cause of condition?

A

vit A overuse can result in intracranial HTN, skin changes, hepatosplenomegaly

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34
Q

significant kyphoscoliosis and high plantar arch. ML to experience…

A

degeneration of the spinocerebellar tracts

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35
Q

atrophy of the caudate nucleus

A

huntington dse

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36
Q

upper motor neuron lesions cause

A

spastic rigidity, hyperreflexia and paresis

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37
Q

can cause UMNL

A

CS tract, internal capsule- posterior limb, primary motor cortex lesions

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38
Q

pure sensory stroke. 5 years later, dies. autopsy shows 5mm cavties in deep structures of her brain filled with clear fluid. best explains autopsy findings?

A

small vessel lipohyalinosis

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39
Q

an infant has difficulty feeding because of an underdeveloped mandible. dev of the ff structures is also impaired

A

malleus (first arch syndrome, associated with trigem nerve)

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40
Q

common SE of sertraline

A

sexual dysfunction (SSRI)

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41
Q

atropine poisoning

A

blind as bat, mat as a hatter, red as a beet, hot as a hare, dry as a bone, the bowel and bladder lose their tone, and the heart runs alone

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42
Q

reversal of atropine poisoning

A

cholinesterase inhibitors (physostigmine)

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43
Q

atropine is indicated for ___

A

tx of bradycardia; decreases vagal influence on SA and AV

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44
Q

common SE of atropine

A

increased IOP, may precipitate acute closed-angle glaucoma in some pts

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45
Q

inhaled anesthetic has a very high arteriovenous concentrtion after beginning inhalation. best describes properties of the new anesthetic?

A

slow onset of action

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46
Q

korsakoff syndrome is associated with

A

damage of medial dorsal nucleus of the thalamus

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47
Q

permanent in Korsakoff syndrome

A

permanent memory loss and confabulation

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48
Q

organophosphate tx: atropine vs pralidoxime

A

atropine reverses muscarinic effects but doesn’t prev dev of nicotinic effects like ms paralysis; pralidoxime rev both musc and nic eff by restring cholinesterase from its bond w these substances

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49
Q

primary CNS lymphoma of AIDS

A

associated with EBV, +cd20 and 79a

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50
Q

Measles virus is

A

a helical, enveloped RNA virus, member of Paramyxoviridae (contains hemagglutinin in its capsid)

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51
Q

saccular aneurysms are found in

A

circle of Willis, with ACA being the most common site

52
Q

charcot bouchard anuerysms are found in

A

arterioles that supply the basal ganglia, internal capsule, deep white matter

53
Q

diabetic mononeuropathy

A

inv CN3, nerve damage is ischemic, only somatic nerve fibers are affected. PS retain fx.

54
Q

angiomatous lesion inv CB; cystic mass in right kidney

A

VHL dse

55
Q

wild, fliinging movements of right arm. pmi sign for long standing HTN. which area of brain inj

A

subthalamic nucleus

56
Q

huntington dse

A

chorea, dementia, behav abn; caudate n atrophy

57
Q

peripheral neuropathy in DM due to

A

endoneural arteriole hyalinization

58
Q

shrill crying, tremor, rhinorrhea, sneezing, diarrhea

A

opium withdrawal

59
Q

low dose-morphine injected into epidural space. ML direct postsynaptic action of the drug on the spinal level?

A

increasing potassium efflux out of the cells

60
Q

MOA triptans

A

postsynaptic serotonin receptor stimulation

61
Q

Refsum dse tx

A

avoid chlorophyll

62
Q

MOA sumatriptan

A

postsynaptic serotonin receptor stimulation

63
Q

Lamotrigine is used for _____, watch out for ______

A

refractory partial seizures; skin rash

64
Q

Effect of pramipexole

A

stimulates dopamine receptors

65
Q

Biochemical in Alzheimer’s

A

decreased choline acetyltransferase activity in nucleus basalis

66
Q

right-sided weakness and numbness, with arm more severely affected than his leg. Embolus in

A

left middle cerebral artery

67
Q

Most common tumor of the pineal gland

A

germinoma

68
Q

bilateral acoustic neuromas

A

NF2 on chromosome 22

69
Q

autopsy: intense, bilateral hemorrhagic necrosis of inferior and medial temporal lobes. condition cuased by

A

herpesvirus infection

70
Q

Guillain-Barre syndrome light microscopy

A

segmental demyelination of peripheral nerves and an endoneural inflammatory infiltrate

71
Q

effect of entacapone

A

increases the quantity of levodopa entering the brain

72
Q

3 mutation sites associated with early-onset familial Alzheimer’s

A

APP on chr 21
presenilin 1 gene on chr 14
pres 2 on chr 1

73
Q

what happens to the brain ff cardiac arrest

A

diminished supply to the entire brain causing global cerebral ischemia, or ischemic-hypoxic encephalopathy

74
Q

most vulnerable areas of the brain to hypoxia

A

pyramidal cells of hippocampus, purkinke cells of CB; necrosis of areas supplied by distal-most brances (watershed infarction)

75
Q

stain for GFAP

A

neoplasms of glial origin- astrocytomas, ependymomas, oligodendrogliomas

76
Q

synaptophysin

A

protein found in presynaptic vesicles of neurons, neuroendocrine, and neuroectodermal cells

77
Q

2 drugs for absence seizures

A

ethosux and valproate

78
Q

severe serotonin syndrome- treatment

A

cyproheptadine - 1st gen histamine antagonist with nonspec 5HT1 and 2 receptor antagonistic properties

79
Q

why would PENTAZOCINE precipitate opoid withdrawal in opoid addicts?

A

it’s a partial opioid agonist against mu receptors

80
Q

Late onset Alzheimer’s disease caused by

A

apolipoproteinE4 protein (formation of senile plaques)

81
Q

Histo of pilocytic astrocytoma

A

well-diff neoplasms comprised of spindle cells. Mixed with Rosenthal fibers and granular eosinophilic bodies

82
Q

Muscle fivers more affected in myotonic dystrophy?

A

type 1

83
Q

Compression of the S1 root results specifically in..

A

pain purely in the posterior thigh and leg

diminution of the ankle jerk reflex

84
Q

sciatica is characterized by

A

shooting pain down the posterior thigh and leg; results from impingement of one of the spinal nerves as it leaves the vertebral column

85
Q

Copyright (c) USMLEWorld, LLC., Please do not save, print, cut, copy or paste anything while a test is active.

A

Copyright (c) USMLEWorld, LLC., Please do not save, print, cut, copy or paste anything while a test is active.

86
Q

it is shown that ketamine can block tolerance development to morphine. which NT is ML modulated to achieve the effect described?

A

glutamate

87
Q

Naloxone

A

pure opioid receptor antagonist used for treating opioid intoxication or overdose

88
Q

naloxone has the greatest affinity for

A

mu receptors

89
Q

both upper and lower motor neuron lesions

A

ALS

90
Q

ALS

A

loss of neurons of the anterior horns of the SC

demyelination of lateral CS tract (UMNL)

91
Q

ALS sx

A

muscle weakness and atrophy, spasticity and hyperreflexia

92
Q

4 y/o asian boy presents bc of facial hair growth. PE: enlraged genitalia, pubic hair growth, and impaired upward gaze. this is a

A

pineal germinoma

93
Q

Parinaud syndrome

A

paralysis of upward gaze and convergence- occur due to compression of the tectal area of the MB; pineal tumor

94
Q

non-enzymatic glycosylation of proteins leads to

A

increased thickness, hyalinization, and narrowing of arterial walls.

95
Q

INTRAPARENCHYMAL HEMORRHAGE

A

MCC hypertension; through frmation of C-B pseudoans in small arterioles of BG and thalami

96
Q

SAH

A

saccular aneurysm

97
Q

level of middle CB peduncle in pons

A

trigeminal nerve

98
Q

LAKE LIKE CAVITARY LESION IN LEFT INTERNAL CAPSULE

A

hypertensive arteriolar sclerosis of small, penetrating arterioles

99
Q

Arnold chiari malformation is

A

The caudal extension of medulla and cerebellar vermis through the foramen magnum

100
Q

Arnold chiari malformation is found with

A

Non communicating hydrocephalus, platybasia

101
Q

Dandy walker malformation is

A

Partial or complete absence of cerebellar vermis

102
Q

Dandy walker found with

A

Cystic dilation of fourth ventricle, non communicating hydrocephalus

103
Q

Syringomelia is

A

Fluid filled cavity within the cervical spinal cord that produces cord enlargement, expands and degenerates spinal tracts

104
Q

Syringomelia presentation

A

Decreased pain and temperature sensation in hands, loss of intrinsic hand muscles

105
Q

Syringomelia destructs…

A

Crossed lateral spinothalamic tracts, anterior horn cells

106
Q

NF1 associated with

A

Optic gliomas
Lisch nodules
Axillary/inguinal freckling

107
Q

NF1 tumor associations

A

Pheochromocytoma
Wilms tumor
CML (juvenile)

108
Q

NF2 associated with

A

Bilateral acoustic neuromas
Juvenile cataracts
Meningiomas

109
Q

Tuberous sclerosis

A

AD, mental retardation; hamartomas in brain and kidneys

110
Q

Tuberous sclerosis triad

A

Seizures
Mental retardation
Angiofibromas
Ash leaf lesions

111
Q

Highly predictive of tub sclerosis

A

Rhabdomyoma

112
Q

Describe vascular face malformation of sturge weber syndrome

A

In a trigeminal nerve distribution

113
Q

Arnold chiari malformation is

A

The caudal extension of medulla and cerebellar vermis through the foramen magnum

114
Q

Arnold chiari malformation is found with

A

Non communicating hydrocephalus, platybasia

115
Q

Dandy walker malformation is

A

Partial or complete absence of cerebellar vermis

116
Q

Dandy walker found with

A

Cystic dilation of fourth ventricle, non communicating hydrocephalus

117
Q

Syringomelia is

A

Fluid filled cavity within the cervical spinal cord that produces cord enlargement, expands and degenerates spinal tracts

118
Q

Syringomelia presentation

A

Decreased pain and temperature sensation in hands, loss of intrinsic hand muscles

119
Q

Syringomelia destructs…

A

Crossed lateral spinothalamic tracts, anterior horn cells

120
Q

NF1 associated with

A

Optic gliomas
Lisch nodules
Axillary/inguinal freckling

121
Q

NF1 tumor associations

A

Pheochromocytoma
Wilms tumor
CML (juvenile)

122
Q

NF2 associated with

A

Bilateral acoustic neuromas
Juvenile cataracts
Meningiomas

123
Q

Tuberous sclerosis

A

AD, mental retardation; hamartomas in brain and kidneys

124
Q

Tuberous sclerosis triad

A

Seizures
Mental retardation
Angiofibromas
Ash leaf lesions

125
Q

Highly predictive of tub sclerosis

A

Rhabdomyoma

126
Q

Describe vascular face malformation of sturge weber syndrome

A

In a trigeminal nerve distribution

127
Q

Most common acquired defect in meningoiomas

A

NF22 on chr 22, Merlin gene

USMLE 1 (11 decks)

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