NEURO 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
2
Q
chronic thiamine (b1) deficiency leads to
A
diminished ability of cerebral cells to utilize glucose
3
Q
mechanism of b1 deficiency
A
decreased function of enzymes that use B1 as a cofactor:
pyruvate DH
a-kg DH
transketolase
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
5
Q
cannot undergo mitochondrial beta oxidation
A
vlcfa, phytanic acid
6
Q
peroxisome takes vlcfa and phytanic acid and metabolizes them via
A
special beta ox or alpha ox
7
Q
Zellweger syndrome
A
infants are unable to properly form myelin in the CNS
8
Q
Refsum disease
A
results from a defect in peroxismal alpha ox and leads to accum of phytanic acid in body;
9
Q
Decreases morbidity and mortality due to cerebral vasopasm ff SAH
A
Nimodipine
10
Q
threat ff SAH
A
vasospasm in 20-30% of patients; altered mental status and focal neuro deficits
11
Q
sx of vasopasm occur ___ days ff SAH
A
3-8 days
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)
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
14
Q
synringomelia presentation
A
bilateral loss of pain and temp
destruction of motor neurons causes
flaccid paralysis and
atrophy of intrinsic hand ms
15
Q
GABA A and C are
A
ion channels
16
Q
GABA b receptor is linked to a
A
G-protein
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
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
19
Q
antipsychotics can cause
A
EPS sx!
20
Q
tx for drug-induced parkinsonism
A
benztropine and trihexyphenidyl
[(EPS) centrally acting antimuscarinic agents]
21
Q
sciatica mostly involved
A
L5 or S1
22
Q
a strong non-specific muscarinic agonist has been developed. this would ML
A
release endothelium-derived relaxation factor
23
Q
In ischemic brain infarcts, red neurons appear…
A
12-24 hours later
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
25
How to correct cardiac abn caused by TCA
sodium bicarbonate
26
5 y/p recent onset gait instability and ataxia. midline posterior fossa mass. biopsy: sheets of primitive cells and many mitotic figures
medulloblastoma
27
cerebellar tumors
pilocytic astrocytoma, medulloblastoma
28
MR, large ears, long face, prom mandible, large testes. Hand joints are hyperextensible. ML dx?
fragile X syndrome
29
short acting hypnotic that's not BZD
zolpidem
30
tx resistant depression and insomnia. painful erection. what med is this?
trazodone
31
prog gait instability and dysarthria, degeneration of post col and SCB tracts.
freidrich's ataxia
32
Freidrich's ataxia is closely mimicked by
vitamin E deficiency
33
headaches and vomiting, papilledema, dry skin, hepatosplenomegaly. cause of condition?
vit A overuse can result in intracranial HTN, skin changes, hepatosplenomegaly
34
significant kyphoscoliosis and high plantar arch. ML to experience...
degeneration of the spinocerebellar tracts
35
atrophy of the caudate nucleus
huntington dse
36
upper motor neuron lesions cause
spastic rigidity, hyperreflexia and paresis
37
can cause UMNL
CS tract, internal capsule- posterior limb, primary motor cortex lesions
38
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?
small vessel lipohyalinosis
39
an infant has difficulty feeding because of an underdeveloped mandible. dev of the ff structures is also impaired
malleus (first arch syndrome, associated with trigem nerve)
40
common SE of sertraline
sexual dysfunction (SSRI)
41
atropine poisoning
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
42
reversal of atropine poisoning
cholinesterase inhibitors (physostigmine)
43
atropine is indicated for ___
tx of bradycardia; decreases vagal influence on SA and AV
44
common SE of atropine
increased IOP, may precipitate acute closed-angle glaucoma in some pts
45
inhaled anesthetic has a very high arteriovenous concentrtion after beginning inhalation. best describes properties of the new anesthetic?
slow onset of action
46
korsakoff syndrome is associated with
damage of medial dorsal nucleus of the thalamus
47
permanent in Korsakoff syndrome
permanent memory loss and confabulation
48
organophosphate tx: atropine vs pralidoxime
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
49
primary CNS lymphoma of AIDS
associated with EBV, +cd20 and 79a
50
Measles virus is
a helical, enveloped RNA virus, member of Paramyxoviridae (contains hemagglutinin in its capsid)
51
saccular aneurysms are found in
circle of Willis, with ACA being the most common site
52
charcot bouchard anuerysms are found in
arterioles that supply the basal ganglia, internal capsule, deep white matter
53
diabetic mononeuropathy
inv CN3, nerve damage is ischemic, only somatic nerve fibers are affected. PS retain fx.
54
angiomatous lesion inv CB; cystic mass in right kidney
VHL dse
55
wild, fliinging movements of right arm. pmi sign for long standing HTN. which area of brain inj
subthalamic nucleus
56
huntington dse
chorea, dementia, behav abn; caudate n atrophy
57
peripheral neuropathy in DM due to
endoneural arteriole hyalinization
58
shrill crying, tremor, rhinorrhea, sneezing, diarrhea
opium withdrawal
59
low dose-morphine injected into epidural space. ML direct postsynaptic action of the drug on the spinal level?
increasing potassium efflux out of the cells
60
MOA triptans
postsynaptic serotonin receptor stimulation
61
Refsum dse tx
avoid chlorophyll
62
MOA sumatriptan
postsynaptic serotonin receptor stimulation
63
Lamotrigine is used for _____, watch out for ______
refractory partial seizures; skin rash
64
Effect of pramipexole
stimulates dopamine receptors
65
Biochemical in Alzheimer's
decreased choline acetyltransferase activity in nucleus basalis
66
right-sided weakness and numbness, with arm more severely affected than his leg. Embolus in
left middle cerebral artery
67
Most common tumor of the pineal gland
germinoma
68
bilateral acoustic neuromas
NF2 on chromosome 22
69
autopsy: intense, bilateral hemorrhagic necrosis of inferior and medial temporal lobes. condition cuased by
herpesvirus infection
70
Guillain-Barre syndrome light microscopy
segmental demyelination of peripheral nerves and an endoneural inflammatory infiltrate
71
effect of entacapone
increases the quantity of levodopa entering the brain
72
3 mutation sites associated with early-onset familial Alzheimer's
APP on chr 21
presenilin 1 gene on chr 14
pres 2 on chr 1
73
what happens to the brain ff cardiac arrest
diminished supply to the entire brain causing global cerebral ischemia, or ischemic-hypoxic encephalopathy
74
most vulnerable areas of the brain to hypoxia
pyramidal cells of hippocampus, purkinke cells of CB; necrosis of areas supplied by distal-most brances (watershed infarction)
75
stain for GFAP
neoplasms of glial origin- astrocytomas, ependymomas, oligodendrogliomas
76
synaptophysin
protein found in presynaptic vesicles of neurons, neuroendocrine, and neuroectodermal cells
77
2 drugs for absence seizures
ethosux and valproate
78
severe serotonin syndrome- treatment
cyproheptadine - 1st gen histamine antagonist with nonspec 5HT1 and 2 receptor antagonistic properties
79
why would PENTAZOCINE precipitate opoid withdrawal in opoid addicts?
it's a partial opioid agonist against mu receptors
80
Late onset Alzheimer's disease caused by
apolipoproteinE4 protein (formation of senile plaques)
81
Histo of pilocytic astrocytoma
well-diff neoplasms comprised of spindle cells. Mixed with Rosenthal fibers and granular eosinophilic bodies
82
Muscle fivers more affected in myotonic dystrophy?
type 1
83
Compression of the S1 root results specifically in..
pain purely in the posterior thigh and leg
| diminution of the ankle jerk reflex
84
sciatica is characterized by
shooting pain down the posterior thigh and leg; results from impingement of one of the spinal nerves as it leaves the vertebral column
85
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86
it is shown that ketamine can block tolerance development to morphine. which NT is ML modulated to achieve the effect described?
glutamate
87
Naloxone
pure opioid receptor antagonist used for treating opioid intoxication or overdose
88
naloxone has the greatest affinity for
mu receptors
89
both upper and lower motor neuron lesions
ALS
90
ALS
loss of neurons of the anterior horns of the SC
| demyelination of lateral CS tract (UMNL)
91
ALS sx
muscle weakness and atrophy, spasticity and hyperreflexia
92
4 y/o asian boy presents bc of facial hair growth. PE: enlraged genitalia, pubic hair growth, and impaired upward gaze. this is a
pineal germinoma
93
Parinaud syndrome
paralysis of upward gaze and convergence- occur due to compression of the tectal area of the MB; pineal tumor
94
non-enzymatic glycosylation of proteins leads to
increased thickness, hyalinization, and narrowing of arterial walls.
95
INTRAPARENCHYMAL HEMORRHAGE
MCC hypertension; through frmation of C-B pseudoans in small arterioles of BG and thalami
96
SAH
saccular aneurysm
97
level of middle CB peduncle in pons
trigeminal nerve
98
LAKE LIKE CAVITARY LESION IN LEFT INTERNAL CAPSULE
hypertensive arteriolar sclerosis of small, penetrating arterioles
99
Arnold chiari malformation is
The caudal extension of medulla and cerebellar vermis through the foramen magnum
100
Arnold chiari malformation is found with
Non communicating hydrocephalus, platybasia
101
Dandy walker malformation is
Partial or complete absence of cerebellar vermis
102
Dandy walker found with
Cystic dilation of fourth ventricle, non communicating hydrocephalus
103
Syringomelia is
Fluid filled cavity within the cervical spinal cord that produces cord enlargement, expands and degenerates spinal tracts
104
Syringomelia presentation
Decreased pain and temperature sensation in hands, loss of intrinsic hand muscles
105
Syringomelia destructs...
Crossed lateral spinothalamic tracts, anterior horn cells
106
NF1 associated with
Optic gliomas
Lisch nodules
Axillary/inguinal freckling
107
NF1 tumor associations
Pheochromocytoma
Wilms tumor
CML (juvenile)
108
NF2 associated with
Bilateral acoustic neuromas
Juvenile cataracts
Meningiomas
109
Tuberous sclerosis
AD, mental retardation; hamartomas in brain and kidneys
110
Tuberous sclerosis triad
Seizures
Mental retardation
Angiofibromas
Ash leaf lesions
111
Highly predictive of tub sclerosis
Rhabdomyoma
112
Describe vascular face malformation of sturge weber syndrome
In a trigeminal nerve distribution
113
Arnold chiari malformation is
The caudal extension of medulla and cerebellar vermis through the foramen magnum
114
Arnold chiari malformation is found with
Non communicating hydrocephalus, platybasia
115
Dandy walker malformation is
Partial or complete absence of cerebellar vermis
116
Dandy walker found with
Cystic dilation of fourth ventricle, non communicating hydrocephalus
117
Syringomelia is
Fluid filled cavity within the cervical spinal cord that produces cord enlargement, expands and degenerates spinal tracts
118
Syringomelia presentation
Decreased pain and temperature sensation in hands, loss of intrinsic hand muscles
119
Syringomelia destructs...
Crossed lateral spinothalamic tracts, anterior horn cells
120
NF1 associated with
Optic gliomas
Lisch nodules
Axillary/inguinal freckling
121
NF1 tumor associations
Pheochromocytoma
Wilms tumor
CML (juvenile)
122
NF2 associated with
Bilateral acoustic neuromas
Juvenile cataracts
Meningiomas
123
Tuberous sclerosis
AD, mental retardation; hamartomas in brain and kidneys
124
Tuberous sclerosis triad
Seizures
Mental retardation
Angiofibromas
Ash leaf lesions
125
Highly predictive of tub sclerosis
Rhabdomyoma
126
Describe vascular face malformation of sturge weber syndrome
In a trigeminal nerve distribution
127
Most common acquired defect in meningoiomas
NF22 on chr 22, Merlin gene
