Neuro 3 Flashcards by Lauren Bretz

Neurologic damage associated with B12 deficiency

subacute, combined degeneration of the posterior and lateral spinal columns.

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Best lab test for B12 deficiency

High serum methylmalonic acid levels

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Syringomyelia

disproportionate loss of pain and temperature sensation involving arms and hands. Causes damage to central white commissure.

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Symptoms of ventral white commissure damage

loss of pain and temperature sensation bilaterally. Still have touch, vibration, and temperature

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hydrocephalus
intracranial calcifications
chorioretinitis
in a newborn

Congenital toxoplasma infection. Why pregnant mothers should not handle cat litter

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Myoclonic seizures

repetitive seizures consisting of brief, symmetric, muscular contraction with loss of body tone.
Seizures are precipitated by stress and sleep deprivation

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First line drug of choice for myoclonic seizures

valproic acid

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First line drug of choice for partial seizures (simple and complex)

carbamazepine

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First line drug of choice for tonic-clonic seizures

phenytoin, carbamazepine, valproate

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First line drug of choice for absence seizure

ethosuximide

second-> valproate

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MOA of valproic acid

supresses abnormal electric activity in the cortex by affecting GABA and NMDA receptors as well as Na and K channels

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signs of upper motor neuron lesion

hyperreflexia, spasticity, babinski sign

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Gram positive rods with tumbling motility at room temperature

Listeria monocytogenes

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Most common cause of listeria transmission in adults

refrigerated food

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MOA of organophosphate poisioning

irreversible cholinesterase inhibitors. Elicit cholinergic stimulation that lasts until new cholinesterase can be synthesized

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Treatment for organophosphate posioning

muscarinic antagonists (atropine)
cholinesterase enzyme inhibitor (pralidoxime)

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Symptoms of CNIII palsy

ptosis
downward and laterally deviated eye
impaired pupillary constriction and accommodation
diagonal diploplia

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Most worrisome cause of CNIII palsy

enlarging intracranial aneurysm

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Vision deficit caused by macular lesion

central scotoma: altered central vision surrounded by areas of normal vision

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Causes of polyhydraminos

decreased fetal swallowing: fistula or anencephaly

increased urine output: anemia or twin-twin transfusion

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MOA of buproprion

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inhibits presynaptic reuptake of dopamine and norepinephrine (greater effect on dopamine)

Drugs that can cause seizures

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buproprion
clozapine- antipsychotic
isoniazid- if given without B6
ciprofloxacin
imipenem
---Higher risk in patients with previous seizures, anorexia, or bullemia---

Signs of lower motor neuron lesion

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flaccid paralysis, areflexia, atrohpy, fasiculation

Where do you draw the line between upper motor neurons and lower motor neurons?

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Above or below anterior horn

homonymous hemianopsia

visual field loss of half (vertically) of the same side of both eyes (left half of visual field of both eyes). Caused by optic tract lesion Optic tract leison also associated with abnormal swinging flashlight test

Vitamin E deficiency mimics what inherited disorder?

Friedreich's ataxia

Symptoms of Friedreich's ataxia and vitamin E deficiency

ataxia, dysarthria, loss of both position and vibration sensation Due to degeneration of spinocerebellar tracts, dorsal columns, and peripheral nerves

Antipsychotic side effects

Extrapyramidal: - acute dystonic reaction (muscle contractions) - akathisia (restlessness) - Drug induced parkinsonism Tardive dyskinesia (involuntary movements) Neuroepileptic malignant syndrome: fever, rigidity, mental status changes, autonomic instability

Axonal reaction

changes in the body of a neuron after the axon has been damaged Increased protein synthesis: enlarged, rounded cells, peripherally located nuclei, dispersed finely granular Nissl substance

Two classes of dopamine agonists used in Parkinson's

ergot compounds- bromocriptine and pergolide | nonergot compounds- pramipexole and ropinrole

How does the abnormal huntingtin protein effect expression of other genes?

Prevents transcription via hypermethylation of histones

When do we draw the line between maternity blues and postpartum depression?

2 weeks

Treatment for toxoplasmosis

protozoan: treat with pyrimethamine and sulfadiazine

Second most common cause of brain lesion in AIDS patient?

primary central nercous system lymphoma, often associated with latent EBV infection B cell lymphoma

Nerve that innervates posterior (extensor) compartment of the arm

radial

Radial nerve provides innervation to what part of the hand?

radial half or the dorsal hand

Median nerve supplies sensory innervation to what part of the hand

palmar and dorsal surfaces of the first 3 and 1/2 digits

What nerve is damaged by radial head subluxation

deep branch or radial nerve

Why is trazodone (antidepressent used for insominia) contraindicated in adolescent boys?

can cause priaprism

What nerve innervates the stapedius muscle? | What is the consequence of paralysis of this muscle?

Innervated by stapedius nerve (branch of CNVII) | paralysis causes increased sensitivity to sound

CNS side effect of levadopa?

Dopamine increases anxiety and agitation. Will not be decreased by addition of carbadopa, but worsened because more dopamine is available for the brain

MOA of morphine

binds to mu opioid receptors, activates potassium channels to increase efflux -> hyperpolarizes postsynaptic neurons and cease pain transmission

Signs of lesion to occipital lobe

homonymous hemianopia with macular sparing | Caused by PCA infarct

Recurrent lobar hemorrhage in elderly

cerebral amyloid angiopathy (amyloid deposited in arterial wall, weakens wall and predisposes it to rupture.

What genetic disorder is associated with bilateral acoustic neuromas?

NF-2, gene found on chromosome 22

Two immediate physical symptoms of marijuana use

rapid heart rate and conjunctival injection

How long is marijuana retained in tissues?

Lipophilic, can stay in tissues for up to 30 days

What structures can become compromised in transtentorial herniation?

Occulomotor nerve- fixed, dilated pupil Posterior cerebral artery Contralateral cerebral peduncle Basilar artery- brainstem hemmorrhages

Phenytoin toxicities

1. Ataxia and nystagmus 2. gingival hyperplasia, coarsening of facial features, hirsutism 3. megaloblastic anemia (messes with folate metabolism) 4. Cyp450 inducer 5. Teratogenic- fetal

Which atypical antipsychotic is most likely to cause Extrapyramidal symptoms

Risperidone

Neuro 3 Flashcards

(50 cards)