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A-Step 1 > Neuro 3 > Flashcards

Neuro 3 Flashcards

1
Q

Neurologic damage associated with B12 deficiency

A

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

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2
Q

Best lab test for B12 deficiency

A

High serum methylmalonic acid levels

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3
Q

Syringomyelia

A

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

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4
Q

Symptoms of ventral white commissure damage

A

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

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5
Q

hydrocephalus
intracranial calcifications
chorioretinitis
in a newborn

A

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

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6
Q

Myoclonic seizures

A

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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7
Q

First line drug of choice for myoclonic seizures

A

valproic acid

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8
Q

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

A

carbamazepine

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9
Q

First line drug of choice for tonic-clonic seizures

A

phenytoin, carbamazepine, valproate

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10
Q

First line drug of choice for absence seizure

A

ethosuximide

second-> valproate

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11
Q

MOA of valproic acid

A

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

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12
Q

signs of upper motor neuron lesion

A

hyperreflexia, spasticity, babinski sign

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13
Q

Gram positive rods with tumbling motility at room temperature

A

Listeria monocytogenes

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14
Q

Most common cause of listeria transmission in adults

A

refrigerated food

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15
Q

MOA of organophosphate poisioning

A

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

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16
Q

Treatment for organophosphate posioning

A 
muscarinic antagonists (atropine)
cholinesterase enzyme inhibitor (pralidoxime)
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17
Q

Symptoms of CNIII palsy

A

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

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18
Q

Most worrisome cause of CNIII palsy

A

enlarging intracranial aneurysm

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19
Q

Vision deficit caused by macular lesion

A

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

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20
Q

Causes of polyhydraminos

A

decreased fetal swallowing: fistula or anencephaly

increased urine output: anemia or twin-twin transfusion

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21
Q

MOA of buproprion

A

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

22
Q

Drugs that can cause seizures

A 
buproprion
clozapine- antipsychotic
isoniazid- if given without B6
ciprofloxacin
imipenem
---Higher risk in patients with previous seizures, anorexia, or bullemia---
23
Q

Signs of lower motor neuron lesion

A

flaccid paralysis, areflexia, atrohpy, fasiculation

24
Q

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

A

Above or below anterior horn

25
Q

homonymous hemianopsia

A

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

26
Q

Vitamin E deficiency mimics what inherited disorder?

A

Friedreich’s ataxia

27
Q

Symptoms of Friedreich’s ataxia and vitamin E deficiency

A

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

28
Q

Antipsychotic side effects

A

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

29
Q

Axonal reaction

A

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

30
Q

Two classes of dopamine agonists used in Parkinson’s

A

ergot compounds- bromocriptine and pergolide

nonergot compounds- pramipexole and ropinrole

31
Q

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

A

Prevents transcription via hypermethylation of histones

32
Q

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

A

2 weeks

33
Q

Treatment for toxoplasmosis

A

protozoan: treat with pyrimethamine and sulfadiazine

34
Q

Second most common cause of brain lesion in AIDS patient?

A

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

35
Q

Nerve that innervates posterior (extensor) compartment of the arm

A

radial

36
Q

Radial nerve provides innervation to what part of the hand?

A

radial half or the dorsal hand

37
Q

Median nerve supplies sensory innervation to what part of the hand

A

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

38
Q

What nerve is damaged by radial head subluxation

A

deep branch or radial nerve

39
Q

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

A

can cause priaprism

40
Q

What nerve innervates the stapedius muscle?

What is the consequence of paralysis of this muscle?

A

Innervated by stapedius nerve (branch of CNVII)

paralysis causes increased sensitivity to sound

41
Q

CNS side effect of levadopa?

A

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

42
Q

MOA of morphine

A

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

43
Q

Signs of lesion to occipital lobe

A

homonymous hemianopia with macular sparing

Caused by PCA infarct

44
Q

Recurrent lobar hemorrhage in elderly

A

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

45
Q

What genetic disorder is associated with bilateral acoustic neuromas?

A

NF-2, gene found on chromosome 22

46
Q

Two immediate physical symptoms of marijuana use

A

rapid heart rate and conjunctival injection

47
Q

How long is marijuana retained in tissues?

A

Lipophilic, can stay in tissues for up to 30 days

48
Q

What structures can become compromised in transtentorial herniation?

A

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

49
Q

Phenytoin toxicities

A
  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
50
Q

Which atypical antipsychotic is most likely to cause Extrapyramidal symptoms

A

Risperidone

A-Step 1 (15 decks)

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