neuro Flashcards
narcolepsy (deficiency of… what is cataplexy?)
-deficiency of orexin-cataplexy is loss of motor function of legs in response to strong emotions (falling to the ground when laughing)
guillen barre
-acute demyelinating disease, ascending bilaterally-typically follows infection (campy jejuni)-tx: with plasmapheresis and IgG can make for full recovery
quiss, qiq, siq, sqs (kiss, kick, sick, super kinky sex)
-a1, a2, b1, b2 -m1, m2, m3-d1, d2, h1,-h2, v1, v2
embryologic origin of chromaffin cells… what do they secrete
-neural crest-nor-epi, epi etc, from adrenal medulla
tau protiens
-Picks disease
alpha-synuclein
-dimentia with lewy bodies
neurofibrillary tangles
-alzheimer’s disease
vagotomy
-transection of the vagus nerve, used to decrease stomach acid secretion in peptic ulcer dz refractory to medical tx:
explosive, constant headaches (type, tx, associated symptoms, where is the headache located, when do you get them)
- cluster headaches-abbortive O2 therapy-lacrimation, ptosis, conjunctival injection, nasal congestion
- unilateral, often involving the eye or right temple
- often occurs at night
korsakoff’s amnesia
-profound inability to form new memories, final stages of weirnicke’s encephalopathy -due to bilateral destruction of maxillary bodies
cryptococcal meningitis (who is at risk, what is tx)
- sub-acute meningitis-immunocompromised pts
- amphotericin b and flucytosine
otitis externa (bug, signs, who gets it)
-pseudomonas -periauricular pain and erythema-swimmers
ventral posteriormedial nucleus
-all sensory modalities of the face
lateral geniculate nucleus
-visual information from the optic tract
medial geniculate nucleus
-auditory information for inferior colliculus
ventral posteriorlateral nucleus
-all sensory modalities from the body
patau syndrome (chromosome and CNS development)
- trisomy 13
- holoprosencephaly, problems with fusion of midline structures
- micropthalmia, polydactyly, congenital heart disease
vertical and horizontal nystagmus (why and tx)
- PCP
- benzos
meningitis in non-immunized children (and tx)
- H.influenza
- 3rd gen cephalosporin
neurotransmitter responsible for REM sleep
-acetylcholine
which spinal tracts are affected in central pontine myelinolysis? (2)
-corticospinal and corticobulbar
multiple sclerosis… (HLA… 3 common signs… diagnosis… tx…)
- association with HLA-DR2
- scanning speech, blurry vision (one eye) internuclear opthalmopalegia (MLF)
- IgG oligoclonal bands
- steroids (acute exacerbation) interferon beta (chronic)
demyelinating associations… (MS, subacute sclerosing panenecephalitis, progressive multifocal leukoencephalopathy, central pontine myelinolysis)
- oligoclonal IgG bands
- measles virus, progressive, leads to death
- JC virus, waits for immunocompromised time in your life
- locked in syndrome
metastatic brain cancer (what percentage of brain cancers, where do mets come from, where do the end up)
- 50%
- breast, liver, kidney (3 most common)
- well circumscribed, typically at grey/white junction
leukodystrophies: name them (3), inheritance, problem
- metachromatic leukodystrophy: AR, deficiency of aryl sulfatase, most common, accumulate in lysosomes of myelin producing cells
- krabbe disease: AR, deficiency of galactocerebrosidase, accumulates in macrophages
- adrenoleukodystrophy: X-linked, impaired addition of coenzyme-A to fatty acids
normal pressure hydrocephaly (classic triad, pathophys, tx)
- wet, wobbly, wacky (urinary incontinence, gait difficulty, mental decline), treatable cause of dementia
- too much CSF, over production or decrease absorption
- ventriculoperitoneal shunt
subthalamic n. acts indirectly on thalamus by…
-activating globus pallidus internus, which then inhibits the thalamus
rubeola virus (what is it, and potential bad outcome)
- measles
- can lead to subacute sclerosing panencephalitis
meningitis in very young and very old patients… (organism and empiric tx)
- listeria (often due to unpasteurized dairy)
- ampicillin
transport from hypothalamus to posterior pituitary requires transport proteins
- nuerophysin I: oxytocin
- neurophysin II: ADH
fungal meningitis (CSF profile, common pathogen, tx)
- high opening pressure, high WBC, high protein NL/low glucose
- crypto
- induction with amphotericin B, continue with flucytosine
trisomy 21 has associated risks congenitally (1) and later in life (3)
- congenital heart defect
- early onset alzheimers, ALL and AML
psammoma bodies occur where… (4)
- PSaMMoma
- Papillary (thyroid)
- Serous (ovary)
- Meningioma
- Mesothelioma
Neuroblastoma (presents as, genetics)
- large mass, can be anywhere along sympathetic chain, often adrenal medulla, elevated catecholamines, HTN
- n-myc
dementia with levy bodies (classic (differentiating) symptoms… accumulation of…)
- visual hallucinations w/memory decline and parkinsonism
- alpha-synuclein
only seen in LMN deficits…
-fasciculations, muscle twitching as neuron dies and releases ACh
tx for increasing ICP
- intubate and hyperventilate
- CO2 is powerful vasodilator for cerebral vessels, blow off as much as you can
at risk for bell’s palsy
-AIDS, lyme disease, sarcoid, tumors (ya i know)
full anterior fontanelle
- elevated ICP…
- possibly due to neonatal meningitis
tetanus (MOA)
-toxin that prevents release of glycine
gerstmen’s syndrome (4) and location of lesion
-inability to distinguish right from left, distinguish fingers, write and do math
angular gyrus
physical signs of fetal alcohol syndrome
- microcephaly, low set ears, thin lips
- left/right shunt
- mental delay
neonatal meningitis (3 organisms) and complication (after successful tx)
- group B strep, beta hemolytic, bacitracin resistant, gram positive in chains
- e.coli
- listeria
- meningeal scarring… elevated ICP
B12 deficiency results in degeneration of neurons and myelin in… (3)
- dorsal columns
- lateral corticospinal tract
- spinocerebellar tract
fried eggs in the brain
- oligodendrocytes… oligodendroglioma
- most common in frontal lobes
fragile-X syndrome (phenotype and inheritance, genetics)
- long face, macroorchidism, large everted ears
- X linked…
- CGG repeat (demonstrates anticipation) in FMR1 gene
fabrys (inheritance, enzyme, accumulation)
- x-linked
- a-galactosidase A
- leads to accumulation of ceremide trihexoside
diabetics and sinuses…? and feared complication
- mucor infection (high glucose content?)
- meningitis
medial medullary syndrome
- due to infarct of the medial medulla in the brainstem
- face is spared with exception of deviation of tongue
- pain and temp spared, motor and proprioception diminished (UMN pattern)
condution aphasia (pt symptoms, what structure is affected, what is it’s normal role)
- language is normal, except cannot repeat
- due to failure of communication between broca’s and wernicke’s area via arcuate fasciculus
cherry red spots on fudiscopic exam… (2)
- tay sachs and neimann pick
- lysosomal storage disorder
CMV eye problems
- rapid progressive vision loss
- eventual retinal detachment
arnold-chiari has common association with dilating spinal cord problem… (which damages which part of the cord)
- syringomyelia
- spinothalamic tract as it sends crossing fibers
- results in bilateral loss of paint/temp
HIV pt with really low CD4 is at risk of new onset siezures due to infection with…
-toxoplasmosis gondii
neurofibromatosis type 1 (signs/symptoms, gene (and chromosome location))
- nuerofibromas in skin, cafe-au-lait spots, spinal cord lesion, lisch nodules (pigmented hamartomas of the iris),
- AD inheritance, NF-1 gene on chromosome 17, leads to decresed activity of Ras
neuroleptic malignant syndrome
- onset of fever, hypertension, muscle aches, rigidity after admin of either typical or atypical antipsychotics
- caused by blockade of dopamine receptors
chemoreceptor trigger zone (CTZ) - where is it located and why is that important
- located in the posterior medulla, at the floor of the 4th ventricle
- it is outside the BBB, so it can sense toxic substances and initiate vomiting
neurofibromatosis-2 (NF-2) (does NOT affect what, DOES effect what (pathognomonic))
- does NOT affect oligodendrocytes
- acoustic neuromas (schwannoma of CN8)
most common direct brain abnormality in HIV
-HIV dementia complex
where are the following made: norepi, ACh, serotonin, dopamine
- locus ceruleus
- basal nucleus of Meynert
- raphe nucleus
- ventral tegmentum and substantia nigra
bunion bodies (what are they???)
- cytoplasmic inclusions, PAS positive remnants of autophagic vacuoles
- seen in neurons of ALS patients
neural tube closer defects (drugs that cause it, preventative supplement, lab test to detect problem in utero)
- carbemazepine and valproate
- folate
- elevated alpha-fetoprotein
macrophages of brain… (bonus point for macrophages of liver and skin)
- microglial cells
- kupfer cells (liver)
- langerhans cells (skin)
artery of adamkiewicz (where is it, what does it supply blood to?)
- leaves aorta, enters spinal cord at level of T8
- blood supply for ventral spinal cord below the level of T8
