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neuro Flashcards

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USMLE® Step 1 flashcards
1
Q

narcolepsy (deficiency of… what is cataplexy?)

A

-deficiency of orexin-cataplexy is loss of motor function of legs in response to strong emotions (falling to the ground when laughing)

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2
Q

guillen barre

A

-acute demyelinating disease, ascending bilaterally-typically follows infection (campy jejuni)-tx: with plasmapheresis and IgG can make for full recovery

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3
Q

quiss, qiq, siq, sqs (kiss, kick, sick, super kinky sex)

A

-a1, a2, b1, b2 -m1, m2, m3-d1, d2, h1,-h2, v1, v2

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4
Q

embryologic origin of chromaffin cells… what do they secrete

A

-neural crest-nor-epi, epi etc, from adrenal medulla

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5
Q

tau protiens

A

-Picks disease

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6
Q

alpha-synuclein

A

-dimentia with lewy bodies

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7
Q

neurofibrillary tangles

A

-alzheimer’s disease

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8
Q

vagotomy

A

-transection of the vagus nerve, used to decrease stomach acid secretion in peptic ulcer dz refractory to medical tx:

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9
Q

explosive, constant headaches (type, tx, associated symptoms, where is the headache located, when do you get them)

A
  • cluster headaches-abbortive O2 therapy-lacrimation, ptosis, conjunctival injection, nasal congestion
  • unilateral, often involving the eye or right temple
  • often occurs at night
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10
Q

korsakoff’s amnesia

A

-profound inability to form new memories, final stages of weirnicke’s encephalopathy -due to bilateral destruction of maxillary bodies

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11
Q

cryptococcal meningitis (who is at risk, what is tx)

A
  • sub-acute meningitis-immunocompromised pts

- amphotericin b and flucytosine

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12
Q

otitis externa (bug, signs, who gets it)

A

-pseudomonas -periauricular pain and erythema-swimmers

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13
Q

ventral posteriormedial nucleus

A

-all sensory modalities of the face

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14
Q

lateral geniculate nucleus

A

-visual information from the optic tract

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15
Q

medial geniculate nucleus

A

-auditory information for inferior colliculus

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16
Q

ventral posteriorlateral nucleus

A

-all sensory modalities from the body

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17
Q

patau syndrome (chromosome and CNS development)

A
  • trisomy 13
  • holoprosencephaly, problems with fusion of midline structures
  • micropthalmia, polydactyly, congenital heart disease
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18
Q

vertical and horizontal nystagmus (why and tx)

A
  • PCP

- benzos

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19
Q

meningitis in non-immunized children (and tx)

A
  • H.influenza

- 3rd gen cephalosporin

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20
Q

neurotransmitter responsible for REM sleep

A

-acetylcholine

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21
Q

which spinal tracts are affected in central pontine myelinolysis? (2)

A

-corticospinal and corticobulbar

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22
Q

multiple sclerosis… (HLA… 3 common signs… diagnosis… tx…)

A
  • association with HLA-DR2
  • scanning speech, blurry vision (one eye) internuclear opthalmopalegia (MLF)
  • IgG oligoclonal bands
  • steroids (acute exacerbation) interferon beta (chronic)
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23
Q

demyelinating associations… (MS, subacute sclerosing panenecephalitis, progressive multifocal leukoencephalopathy, central pontine myelinolysis)

A
  • oligoclonal IgG bands
  • measles virus, progressive, leads to death
  • JC virus, waits for immunocompromised time in your life
  • locked in syndrome
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24
Q

metastatic brain cancer (what percentage of brain cancers, where do mets come from, where do the end up)

A
  • 50%
  • breast, liver, kidney (3 most common)
  • well circumscribed, typically at grey/white junction
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25
Q

leukodystrophies: name them (3), inheritance, problem

A
  • 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
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26
Q

normal pressure hydrocephaly (classic triad, pathophys, tx)

A
  • wet, wobbly, wacky (urinary incontinence, gait difficulty, mental decline), treatable cause of dementia
  • too much CSF, over production or decrease absorption
  • ventriculoperitoneal shunt
27
Q

subthalamic n. acts indirectly on thalamus by…

A

-activating globus pallidus internus, which then inhibits the thalamus

28
Q

rubeola virus (what is it, and potential bad outcome)

A
  • measles

- can lead to subacute sclerosing panencephalitis

29
Q

meningitis in very young and very old patients… (organism and empiric tx)

A
  • listeria (often due to unpasteurized dairy)

- ampicillin

30
Q

transport from hypothalamus to posterior pituitary requires transport proteins

A
  • nuerophysin I: oxytocin

- neurophysin II: ADH

31
Q

fungal meningitis (CSF profile, common pathogen, tx)

A
  • high opening pressure, high WBC, high protein NL/low glucose
  • crypto
  • induction with amphotericin B, continue with flucytosine
32
Q

trisomy 21 has associated risks congenitally (1) and later in life (3)

A
  • congenital heart defect

- early onset alzheimers, ALL and AML

33
Q

psammoma bodies occur where… (4)

A
  • PSaMMoma
  • Papillary (thyroid)
  • Serous (ovary)
  • Meningioma
  • Mesothelioma
34
Q

Neuroblastoma (presents as, genetics)

A
  • large mass, can be anywhere along sympathetic chain, often adrenal medulla, elevated catecholamines, HTN
  • n-myc
35
Q

dementia with levy bodies (classic (differentiating) symptoms… accumulation of…)

A
  • visual hallucinations w/memory decline and parkinsonism

- alpha-synuclein

36
Q

only seen in LMN deficits…

A

-fasciculations, muscle twitching as neuron dies and releases ACh

37
Q

tx for increasing ICP

A
  • intubate and hyperventilate

- CO2 is powerful vasodilator for cerebral vessels, blow off as much as you can

38
Q

at risk for bell’s palsy

A

-AIDS, lyme disease, sarcoid, tumors (ya i know)

39
Q

full anterior fontanelle

A
  • elevated ICP…

- possibly due to neonatal meningitis

40
Q

tetanus (MOA)

A

-toxin that prevents release of glycine

41
Q

gerstmen’s syndrome (4) and location of lesion

A

-inability to distinguish right from left, distinguish fingers, write and do math
angular gyrus

42
Q

physical signs of fetal alcohol syndrome

A
  • microcephaly, low set ears, thin lips
  • left/right shunt
  • mental delay
43
Q

neonatal meningitis (3 organisms) and complication (after successful tx)

A
  • group B strep, beta hemolytic, bacitracin resistant, gram positive in chains
  • e.coli
  • listeria
  • meningeal scarring… elevated ICP
44
Q

B12 deficiency results in degeneration of neurons and myelin in… (3)

A
  • dorsal columns
  • lateral corticospinal tract
  • spinocerebellar tract
45
Q

fried eggs in the brain

A
  • oligodendrocytes… oligodendroglioma

- most common in frontal lobes

46
Q

fragile-X syndrome (phenotype and inheritance, genetics)

A
  • long face, macroorchidism, large everted ears
  • X linked…
  • CGG repeat (demonstrates anticipation) in FMR1 gene
47
Q

fabrys (inheritance, enzyme, accumulation)

A
  • x-linked
  • a-galactosidase A
  • leads to accumulation of ceremide trihexoside
48
Q

diabetics and sinuses…? and feared complication

A
  • mucor infection (high glucose content?)

- meningitis

49
Q

medial medullary syndrome

A
  • 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)
50
Q

condution aphasia (pt symptoms, what structure is affected, what is it’s normal role)

A
  • language is normal, except cannot repeat

- due to failure of communication between broca’s and wernicke’s area via arcuate fasciculus

51
Q

cherry red spots on fudiscopic exam… (2)

A
  • tay sachs and neimann pick

- lysosomal storage disorder

52
Q

CMV eye problems

A
  • rapid progressive vision loss

- eventual retinal detachment

53
Q

arnold-chiari has common association with dilating spinal cord problem… (which damages which part of the cord)

A
  • syringomyelia
  • spinothalamic tract as it sends crossing fibers
  • results in bilateral loss of paint/temp
54
Q

HIV pt with really low CD4 is at risk of new onset siezures due to infection with…

A

-toxoplasmosis gondii

55
Q

neurofibromatosis type 1 (signs/symptoms, gene (and chromosome location))

A
  • 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
56
Q

neuroleptic malignant syndrome

A
  • onset of fever, hypertension, muscle aches, rigidity after admin of either typical or atypical antipsychotics
  • caused by blockade of dopamine receptors
57
Q

chemoreceptor trigger zone (CTZ) - where is it located and why is that important

A
  • 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
58
Q

neurofibromatosis-2 (NF-2) (does NOT affect what, DOES effect what (pathognomonic))

A
  • does NOT affect oligodendrocytes

- acoustic neuromas (schwannoma of CN8)

59
Q

most common direct brain abnormality in HIV

A

-HIV dementia complex

60
Q

where are the following made: norepi, ACh, serotonin, dopamine

A
  • locus ceruleus
  • basal nucleus of Meynert
  • raphe nucleus
  • ventral tegmentum and substantia nigra
61
Q

bunion bodies (what are they???)

A
  • cytoplasmic inclusions, PAS positive remnants of autophagic vacuoles
  • seen in neurons of ALS patients
62
Q

neural tube closer defects (drugs that cause it, preventative supplement, lab test to detect problem in utero)

A
  • carbemazepine and valproate
  • folate
  • elevated alpha-fetoprotein
63
Q

macrophages of brain… (bonus point for macrophages of liver and skin)

A
  • microglial cells
  • kupfer cells (liver)
  • langerhans cells (skin)
64
Q

artery of adamkiewicz (where is it, what does it supply blood to?)

A
  • leaves aorta, enters spinal cord at level of T8

- blood supply for ventral spinal cord below the level of T8

USMLE (17 decks)

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