Neuro

Question 1

Who is at inc risk for pediatric hydrocephalus?

Answer 1

“Toy and brachycephalic dogs are at increased risk, including the Maltese terrier, Yorkshire terrier, English bulldog, Chihuahua, Lhasa apso, Pomeranian, toy poodle, cairn terrier, Boston terrier, pug, and Pekingese.”

Excerpt From: Bonagura, John D. “Kirk’s Current Veterinary Therapy XV.” Elsevier Health Sciences, 2013-12-01. iBooks.
This material may be protected by copyright.

Question 2

What’s the significance of peri ventricular edema on MRI of a or w hydrocephalus? T2 FLAIR

Answer 2

“Periventricular edema usually is associated with acute hydrocephalus and increased intraventricular pressure”

Question 3

Acetazolamide mechanism and use?

Answer 3

Used for hydrocephalus

“carbonic anhydrase inhibitor that decreases CSF production”

Excerpt From: Bonagura, John D. “Kirk’s Current Veterinary Therapy XV.” Elsevier Health Sciences, 2013-12-01. iBooks.
This material may be protected by copyright.

Question 4

What meds can u use to txt hydrocephalus

Answer 4

Acetazolamide furosemide pred and omeprazole

Question 5

What is a quadrigeminal cyst

Answer 5

“Intracranial arachnoid cyst (IAC), also termed intraarachnoid cyst and quadrigeminal cyst, is a developmental brain disorder in which cerebrospinal fluid (CSF) is believed to accumulate within a split of the arachnoid membrane during embryogenesis”

More common in small breed dogs and brachycephalics.

Question 6

What is the tx of choice for feline meningioma

Answer 6

Surgery. Super easy to remove and can be completely excised

Question 7

What is txt of choice for canine meningioma?

Answer 7

Surgery but these are more aggressive than feline so often not removed completely. So u have to do radiation or chemo

Question 8

What do u do about pituitary tumors

Answer 8

“Radiation therapy is the treatment of choice for those tumors, although the prognosis is worse if neurologic signs are present. The ratio of pituitary height to brain area is used to discriminate between pituitary microadenoma and macroadenoma and to determine the feasibility of surgical removal”

Question 9

Which chemo drugs cross BBB

Answer 9

Procarbazine, hydroxyurea, CCNU, pred

lspar doesn’t but works on DNS da

Question 10

How does gabapentin work as an anti seizure agent

Answer 10

“Gabapentin, a structural analog of γ-aminobutyric acid (GABA), probably exerts its antiseizure effects via inhibition of voltage-gated calcium channels in the brain.”

Question 11

How does pregablin work

Answer 11

“Pregabalin has a greater affinity for the α2δ-subunit of voltage-gated calcium channels than gabapentin and purportedly is more effective in people than its predecessor as both an anticonvulsant and a pain-relieving drug.”

Excerpt From: Bonagura, John D. “Kirk’s Current Veterinary Therapy XV.” Elsevier Health Sciences, 2013-12-01. iBooks.
This material may be protected by copyright.

Question 12

Felbamate MOA

Answer 12

“Proposed mechanisms of action include blocking of N-methyl-d-aspartate (NMDA)–mediated neuronal excitation, potentiation of GABA-mediated neuronal inhibition, and inhibition of voltage-sensitive neuronal sodium and calcium channels. Felbamate also may offer some protection to neurons from hypoxic-ischemic damage.”

Probably not sedating and efficacious. ADE may include hepatotoxicity and blood dyscrasia and maybe KCS. Rare

Excerpt From: Bonagura, John D. “Kirk’s Current Veterinary Therapy XV.” Elsevier Health Sciences, 2013-12-01. iBooks.
This material may be protected by copyright.

Question 13

How does keppra work

Answer 13

“mechanism of action of the anticonvulsant effects of levetiracetam is not entirely clear but appears to be related to its binding with a specific synaptic vesicle protein (SV2A) in the brain. Unlike other anticonvulsant drugs, levetiracetam does not appear to have a direct effect on common neurotransmitter pathways (e.g., GABA, NMDA) or ion channels (e.g., sodium, T-type calcium).”

Question 14

What happens when you give keppra and pb together

Answer 14

Leveriracetam gets metabolized faster

Question 15

What happens when you give zonisamide and pb together

Answer 15

Zonisamide elimination half life decreases

Question 16

What is a seizure

Answer 16

“seizure is initiated by a high-frequency burst of action potentials within a local, hypersynchronized population of neurons. When a large enough population of neurons is involved, a characteristic spike can be seen in the electroencephalogram (EEG). Within this population, individual neurons experience a sequence of events that includes the following: (1) an intracellular influx of calcium and sodium, leading to a high-frequency burst of action potentials at approximately 700 to 1000/sec; (2) a phase during which the cell remains depolarized; and finally (3) rapid influx of chloride or efflux of potassium mediated by γ-aminobutyric acid (GABA) receptors, which leads to rapid repolarization and hyperpolarization. Although the cause commonly is forebrain disease, other areas of the brain, including the thalamus, subcortical nuclei, and brainstem, can participate in the genesis and propagation of seizures.”

.

Question 17

What is a cluster seizure? What’s SE?

Answer 17

“Cluster seizures and status epilepticus are the two most life-threatening types of seizures. A cluster of seizures is defined clinically as more than one seizure within a 24-hour period, between which the patient returns to normal mentation and activity. Status epilepticus is seizure activity that continues unabated for longer than 5 minutes or multiple seizures between which the patient does not return to normal mentation”

Excerpt From: Bonagura, John D. “Kirk’s Current Veterinary Therapy XV.” Elsevier Health Sciences, 2013-12-01. iBooks.
This material may be protected by copyright.

Question 18

How do midazolam and diazepam work

Answer 18

“These drugs are GABA agonists and cause hyperpolarization of neurons via influx of chloride ions, which results in cessation of seizure activity. They generally are effective and safe when given intravenously in dogs and cats, and have a low likelihood of significant adverse effects, although a small number of cats have been reported to develop fatal acute hepatic necrosis when administered diazepam orally.”

Question 19

What meningitis do Yorkies get

Answer 19

NLE

Question 20

What causes head and neck pain in a patient w GME

Answer 20

Meningeal inflammation

Question 21

Does a normal MRI and CSF rule out NIME?

Answer 21

NOOOOO

Question 22

When working up a pt for inflammatory brain dz, what testing should u do?

Answer 22

Toxo, neospora, rickettsial, crypto, distemper

Question 23

What cat breed has resting nystagmus

Answer 23

Siamese

Question 24

What involves physiologic nystagmus

Answer 24

“Physiologic nystagmus requires coordination between the vestibular system and cranial nerves III, IV, and VI and the medial longitudinal fasciculus.”

Excerpt From: Bonagura, John D. “Kirk’s Current Veterinary Therapy XV.” Elsevier Health Sciences, 2013-12-01. iBooks.
This material may be protected by copyright.

Question 25

How do you localize lesion in paradoxical vestibular dz

Answer 25

PROPRIOCEPTIVE def on SAME SIDE AS LESION

Question 26

Does the severity of CS in a pt with GME correlate w prognosis? What abt CAF findings

Answer 26

NOOOOOO

Question 27

What rickettsial diseases can cause CNS disease

Answer 27

Ehrlichia and RMSF

Question 28

What is disc extrusion

Answer 28

“Disk extrusion is defined as rupture of the anulus fibrosus with displacement of the nucleus pulposus into the vertebral canal or intervertebral foramen. In dogs disk extrusion typically is an acute event and is associated with chondroid metaplasia

Hansen type 1

Question 29

What is disc protrusion

Answer 29

“Disk protrusion is defined as rupture of the inner layers of the anulus fibrosus, partial displacement of the nucleus into the disrupted anulus, and annular hypertrophy. It is associated most frequently with fibroid metaplasia and may result in slowly progressive clinical signs. Spatial relationships with spondylosis deformans may exist.”

Hansen type II

Question 30

What is the cause of hydrocephalus usually in small breed and brachycephalic dogs?

Answer 30

“most commonly identified cause in these breeds is stenosis of the mesencephalic aqueduct associated with fusion of the rostral colliculi. I”

Excerpt From: Bonagura, John D. “Kirk’s Current Veterinary Therapy XV.” Elsevier Health Sciences, 2013-12-01. iBooks.
This material may be protected by copyright.

Question 31

What is spinal shock

Answer 31

“Spinal shock results from interruption of corticospinal tracts and is manifest as a transient loss of pelvic limb spinal reflexes in the setting of an upper motor neuron lesion”

This material may be protected by copyright.

Question 32

What genetic mutation is a high risk factor for development of degenerative myelopathy

Answer 32

“Not all SOD1:c.118A homozygotes develop clinical signs; therefore DM appears to be an incompletely penetrant autosomal-recessive disease, whereas most human SOD1 mutations are autosomal dominant”

Excerpt From: Bonagura, John D. “Kirk’s Current Veterinary Therapy XV.” Elsevier Health Sciences, 2013-12-01. iBooks.
This material may be protected by copyright.

Question 33

What is progression of degenerative myelopathy

Answer 33

“Dogs with DM follow a predictive pattern of clinical signs that begins with UMN pelvic limb paresis and general proprioceptive ataxia, progresses to LMN paraparesis, and then spreads to involve the thoracic limbs and brainstem.”