Neuro 4 Flashcards
Which pharyngeal arch is associated with formation of the mandible, maxilla, malleus, incus, zygoma, vomer, palate, and temporal bone?
first arch neural crest derivatives
What nerve is the first arch associated with?
trigeminal n.
Which pharyngeal arch is associated with the styloid process, lesser horn of the hyoid, and the stapes?
second arch neural crest derivatives
What nerve is the second arch associated with?
facial n.
What muscles does the first arch gives rise to?
all the muscles of mastication, anterior belly of the digastric, mylohyoid, tensor tympani, and tensor veli palatin
Which muscles does the second arch give rise to?
muscles of facial expression, the stylohyoid, stapedius, and the posterior belly of the digastri
Which arches make up cartilaginous structures of the larynx?
fourth and sixth arches
What fetal abnormality does leakage of AFP and acetylcholinesterase indicate?
NTDs - fusion defect
What is an essential activator of carbamoyl phosphate synthase I for the urea cycle from the precursors acetyl-CoA and glutamate?
N-acetylglutamate
What are 4 indications for the long-acting BZ diazepam?
- anxiolytic: anxiety and panic
- sedative-hypnotic: short term Tx of insomnia
- anticonvulsant: status epilepticus, 1st line for alcohol seizure withdrawal
- muscle relaxant: UMN spasticity and tetanus
Which class of drugs should pts on diazepam avoid and why?
1st generation antihistamine antagonists: chlorpheniramine and diphenydramine
- 1st generation antihistamines blocks peripheral and central H1 receptors and can be very sedating because they easily penetrate the BBB and accumulate in the CNS
Which type of schizophrenia is characterized by prominent delusions and auditory hallucinations?
paranoid schizophrenia
Which type of schizophrenia is characterized by significant disturbance of motor function?
catatonic schizophrenia
Which type of schizophrenia is characterized by emotional blunting, eccentric behavior, and loose associations between episodes of active schizophrenia?
residual schizophrenia - they lack hallucinations, delusions, disorganized speech, or catatonia
Which type of schizophrenia describes a pt who is clearly schizophrenic but does not fit a specific category?
undifferentiated schizophrenia
Which type of schizophrenia is characterized by disorganized speech and behavior and a flat or inappropriate affect?
disorganized schizophrenia
A 3yo male is hospitalized with progressive spastic paresis of his lower extremities and choreoathetoid movements. Comprehensive lab testing reveals very high arginine levels in both the child’s plasma and CSF. What enzyme is deficient and what is it normally involved in the production of?
Arginase - involved in the production of urea and ornithine
What is the Dx of a pt with chronic loss of upper extremity pain and temperature sensation, UE weakness and hyporeflexia, LE weakness and hyperreflexia, and kyphoscoliosis?
Syringomyelia
What Sx do you see first wiith syringomyelia, and what Sx appear later?
first: bilateral loss of pain and temp d/t damage of ventral white commissure and anterior horns
later: expresion of syrnix within cervical cord can produce LE weakness and hyperreflexia by affecting the lateral corticospinal tract
Does ALS cause sensory loss?
NO.
What drug is an antiepileptic that is metabolized to phenobarbital and phenylethylmalonamide (PEMA)?
Primidone
Name the conditions associated with Down syndrome.
- Neurologic disease: Alzheimer
- Acute leukemias: AML and ALL
- Congenital heart disease: endocardial cushion defects, VSD, ASD
- GI defects: duodenal atresia and Hirschprung disease
What are negri bodies and where are they commonly found in pts with a rabies infection?
They are round, eosinophilic inclusions seen in the cytoplasm of pyramidal neurons of the hippocampus and cerebellar Purkinje cells
What portion of the tRNA binds amino acids?
3’ end
Which anticonvulsant drug causes gingival hyperplasia and what is the MOA?
Phenytoin - it causes an increased expression of PDGF which stimulates proliferation of gingival cells and alveolar bone
What are SE or lithium?
neuromuscular excitability, nephrogenic diabetes insipidus, hypothyroidism, and cardiac conduction defects
What are the SE of methimazole?
edema, rash, and agranulocytosis
What kind of aneurysms are small in size (
Charcot-Bouchard aneurysms
What are clinical findings of atrophy of nasal mucosa and partial destruction of the nasal septum pathognomonic for in the setting of agitation, chest pain, dilated pupils that are responsive to light, high BP, and tachycardia?
Cocaine abuse
What is the MOA of cocaine abuse?
Cocaine inhibits the presynaptic reuptake of NE, DA, and 5-HT
What can rapid correction of chronic hyponatremia lead to?
central pontine myelinosis: osmoetic demyelination of the axons in the central part of the pons
What are the Sx of central pontine myelinosis?
qudriplegia d/t demyelination of the CST and pseudobulbar palsy d/t demyelination of the corticobulbar tracts of CN IX, X, and XI
Which atypical antipsychotic is most likely to cause EPS?
Risperidone
What syndrome associated with small cell lung carcinoma can cause headache, facial and UE edema, and dilated veins of teh upper torso?
SVC syndrome
Anterior horn cells of a severed axon demonstrate cell body rounding, peripheral displacemtn of the nuclei and dispersion of Nissl substance to the periphery of the cells. These findings most likely describe:
axonal reaction
Other than MS, where else is oligodendrocyte depletion seen?
progressive multifocal leukoencephalopathy
