Neuro 4

Question 1

chronic sleep disorder characterized by freq overwhelming urge to sleep __
assc w sudden loss of motor tone w positive emotion aka __
reduced __ and enter __sleep immediately

hypnogogic (__) and hyponopompic (awakening) hallucinations
and sleep __

Answer 1

narcolepsy
cataplexy
sleep latency, REM

sleep
paralysis

Question 2

Huntington may be caused by transcriptional __
seen w histone ___

DNA __ is epigenetic modification to inhibit gene trxn

Answer 2

silencing
deacetylation

methylation

Question 3

Cryptococcus found in soil contaminated w __
inhaled into __ of lungs to establish the infection

meningitis occurs when Crypto penetrates __ cells of cerebral capillaries
__ in CSF leads to sx

bacterial meningitis usually due to organisms that infect the __

Answer 3

bird droppings
alveoli

endothelial
replication

nasopharynx

Question 4

__ is an irreversible cholinesterase inhibitor
tx w muscarinic antag like __ or __ to reactivate cholinesterase

cholinergic overstimulation can also occur via cholinomimetics C/M

GABA stimulates release of __ ions
pushes membrane potential to become __

Answer 4

Organophosphates
atropine, palidoximine

carbachol, methacholine

Cl
hyperpolarized

Question 5

Resting potential is _mv
maintained by __ permeability

Depolarization occurs w opening of __ Na channels

Repolarization closes _ channels and opens voltage gated __ channels
most __ enters here

hyperpolarization as __ K channels remain open

Answer 5

-70
K+

voltage gated

Na, K
K

voltage gated

Question 6

Lesion to the __ nucleus of hypothalamus results in hyperphagia/obesity

Lesion to the __ nucleus of hypothalamus results in loss of apetite

Pt with long history of hemodialysis can develop __ due to deposition of B2 microglobulin

Answer 6

VM

Lateral

CTS

Question 7

C tetani has ___ which has __ axonal transport to central inhibitory neurons in SC/brain stem

blocks release of inhibitory NT like G/G
leads to __ paralysis

vibrio cholera can cause release of __ from ECL cells
leads to extreme __ loss

Answer 7

tetanospasmin, retrograde

Glycine, gaba, spastic

serotonin
fluid

Question 8

GBS in pt w pruritic maculopapular rash, low grade fever, arthralgia, conjunctivitis is caused by __

Pt w Restless leg syndrome may be deficient in __
tx w dopamine agonist like R/P

Myoclonic epilepsy is __ type
similar to Tonic clonic but no lost __
presents w seizure in both __ as the seizure involves both cerebral hemispheres

provoked by __

Answer 8

Zika

Iron
ropinirole, pramipexole

generalized
conciousness
UE

sleep deprivation

Question 9

Focal seizures tx w C/G/P/P

Generalized seizures tx w L/L/T/V

__ is DA antagonist used for Tourettes

Answer 9

carbamezipine, gabapentin, phenobarbitol, phenytoin

Levetiracetem, lamotrigine, topiramate, valproate

Fluphenazine

Question 10

Isoniazid is similar to __
competes w it for __ of GABA

also inc __ urinary excretion, leading to frank __

subthalamic nucleus is a component of the __, regulating output

damage can dec excitation of GPI, leading to __ w wild involuntary movements on one side

usually occurs from __ stroke

atrophy of lentiform nucleus (GP/Putamen) occurs in __

Answer 10

VB6
synthesis

pyridoxine, deficiency

basal ganglia

hemiballism

lacunar

wilson dz

Question 11

Gait/limb ataxia indicates __ dysfxn
w sheets of primitive blue cells (aka PNET), basophilic nuclei and abundant mitoses, dx is ___

usually located in the ___ w inc __

Pilocytic astrocytoma is made of __ and __ fibers
also located in the __

Answer 11

cerebellar
medulloblastoma

vermis, ICP

astrocytes/Rosenthal
cerebellum

Question 12

NMS caused by excessive blocking of __ receptors in the brain
overdose of anti-__

diffuse muscle _, high __, hyper__, tachy__, AMS

CK is __, leading to myoglobinuria

tx w __ the agent
also D antagonizing ryanodine receptors
or B a dopamine agonist

Answer 12

dopamine
dopamines

rigidity, fever, TN, cardia

high

discontinue
dantrole
bromocriptine

Question 13

SS- excess __

see M, D, AMS, N/D
does not have muscle __
tx w C a serotonin receptor antagonist

Answer 13

serotonin

myoclonus
rigidity
cyproheptadine

Question 14

Succinylcholine is a nondepolarizing agent similar to __ in that in depolarizes NM end plate
not __ by acetylcholinesterase

seen in pt w __ injury, __ injuries, burns

Phase 1 Na channels become __ until repolarization, so pt gets __ paralysis

Phase 2 occurs w __ and repolarization

Major SE is H__
tx pt w V/R instead

Answer 14

Ach
degraded

crush, denervating

inactivated, flaccid

desensitization

hyperKalemia

veuronium, rocuronium

Question 15

CN 9 is motor to __ muscle
stimulates _ gland secretion
sensory/taste to __

lesions can lead to loss of __, general sensation in P/T, __ ear cavity
lose of taste/sensation in poster __ of tongue

salivary secretion by submandibular/sublingual glands come from PNS fibers of __ on CN 7 and __ nerves

Answer 15

stylopharyngeus
parotid
posterior 1/3

gag, pharynx, tonsils, 1/3, middle

superior salivary nucleus, lingual

Question 16

voluntary muscle movements come from the __ tract
1st order neuron in __/__ cotex of frontal lobe

descend through IC/M/P/M

can ___and leave as Lateral CS tract
if not, form the __ CS tract

synapse on 2nd order neuron in __ cell

Answer 16

CS
prefrontal/frontal

internal capsule, midbrain/pons/medulla

decussate, anterior

anterior horn

Question 17

Huntington disease has bilateral atrophy of the __ and__ which is the striatum

will see dec levels of __/__/__

HD gene located on chromosome __

__ is Xlinked Recessive disorder of self mutilation and hyperuricemia

def in \_\_, leading to defect in purine salvage pathway
inc degredation of guanine/hypoxanthine to \_\_

thus, must increase activity of PRPP __ enzyme

Answer 17

caudate, putamen

GABA/Ach/SP

4

Lesch Nyhan

HGPRT, uric acid

amidotransferase

Question 18

A Comm aneurysm can compress the __ leading to bitemporal hemianopia

P Comm aneurysm can compress CN __ w resultant palsy

Infarct of PCA can lead to __ problems
macula spared bc of collateral bf w ___

Answer 18

optic chiasm

3

visual

MCA

Question 19

occlusion of \_\_ leads to lateral pontine syndrome
ipsi loss of \_\_/\_\_ in face
ipsi facial \_\_/\_\_ loss
contra loss of \_\_/\_\_ in trunk
also see \_\_ dysfxn

__ deficiency leads to WE/WK
affects mammillary body in the __ circuit

alcohol/malnourished pt needs __ supplementing before receiving dextrose

Answer 19

Anterior inferior cerebellar
paint/temp
muscle, hearing
paint/temp
cerebellar

Thiamine VB1
papez

thiamine

Question 20

micro findings of prior disease shows large __ in gray matter
no __ changes

Pt w difficulty speaking, singing, writing has _ aphasia

located in the caudal part of __
brodmann area __/__
usually in the __ hemi
may also have right __

damage to __ gyrus can cause sensation loss
lesion in __ gyrus can cause paralysis of skeletal muscles

Answer 20

vacuoles
inflamm

inferior frontal gyrus
44-45
left
hemiparesis

post central
precentral

Question 21

caudal superior temporal gyrus is __ area
Brodmann area __

susceptibility to MH is __
defect in __ on SR
large amounts of __ released, producing ATP dependent reuptake
thus, ATP loss and __ produced, leading to rhabdoo

look for __/muscle __ after surgery
also __ is common
tx w __

occurs after use of inhaled __ or S

Answer 21

Wernicke
22

AD
ryanodine receptor
Ca
heat

high fever, rigidity
myoglobinemia
Dantrolene

anesthetics, succinylcholine

Question 22

CM of focal seizure depends on __ involved

frontal eye fields responsivle for __ eye movement

distal radial nerve lesions spare the __ muscle

Answer 22

brain region

horizontal

triceps brachialis

Question 23

fixed segmental loss of UE pain/temp, upper extremity LMN signs, and LE UMN signs indicates ___
may occur w ___

w bacterial men, get L__, blood __ and _ ab

Answer 23

syringomyelia

scoliosis

LP, culture, empiric

Question 24

__ occurs after halothane use w jaundice, hepatomegaly, inc AST/ALT, bilirubin

biopsy shows __ necrosis

occurs w halogenated __
matabolized by __ system, producing a reactive intermediate, and resulting __ damage

Answer 24

halothane hepatotoxicity

centrilobular

inhaled anesthetics, p450
hepatocellular

Question 25

__ is NMDA receptor antag for dissocaitive amnesia
has adverse __/___ effects

__ is inhaled anesthetic that inhibits NMDA receptor
may reduce __synthase, leading megaloblastic anemia

__ is IV anesthetic that potentiates GABA

CN 3 found bw __/__ arteries
damage due to somatic __ injury

Answer 25

Ketamne
cardio/neruo

NO, methionine

propofol

PC, superior cerebellar
efferent fiber

Question 26

Abusive head trauma is caused by __

infants have __ heads/SA spaces, __ brain water content, __ cervical muscle tone

presents w acute on chronic ___

look for __ hemorrhages
may have fracture of __

Answer 26

vigorous shaking

larger, greater, less

subdural hematoma

retinal
posterior ribs

Question 27

Pt w PD may become __ after 5+ years of therapy

NS degen leads to excitation of GPI and excessive __ via STN
presents w rigidity and __ intractable to meds

thus, tx is high freq brain stimulation to inhibit the __ or __

Answer 27

refractory

inhibition
bradykinesia

GPI, STN

Question 28

reduced sensation and spasticity of LE suggest lesion in __

w optic neuritis, dx is ___
sx will __/__
attract T cells and __ which take up myelin debris
then __ cells recruited and form antibodies

__ demyelination occurs, resulting in hypertrophy/hyperplasia and __

Answer 28

spinal cord lesion

MS
wax/wane
macrophage
B

patchy
glail scarring

Question 29

__ is the process occurring when axon is damaged, resulting in breakdown of myelin sheath __ to injury

in PNS, schwann cells sense axonal degen, secreting __/__ to recruit macros

this clears __ and attempts to facilitate __

In CNS, __ is barrier, leading to macros/microglia being recruited slowly
debris __ as oligodendrocytes undergo apoptosis
suppresses __ growth via inhibitry factors

eventually, this forms a __

Answer 29

wallerian degeneration
distal

cytokines/chemokines

debris, axonal regen

BBB
persists
axonal

glial scar

Question 30

hemorrhagic transformation of embolic stroke occurs w/in __ after event

__ is AD disorder, w inc number of CTG repeats encoding for __protein kinase
presents w slowed __

C/Frontal __/__ atrophy seen
atrophy of __ fibers is prominent

Answer 30

7 days

Myotonic dystrophy
myotonia

cataracts, frontal balding, gonadal
Type 1

Question 31

first order SNS neurons located in __
descending to __-__ of SC and synapse on __ horns

exit via anterior nerve roots/white connecting rami to 3rd order neurons in __ ganglion

postgang fibers then travel along __ to target

damage to vagus nerve results in uvula deviating __ from side of lesion

Answer 31

hypothalamus
C8-T1
lateral

superior cervical

carotid arteries

away

Question 32

__ is NSCLC near superior sulcus

may have ipsi __ pain, upper limb __, and __ arm weaknesss due to involvement of the brachial plexus

can see __ syndrome w involved __ symp ganglia

Answer 32

Pancoast tumor

shoulder, paresthesias, areflexic

Horner

cervical

Question 33

__ virus is enveloped, ssRNA
has membrane bound __ for cell surface adhesion

__ protein for viral assembly

Subacute sclerosing panencehalitis is comp __ after initial infection

due to mutated/absent __
prevents __ virions from forming

accumulation of viral __ occurs, resulting in inflammation/demyelination and gliosis

sx are __ and D__, visual, myoclonus

__ of measles antibodies present in CSF

Answer 33

measles, hemagluttinin

matrix

years

matrix protein
enveloped

nucleocapsids

neuro, dementia

oligoclonal bands

Question 34

Jc virus is __ stranded __ virus
leads to __ in IC individual

___ palsy is a form of parkinsonism
neurodeg of __ and frontal subcortical __
sx include __ dysfxn, __ gaze palsy

biopsy shows phosphorylated __ proteins

Answer 34

DS DNA

neuro deficits