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neuro Flashcards

1
Q

Mode of pathogen progression of Listeria for immunosuppressed and pregnant women

A

ingestion of unpasteurized milk, soft cheeses, coleslaw, and ready to eat turkey and pork

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2
Q

bacteria causing neonatal meningitis

A

Group B Strep, Listeria, E. Coli

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3
Q

Listeria monocytogenes

A

G+, beta hemolytic, catalase +, bacillus, causes meningitis in neonates
can be contracted by passage through birth canal, inhalation of infected amniotic fluid, or nosocomial infection: in immunosuppressed most common route is ingestion of unpasteurized milk

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4
Q

ACA supplies what area of the brain, and when damaged causes

A

medial surface of the brain, motor and sensory cortices of the contralateral leg and foot

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5
Q

layers of the head from superficial to deep

A

skin, periosteum, bone, dura mater, arachnoid, pia, and brain parenchyma

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6
Q

Meningeal layers of the brain

A

dura, arachnoid, pia

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7
Q

subarachnoid hemorrhage sx

A

worst HA ever, nuchal rigidity

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8
Q

Most common causes of subarachnoid hemorrhages

A

berry aneurysms, less commonly from arteriovenous malformations

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9
Q

CSF in subarachnoid hemorrhages

A

appear yellow - bilirubin in CSF, sign of hemorrhage and blood cell breakdown because the subarachnoid space is continuous with the spinal space

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10
Q

Intraparenchymal hemorrhage

A

caused by chronic hypertension, commonly affect the basal ganglia and thalamus - grossly appears more like a bruise and less like a pool of blood like a subarachnoid hemorrhage

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11
Q

subdural hemorrhage

A

caused by damage to bridging veins, potential space between dura and arachnoid mater

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12
Q

epirdural hemorrhage

A

temperoparietal bone fx, damage to the middle meningeal artery

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13
Q

Huntington Disease

A

chorea, dystonia, altered behavior, and dementia
AD
CAG triplet repeats on 4p
Genetic Anticipation
Caudate and Putamen are mainly affected, altering indirect pathway of basal ganglia - loss of motor inhibition
Gliosis - proliferation of astrocytes in areas of CNS damage
imaging - lateral ventricles may appear dilated due to caudate atrophy
Reserpine - minimizes motor abnormalities

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14
Q

Alzheimer’s Disease

A

Most common cause of dementia in elderly
deposition of neuritic plaques - abnormally cleaved amyloid protein
Neurofibrillary tangles - phosphorylated tau protein in cerebral cortex
Doneprezil/Vitamin E therapy - slows down progression

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15
Q

Wilson Disease

A

AR
failure of copper to enter the circulation bound to ceruloplasmin due to problem with excretion of copper from the liver
copper accumulation in the liver, corneas, and basal ganglia
Sx - asterixis, parkinsonian symptoms, cirrhosis, Kayser-Fleischer rings (corneal deposits of copper)

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16
Q

Parkinson Disease

A

Loss of dopaminergic neurons in the substantia nigra leading to depigmentation
Alter direct pathway of basal ganglia, decreasing excitation
Difficulty initiating movement, cogwheel rigidity, shuffling gait, pill-rolling tremor
Tx - Levodopa/Carbidopa combo

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17
Q

MS

A

scattered plaques of demyelination anywhere in the CNS
periventricular areas and the optic nerve are commonly affected due to high levels of myelination
Oligodendricytes (responsible for CNS myelination) are autoimmune targets
recurrent multifocal lesions separated in time and space
optic neuritis, internuclear ophthalmoplegia (diff. with horizontal eye movements), sensory and motor changes, Lhermitte sign (electric shock felt down the spine with neck flexion

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18
Q

meningohydroencephalocele

A

protrusion of the meninges, brain, and portion of the ventricle through a defect in the skull

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19
Q

spina bifida with meningomyelocele

A

protrusion of the meninges and spinal cord through a vertebral defect to form a sac

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20
Q

meningoencephalocele

A

protrusion of the meninges and brain through a defect in the skull

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21
Q

protrusion of the meninges through a defect in the skull

A

meningocele

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22
Q

Spina Bifida with meningocele

A

protrusion of the meninges through a vertebral defect to form a sac, spinal cord remains in its normal position

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23
Q

Foramina of the Trigeminal Nerve

A

Standing Room Only
Superior Orbital Fissure - V1
Foramen Rotundum - V2
Foramen Ovale - V3

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24
Q

Compression of the CN V3

A

mandibular division - numbness of the ipsilateral jaw and lower face

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25
Q

Compression of CN V2

A

maxillary division - decreased sensation over the cheek and middle face
leaves skull through foramen rotundum

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26
Q

What foramen transmits IX, X, XI

A

Jugular Foramen

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27
Q

Glossopharyngeal

A

motor inervation of stylopharyngeus muscle, parasympathetic innervation of the parotid gland, nd sensory innervation of the pharynx, middle ear, and posterior third of the tongue
Also innervates chemoreceptors and baroreceptors of the carotid body

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28
Q

Vagus Nerve

A

motor innervation of the pharyngeal and laryngeal muscles, parasympathetic innervation to visceral organs, sensory innervation to the pharynx and meninges
Also innervates chemoreceptors and baroreceptors of the aortic arch

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29
Q

Spinal Accessory Nerve

A

XI

innervates the sternocleidomastoid and upper part of the trapezius muscle

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30
Q

What passes through the superior orbital fissure

A

III, IV, V1, VI, superior ophthalmic vein
oculomotor, trochlear, ophthalmic, abducens
lesions of these nerves lead to ipsilateral extraocular muscle paralysis - III, IV, VI
numbness of the ipsilateral forehead and upper face - V1

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31
Q

Tx for ALS

A

Riluzole - reduces presynaptic release of glutamate

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32
Q

ALS

A

upper and lower motor neuron signs

affects both anterior horn cells in the spinal cord and upper motor neurons in the spinal cord - corticospinal tract

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33
Q

B12 neuropathy - subacute combined degeneration of the spinal cord

A

associated with pernicious anemia
demyelination of axons in dorsal columns - loss of vibration and position sense, and spinocerebellar tracts - arm/leg ataxia

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34
Q

Demyelination of axons in the posterior limb of the internal capsule would cause

A

UMN signs

contralateral spastic paralysis secondary to disruption of the descending fibers of the corticospinal tract

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35
Q

What is affected in Charcot - Marie - Tooth Disease

A

neuronal loss in the anterior horn cells and posterior columns in the spinal cord
loss of conscious proprioception - posterior columns
LMN signs - ant. horn motor neurons

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36
Q

Neuronal loss in the region of anterior horn cells in the spinal cord
An acute inflammatory viral infection that affects the lower motor neuron and results in flaccid paralysis

A

Poliomyelitis

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37
Q

Supraoptic hypophyseal tract of hypothalamus controls:

A

ADH and oxytocin are synthesized in the supraoptic and paraventricular nuclei and transported to the posterior pituitary via the suproaptic hypophyseal tract

ADH facilitates the retention of water and therefore the concentration of urine
Oxytocin stimulates the release of milk not it’s synthesis

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38
Q

Hypothalamic-hypophyseal portal system

A

connects the hypothalamus with the anterior pituitary

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39
Q

milk synthesis is mediated by

A

prolactin

secreted by anterior pituitary

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40
Q

ovulation is stimulated by

A

LH

secreted by anterior pituitary

41
Q

Salt retention is the primary function of

A

aldosterone

42
Q

spermatogenesis is stimulated by

A

follicle-stimulating hormone

secreted by anterior pituitary gland

43
Q

function and location of the chemoreceptor trigger zone

A

area postrema of the medulla, on the floor of the 4th ventricle, outside of the BBB
controls vomitting

44
Q

Prochlorperazine

A

anti-psychotic, dopamine blocker at the chemoreceptor trigger zone
used for anti-emetic properties

45
Q

Pituitary Gland Roles

A 
TAN HATS
thirst
adenohypophysis 
neurohypophysis
hunger
autonomic regulation
temperature regulation
sexual urges
46
Q

Internal Carotid Artery supplies blood to what arteries

A

ACA and MCA

47
Q

Where is the lesion in Wernicke Korsakoff syndrome

A

Mamillary bodies

48
Q

Korsakoff psychosis is characterized by

A

anterograde amnesia and confabulation

49
Q

Wernicke’s Encephalopathy

A

confusion, ataxia, and ophthalmoplegia
assoc. with alcoholism
reversible with thiamine

50
Q

kluver bucer syndrome

A

bilateral lesions to the amygdala

hyperorality, hypersexuality, and disinhibition

51
Q

meningioma

A

often located in convexities of cerebral hemispheres

Psammoma bodies - laminated mineral deposits formed via calcification of whorled clusters

PSaMMoma
Papillary - thyroid
Serous - ovary
Meningioma
Mesothelioma
52
Q

oligodendrogliomas

A

cerebral hemispheres in middle aged people

fried egg cells

53
Q

Internuclear opthalmoplegia

A

indicative of MS
lesion of medial longitudinal fasciculus - movement started by CN VI and cannot be transmitted to III - diplopia and nystagmus

54
Q

Arcuate fasciculus connects what two areas

A

Broca’s and Wernicke’s of left hemisphere

Manifests as impaired repetition

55
Q

Medial Lemniscus carries what information

A

sensory information on light touch, conscious proprioception, and vibration in the extremities from the nucleus gracilis and cuneatus to the thalamus

56
Q

role of the internal segment of the globus pallidus in Parkinson’s Disease

A

excessive inhibition of the ventral lateral nucleus of the thalamus making it difficult for patients to initiate movements
normally, dopaminergic neurons from the substantia nigra induce striatal neurons to inhibit the globus pallidus, thereby lifting the inhibition of the thalamus

57
Q

bells palsy affects which nerve

A

VII
afferent taste from ant 2/3 of ipsilateral tongue
touch and pain sensory fibers from ipsilateral ear
motor fibers to muscles of facial expression, ipsilateral paralysis
ipsilateral stapedius
dryness in ipsilateral eye and mouth - facial nerve carries parasympathetic fibers to ipsilateral lacrimal and submandibular/sublingual glands
+ facial muscle weakness prevents eyelids from closing - exacerbating eye dryness

58
Q

physostagmine vs neostigmine MOA

A

both are reversible anticholinesterases
Physostagmine - crosses BBB, better CNS penetration, used as antidote for anticholinergic toxicity
Neostigmine - does not cross BBB, better peripheral action especially on skeletal muscle, used to treat Myasthenia Gravis

59
Q

PICA supplies blood to

A

dorsolateral quadrant of the medulla, including the nucleus ambiguous and the inferior surface of the cerebellum - holds V (face and pain), vestibular nuclei, nucleus ambiguous (palate problems and hoarse voice), spinothalamic tract (contra pain and temp), descending sympathetic fibers (Horners Syndrome)

60
Q

Lateral Medullary Syndrome - Wallenberg Syndrome

A

PICA stroke

61
Q

cochlea and vestibular nuclei supplied by what artery

A

labyrinthine artery

62
Q

internal capsule, caudate, putamen and globus pallidus are perfused by

A

lateral striate arteries of MCA

assoc. with lacunar infarcts

63
Q

Guillan Barre is most common caused by an infection by

A

campylobacter jejuni

64
Q

Guillan Barre is best treated by

A

plasmapherisis followed by immunoglobulins and supportive care

65
Q

Acute injury to CNS (cauda equina syndrome, metastatic bone disease, or spinal cord injury) is best treated by

A

glucocorticoids

66
Q

Donepezil is used for

A

initial tx of Alzheimer’s

acetylcholinesterase inhibitor - increases ACh in presynaptic space

67
Q

Selegilin

A

MAO B inhibitor

increases dopamine, used in parkinson’s

68
Q

Diazapam

A

increases frequency of GABA channel opening
Tx for anxiety, status epilepticus, and alcohol withdrawal
Benzodiazapine

69
Q

Bromocriptine

A

dopamine receptor agonist, used in Parkinson’s

70
Q

Desmopressin

A

ADH analog

Taken nasally to treat central diabetes insipidus

71
Q

Central Diabetes Insipidus

A

Failure of kidneys to concentrate urine due to lack of ADH secretion from the posterior pituitary - without ADH distal tubules remain impermeable to water
caused by head trauma, hypothalamic and pituitary tumors
characterized by low urine specific gravity and high serum osmolality

72
Q

Nephrogenic Diabetes Insipidus

A

Principal cells of the kidneys do not respond to ADH because of defective ADH receptors
caused by lithium toxicity and hypercalcemia
characterized by low urine specific gravity and high serum osmolality

73
Q

Hydrochlorothiazide

A

diuretic used to treat nephrogenic DI

ADH is futile if receptors are defective

74
Q

JC virus in AIDS patients is associated with which disease

A

Progressive multifocal Leukoencephalopathy
multiple areas of demyelination in the CNS white matter
reactivation of dormant virus
initial findings- speech, memory, coordination, vision deficits
rapid

75
Q

Common fungal cause of meningitis in AIDS pts

A

Cryptococcus neoformans

76
Q

Where would a HSV 1 encephalitic lesion most likely present in an AIDS pt

A

Temporal Lobe

77
Q

Pneumocystis jiroveci

A

common cause of pneumonia in HIV pts whose CD4+ cell counts are less than 200
xray would show ground glass appearance

78
Q

Toxoplasmosis is the most common cause of encephalitis in pts with

A

HIV
CD4+ count less than 100
seizures and headache
ring enhancing lesions with surrounding edema

79
Q

A disease described by dementia, increased impulsivity and hyperoral habits (frontotemporal dementia),
confirmed by intracytoplasmic, silver-staining spherical tangles and occasional balloon neurons

A

Pick Disease

80
Q

What is affected by a midshaft humerus fracture

A

The radial groove
Radial nerve and brachial artery
inability to extend the wrist and metacarpophalangeal joints of all digits

81
Q

What causes a winged scapula

A

Long thoracic nerve damage - innervated Serratus Anterior

injury to the axilla or lateral thoracic wall

82
Q

What type of injury can cause damage to the axillary nerve

A

Surgical neck of the humerus fracture or anterior shoulder dislocation
Axillary nerve innervates deltoid - abduction

83
Q

Weakness in adduction and abduction of the fingers can be caused

A

Damage to the ulnar nerve at the medial epicondyle

84
Q

Supracondylar humerus fracture causes damage to what nerve

A

Median

85
Q

What nerve roots are compressed in Erb Palsy

A

C5 and C6

Axillary nerve

86
Q

cluster headaches

A

Always unilateral
repetitive headaches that occur for weeks to months at a time with intervening periods of remission
typically around the eye or temple and are excruciating
not preceded by prodromal symptoms

87
Q

migraine headaches

A

preceded by prodromal symptoms
can be bilateral
increase in severity and can last 10-12 hours

88
Q

A headache that frequently presents with unilateral ear or auricular pain radiating to the jaw is caused by

A

temporomandibular joint dysfunction syndrome

89
Q

The most common headache syndrome that typically presents with bifrontal squeezing and constant pain

A

tension headaches

typically relieved by NSAIDs

90
Q

Naloxon reverses the effects of

A

opioid intoxication
opioid receptor antagonist
opioid intoxication can present with miosis due to increased parasympathetic tone

91
Q

shaking chills of indicative of

A

bacteremia and sepsis

hypotension, increased WBC, increased temp

92
Q

a patient has a resected ileum, eats a normal diet, and now presents with weakness in all extremities and + Romberg sign - what is the most likely diagnosis

A

B12 deficiency - leads to abnormal myelin
macrocytic, megaloblastic anemia withhypersegmented neutrophils on blood smear

B12 combines with intrinsic factor from parietal cells and is reabsorbed in the ileum

93
Q

Bupropion is an antidepressant contraindicated in which patients for increased risk of seizures

A

Anorexia nervosa

94
Q

The anterior pituitary develops from

A

rathke’s pouch which is composed of surface ectoderm

95
Q

A functional anterior pituitary adenoma presents with

A

bitemporal hemianopsia and amenorrhea due to prolactin hypersecretion

96
Q

gut tube epithelium and its derivatives originate from

A

endoderm

97
Q

most of the body’s connective tissue comes from

A

mesoderm

98
Q

the parafollicular cells of the thyroid are derived from

A

neural crest

99
Q

posterior pituitary is derived from

A

neuroectoderm

neuro (18 decks)

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