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Step 1 Crush 250! - Hans > neuro 490 - 494 > Flashcards

neuro 490 - 494 Flashcards

1
Q

what neurocutaneous dz is associated with optic gliomas?

A

NF type 1

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2
Q

NF type 1 is also called

A

von Recklinghausen dz

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3
Q

what neurocutaneous dz (ND) is associated with shagreen patches?

A

TS

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4
Q

what ND is associated with pheochromocytoma?

A

VHL

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5
Q

what type of multiple endocrine neoplasia is associated with pheochromocytoma?

A

MEN2B

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6
Q

what ND is associated with GNAQ gene mutation?

A

sturge weber syndrome

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7
Q

which ND is associated with 2’ polycythemia?

A

VHL (hemangioblastoma –> inc EPO)

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8
Q

what ND is associated with inc incidence of subependymal astrocytomas and ungual fibroma

A

TS

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9
Q

which ND is associated with early onset glaucoma?

A

sturge weber

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10
Q

explain the pathophysio behind early onset glaucoma in sturge weber

A

ipsilateral leptomeningeal angioma & episcleral hemangioma –> inc IOP –> early onset glaucoma

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11
Q

which ND is associated with seizures, epilepsy, and intellectual disability?

A

sturge weber

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12
Q

what ND is associated with mitral regurge?

A

TS

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13
Q

what path is associated with tram track calcification (opposing gyri)?

A

sturge weber

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14
Q

what is nevus flammeus and what dz is associated with it?

A

a non neoplastic brithmark in CN V1/V2 distribution, Sturge Weber

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15
Q

what neurocutaneous disorder is non-inherited (somatic)?

A

Sturge weber

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16
Q

what neurocutaneous disorder is due to the developmental anomaly of neural crest derivatives?

A

Sturge weber

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17
Q

what is the role of neurofibromin in NF1?

A

a negative regulator of RAS on ch#17

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18
Q

what path is associated with shagreen patches?

A

TS

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19
Q

what path is associated with cafe au lait spots?

A

NF1

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20
Q

what path is associated with carvernous hemangioma in skin, mucosa, skin, organs?

A

vHL

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21
Q

2 neurocutaneous disorders associated with intellectual disability?

A

sturge weber, TS

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22
Q

what is the type of headache associated with repetitive brief headache?

A

cluster

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23
Q

describe the characteristics of tension headache

A

steady pain, no photophobia or phnophobia. No aura

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24
Q

how would you diff cluster, tension, migraine headache in terms of their location?

A

cluster: unilateral
tension: bilateral
migraine: unilateral

25
Q

what type of headache is associated with excruciating periorbital pain with lacrimation and rhinorrhea with potential Horner syndrome?

A

Cluster

26
Q

treatments for cluster headache?

A

100% O2, sumatriptan

27
Q

target of sumatriptan?

A

5HT 1B/1D agonist –> inhibit trigeminal nerve activation, vasoactive peptide release –> induces vasoconstriction

28
Q

how is trigeminal neuralgia diff from cluster headache?

A

TN produces repetitive shooting pain in the distribution of CN5 that lasts for less than 1 min

29
Q

how would you diff cluster, tension, migraine headache in terms of duration?

A

cluster: 15 min - 3 hours
tension: more than 30 min (typically 4-6hr)
migraine: 4-72 hrs

30
Q

explain the pathophysio of migraine

A

due to irritation of CN V, meninges, or blood vessels

31
Q

in migraine, what 3 substances are released from blood vessels?

A

substance P, calcitonin gene related peptide, vasoactive peptides

32
Q

4 DOC for migraine prophylaxis?

A

propranolol, topiramate, CCB, amitriptyline

33
Q

4 DOC for tension headache?

A

analgesics, NSAIDs, acetaminophen, amitriptyline for chronic pain

34
Q

mnemonics for migraine headache?

A

POUND

Pulsatile
One day duration
Unilateral
Nausea
Disabling
35
Q

in terms of the location of the lesion, how can you diff peripheral vs ventral vertigo?

A

peripheral: inner ear etiology
central: brain stem or cerebellar lesion

36
Q

how would you test peripheral vertigo?

A

positional testing to see if there is any delayed horizontal nystagmus

37
Q

how would you test central vertigo?

A

positional testing will reveal immediate nystagmus in any direction

38
Q

name 3 inner etiologies that can cause peripheral vertigo

A
  1. semicircular canal debris
  2. vestibular nerve infection
  3. Meniere dz
39
Q

what brain tumor is associated with chick wire capillary pattern?

A

oligodendrogioma

40
Q

what brain tumor is associated with drop metastases to spinal cord?

A

medulloblastoma

41
Q

in uncal herniation, you get 2 unique clinical symptoms (other than CN3 symptoms), what are they? Explain.

A
  1. contralateral crus cerebri at the Kernohan notch –> ipsilateral paresis, a false localization sign
  2. ipsilateral PCA –> contralateral hmonymous hemianopia
42
Q

what type of hernia can cause coma or death as a result of compressing brain stem?

A

cerebellar tonsillar herniation into the foramen magnum

43
Q

what is uncus?

A

medial temporal lobe

44
Q

what cranial nerve is affected by uncus herniation?

A

CN3

45
Q

2 clinical symptoms from CN3 lesion?

A

blown pupil, down and out gaze

46
Q

what type of hernia leads to duret hemorrhages?

A

downward transtentorial (central) herniation due to caudal displacement of the brain stem

47
Q

duret hemorrhage is due to a rupture of what blood vessel?

A

paramedian basilar artery branches

48
Q

what type of hernia compresses anterior cerebral artery?

A

cingulate (subfalcine) herniation under falx cerebri

49
Q

pts with cingulate (subfalcine) herniation will present what types of focal neurological deficits?

A

contralateral paralysis of the lower limbs

contralateral loss of sensation of the lower limbs

50
Q

childhood tumors occur normally in infratentorial. what is the exception?

A

craniopharyngioma (occurs in supratentorial)

51
Q

which brain tumor is associated with small blue cell (Homer Wright rosetts)?

A

medulloblastoma

52
Q

what other 2 paths are associated with small blue cells?

A
  1. Ewing (anaplastic small blue cells)

2. Neuroblastoma (neural crest cells –> Homer Wright rosette)

53
Q

what 2 childhood brain tumors can affect the 4th ventricle?

A

medulloblastoma, ependymoma

54
Q

what tumor is associated with rosenthal fibers?

A

pilocytic astrocytoma

55
Q

what is rosenthal fibers?

A

eosinophilic, corkskrew fibers

56
Q

what 2 brain tumors are GFAP positive?

A 
glioblastoma multiforme (grade 4 astrocytoma)
pilocytic astrocytoma
57
Q

DOC for glaucoma emergenices?

A

pilocarpine (very effective at opening meshwork into canal of Schlemm)

58
Q

what 2 opioids are used for diarrhea?

A

loperamide, diphenoxylate

59
Q

what 2 drugs are used for maintenance programs for heroin addicts?

A

methadone, buprenorphine + naloxone

Step 1 Crush 250! - Hans (41 decks)

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