Neuro Flashcards
What CSF markers are low in narcolepsy
Low levels of hypocretin (orexin)
Orexin promotes wakefulness and inhibits rem in lateral hypothalamus
What do you call being tired all the time that is not explained by a sleep disorder
Hypersomance
Do not feel refreshed after a nap
Compare methadone to heroine
Methodone has a longer half life
Give an example of stimulus control therapy for insomnia
Leave bedroom if but asleep in 20 minutes
Only go to bed when actually tired
What is a scomotoma
Any visual field defect surrounded by unimpaired vision
Central- macula lesion
Transcetion of contralateral optic tract would lead to what vision
Homonymous hemianposia
Loss of vision in the same side on both eyes
What does the locus ceruleus house
Norepinephrine secreting neurons
What does the nucleaus basalis of meynert house
Cholenergic neurons
This is damaged in Alzheimer’s
Where are serotonin releasing neurons contained
Ralphi nuclei
What is Zellweger syndrome
Peroxisomal disease
Infant cannot form mylin
Symptoms of zelwegger
Aka no mylin
Hypotonia
Sz
Heptomegally
Death in months
What disease is treated by restricting cholophil
Refsum
Defect in peroxisome
Nerve control of eyes
SO4 LR6
All others are tree
Double vision when looking down
Vertical diplopoa, Eye deviating upward
Trochlear damage
Eye deviates medially, horizontal diplopia
Abducens lesion
What kind of drug is a triptan
Post snap Serotonin receptor stimulator
Rx for migraine
What kind of action does a tricyclic have
Strong anticholenergic
What makes a pupil get smaller
Oculomotor nerve
What is the prefered treatment for restless leg syndrome
Dopamine agonist
Restless leg syndrome may be asc with this heme finding
Iron deficiency anemia
This is the measure of how far along an axon an electrical signal might propogate
Length constant
How does mylination affect neuron capcitence
Mylein decreases capacitance
Baby with seizures, intellectual disability, and no color in substantia niagra
PKU
phenylalanine deficiency
What do all eye nerves travel through
Superior orbital fissure
Adding carbidopa to levodopa changes what?
Carbidopa increases levidopa getting to the brain
Decreases periferal side effects (NV hypotension)
Increases central side effects (agitation)
How do you treat Wilson’s disease
D penicillamine chelation
Symptoms of wilsons
AR ATP7B mutation
Copper accumulates in eye liver brain
s/s Parkinsonisn, kayser fleicher rings
Lab findings in wilsons
Elevated transaminase
Low serum ceruloplasmin
How does tetrodotoxin work?
From puffer fish
Inactivates nerve na channels
No upstroke in action potential
PKU patients are likely to be low in what neurotransmitter
Serotonin
They need low phenyl diet and BH4 (makes 5ht) as treatment
Drug of choice for absence seizures
Ethosuximide
Sodium valproate
Why is wrong in lych nyne
deficiency of the enzyme
hypoxanthine-guanine phosphoribosyltransferase (HGPRT)
What is an organophosphate
A cholenesterase inhibitor
Leads to cholinergic over stimulation
Symptoms of organophosphate poisoning
Salvation
Tear eyes
Bradycardia
Bronchospasam
This urea cycle disorder shows no or little increase in ammonia
Arginase deficiency
S/s spacity
Chorea
Rx: low protein
This drug will precipitate an opioid with drawl and it is not narcan
Buprenorphine
Partial opioid agonist
Acts as an antagonist when I. The presence of other opioids
What does a PCA stroke produce (symtoms)
Contralateral hemianopia with macular sparing
Thalamus may be involved leading to contralateral parastheisias
Other cortical s/s may be seen
What artery helps supply the
optic tract
Lateral geniculate
Hippocampus
Amydiala
Anterior choroidal artery
Destruction of this leads to hyperphagia
Ventromedial
Destruction if this leads to anaorexia
Lateral nucleaus
Destruction leads to hyperthermia
Anterior nuc
Destruction leads to hypothermia
Posterior nuc
New acronym to remeber lateral vs Ventromedial destruction
Destruction
Lateral makes you lean
Medial makes more
EXACTLY how does a benzo work
Increases FREQUENCY of cl channel for GABA
What do barbs do to nerves
Increase duration of cl opening for GABA
How does phenytoin work
Inhibits high frequency firing of sodium channels
What is the edrophonuum test for
Myasthenia gravis
You know someone has m gravis but still has symtoms
You administer edrophonuim
Why?
Edrophonuim (when you already know there is m gravis)
Helps: when patient needs a HIGHER med dose
Does nothing: the patient is in cholinergic crisis, needs LESS meds
A craniopharingioma derives from
Ranthky pouch - precursor to ant pit
What does a craniopharingioma look like
Calcified cyst with cholesterol crystals
Usually supper seller
Often in kids
Where will an acoustic neuroma arise from (usually)
Cerebellopontine angle where 8th nerve comes off of
Vitamin b1 deficiency causes
Wernicke
Symptoms of wernike
Damage to mammillary bodies
Horizontal nystagmus
What can make wernike way worse
Glucose infusion
B1 is cofactor in glucose metabolism, do giving glu with b1 will make you worse
What are estazolam and triazolam
Benzos
What is prolly most common reason for cognitive decline in HIV
HIV dementia
Micro glial nodules
What is a middle ear cholestoma
a collection of SQUAMOUS CELL DEBRIS
form a mass behind membrane
cause a conduction hearing loss
Is a cholestoma made from cholesterol
NO
Cholestoma is squamous cell debris build up in middle ear
Cholesterol granulaomas can form, but are rare and apear green/black
Involuntary movements after chronic use of antipsychotics
lip smaking, chorea
Tardive dyskinesia
Fever, rigidity, AMS, and autonomic instability after antipsychotics
Neuoeptic malgnant syndrome
sudden onset sustained mucsle contractions with antipsycotics
Extrapyramidal side effect (EPS)
Acute dystonic rxn
Subjective restlessness and inablity to sit still with antipsycotics
Akathisia
EPS
Tremor, ridgidity, bradykinesia, masked face with antipsycotic
EPS
Drug induced parkinsons
This problem can arise when CSF is not reabsorbed well
communicating hydrocephalus
This is when csf is not being absorbed well, so reflexively there is less csf made. Intercranial pressure will be normal
Normal pressure hydrocephalus
This has a normal ISP, the corticals atrophy, and the ventricles are dilated
Hydrocephalus ex vacuo
This is a hydrocephulus that is not well understood but happens morewith obesity
Pseudotumor cerebri
The changes in a neural cell body after an axon is severed is called
axonal reaction- changes reflect ↑ protein synth for repair
shows cellular edema, displacd nucleus, and dispersed nissle substance
Is Korsakoff syndrome reversible with thiamine
NO
The memory problems are forever
However, eye stuff, ataxia, and confusion can be reversed
What Da pathway controls prolactin secretion
Tuberoinfundibular
diseased in hyperprolactinemia
What Da pathway regulates behavior
Mesolimbic-mesocortical
diseased in schizophrenia
What Da pathway regulates voluntary movement
Nigrostriatal
diseased in parkinson’s
