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Neuro Flashcards

1
Q

Picks Disease

A
  • atrophy of frontal and temporal lobes
  • pick bodies (cytoplasmic inclusions of tau)
  • personality and behavioral change (inappropriate behavior)
  • autosomal dominant
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2
Q

Alzheimer Disease

A
  • generalized brain atrophy
  • neurofibrillary tangles
  • amyloid plaques
  • chromosome 21
  • apo E4 inc. risk (apo E2 dec. risk)
  • dec. choline acetyltransferase activity in nucleus basalis
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3
Q

Tx for Status Epilepticus

A
  1. Give benzodiazepine (lorazepam) to stop seizure and simultaneously give phenytoin to prevent seizures (blocks Na channels)
  2. If still seizing, give barbiturate or place under general anesthesia
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4
Q

Scotoma

A

Visual field defect that involves parts of the retina or the optic nerve causing a discrete area of altered vision surrounded by zones of normal vision.
Lesions of macula cause central scotomas.

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5
Q

Pilocytic Astrocytoma

A

Cystic tumor in cerebellum of child. Biopsy shows spindle cells with hairlike processes associated with microcysts. These are mixed with Rosenthal fibers and granular eosinophilic bodies.
-most common brain neoplasm of childhood

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6
Q

Disdiadokokinesia

A

Inability to perform rapid, alternating movements.

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7
Q

Epidural Hematoma

A

Lucid interval followed by LOC.
Due to tear of middle meningeal artery.
Located between bone and dura mater, lens shaped

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8
Q

Charcot Bouchard Aneurysms

A

Cause: HTN
Location: basal ganglia, cerebellum, thalamus, pons
Size:

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9
Q

Inhibitory Neurotransmitters

A
  • glycine

- gamma-aminobutyric acid (GABA)

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10
Q

Neurophysins

A

Carrier protein for vasopressin and oxytocin.

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11
Q

What cells secrete aqueous humor in the eye?

A

Ciliary Epithelium

This is inhibited by nonselective beta blockers and carbonic anhydrase inhibitors

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12
Q

What cells does the immune system attack in MS?

A

Oligodendrocytes (secrete myelin)

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13
Q

What cells secrete myelin in the PNS?

A

Schwann cells, which are targeted by the immune system in ALS.

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14
Q

Waterhouse Friedrickson

A

-N. mening leads to sepsis, leads to DIC, leads to adrenal infarct

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15
Q

Tau Protein Diseases

A
  • Alzheimers

- Picks

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16
Q

a-Synuclein Diseases

A
  • Lewey Body Dementia

- Parkinsons

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17
Q

Apolipoprotien

A
  • Alzheimers
  • E2 is protectice
  • E4 is inc. risk
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18
Q

SOD1 Gene Mutation

A

-ALS

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19
Q

GFAP

A
  • glial fibrillary acidic protein

- tumor marker of glial neuron support cells (ie astrocytes)

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20
Q

Rosenthal Fibers

A

-pilocytic astrocytoma

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21
Q

Subdural Hematoma

A
  • rupture of cortical bridging veins
  • banana shaped
  • gradual HA and confusion
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22
Q

Pineal Gland

A
  • located behind third ventricle
  • in charge of sleep and heat cycles in animals
  • germinoma makes HCG if you have a tumor and can cause vertical gaze palsy and N/V
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23
Q

What signifies a complex seizure?

A
  • characterized by loss of memory during the event

- compared to simple where memory is maintained

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24
Q

Schwannomas

A
  • tumor of peripheral nervous system (can still be in cranium)
  • antoni A, antoni B, verocay bodies
  • S100+
  • may arise on any cranial nerve (except CN 2)
  • most common site is cerebellopontine angle at CN 8 (acoustic neuromas)
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25
Q

What effect does pCO2 have on cerebral vasculature?

A
  • pCO2 is a potent vasodilator of cerebral vasculature
  • inc. breathing rate causes dec. pCO2 and causes cerebral vasoconstriction > dec. cerebral blood flow and dec. cerebral intracranial pressure
26
Q

Open Angle Glaucoma

A
  • inc. intraocular pressure due to inc. secretino of dec. outflow of aqueous humor
  • progressive loss of peripheral visual fields
  • chronic
  • painless
27
Q

Closed Angle Glaucoma

A
  • acute
  • painful
  • sudden rise in intraocular pressure
28
Q

Drug of Choice for Status Epilepticus

A
  • benzodiazepines

- inc. effect of GABA-A receptor > inc. influx of Cl- > hyperpolarization

29
Q

Length Constant

A
  • also called space constant
  • measure of how far along an axon an electrical impulse can propagate
  • dec. in MS
30
Q

Flame Shaped Retinal Hemorrhages

A
  • caused by sever HTN in retinal precapillary arterioles
  • cause painless, unilateral visual disturbances
  • causes fibrinous necrosis
31
Q

Cauda Equina Syndrome

A
  • compression of spinal cord nerve roots below conus medullaris
  • pts presents with bilateral radicular pain, saddle anesthesia, and hyporeflexia
  • bowel and bladder incontinence are late manifestations
32
Q

Acute Dystonic Reaction

A
  • extrapyramidal symptoms due to antipsychotic medications
  • sudden involuntary contraction of a major muscle group
  • due to D2 antagonism in the nigrostriatal pathway
33
Q

Signs of Shaken Baby Syndrome

A

Subdural hemorrhage and retinal hemorrhage.

34
Q

What part of CN 3 is damaged first in diabetic neuropathy?

A

Central somatic fibers are affected before peripheral parasympathetic fibers.
Sx: ptosis, down and out gaze, but normal accommodation and rxn to light

35
Q

Essential Tremor Tx and Characteristics

A
  • AD
  • symmetric tremor that inc. when holding one position
  • improves with alcohol consumption
  • tx: non-selective beta blocker
36
Q

Function of Ventromedial Hypothalamic Nuclei

A
  • mediates satiety

- destruction causes hyperphagia and obesity

37
Q

Function of Lateral Hypothalamic Nuclei

A
  • mediates hunger

- destruction leads to anorexia (you shrink laterally)

38
Q

Function of Anterior Hypothalamic Nuclei

A
  • mediates heat dissipation (cooling)
  • destruction leads to hyperthermia
  • A/C= anterior cooling
39
Q

Function of Posterior Hypothalamic Nuclei

A
  • mediates heat conservation
  • destruction leads to hypothermia
  • if posterior nucleus is destructed, you become poikilothemic (like a reptile)
40
Q

Function of Arcuate Hypothalamic Nucleus

A

-secretion of DA (inhibits prolactin), GHRH, and GnRH

41
Q

Function of Paraventricular Hypothalamic Nucleus

A

-antiduretic hormone, CRH, oxytocin, and TRH secretion

42
Q

Function of Supraoptic Hypothalamic Nucleus

A

-secretion of antidiuretic hormone

43
Q

Function of Suprachiasmatic Hypothalamic Nucleus

A
  • circadian rhythym regulation and pineal gland fxn

- you need sleep to be charismatic

44
Q

Where are the neurons that release serotonin in the brain?

A

-Raphe nuclei located in midbrain, pons, and medulla

45
Q

Meningioma

A
  • slow growing, benign tumor of meningothelial cells of arachnoid
  • whorled pattern, psammoma bodies
  • may cause seizures, HA, N
46
Q

Valproate MOA and Side Effects

A
  • inc. Na channel inactivation, inc. GABA concentration
  • inhibits folate absorption-> neural tube defects in pregnancy
  • GI distress, hepatotoxicity, weight gain
47
Q

Locus Ceruleus

A
  • plays role in panic attacks and panic disorder
  • located in caudal pontine central gray matter
  • contains large amounts of norepinephrine
48
Q

Proptosis

A

-protrusion of eye ball

49
Q

Cataplexy

A
  • sudden loss of muscle tone that occurs in response to intense (usually positive) emotions
  • associated with narcolepsy
50
Q

Narcolepsy

A
  • frequent overwhelming urges to sleep
  • associated with cataplexy
  • results from depletion of hypocretin-secreting neurons in the lateral hypothalamus
  • short REM cycle
  • hypnagogic (falling asleep) and hypnopompic (waking up) hallucinations
  • low cerebrospinal fluid levels of hypocretin 1
51
Q

Effect of epinephrine on a2 and b2 receptors in terms of insulin secretion.

A
  • b2 (Gs) receptor binding by epi causes inc. insulin secretion
  • a2 (Gi) receptor binding by epi causes dec. insulin secretion
  • a2 effect usually is predominant leading to overall inhibition of insulin secretion
52
Q

Medulloblastoma

A
  • gait instability
  • limb ataxia
  • above are sx of cerebellar involvement
  • sheets of primitive cells w/ many mitotic figures
  • aggressive
  • more common in kids
  • commonly in cerebellar vermis
53
Q

Ependymomas

A
  • third most common brain neoplasm found in children
  • in walls of ventricles and hamper CSF flow -> hydrocephalus
  • rosettes
54
Q

Brain Tumors in Kids

A
  • Poilocytic astrocytoma-cystic
  • medulloblastoma-sheets of cells with mitotic figures
  • ependymoma-4th ventricle-> hydrocephalus, pseudorosettes
  • craniopharyngioma- optic chiasm compression
55
Q

What cells are involved in glial scar formation?

A
  • astrocytes

- present several months to years after ischemia infarction

56
Q

Effect of too rapid correction of chronic hyponatremia?

A
  • osmotic demyelination of axons in the central pons
  • called central pontine myelinolysis
  • sx: spastic quadriplegia and pseudobulbar palsy
57
Q

Decerebrate vs Decorticate Posturing

A
  • brain damage at or below red nucleus (midbrain tegmentum, pons) causes decrerebrate (extensor) posturing
  • damage to neural structures above red nucleus (cerebral hemispheres) results in decorticate (flexor) posturing
58
Q

Glioblastoma

A
  • most common primary cerebral neoplasm in adults
  • poor prognosis
  • arises from astrocytes
  • may cross midline (butterfly glioma)
  • contain areas of necrosis and hemorrhage
  • solitary lesion differentiates from metastisis
59
Q

Moro Reflex

A
  • appropriate in babies up to 4 or 5 months

- beyond this age indicates neurological defects

60
Q

What part of the basal ganglia when damaged will cause large amplitude limb movements?

A

-subthalamic nucleus

61
Q

Uncle Herniation

A
  • may result in compression of ipsilateral third cranial nerve
  • causes fixed dilated pupil due to damage to parasymp fibers on outer portion of CN3
  • may also see decerebrate posturing

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