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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
What effect does pCO2 have on cerebral vasculature?
- 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
Open Angle Glaucoma
- inc. intraocular pressure due to inc. secretino of dec. outflow of aqueous humor - progressive loss of peripheral visual fields - chronic - painless
27
Closed Angle Glaucoma
- acute - painful - sudden rise in intraocular pressure
28
Drug of Choice for Status Epilepticus
- benzodiazepines | - inc. effect of GABA-A receptor > inc. influx of Cl- > hyperpolarization
29
Length Constant
- also called space constant - measure of how far along an axon an electrical impulse can propagate - dec. in MS
30
Flame Shaped Retinal Hemorrhages
- caused by sever HTN in retinal precapillary arterioles - cause painless, unilateral visual disturbances - causes fibrinous necrosis
31
Cauda Equina Syndrome
- 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
Acute Dystonic Reaction
- extrapyramidal symptoms due to antipsychotic medications - sudden involuntary contraction of a major muscle group - due to D2 antagonism in the nigrostriatal pathway
33
Signs of Shaken Baby Syndrome
Subdural hemorrhage and retinal hemorrhage.
34
What part of CN 3 is damaged first in diabetic neuropathy?
Central somatic fibers are affected before peripheral parasympathetic fibers. Sx: ptosis, down and out gaze, but normal accommodation and rxn to light
35
Essential Tremor Tx and Characteristics
- AD - symmetric tremor that inc. when holding one position - improves with alcohol consumption - tx: non-selective beta blocker
36
Function of Ventromedial Hypothalamic Nuclei
- mediates satiety | - destruction causes hyperphagia and obesity
37
Function of Lateral Hypothalamic Nuclei
- mediates hunger | - destruction leads to anorexia (you shrink laterally)
38
Function of Anterior Hypothalamic Nuclei
- mediates heat dissipation (cooling) - destruction leads to hyperthermia - A/C= anterior cooling
39
Function of Posterior Hypothalamic Nuclei
- mediates heat conservation - destruction leads to hypothermia - if posterior nucleus is destructed, you become poikilothemic (like a reptile)
40
Function of Arcuate Hypothalamic Nucleus
-secretion of DA (inhibits prolactin), GHRH, and GnRH
41
Function of Paraventricular Hypothalamic Nucleus
-antiduretic hormone, CRH, oxytocin, and TRH secretion
42
Function of Supraoptic Hypothalamic Nucleus
-secretion of antidiuretic hormone
43
Function of Suprachiasmatic Hypothalamic Nucleus
- circadian rhythym regulation and pineal gland fxn | - you need sleep to be charismatic
44
Where are the neurons that release serotonin in the brain?
-Raphe nuclei located in midbrain, pons, and medulla
45
Meningioma
- slow growing, benign tumor of meningothelial cells of arachnoid - whorled pattern, psammoma bodies - may cause seizures, HA, N
46
Valproate MOA and Side Effects
- inc. Na channel inactivation, inc. GABA concentration - inhibits folate absorption-> neural tube defects in pregnancy - GI distress, hepatotoxicity, weight gain
47
Locus Ceruleus
- plays role in panic attacks and panic disorder - located in caudal pontine central gray matter - contains large amounts of norepinephrine
48
Proptosis
-protrusion of eye ball
49
Cataplexy
- sudden loss of muscle tone that occurs in response to intense (usually positive) emotions - associated with narcolepsy
50
Narcolepsy
- 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
Effect of epinephrine on a2 and b2 receptors in terms of insulin secretion.
- 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
Medulloblastoma
- 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
Ependymomas
- third most common brain neoplasm found in children - in walls of ventricles and hamper CSF flow -> hydrocephalus - rosettes
54
Brain Tumors in Kids
- Poilocytic astrocytoma-cystic - medulloblastoma-sheets of cells with mitotic figures - ependymoma-4th ventricle-> hydrocephalus, pseudorosettes - craniopharyngioma- optic chiasm compression
55
What cells are involved in glial scar formation?
- astrocytes | - present several months to years after ischemia infarction
56
Effect of too rapid correction of chronic hyponatremia?
- osmotic demyelination of axons in the central pons - called central pontine myelinolysis - sx: spastic quadriplegia and pseudobulbar palsy
57
Decerebrate vs Decorticate Posturing
- 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
Glioblastoma
- 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
Moro Reflex
- appropriate in babies up to 4 or 5 months | - beyond this age indicates neurological defects
60
What part of the basal ganglia when damaged will cause large amplitude limb movements?
-subthalamic nucleus
61
Uncle Herniation
- 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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