Neuro

Question 1

Deficiency in what leads to recurrent Neisseria

Answer 1

MAC

makes pore in bacterial membrane

Question 2

Treatment of N. Meningitidis

Answer 2

IV ceftriaxone

Question 3

Absence of T cells leads to?

Answer 3

Fungal and Viral infections

ie: Digeorge syndrome (no thymus & parathyroid)

Question 4

Chronic Granulomatous disease what kind of organisms susceptible to

Answer 4

gram positive like staphylcocci

LACK NADPH oxidase

Question 5

NF type I

what embryological develop the cutaneous neurofibromas?

Answer 5

Benign nerve sheath neoplasm predominantly Schwann cells –> from neural crest

Question 6

How is axillary nerve most often injured and how does it present

Answer 6

shoulder trauma (anterior dislocation, humeral fracture)
presents sensory loss over lateral shoulder and weakness on shoulder abduction (due to denervation of deltoid muscle)

Question 7

What is acute dystonic reaction (spasmodic torticollis)

Answer 7

a type of extrapyramidal symptom (EPS) most likely due to recent initation of antipsychotic medication
can develop abruptly anytime between 4hrs-4days after antipsychotic medication
= sudden involuntary contraction of major muscle group etc.
D2 ANTAGONISM IN NIGROSTRIATAL PATHWAY

Question 8

NF1 inheritance

Answer 8

AD mutation on NF1 gene located on chromosome 17
Cafe au lait spots
multiple neurfibromas
Lisch nodules

Question 9

What molecular mechanisms causes huntington’s

Answer 9

hypoacetylated histones bind tightly to DNA and prevent transcription of genes

Question 10

What is polypeptide precursor to Beta endorphins

Answer 10

Beta endorphin is derived from POMC

also produces ACTH and MSH

Question 11

Wernicke encephalopathy triad

Answer 11

confusion, ataxia, opthalmoplegia

damage to mamillary bodies

Question 12

What can exacerbate and precipitate Wernicke encephalopathy

Answer 12

Glucose infusion
b/c thiamine is necessary for enzymes in glucose metabolism
so always give thiamine with it

Question 13

What vitamin overdose can result in intracranial hypertension, skin changes, and hepatosplenomegaly

Answer 13

Vitamin A

Question 14

Decerebrate posturing

Answer 14

Damage to brainstem at/below level of red nucleus (e.g. midbrain tegmentum/pons) results in decerebrate (extensor) posturing due to loss of descending excitation to upper limb flexors (via the rubrospinal tract) and predominance of the extensors (controlled by the vestibulospinal tract)

Question 15

Decorticate posturing

Answer 15

Damage above red nucleus (e.g cerebral hemispheres) results in decorticate (flexor) posturing due to loss of descending inhbition of red nucleus and subsequent hyperactivity of upper-extremity flexor muscles

Question 16

What does arteriovenous concentration gradient reflects in inhaled anesthetics?

Answer 16

Reflects overall tissue solubility of an anesthetic

High tissue solubility characterized by large arteriovenous concentration gradient and slower onset of action

Question 17

Where is neonatal intraventricular hemorrhage usually occur?

Answer 17

in fragile germinal matrix and increases in frequency with decreasing age and birth weight

can lead to long-term neurodevelopmental impairment

Question 18

What CN inervates stapedius muscle and what would paralysis of stapedius muscle result in

Answer 18

inervated by stapedius nerve (branch of facial nerve)

results in hyperacusis (increased sensitivity to sound)

Question 19

What is afferent and efferent limb of the light reflex pathway

Answer 19

afferent= optic nerve
efferent= parasympathetic fibers of oculomotor nerve

Question 20

Which nerve injury results in a positive trendelenburg sign

Answer 20

superior gluteal nerve injury results in weakness & paralysis of gluteus medius, minimus, tensor fasciae latae muscle
these muscle stabilize pelvis and abduct the thigh

Question 21

What are nerve is affected in baseball pitcher with right arm weakness and numbness. diminished strength on elbow flexion and absent bicepts reflex. sensory loss on lateral forearm.

Answer 21

Musculocutaneous innervates major forearm flexors (eg biceps bachii, bachialis) and coracobrachialis (flexes and adducts arm
Derived from upper trunk of brachial plxus (C5-C7) and can be injured by trauma or strenous upper extremity exercise

Question 22

What is histopathologic finding of HIV-associated dementia in AIDS patients with progrssive cognitive decline

Answer 22

microglial nodules, groups of activated macrophages/microglial cells around area of necrosis that fuse to form multinucleated giant cells

Question 23

What does irreversible injury in neuron look like?

Answer 23

“red neuron”
evidence 12-24 hours
shrinkage of cellboxy, eosinophila of cytoplasm, pkynosis of nucleus and loss of Nissl substance

Question 24

MOA of phenytoin, cabamazepine, and valproic acid

Answer 24

inhibits neuronal high frequency firing by reducing ability of sodium channels to recover from inactivation

Question 25

MOA of ethosuximide

Answer 25

block T type calcium channels in thalamic neurons causing hyperpolarization and is approved for treatment of absence seizures

Question 26

What’s Guillain-Barre syndrome

Answer 26

acute demyelinating peripheral neuropathy

segmental demyelination of peripheral nerves and an endoneural inflammatory infiltrate seen on light microscopy

Question 27

Teratology of Fallot

Answer 27

PROV
PULMONARY STENOSIS
Right Ventricular hypertrophy
Overriding aorta
VSD

or IHOP
Intraventricular septal defect
Hypertrophy of RV
Overriding aorta
Pulmonary stenosis

Question 28

X-linked recessive disorders

Answer 28

Obviously Female Will Often Give Her Boys Her x-Linked Disorders

Ornithine Transcarbamylase deficiency 
Fabry Disease
Wiskott-Aldrich syndrome
Ocular Albinism
G6PD deficiency
Hunter Syndrome
Bruton agammaglobinemia
Hemophilia A & B
Lesch-Nyhan syndrome
Duchenne (and Becker) Muscular Dystrophy