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A-Step 1 > Neuro 5 > Flashcards

Neuro 5 Flashcards

1
Q

HIV patient
sensory ataxia
irregularly shaped pupils that do not react to light but do constrict with accomidation

A

Tabes dorsalis

Neurosyphilis

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2
Q

Cause of Argyl Robertson pupils

A

damage to the midbrain tectum

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3
Q

India Ink staining of CSF is used to diagnose:

A

Cyptococcal meningitis

Caused by cryptococcus neoformans

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4
Q

Treatment for cyptococcal meningitis

A

Amphotericin B and flucytosine

-> Use fluconazole for long term maitenance

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5
Q

Where is the caudate found

A

inferolateral wall of the anterior horn of the lateral ventricle. Separated from the globus pallidus and putamen by the internal capsule

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6
Q

In what genetic disease is the caudate atrophied?

A

Huntingtons

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7
Q

Two causes of glaucoma (broad)

A

Diminished outflow

increased secretion

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8
Q

MOA of timolol

A

Beta blocker

works by diminishing the secretion of aqueous humor by the ciliary epithelium

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9
Q

Which two sympathetic sites are not controlled by norepinephrine?

A

Adrenal glands and sweat glands (both use acetylcholine)

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10
Q

Pathway of thiopental through the body

A

IV-bloodstream-brain-muscle and adipose tissue

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11
Q

Parasthesias of the thumb, index, and middle finger

A

Carpel tunnel syndrome (entrapment of median nerve)

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12
Q

Causes of carpal tunnel syndrome

A 
repetative movements
Fluid retention- hypothyroidism
diabetes
RA
dialysis associated amyloidosis (beta-2 microglobulin)
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13
Q

Most important biochemical abnormality in Alzheimers disease

A

decrease in acetylcholine level
Occurs due to deficiency of choline acetyltranferase
Most notable in the basal nucleus of Meynert and hippocampus

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14
Q

What meningococcal virulence factor allows for attachment to the nasopharynx

A

pili

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15
Q

spinal nerve root whose compression would cause pain purely in the posterior thigh and leg as well as diminution of the ankle jerk reflex

A

S1

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16
Q

MOA of nicotinic receptor

A

ligand gated ion channel that opens after binding acetlycholine. Results in immediate influx of Na, Ca into the cell and outflux of K+

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17
Q

Damage to what nerve causes foot drop and high stepping gait

A

common peroneal

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18
Q

Selegiline

A

inhibitor of MAO, type B.

Use: prevent MPTP damage to dopaminergic neurons. Delays progression of Parkinson’s disease

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19
Q

Clozapine

A

Atypical antipsychotic
Useful because it treats both positive and negative psychotic symptoms
Acts on D4 receptors, less likely to cause dopaminergic side effects
AE: risk of life threatening agranulocytosis, watch CBC. Seizures

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20
Q

MOA of ethosexamide

A

Decreases calcium current in thalamic neurons

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21
Q

MOA of Phenytoin, carbamazepine and valproic acid

A

reduces the ability of Na channels to recover from inactivation

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22
Q

Holoprosencephaly

A

failure of forebrain cleavage into cerebral hemispheres

23
Q

Malformation

A

primary abnormality in a development process

24
Q

Disruption

A

secondary destruction of a previously well-formed tissue or organ

25
Q

Uses of bethanocol

A

stimulate peristalsis in postoperative ileus and treat non-obstructive urinary retention.

26
Q

Uses of carbachol and pilocarpine

A

lower intraocular pressure in glaucoma

27
Q

Why do cholinergics work well for glaucoma

A

miosis causes iris to move further from the cornea, widens he anterior chamber angle.

28
Q

Clinical presentation of excessive cholinergic stimulation

A 
DUMBELS
diarrhea
urination
miosis
bronchospasm
Emesis
lacrimation
salivation
29
Q

Effect of increased acetylcholine in nicotinic synapses of NMJ

A

fasiculations followed by paralysis

30
Q

Why does atropine only fix some of the complications of organophosphate poisioning?

A

stimulates muscarinic and nicotinic cholinergic receptors. Atropine only reverses muscarinic effects.
Pralidoxime can, but is only effective early after exposure.

31
Q

How do meningiomas cause damage?

A

Benign tumors, only cause damage when they compress other brain structures

32
Q

Function of microglial cells

A

move into an area of damage after ischemic injury and phagocytize the fragments neurons, myelin and necrotic debris

33
Q

Syringomyelia

A 
cystic dilitation in cervical spinal cord. Causes damage to ventral white commisure and anterior horns
Symptoms:
- chronic loss of UE pain and temp
- UE weakness and hyporeflexia (LMN)
- LE weakness and hyperreflexia (UMN)
-kyphoscoliosis
Usually at levels C8 -T1
34
Q

What CN is effected by infarcts of the anterior portion of the medial pons?

A

trigeminal

35
Q

Rapid correction of what metabolite deficiency causes central pontine myelinolysis

A

chronic hyponatremia

36
Q

What are the two types of typical antipsychotics? How do their side effects differ?

A 
Low potency (Chlorpromazine, Thioridazine): non-neurologic
High potency (Haloperidol, Fluphenazine): extrapyramidal
37
Q

What disease causes lesions to both upper and lower motor neurons

A

AML

38
Q

What drug is used for AML? What is it’s MOA?

A

Riluzole.

decreases glutamate release

39
Q

How does hydrocephalus present in early infancy? What are the long-term sequelae?

A

Irritability, poor feeding, increased head circumfrence, and enlarged ventricles on CT
sequlae: lower extremity spasticity (due to stretching of the periventricular pyramidal tracts
visual diturbances
learning disabilites

40
Q

Two mechanisms of diabetic neuropathy

A
  1. Non-enzymatic glycosylation of proteins leads to hyalinization of arteries -> ischemic nerve damage
  2. Intracellular hyperclycemia (turned into sorbitol) in nerves causes osmotic damage
41
Q

What drugs are used to prevent cerebral vascular spasm after a subarachnoid hemorrhage

A

Calcium channel blockers, especially nimodipine

42
Q

Most common first manifestation of alcohol withdrawl

A

tremulousness

Also: GI distress, agitation, anxiety, autonomic disturbance

43
Q

What is the most common pathogen associated with foreign body infections. Why?

A

Staph epidermidis, because it can form biofilms.

44
Q

Essential tremor

A 
slowly progressive symmetric postural or kinetic tremor in upper extremitites. 
AD inherited (familial tremor)
45
Q

What the first line treatment for essential tremor

A

Propranolol (nonspecific beta adernergic antagonist)

46
Q

Halothane-associated hepatitis

A

two to four days after surgery under general anathesia
Liver tenderness, hepatomegaly, increase LFTs
Biopsy shows widespread centrilobular hepatic necrosis.
Due to direct injury by halothane metabolites

47
Q

MOA of triptans

A

abortive therapy for migraines

serotonin agonists

48
Q

What two types of drugs are used for migraine prophylaxis

A

beta blockers, TCAs, and anticonvulsants

49
Q

Meniere’s disease

A

tinnitus, vertigo, sensurineural hearing loss

due to increased volume of endolymph

50
Q

What drugs can cause drug-induced parkinsonism

A

D2 receptor blockers-> Antipsychotics, antiemetics, gastric motility agents

51
Q

Treatment for drug-induced parkinsonism

A

Stop offending agent

benztropine (centrally acting antimuscarinic) and amantidine (anti-flu drug)

52
Q

Three sites of action of first generation antihistamines that cause side effects

A
  1. anti-muscarininc
  2. anti-alpha adernergic
  3. anti-serotonergic
53
Q

What drug is used for patients with combined tonic-clonic and absence seizures?

A

Valproate

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