Neuro 5

Question 1

Neurologic consequences of B12 deficiency due to abnormal __ synthesis

degenerates __ of spinal cord- losing proprioception/vibration
look for __ abnorms
__ CS tract w UMN signs
axonal degen of __ leads to numbness/paresthesias

tabes dorsalis has damage to dorsal __/__ w lost position/vibration + pain

Answer 1

myelin

dorsal column
gait
lateral
peripheral nerves

column/horn

Question 2

Anterior spinal syndrome presents w loss of __ below injury w loss of _/__

H, C, intracranial calcifications seen in congenital __
mother infected in first __ of pregnancy

Answer 2

strength
temp/pain

hydrocephalus, chorioretinitis
toxo
6m

Question 3

__ nerve arises from L1
motor to __ ab wall muscles
sensory to skin above __ region or __ region
can be damaged during __

__ nerve comes from L1/L2, provides motor for cremasteric reflex in men

__ nerve arises from L1/L2 to supply sensation to upper/medial thigh and exertnal genitalia

Answer 3

iliohypogastric, anterolateral
pubic, gastric
ab surgery

genitofemoral

ilioinguinal

Question 4

__ is imprinting disorder w deletion of parental chromosome __
leads to hypotonia and hyper__, motor delay, __ disability and __ problems

Answer 4

Prader Willi
15
phagia, intellectual, behavior

Question 5

MG has dec compound muscle AP __ w repeated excitation
rapid restoration of strength w __

autoantibodies destroy receptor on __ plate
dec number of Ach __, thus reducing end plate __

threshold potential not reached, so muscle cells do not __

tx w ___ like P
to avoid side effects, use selective muscarinic antagnoist like G/H/P
these preferentially inhibit __ receptors

Answer 5

amplitude
rest

motor end
receptors, potential

depolarize

cholinesterase inhib, pyridostigmine

glycopyrrolate, hyoscamine, propantheline
nicotinic

Question 6

__ is nonselective muscarinc agonist

arginase deficiency sx
__ diplegia, abnormal __, and __ delay

elevated __ levels, cannot produce urea/ornithine
tx w low __ diet
unlike others, has no __

hyper__ is assc w atherosclerosis/thrombotic events

citrullinemia/OTC def leads to excess __
accompanied by __

__ is formed from ___ via tryptophan hydroxylase

Answer 6

pilocarpine

spastic, movement, growth

arginine
protein

hyperammonemia

homocysteiemia

carbamoyl phosphate
hyperammonemia

Serotonin, tryptophan

Question 7

Acoustic schwannoma affects cochlear CN8 leading to __ hearing loss and T
vestibular portion leads to V/N

compression of CN v leads to loss of facial __/muscles of __/affarent __

compressed CN 7 can lead to __ paralysis, loss of __ in tongue, and __ due to paralzed stapedius

bilateral involvement seen in

Answer 7

sensorineural, tinnitus
vertigo/nystagmus

sensation, mastication, corneal reflex

facial muscle, taste, hyperacusis

NF2

Question 8

C botulinum has preformed \_\_
descending paralysis w 3Ds
occur after eating \_\_
toxin affects \_\_ nerves via endocytosis
prevents binding/fusion of \_\_ w/in plasma membrane

no release of __ into synapse
toxin is __ and is destroyed w cooking

Answer 8

neurotoxin
Dysphagia, dysphonia, diplopia
canned food
cholinergic
vesicles

Ach
heat labile

Question 9

Poisoning due to muscarinic __ prevents __ action of Ach

organophosphates prevent Ach __ w/in synaptic cleft
sx include weakness, P, L, seizures, __ toxicities

Answer 9

antags, postsynaptic

degredation
paralysis, lethargy, muscarinic

Question 10

Diazepam can be used as \_\_ for GAD/PA
sedative _ effect for insomnia
\_\_ for status epilepticus
also for alcohol withdrawal seizures w C
muscle relaxant w \_\_ disorders/tetanus

SE is __ w M/C problems
avoid w A/B/1st gen __

Clorpheniramine/D/P/H are 1st gen antihistamines
major SE is __ by crossing BBB

Answer 10

anxiolytic
hypnotic
anticonvulsant, Chlordiazepoxide
UMN

sedation, memory/conc
alcohol, barbs, antihistamine

diphenhydramine, promethazine, hydroxyzine

Question 11

__ is used in tx of ACS
inhibit NT from interacting at __ synapse
__ blocker dec HR
__ blocker causes bronchoconstriction/wheezing

SE is ___ in pt w asthma/COPD

Answer 11

B blocker, adrengergic
B1
B2

SOB

Question 12

NTD due to failure of fusion of ___
begins in __ region and proceeds __

w failure to close, __ and __ can leak into amniotic fluid, and are seen at high levels

Answer 12

neural plate
cranial
caudally

AFP, AChE

Question 13

__ is vasc malformation of liver/brain
abnormal, __ bv w thin __
leading to recurrent __

can present w __ deficits/s if brain is involved

__ is seen around bv forming perivascular pseudorosettes

__ is a tuor w psuedopalisading necrosis

Answer 13

cavernous hemangioma
dilated, adventitia
bleeds

neuro/seizures

ependymoma

glioblastoma

Question 14

__ is do w underdevelopment of posterior fossa
results in __/__ herniating through the foramen magnum

Type 1 assc w low lying cerebellar ___ below the FM
presents w paroxysmal occipital HA an _ dysfxn

Type 2 evident as __
see downward displacement of cerebellum and ___ due to aqueductal stenosis
compression of __ can lead to apnea/stridor/dysphagia
assc w __ causing lower limb paralysis

Answer 14

Chiari malformations
cerebellum/medulla

vermis
cerebellar

neonate
NCH
medulla
myelomeningocele

Question 15

Metabolic derangements like ___ can result in seizure

Seizure is __ if originates in 1 hemisphere
or __ in both hemispheres

Simple if __ preserved
Complex is loss of ___

Answer 15

DKA

partial
generalized

conciousness
conciousness

Question 16

Absence seizure is a __ seizure lasting less than __ sec w staring spells (lack of __) in child

__ seizure leads to loss of postural tone and conciousness

___ is focal seizure w lost conciousness and behavioral abnorms
followed by __ confusion
may have preceding __

tongue biting/bowel incontinence/myoclonus seen in __ seizure

Answer 16

generalized, 10, conciousness

atonic

complex partial
post ictal
aura

generalized tonic clonic

Question 17

Hepatic hydroxylation of phenytoin is __
lower doses are eliminated __ thus non __

phenytoin induces __
interacts w other p450 meds

P450 induces B/R/C/G/A

P450 inhibitors I/C/M/A/G juice

Answer 17

dose dependent
quickly, toxic

p450

barbs, rifampin, carbamezipine, griseofulvin, alcohol

isoniazid, cimetidine, macrolids, azole, grapefruit

Question 18

absence seizure provoked by __
ECG shows 3Hz __ pattern
tx w __ to inhibit T type Ca channels
or V

Carbamezipine/Gabapentin/Phenobarbitol/Pheynoin preferred for __ seizures

Answer 18

hyperventilation
spike and wave
ethosuximide
valproate

focal

Question 19

motor innervation of tongue by __
exception is palatoglossus muscle innervted by __

genera sensory of tongue
Anterior 2/3 by __
Posterior 1/3 by __
Posterior of tongue root __

taste sensation
Anterior 2/3 by __ branch of Facial nerve
Posterior 1/3 by ___
Posterior of tongue root __

anterior to terminal sulcus/foramen cecum is located in __ of tongue

Answer 19

CN 9
vagus

CN V3
glossopharyngeal
vagus

chorda tympani
glossopharyngeal
vagus

anterior 2/3

Question 20

excessive daytime sleepiness, episodic loss of motor tone (cataplexy), sleep paralysis dx is __

caused by lack of hypocretin 1 aka __
or __ orexin B
produced in ___

these promote W and inhibit __
Hypocretin 1 is only detectable in __ and should be __

Answer 20

narcolepsy
orexin a
hypocretin 2
lateral hypothalamus

wake, REM
CSF, low

Question 21

positive romberg seen in __ ataxia

seen in _ column/__ nerve defets

CT images show ischemic area to be __ and poorly __
also see E__ and loss of Grey/white __

__ present 1w after infarct
see abundance of __ in microglia due to breaking down __ products

Answer 21

sensory

posterior, peripheral

hypodense, delineated
edema, jxn

Microglia
lipids
myelin

Question 22

__ is motile, gram neg, facultative anaeobic rod
ferments L/G

can grow on __ agar, which prevents growth of __ orgs
orgs that ferment __ have pink/red appearance
E coli/K/E

__ is major virulence factor

Answer 22

e coil
lactose/glucose

maconkey
gram positive
lactose
klebsiella, enterobacter
K1 capsular antigen

Question 23

erythrocyte glutathione reductase def can be seen in pt w vitamin __ deficiency
see __ anemia

__ deficiency is congenital hemolytic anemi due to impaired glycolytic ATP generation

Answer 23

B2
normocytic

pyruvate kinase

Question 24

__ nerve lies bw FCU and FDP
also seen bw Olecranon and __ of humerus

__ courses bw humeral/ulnar heads of pronator teres
also found bw FDP and ___ in the carpal tunnel

__ nerve located bw Biceps/coracobrachialis muscles

Answer 24

ulnar
medial epicondyle

median nerve
FDS

musculocutaneous

Question 25

__ supplies medial portion of 2 hemispheres
occulsions leads to abnorms in __ and __ changes
maybe __ incontinence

Answer 25

ACA
legs, behavioral
urinary

Question 26

UMN lesions affect the __ motor system
__ tracts, M/p/M, IC, and __ gyrus

look for __ spasticity
damage to __ GP leads to excesive movement
damage to __ GP leads to diminished movement

Answer 26

pyramidal
CS, midbrain, pons, medulla, internal capsule, precentral

clasp knife

internal
external

Question 27

anticholinergic agents like A/S competitively inhibit Ach at Muscrinic receptor
reverse w __ inhibitors like P

SAH, blood accumulates bw A/P
LP shows B/X

Answer 27

atropine, scopolamine
cholinesterase, physostigmine

arachnoid, pia
blood/xanthochromia

Question 28

months to years after ischemic infarct, __ predominate and form __ cavity

reactive gliosis helps to protect __ areas from inflamm response

paresthesias, weakness, dizziness, nausea w food consumption think __ producing tetrodotoxin

binds voltage gated __ channels, in neural/cardiac tissue
preventing __
can lead to severe __ and P

Answer 28

astrocytes, cystic

surrounding

pufferfish

Na, depolarization
hypoTN, paralysis

Question 29

Tetrodotoxin/saxitoxin bind __ channels and block Na __, stopping AP

ciguatoxin/batrachotoxn bind __ channel and keep it open, causing recurrent ___

Answer 29

Na, influx

Na, depolarization

Question 30

blood solubility of anesthetic determined by __ partition coefficient
high solubility leads to __ BGPC

thus, drug is more soluble in __ w slower equilibrium in __
time to onset is __

N2O has rapid onset, much __ BGPC

Answer 30

blood gas
higher

blood, brain
longer

lower

Question 31

__ is neuroprotective agent to tx AD
__ is NMDA receptor antag to tx AD
__ is cholinesterase inhib for AD

NPH presents w __ opening pressure bc ventricles enlarge slowly

acute causes of CH will have __ opening pressure

__ is absence of gyri

Answer 31

Vitamin E
Memantine
Donezepil

normal
high

lissencephaly

Question 32

__ tentorial herniaton presents w CN 3 palsy and affected PCA

Neurodegenerative dz can lead to hydrocephalus __ w cortical atrophy

atrophy in AD is most pronounced in the T lobe and H

Answer 32

transtentorial

ex vacuo

temporoparietal lobe and hippocampus

Question 33

__ runs in the posterior triangle of the neck
injury results in weakness of __/__ muscles
see __ of shoulder, impaired __ of arm above horizontal, and winging of __

__ innervates deltoid
see impaired abdcion __ horizontal plane

most powereful adductor of arm is __
innervated by __ nerve

__ innervates the serratus anterior
injury leads to impaired __ and __ of scapula, no __

Answer 33

Spinal accessory nerve
trapezius/SCM
drooping, abduction, scapula

axillary nerve, below

lat dorsi, thoracodorsal

serratus anterior
abduction, winging, droop

Question 34

infarct of anterior medial pons can lead to D and contralateral hemiparesis w __ facial palsy
due to disruption of ipsilateral __/__ tracts
may have D/D

__ nerve is found here

__ nerve is located on dorsalateral pons
not present if there is __ of the forehead muscles

Answer 34

dysarthria, lower
CS/corticobulbar
dysmetria/dysdiadokinesia

trigeminal

facial
sparing

Question 35

Sacral micturation center located at __/__ level, responsible for bladder __

stimulated by __ fibers to __ receptors on bladder wall

pontine micturation center located in the __ formation
leads to relaxation of __ w bladder contraction

Cerebral cortex inhibits __

Answer 35

S2-S4, contraction

PNS, cholinergic

reticular, EUS

SMC

Question 36

In NPH, dec absorption of __ leads to ventricular enlargement
compresses the C__, blocking descending cortical fiber impulse from cortex to ___

thus, there is no __ from cerebral cortex
pt gets __ as bladder fills, emptying when full

Answer 36

CSF
corona radiata
SMC

inhibition
urge incontinence