Neuro Flashcards
Hallmarks of ALS
decreasing strength, fasciulations (LMN), hyperreflexia (UMN), NORMAL SENSORY EXAM
What are the hallmarks of Occulomotor plasy?
mydriasis, ptosis and outward strabismus (CNIII)
How to remember innervation of eye muscles?
LR6-SO4-R3.
CN VI innervates the Lateral Rectus.
CN IV innervates the Superior Oblique.
CN III innervates the Rest.
How do local anesthetics like bupivicaine work?
inhibiting membrane Na channels = decreasing the excitability of the sensory nerves
Which nerve lesion would lead to hyperacusis bc of stapedius muscle paralysis?
CN VII (Bell’s Palsy)
What causes medial medullary syndrome?
occlusion of anterior spinal artery
What are the symps of medial medullary syndrome (4)?
- ipsi flaccid paralysis
- ipsi tongue deviation
- contra spastic paresis
- contra loss tactile/vib/proprio
Which cranial artery is not a part of the circle of Willis and will cause the greatest ischemic deficit?
Middle cerebral artery
Which tumor is pathognomonic for tuberous sclerosis?
Subependymal giant cell astrocytoma that grows from the walls of the lateral ventricle
Which nerve is responsible for:
Taste and somatosensation from posterior 1/3 of tongue, swallowing, salivation, monitoring carotid body and sinus chemo- and baroreceptors, and stylopharyngeus?
Glossopharyngeal (IX)
Which enzyme preferentially metabolizes dopamine?
MOA-B
Which drug helps treat Parkinson’s by inhibiting MOA-B?
Selegiline
Berry aneurysm at the Circle of Willis is associated with which 2 genetic diseases?
- Adult PKD
2. Marfan Syndrome
The middle meningeal artery passes through which foramen?
foramen spinosum
What is HIV encephalopathy?
Subacute inflammation of brain parenchyma w/dementia and high viral load in AIDS pts
What is Perinaud syndrome?
paralysis of conjugate vertical gaze, light-near dissociation due to lesion in superior colliculi
What three diseases can cause Perinaud syndrome?
- stroke
- hydrocephalus
- pinealoma
Lacunar stroke of which brain structure would cause pure motor deficit on the left?
Right internal capsule (where corticospinal tract runs)
What is holoprosencephaly? Is it common in which genetic disorder?
holo = incomplete separation of the cerebral hemispheres; in Patau Syndrome (c13)
Where is the lesion that causes “pie in the sky” vision?
Meyer’s loop in temporal lobe
Where is the lesion that causes homonymous superior quadrantanopia?
Optic radiations to Cuneus in parietal lobe
What are the 2 classes of local anesthetics? How do you tell them apart?
Esters: 1 or no “i”
Amides: 2 “i”s
Frontotemporal dementia is the most common form of which disease?
Pick disease
What is Hereditary hemorrhagic telangiectasia? 6 symptoms?
Inherited blood vessel disorder: branching skin lesions (telangiectasias), recurrent epistaxis, skin discolorations, arteriovenous malformations (AVMs), GI bleeding, hematuria
Thrombus in which artery would result in “locked-in” syndrome?
Basilar artery
Which pharyngeal arches give rise to the blood vessels that supply the brain?
pharyngeal arches 3 and 4
What causes retinopathy of prematurity?
accelerated neovascularization in inner layers of retina
Which organisms use retrograde transport via dynein to cause disease (4)?
Herpesvirus
Poliovirus
Rabies virus
Tetanus toxin
The recurrent laryngeal nerves branch off of which nerve?
Vagus
What are the 3 key symps of middle cerebral artery of dominant sphere?
- Broca aphasia
- spastic paresis of contra face and upper limb
- anesthesia of contra face and upper limb
How does light affect Marcus-Gumm pupils?
constriction of both when light hits unaffected eye
dilation of both when light hits affected eye
What drug/MOA would be used for short-term treatment of generalized anxiety disorder?
Benzos that increase GABA frequency (not duration)
What is atonic seizure?
“drop” seizures (falls to floor); commonly mistaken for fainting
What is benign essential tremor? How to treat it?
Progressive, high-frequency tremor worsened with movement and anxiety
Beta-blockers (propanolol) or primidone
What causes left-sided sensory neglect?
Lesion in right parietal or frontal lobe
What is Osmotic demyelination syndrome (central pontine myelinolysis)?
Acute paralysis, dysarthria, dysphagia, diplopia, loss of consciousness caused by overly correcting hyponatremia
- “locked in” syndrome
Correcting serum Na+ too fast: “From low to high, your pons will die” (osmotic demyelination syndrome) “From high to low, your brain will blow” (cerebral edema/herniation)
What happens if hypernatremia is corrected too quickly?
cerebral edema/herniation
Correcting serum Na+ too fast: “From low to high, your pons will die” (osmotic demyelination syndrome) “From high to low, your brain will blow” (cerebral edema/herniation)
Symptoms of myotonic dystrophy T1?
myotonia, muscle wasting, cataracts, testicular atrophy, frontal balding, arrhythmia
What are the genetic characteristics of myotonic dystrophy?
Autosomal dominant.
CTG trinucleotide repeat expansion in the DMPK gene
Through which holes do the branches of the Trigem exit the skull?
Standing Room Only:
Superior orbital fissure = V1
Rotundum = V2
Ovale = V3
Where is the area postrema (causes vomiting) located?
floor of the 4th ventricle
Which drug extends the life of ALS pts?
Riluzole (inhibits Glutamine)
Where are nuclei for cranial nerves located (3-12)?
midbrain: 3-4
pons: 5-8
upper medulla: 9, 10, 12
What i the first-line treatment for status epilepticus?
Benzos
What is status epilecticus?
continuous or recurring seizure(s) that may result in brain injury; variably defined as > 10–30 min
Which lab studies should be done to monitor lithium toxicity?
TSH every 6-12mo
What are the hallmarks if rabies encephalitis (4)?
agitation, photophobia, hydrophobia, hypersalivation
Which antidepressant is contraindicated in pts w bulimis/anorexia? and why?
Buproprion bc it causes seizures
Benztropine is often used to aleviate parkinsonian effects; what is its side-effect?
Its anitmuscarinic, so anti-DUMBBELLS =
xerostomia (dryness)
Loud sounds damage which organ that leads to hearing loss?
Organ of corti (hair cells)
What is Charcot-Marie-Tooth Disease?
nerve disorders = defective production of proteins involved in the structure and function of peripheral nerves or the myelin sheath
What are the symptoms of Charcot-Marie-Tooth Disease?
Involves deep peroneal/fibular nerve in kids =
- muscle-wasting lower limb (stork-like legs)
- foot drop and pes cavus (high arches)
Where is Wernicke’s area?
Superior temporal gyrus
Where is Broca’s area?
Inferior frontal gyrus
What is the temporo-occipital association cortex?
The “what” pathway: processes visual stimuli
What is the parietal-occipital association cortex?
The “where” pathway: analyzes spatial relationships between objects
What drug is used to treat depression in Parkinsons pts?
Amitriptyline
What is Lateral medullary (Wallenberg) syndrome?
Occlusion of PICA = nucleus amiguus effects (hoarseness, dysphagia)
Which nerve supplies sensory to ant. leg and dorsum of the foot, and motor to evert and dorsiflex the foot?
common peroneal/fibular
Which nerve gets damaged with injury of midshaft of humerus?
Radial nerve (wrist drop)
Which nerve gets damaged with injury of surgical neck of humerus?
Axillary nerve (deltoid issues)
