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USMLE Step 1 > Neuro > Flashcards

Neuro Flashcards

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USMLE® Step 1 flashcards
1
Q

Hallmarks of ALS

A

decreasing strength, fasciulations (LMN), hyperreflexia (UMN), NORMAL SENSORY EXAM

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2
Q

What are the hallmarks of Occulomotor plasy?

A

mydriasis, ptosis and outward strabismus (CNIII)

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3
Q

How to remember innervation of eye muscles?

A

LR6-SO4-R3.
CN VI innervates the Lateral Rectus.
CN IV innervates the Superior Oblique.
CN III innervates the Rest.

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4
Q

How do local anesthetics like bupivicaine work?

A

inhibiting membrane Na channels = decreasing the excitability of the sensory nerves

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5
Q

Which nerve lesion would lead to hyperacusis bc of stapedius muscle paralysis?

A

CN VII (Bell’s Palsy)

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6
Q

What causes medial medullary syndrome?

A

occlusion of anterior spinal artery

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7
Q

What are the symps of medial medullary syndrome (4)?

A
  1. ipsi flaccid paralysis
  2. ipsi tongue deviation
  3. contra spastic paresis
  4. contra loss tactile/vib/proprio
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8
Q

Which cranial artery is not a part of the circle of Willis and will cause the greatest ischemic deficit?

A

Middle cerebral artery

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9
Q

Which tumor is pathognomonic for tuberous sclerosis?

A

Subependymal giant cell astrocytoma that grows from the walls of the lateral ventricle

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10
Q

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?

A

Glossopharyngeal (IX)

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11
Q

Which enzyme preferentially metabolizes dopamine?

A

MOA-B

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12
Q

Which drug helps treat Parkinson’s by inhibiting MOA-B?

A

Selegiline

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13
Q

Berry aneurysm at the Circle of Willis is associated with which 2 genetic diseases?

A
  1. Adult PKD

2. Marfan Syndrome

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14
Q

The middle meningeal artery passes through which foramen?

A

foramen spinosum

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15
Q

What is HIV encephalopathy?

A

Subacute inflammation of brain parenchyma w/dementia and high viral load in AIDS pts

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16
Q

What is Perinaud syndrome?

A

paralysis of conjugate vertical gaze, light-near dissociation due to lesion in superior colliculi

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17
Q

What three diseases can cause Perinaud syndrome?

A
  1. stroke
  2. hydrocephalus
  3. pinealoma
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18
Q

Lacunar stroke of which brain structure would cause pure motor deficit on the left?

A

Right internal capsule (where corticospinal tract runs)

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19
Q

What is holoprosencephaly? Is it common in which genetic disorder?

A

holo = incomplete separation of the cerebral hemispheres; in Patau Syndrome (c13)

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20
Q

Where is the lesion that causes “pie in the sky” vision?

A

Meyer’s loop in temporal lobe

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21
Q

Where is the lesion that causes homonymous superior quadrantanopia?

A

Optic radiations to Cuneus in parietal lobe

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22
Q

What are the 2 classes of local anesthetics? How do you tell them apart?

A

Esters: 1 or no “i”
Amides: 2 “i”s

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23
Q

Frontotemporal dementia is the most common form of which disease?

A

Pick disease

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24
Q

What is Hereditary hemorrhagic telangiectasia? 6 symptoms?

A

Inherited blood vessel disorder: branching skin lesions (telangiectasias), recurrent epistaxis, skin discolorations, arteriovenous malformations (AVMs), GI bleeding, hematuria

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25
Q

Thrombus in which artery would result in “locked-in” syndrome?

A

Basilar artery

26
Q

Which pharyngeal arches give rise to the blood vessels that supply the brain?

A

pharyngeal arches 3 and 4

27
Q

What causes retinopathy of prematurity?

A

accelerated neovascularization in inner layers of retina

28
Q

Which organisms use retrograde transport via dynein to cause disease (4)?

A

Herpesvirus
Poliovirus
Rabies virus
Tetanus toxin

29
Q

The recurrent laryngeal nerves branch off of which nerve?

A

Vagus

30
Q

What are the 3 key symps of middle cerebral artery of dominant sphere?

A
  1. Broca aphasia
  2. spastic paresis of contra face and upper limb
  3. anesthesia of contra face and upper limb
31
Q

How does light affect Marcus-Gumm pupils?

A

constriction of both when light hits unaffected eye

dilation of both when light hits affected eye

32
Q

What drug/MOA would be used for short-term treatment of generalized anxiety disorder?

A

Benzos that increase GABA frequency (not duration)

33
Q

What is atonic seizure?

A

“drop” seizures (falls to floor); commonly mistaken for fainting

34
Q

What is benign essential tremor? How to treat it?

A

Progressive, high-frequency tremor worsened with movement and anxiety
Beta-blockers (propanolol) or primidone

35
Q

What causes left-sided sensory neglect?

A

Lesion in right parietal or frontal lobe

36
Q

What is Osmotic demyelination syndrome (central pontine myelinolysis)?

A

Acute paralysis, dysarthria, dysphagia, diplopia, loss of consciousness caused by overly correcting hyponatremia
- “locked in” syndrome

Correcting serum Na+ too fast:
ƒ “From low to high, your pons will die”
(osmotic demyelination syndrome)
ƒ “From high to low, your brain will blow”
(cerebral edema/herniation)
37
Q

What happens if hypernatremia is corrected too quickly?

A

cerebral edema/herniation

Correcting serum Na+ too fast:
ƒ “From low to high, your pons will die”
(osmotic demyelination syndrome)
ƒ “From high to low, your brain will blow”
(cerebral edema/herniation)
38
Q

Symptoms of myotonic dystrophy T1?

A

myotonia, muscle wasting, cataracts, testicular atrophy, frontal balding, arrhythmia

39
Q

What are the genetic characteristics of myotonic dystrophy?

A

Autosomal dominant.

CTG trinucleotide repeat expansion in the DMPK gene

40
Q

Through which holes do the branches of the Trigem exit the skull?

A

Standing Room Only:

Superior orbital fissure = V1
Rotundum = V2
Ovale = V3

41
Q

Where is the area postrema (causes vomiting) located?

A

floor of the 4th ventricle

42
Q

Which drug extends the life of ALS pts?

A

Riluzole (inhibits Glutamine)

43
Q

Where are nuclei for cranial nerves located (3-12)?

A

midbrain: 3-4
pons: 5-8
upper medulla: 9, 10, 12

44
Q

What i the first-line treatment for status epilepticus?

A

Benzos

45
Q

What is status epilecticus?

A

continuous or recurring seizure(s) that may result in brain injury; variably defined as > 10–30 min

46
Q

Which lab studies should be done to monitor lithium toxicity?

A

TSH every 6-12mo

47
Q

What are the hallmarks if rabies encephalitis (4)?

A

Ž agitation, photophobia, hydrophobia, hypersalivation Ž

48
Q

Which antidepressant is contraindicated in pts w bulimis/anorexia? and why?

A

Buproprion bc it causes seizures

49
Q

Benztropine is often used to aleviate parkinsonian effects; what is its side-effect?

A

Its anitmuscarinic, so anti-DUMBBELLS =

xerostomia (dryness)

50
Q

Loud sounds damage which organ that leads to hearing loss?

A

Organ of corti (hair cells)

51
Q

What is Charcot-Marie-Tooth Disease?

A

nerve disorders = defective production of proteins involved in the structure and function of peripheral nerves or the myelin sheath

52
Q

What are the symptoms of Charcot-Marie-Tooth Disease?

A

Involves deep peroneal/fibular nerve in kids =

  • muscle-wasting lower limb (stork-like legs)
  • foot drop and pes cavus (high arches)
53
Q

Where is Wernicke’s area?

A

Superior temporal gyrus

54
Q

Where is Broca’s area?

A

Inferior frontal gyrus

55
Q

What is the temporo-occipital association cortex?

A

The “what” pathway: processes visual stimuli

56
Q

What is the parietal-occipital association cortex?

A

The “where” pathway: analyzes spatial relationships between objects

57
Q

What drug is used to treat depression in Parkinsons pts?

A

Amitriptyline

58
Q

What is Lateral medullary (Wallenberg) syndrome?

A

Occlusion of PICA = nucleus amiguus effects (hoarseness, dysphagia)

59
Q

Which nerve supplies sensory to ant. leg and dorsum of the foot, and motor to evert and dorsiflex the foot?

A

common peroneal/fibular

60
Q

Which nerve gets damaged with injury of midshaft of humerus?

A

Radial nerve (wrist drop)

61
Q

Which nerve gets damaged with injury of surgical neck of humerus?

A

Axillary nerve (deltoid issues)

USMLE Step 1 (13 decks)

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