Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Step 1 > Neuro > Flashcards

Neuro Flashcards

1
Q

Benign brain tumor that pushes on the brain tissue without invading it. seen parasaggital or at edges

A

Meningioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

“fried-egg appearance”, can have calcifications

A

oligodendroglioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

perivascular rosettes, hydrocephalus, 4th ventricle

A

Ependymoma (ependymal cells line ventricles)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

degeneration of anterior motor horn

A

Poliomyelitis or Werdnig Hoffman

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Synringomyelia (anterior white commisure)

A

LMN sx i.e. weakness + loss of P/T from UE (because usually at c8-t1)

Can expand to hit Anterior motor horn, as well as lateral horn t1 (horners)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

UMN and LMN signs

A

ALS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hypertrophic cardiomyopathy + degen of several neural tracks

A

Friedreich ataxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

where do you do lumbar puncture

A

L4-L5. spinal cord stops at L2 but cauda equina til s2. subarachnoid space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

most common cause of Subarachnoid Hemorrhage (bleed on bottom of the brain)

A

Rupture of berry aneurysm (anterior circle of willis –> ACom branch points)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

why is a Berry aneurysm susceptible to rupture?

A

Lacks a media layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

whats the AFP level in neural tube defect

A

HIGH as a fuckin KITE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

most common cause of hydrocephalus in new born

A

Cerebral aqueduct stenosis (blocks 3–>4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Foramen of Monro

A

Lateral ventricles –> 3rd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

4th ventricle through Foramen meagendie/luschka into:

A

subarachnoid space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Define dandy-walker formation

A

congenital failure of cerebrellar vermis –> presents with absent cerebrelleum and massively dilated 4th ventricle (posterior fossa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

massivelyd dilated 4th ventricle

A

Dandy walker formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

downward displacement of cerebellar vermis and tonsils through foramen magnum

A

Arnold Chiari (2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

name 3 common associations with Arnold-Chiari malformation (type 2)

A

(cerebellar herniation)

Hydrocephalus, Synringomyelia, Meningomyelocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Cystic degeneration of the spinal cord

A

Syringomyelia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

lose pain and temp in UE

A

Syringomyelia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Lateral horn of hypothalamospinal tract

A

Synringomyelia can expand and knock this out = horners (t1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

muscle atrophy and weakness in syringomyelia

A

expands to knock out Anterior Horn (LMNs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Polio damages:

A

Anterior motor horn–> LMN signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Floppy baby, autosomal recessive

A

Werdnig-Hoffman; degen of anterior motor horn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

ALS: Degen of ________

A

UMN and LMN of Corticospinal tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Corticospinal tract is damaged in

A

ALS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Enzyme mutation that can cause ALS

A

Superoxide dismutase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

_____ increases survival in ALS pt by ______

A

Riluzole (“Lou gehrigs”) increases survival by decreasing presynaptic glutamate release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Glutamate antagonist

A

Riluzole used to treat ALS (Lou Gehrigs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the neural components of Friedreich Ataxia

A

Degenerative disorder of the cerebellum: ataxia

and Spinal cord: loss of MVP, deep tendon reflex, LE muscle strength

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

describe the frataxin gene (lost in freidreich)

A

Mitochondrial iron regulation…loss = iron buildup and thus free radical damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

first sign of friedreich ataxia

A

clumsyness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Neisseria menigitidis meningitis

A

through the NOSE nigga.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

signs of meingitis

A

headache, nuchal rigidity, fever; Photophobia, vomiting, altered mental status.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

where does lumbar puncture sample

A

Subarachnoid space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what ischemic neural effects can an Insulinoma have?

A

Repeated bouts of hypoglycemia –> global cerebral ischemia (brai needs glucose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Pt has a stroke…whats the protocol for tx

A

give tPA–> have to do CT (noncontrast) to RULE OUT HEMORRHAGE!! tPA within 1st 4 hours

aspirin/clopidogrel can be given to reduce risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

does TIA register on MIA?

A

Nope, its a reversible thang less than 15 minutes of focal neuro dysf(x)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

hypoxia and irreversible damage

A

irreversible damage after 5 minutes of hypoxia.

Hippocampus (pyramidal neurons/temporal lobe), Cerebral cortex (laminar necrosis layers 3 5 6)
Cerebellum (purkinje layer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

hyaline arteriolosclerosis (HTN) leads to what type of stroke?

A

Lacunar stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Describe lacunar stroke

A

involves lenticulostriate vessels = small lacunar infarcts (cystic areas)

Thalamus: pure sensory
Internal capsule: pure motor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

earliest change in ischemic stroke

A

Liquefactive necrosis 1st sign = red neuron = eosinophilic change of neuron cytoplasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

which cells are responsible for gliosis post storke

A

astrocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

in stroke, neutrophils are day 1-3, which cell is day 4-7?

A

Microglia (MQ of the brain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what are the 2 aneurysms in the brain?

A

Berry aneurysm (subarachnoid space) and Charcot-Bouchard (parenchymal space)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Describe charcot-bouchard aneurysm

A

due to HYPERTENSION.

LENTICULOSTRIATE vessels going to BASAL GANGLIA (look in the center where the cord would attach)

intracerebral hemorrhage/bleeding into PARENCHYMA (so not lobar)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

sudden headache + nuchal rigidity

A

subarachnoid hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

LP indicating SAH

A

Xanthochromia (yellow due to bilirubin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what does yellowish LP indicate

A

Subarachnoid Hemorrhage.

Can be a bloody or yellowish tap = SAH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Berry aneurysm can cause

A

Bitemporal hemianopia by compressing optic chiasm
Subarachnoid hemorrhage
Hemorrhagic stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

lens shaped lesion on CT

A

Epidural hematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

lucid interval after bleed

A

Epidural hematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

crescent shaped lesion on CT

A

subdural hematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Uncal herniation

A
  1. CNIII: eye moves down and out + dilated pupil
  2. PCA: contralat homonymous hemianopsia – infarction of occipital lobe
  3. Paramedian artery: Duret (brainstem) hem
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

deficiency of Arylsulfatase

A 
Metachromatic Leukodystrophy (demyelination)
-->sulfatides accumulate in lysosomes. ataxia/dementia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

defeciency of galactocerebrosidase

A

Krabbe (buildup of galactocerebrosidase and psychosine). demyelination. Peripheral neuropathy, optic atrophy, developmental delay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Leukodystrophies (inherited mutations fuck up myelin)

A

AR: Metachromatic leukodystrophy (arylsulfatase) and Krabbe (galactocerebrosidase)

X-linked: Adrenoleukodystrophy (long chain fatty acids–> brain and adrenals)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Clining features of MS

A

Blurred vision in one eye (optic nerve)
vertigo and scanning speech (brainstem)
internuclear opthalmoplegia (MLF)
Hemiparesis (periventricular white matter)
Bowel bladder and sexual dysfunction (ANS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Lumbar puncture MS

A

Increased lymphocytes, increased Ig’s with OLIGOCLONAL IgG bands on electrophoresis
Myelin basic protein (because destroyed myelin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Astrocytes

A

Neuroectoderm

GFAP = astrocyte marker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Microglia vs macroglia

A

Microglia: phagocytes. mesodermal
Macroglia: astrocytes, oligo, ependymal. Neuroectoderm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Guillain Barre: injury to

A

schwann cells!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Endoneural inflammation

endomysial inflammation

A

GBS

polymyositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

ADH and oxytocin synthesis

A

made in hypothalamus but stored in PP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Lateral hypothalamus

A

Lose lateral = lose weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Ventromedial hypothalamus

A

Satiety. Lose ventromedial = verymuch hungry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Tau protein

A

Neurofibrillary tangle: Alzheimer

Round aggregates = pick bodies: Pick disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Sx of Pick disease

A

Language (temporal) and behavior (frontal) deficits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Parkinsons, loss of ________ neurons in the _________ of the basal ganglia

A

dopaminergic

substantia nigra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Sx of Parkinsons

A

Tremor (pill rolling) at rest, disappears with movement
Rigidity (cogwheel) in extremities
Akinesia is slowing of voluntary movement
Postural instability/shuffling gait

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Expressionless face and tremor that disappears with movement

A

Parkinsons: Akinesia = expressionless face. Pill rolling tremor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

dementia in Parkinsons vs Lewy body

A

Lewy body: early dementia

Parkinsons: late dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Subtantia nigra vs caudate nucleus disorder

A

SN: Parkinsons (dopaminergic)
CN: Huntington’s (GABAergic. trinucleotide = anticipation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

When and why do you see Chorea (disorder)

A

See it in Huntingtons (loss of GABAergic neurons in caudate nucleus)

Normally, GABA from BG to Cortex has an inhibitory hold on neurons. loss of GABA = random firing/movement = chorea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Increased CSF = expanded/dilated ventrilces = sretching of the _________ fibers = Normal P Hydrocephalus

A

Corona radiata fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Sx of NPH

A

Wet, wobbly, wacky

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Lumbar puncture improves Sx

A

NPH (because removes some csf)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

intracellular vacuoles

A

Spongiform encephalopathy

79
Q

Dementia + ataxia + startle myoclonus (involuntary contractions with mild stimuli)

A

Spongiform encephalopathy

80
Q

layer of gray matter in between internal capsule and ventricle

A

Caudate –> lost in Huntington = hydrocephalus ex vacuo

81
Q

striatum

A

Caudate + Putamen (internal capsule in between them)

82
Q

name a tumor that can cross the corpus callosum

A

GBM “butterfly lesion”

83
Q

pseudopalisading and GFAP +

A

GBM (also, endothelial cell prolif)

84
Q

benign tumor of ARACHNOID Villi/Cells

A

Meningioma

85
Q

psamomma bodies + may present as seizure/focal neuro deficits

A

Meningioma

86
Q

spindle cells in a concentrically whorled pattern

A

Meningioma

87
Q

loss of hearing, tinnitis, s-100 +

A

schwannoma = benign tumor of schwann cells

88
Q

neurofibromatous 2 brain tumor

A

bilateral schwannomas

89
Q

calcified tumor in white matter, usually frontal lobe, seizures

A

Oligodendroglioma

90
Q

where do you see a Pilocytic astrocytoma

A

posterior fossa/cerebellum

91
Q

Cystic and solid components to neural tumor

A

Pilocytic astrocytoma: cystic lesion + mural nodule

92
Q

Eosinophilic fibers of astrocytes on brain tumor biopsy

A

Rosenthal fibers –> Pilocytic Astrocytoma

93
Q

Primitive neuroectodermal tumor (PNET): Name + Histo

A

Medulloblastoma: small blue cells

94
Q

Homer-wright rosettes vs perivascular pseudorosettes

A

Homer-wright: Medulloblastoma, Neuroblastoma (AM)

Perivascular: Ependymoma

95
Q

high mitotic index child brain tumor (posterior fossa)

A

Medulloblastoma = highly malignant

96
Q

neuroblastoma

A

tumor of adrenal medulla in kids
neural crest origin
homer wright rosettes

97
Q

brain tumor from epithelial origin

A

epithelial remnants of Rathke’s pouch = Craniopharyngioma

98
Q

Bitemporal hemianopsia in a child vs adult

A

child: consider Craniopharyngioma
adults: Pituitary adenoma

99
Q

how dos ectoderm become neuroectodorm = neural plate

A

Notochord (which becomes Nucleus polposus)

100
Q

Neural plate gives rise to

A

Notochord and neural crest cells

101
Q

Telencephalon and Diencephalon

A

Part of Forebrain (Football has TDs)

Telencephalon: cerebral hem/lateral ventricles
Diencephalon: thalamus/3rd ventricle

102
Q

Midbrain/aqueduct come from which layer

A

Mesencephalon

103
Q

AFP in spina bifida occulta

A

no structural herniation, just failure of bony spinal to close. intact dura. hair/skin simple.

NORMAL AFP

104
Q

maternal diabetes and messed up brain development

A

Anencephaly

105
Q

Clinical findings of anencephaly

A

Polyhdramnios, increased AFP, no forebrain.

106
Q

failure of L and R hemispheres to separate

A

Holoprosenchepaly

107
Q

Conditions that cause Holoprosencephaly (failure R/L sep)

A

Patau, Fetal alcohol syndrome, Sonic hedgehog signaling pathway

108
Q

Lumbosacral myelomeningocele

A

Arnold Chairi II (herniation through foramen magnum)

109
Q

aquedecutal stenosis + hydrocephalus after cerebellar tonsillar herniation

A

Arnold Chiari II

110
Q

cystic dilation of the 4th ventricle (posterior fossa)

A

Dandy walker

111
Q

congenital hydrocephalus

A

structural: Aqueductal stenosis, Dandy walker, Chairi
infectious: CMV, toxoplasmosis, meningitis

112
Q

Sx of infantile hydrocephalus

A 
Macrocephaly
Poor feeding ("trouble latching while breast feeding")
Muscle hypertonicity 
Hyperreflexia
Seizures/developmental delay
113
Q

why does infantile hydrocephalus cause hyperreflexia and hypertonicity (muscular)

A

UMN damage –> stretching of the periventricular pyramidal tracts

114
Q

sensation/taste anterior 2/3 tongue

1/2 branchial arches

A

Sensation: V
Taste: VII

115
Q

sensation/taste posterior 1/3 tongue

3/4 branchial arches

A

IX (CN 9 = Glossopharyngeal)

116
Q

role of Glossopharyngeal (CN9) and Hypoglossal (CN12) to tongue

A

9: taste and sensation of posterior 1/3
12 (Hypoglossal): Motor innervation to everything except for

palatoglossus (X; elevates posterior tongue during swallowing)

117
Q

Locus ceruleus (pons)

A

Norepinephrine

Increased in anxiety
Decreased in depression

118
Q

Ventral tegmentum and Substantia nigra pars compacts (midbrain)

A

Dopamine

119
Q

Basal nucleus of Meynert

A

ACh

Increased in Parkinson
Decreased in Alzheimers (AD = low ACh)

120
Q

GABA (Nucleus Accumbens) levels in

anxiety and hungtingtons

A

Decreased in both

121
Q

Stress and panic

A

Locus Ceruleus (NE)

122
Q

Nucleus accumbens

A

GABA. Reward/pleasure/addiction/fear

123
Q

Thalamic fibers going to primary somatosensory cortex

A

VPL (pain temp, MVP)
VPM (face…sensation and taste)

Damage to either = complete contralateral sensory loss

dont be a peasant –> my impulse is “ventral” so has to be motor and not sensory

124
Q

VPL nucleus of thalamus

vs in hypothalamus its like “ventromedial area”

A

Spinothalamic tract: Pain and temp

DC/ML: MVP (proprioception, touch, vibration, pressure)

125
Q

Patient has unsteady gait/difficulty walking. which track/nucleus of thalamus

A

VPL –> DC/ML = MVP = lost proprioception

126
Q

VPM nucleus of thalamus

A

VPM –> Makeup goes on the Face

Face sensation and taste

127
Q

LGN and MGN of thalamus

A

LGN: “Light” = vision
MGN: “Music” = hearing

128
Q

VL nucleus of thalamus

A

Motor to Basal ganglia/cerebellum

129
Q

The famous 5 F’s = Limbic system

A

Feeding, Fleeing, Fighting, Feeling, Fucking

emotion, long term memory, behavior, ANS

130
Q

structures of Limbic System

A 
Hippocampus
Amygdala
Mammillary Body 
Fornix
Cingulate Gyrus
131
Q

Acute paralysis, dysarthria, dysphagia, diplopia, loss of consciousness

A

Osmotic demyelination syndrome aka central pontine myelinolysis

132
Q

Cerebral edema/herniation related to Sodium

A

High to low, your brain will blow

133
Q

Romberg

A

+: Ataxia is sensory = DC-ML fucked up

-: Ataxia is cerebellar

134
Q

alpha synuclen intracellular eosinophilic inclusions

A

Lewy bodies –> Parkinsons and Lewy body dementia

135
Q

resting tremor, shuffling gait

A

Parkinsons

136
Q

Angry man with choreo (dancing movements), wheres the damage?

A

Caudate nucleus –> huntingtons

137
Q

Neuronal death via NMDA-R binding and glutamate toxicity

A

Huntingstons: NMDA - Hunt with Glutamatate gun (NRA)

138
Q

CAG Repeats and loss of ACh and GABA

A

Caudate loses ACh and GABA = Hungtingtons

139
Q

No ifs, ands or buts (can’t repeat)

A

Conduction Aphasia: damage to Arcuate Fasciculus. (poor repetition)

140
Q

Disinhibited behavior: Hyperphagia, hypersexuality

A

Kluver-bucy –> amygdala lesion

Frontal lobe damage (R side = disinhibited behavior)

141
Q

Reemergence of primitive reflex, difficulty concentration, poor judgement

A

Frontal lobe damage

142
Q

Eye looks toward side of lesion

A

FEF

143
Q

Eye looks away from lesion

A

PPRF

144
Q

Stroke: Motor/Sensory to Upper Limb and Face

A

MCA

145
Q

temporal lobe (wernicke) and frontal lobe (Broca) stroke

A

MCA

146
Q

Lower limb motor and sensory loss

A

ACA

147
Q

after stroke, can’t walk

A

ACA (lower limb sensorimotor)

148
Q

dysphagia, hoaseness, woming, decreased pain and temp from ipsilat face and cl body

A

PICA: lateral medulla (wallenberg)

149
Q

Paralysis of face

A

AICA: Facial droop means AICAs pooped

150
Q

intracranial hemorrhage that can cross suture lines

A

Subdural hematoma

i.e. shaken baby, alcoholics, blunt trauma/whiplash

151
Q

intracranial hemorrhage that cross falx/tentorium

A

epidural hematoma

152
Q

hemorrhagic stroke/intracerebral hemorrhage

A

Basal ganglia

153
Q

lateral corticospinal tract (UMN)

A

voluntary movement of contralateral limbs

154
Q

positive Romberg, absence of deep tendon reflexes, Latent bacteria

A

Tabes dorsalis

155
Q

Tracts affected by vit b12 def

A

Subacute combined degeneration:
DC-ML (lose mvp)
Lateral corticospinal tract (UMN signs)
Spinocerebellar tract

Ataxic gait, parestheia, impaired position and vibration

156
Q

KYPHOSCOLIOSIS, HCM, Staggering gait, frequent falling, PES CAVUS (high plantar arches)

A 
Friedreich ataxia (trinucleotide repeat GAA)
-->death by cardiomyopathy
157
Q

Brown Sequard syndrome

A

hemisection of spinal cord
CL pain and temp loss
Ipsilateral loss of MVP, and UMN signs
Ipsilateral loss of all sensation at level of lesion

158
Q

UMN vs LMN face lesion

A

UMN: CL lower face paralysis
LMN: ipsilat paralysis of upper and lower face

159
Q

Neuroleptic Malignant Syndrome (after antipsychotic overdose)

A

diffuse muscle rigitidity
high fever/ANS instability
High Creatine kinase (rhabdomyolysis)

Tx = Dantrolene (block Ca rel from RyR of SR) or Bromocriptine (dopamine agonist)

160
Q

2 most common causes of intellectual disability

A 
Down syndrome (most common overall)
Fragile X (most common inherited)
161
Q

CNIII is motor/sensory/both?

A

Pure MOTOR

Some Say Marry Money But My Brother Says Big Boobs Matter Most

162
Q

Radial Nerve Damage (include vs spare triceps reflex)

A

In Axilla (crutches/saturday night palsy) = Proximal injury = lose finger extensors, get wrist drop, absent triceps reflex

Injury to proximal radial nerve as it crosses posterior humerus (MIDSHAFT HUMERUS) spares triceps reflex, lose extensors of hand.

Finger/thumb drop (loss of extension) without wrist or tricep deficits = damage in supinator canal, i.e. mechanic doing lots of screwdriving

163
Q

B12 deficiency rxns

A

MMA —MMA CoA mutase –> Succinyl-CoA (not succinylcholine)

Homocysteine –Methionine synthase/THF–>Methionine

164
Q

rxn in PKU

A

lose PH or its cofactors tetrahydroBiopterin (BH4)

Phenylalanine–Phenylalanine Hydroxylase (PH) –>Tyrosine

165
Q

Cerebellar lesions are different from cerebral because:

A

the cerebellum double crosses you! so ends up being ipsilateral.

  • ->dysdiadochokinesia (loss of rapidly alt movements)
  • ->limb dysmetria (over/undershoot)
  • ->intention tremor (tremor during movement)
166
Q

2 CAN pneumonics

A

Whipples: Cardiac, Arthralgia, Neuro sx
Wernicke: Confusion, Ataxia, Nystagmus

(this is wernicke encephalopathy, not aphasia; and nystagmus interhcangable with opthalmoplegia. due to Thiamine b1 def)

Note: Thiamine def = periph neuropathy, high-output cardiac failure, and Wernickes (ataxia, confusion, nystagmus)

167
Q

Dx of Thiamine deficiency

periph neuropathy + cardiac failure aka wet beri beri DCM + Wernicke encephalopathy aka confusion ataxia nystagmus

A

Increased rbc TRANSKETOLASE activity after giving thiamine

168
Q

Synaptophysin vs GFAP

A

GFAP = Astrocytes (NeuroGlia–>hence responsible for reactive GLIOSIS)
–>Gliomas (non-neuronal tissue) =
Astrocytoma, Ependymoma, Oligodendroglioma
(still part of brain so still all neuroectoderm)

Synaptophysin = neurons, neuroectodermal cells, neuroendocrine

169
Q

Von Hippel Lindau (4)

A
  1. Hemangioblastoma of cerebellum/retina (vascular)
  2. Renal Cell Carcinoma (bilateral)
  3. Pheochromocytomas
  4. Angiomatosis (Cavernous hemangiomas all over)
170
Q

difficulty removing hand from handshake

A

Myotonia (seen in myotonic dystrophy)

171
Q

Frontal balding, cataracts, myotonia, testicular atrophy, arrythmia

A

Myotonic Dystrophy (type 1 fibers. auto dom trinuc rpt)

172
Q

AICA vs PICA

A

Both: Ips P/T Face, CL P/T Body. Vomit/vertigo/nystag

AICA: Lateral Pons. Facial paralysis. Taste ant 2/3 tongue
(Facial droop means AICA pooped)

PICA: Lateral Medulla. Dysphagia/hoarseness
(dont pica horse that can’t eat)

173
Q

Locked-in syndrome

A
  1. Osmotic Demyelination (central pontine myelinolysis)
    - ->correct hyponatremia (low to high pons will die) rapid
  2. Basilar artery stroke

Osmotic demyelination more likely to present with loss of consciousness

174
Q

ACom or PCom: CNIII palsy

A

PCom.

Both can cause visual defects.
Both sites are more likely to be aneurysm than stroke. Both sites = Berry (saccular) aneyrums, with ACom #1

175
Q

Motor and PNS component of CNIII

A

Motor in Middle: Affected by ischemia/ vascular dx (DM)
–>Ptosis, Down-and-out gaze, Horizontal/vert diplopia

PNS outside: Affected by compression (PCA aneurysm)
–>dec Pupillary light reflex, Blown pupil with down/out

176
Q 
Vertical diplopia (can't go down the stairs)
"With Cranial Nerve \_\_\_\_\_ its hard to walk down to the bottom floor"
A 
CN IV (Trochlear = SO4)
head tilts toward side of lesion, can compensatory tilt in other direction while going down stairs
177
Q

Kid has MVP, autism, and intellectual disability. He has a problem in gene ________

A

Methylation ( Fragile X)

178
Q

Kid has ASD, duodenal atresia, palmar crease, sandal gap. His b-HCG is ________, and his condition is a result of ______ _______

A

bHCG INCREASED in Down (dec in 18 and 13)

Meiotic Nondisjunction

179
Q

Elderly patient comes in with insomnia, can we give him Benzo?

A

NO!! Drugs to avoid in elderly:
Benzo’s: cognitive impairment/delirium/falls

TCAs (amytriptyline) and antihistamines (Diphenhydramine) due to strong anticholinergic effects and delirium/falls

180
Q

Temporal lobe herniation =

A

Uncal aka transtentorial herniation! Uncus = medial temporal lobe;

181
Q

Uncal Herniation Manifestations

A
  1. Ipsilateral CNIII = Ipsilat blown pupil/downandout
  2. Ipsilateral PCA = contralat homonymous hemianopia
  3. Compress CL Peduncle = CL Corticospinal tract = IPSILAT HEMIPARESIS
  4. Duret hemorrhages: brainstem (pons/midbrain) due to stretching of Paramedian Basilar Artery (fatal)
182
Q

Recurrent Lobar Hemorrhages in Elderly

A

Cerebral AMYLOID angiopathy

183
Q

Endomysial inflammatory infiltrate
Endoneural hyaline arteriolization
Endoneural inflammatory infiltrate

A

Polymyositis (proximal mm weakness)
Diabetic neuropathy
GBS

184
Q

Headache that gets worse with Valsalva (they will say its worse when he coughs or bears down during MM)

A

Suggests increased ICP aka tumor (and NOT a migraine)

185
Q

contralateral Hemiparesis loss

contralateral Hemisensory loss

A

Corticospinal tract lesion (cortical/brainstem)

Ascending somatosensory = DC-ML and Anterolateral

186
Q

Posterior Communicating Artery (PCom)
Posterior Cerebral Artery (visual/occipital cortex)
PICA (Lateral medulla)

A

PCom: saccular Aneurysm = COMPRESSES CNIII so see ipsilateral down and out + ptosis and myDRiasis

PCA: Contralateral homonymous hemianopia w/macular sparing

PICA: Dec P/T ipsilateral face and CL body; dysphagia, hoarseness, ipsilateral Horner; vomiting/vertigo/nystagmus

187
Q

Parasympathetics vs Sympathetics eye

A

CNIII has PNS fibers on outside….so damage = MYDRIASIS
(seen with compression= PCA aneurysm/Uncal herniation…won’t really be seen with diabetic/vascular/ischemic damage unless severe)

Horners = SNS damage = MIOSIS, ptosis, anhydrosis ——->any lesion above T1 i.e. Syringomyelia (c8-t1), Pancoast tumor, Brown-Sequard (hemisection resulting in CL P/T and Ipsi

PICA: involves ipsilateral Horner (b/c knocks out SNS fibers)

188
Q

Cerebellum Peduncles

A

Input:
Inferior - ipsilateral info
Middle - contralateral cortex info

Output:
Superior - Sends info to contral cortex to modulate movement (via output fibers = Purkinje fibers)

189
Q

Lateral vs Medial Cerebellar Lesion (Romberg is - b/c cerebellar)

A

Lateral: Limb dysmetria (fall to ipsilat side)
Medial: Truncal ataxia/nystagmus

lose Rapid alt movements = dysdiadochokinesia
also lose tandem walking in cerebellar lesion

190
Q

Lesion location :
Chorea (sudden, jerky movements. Huntington)
Hemiballismus (sudden flailing of 1 arm, +/- Ipsi leg)
Intention Tremor (zigzag when extending to target. MS)

A

Chorea: Basal Ganglia

Hemiballismus: Contralat Subthalamic (Basal Ganglia –>Lacunar STROKE)

Intention Tremor: Cerebellum

191
Q
  • Sudden uncontrolled muscle contraction(hiccups/jerks)
  • Sustained, involuntary muscle contraction (writer cramp)
  • High freq tremor w/sustained posture (outstretchedarm)
  • Tremor alleviated by intentional movement
A

Myoclonus
Dystonia (also the eyelid thing. can manual suppress)
Essential Tremor (relieve with EtOH)
Resting tremor (parkinson)

192
Q

Essential tremor tx

A

“Extremely tiring to keep my arm up”
Have some EToH, bETa - blocker
-pt self medicates with EtOH
-Tx with Beta blocker or primidone

193
Q

Dementia and visual hallucinations, followed by parkinsonian features

A

Lewy body dementia (Halewycinations) –> alpha-synuclein defect

194
Q

Autoimmune myelin destruction (demyelinating)

A 
Guillain Barre (PNS)
Multiple Sclerosis (CNS). Can feel fatigue after hot shower

Step 1 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions