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CLINICAL PRESENTATION. MAJOR KEYS > NEURO > Flashcards

NEURO Flashcards

1
Q

peripheral tissues vs CNS repair

A
  • peripheral:
    • fibroblasts migrate to area of injury and help with tissue repair
  • CNS:
    • astrocytes migrate to area of necrosis within 2 weeks
    • necrotic tissue resorbed, cystic space formed (surrounded by astrocytes) + newly formed capillaries
    • GLIOSIS=enlargment and proliferation of astrocytes peripherally a/r the area of necrosis
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2
Q

supraoptic (hypothalamic nuclei)

A

secretion of ADH and oxytocin

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3
Q

paraventricular (hypothalamic nuclei)

A
  • ADH, CRH, oxytocin, TRH secretion
    • corticotropin, thyrotropin
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4
Q

arcuate (hypothalamic nuclei)

A

secretes:

  • DA (inhibits prolactin)
  • GHRH (growth hormone)
  • GRH (gonadotropin)
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5
Q

venttromedial vs. lateral hypothalamic nuclei

A

vent: “Im full” (fatty without me)…lat: “im hungry” (ano without me)

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6
Q

CO2 and cerebral vaculature

A
  • CO2 is a POTENT vasoDILATOR
  • tachypnea causes hypocapnia and cerebral vasoCONSTRICTION…thereby DEC cerebral blood volume and ICP
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7
Q

bacterial meningitis termed

A
  • classic triad:
    • stiff neck
    • altered mentation
    • **fever
  • eval requires:
    • prompt blood cultures
    • empiric AB
    • lumbar puncture
    • CSF analysis
  • eval helps:
    • confirm diagnosis
    • id offending organism
    • determine AB susceptibility
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8
Q

What is the mc primary cerebral neoplam in adults?

A
  • GLIOBLASTOMA-arises from astrocytes, located within cerebral hemispheres
    • can enlargen and cause mass effect with midline shift
    • may cross corpus callosum (butterfly glioma)
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9
Q

glioblastoma CP

A
  • weeks of episodic HA, nausea, progressive weakness
  • seizures
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10
Q

schwannomas CP

A
  • sensorineural hearing loss
  • tinnitus
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11
Q

normal pressue hydrocephalus in elderly patients

A
  • triad:
    • ataxic gait
    • urinary incontinence
    • dementia
  • PP: distortion of paraventricular area
    • later: loss of cortical inhibition on the sacral micturition center causes development of urge incontinence
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12
Q

what is spared by nml pressure hydrocephalus

A
  • cerebellar
  • basal ganglia
  • pontine reticular formation
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13
Q

ataxia-telangiectasia

A

CEREBELLAR ATROPHY LEADS TO ATAXIA

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14
Q

peroxismla disease (NOT MIT) termed

A
  • very long chain and some branched chain FA cant undergo mit beta-oxidation..theyre special, need PEROXISOMES
  • s/s: hypotonia, seizures, hepatomegaly, mental retardation,e arly death
  • get neuro defects d/t improper CNS myelination
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15
Q

SAH and saccular berry aneuryms

A

two peas in a pod

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16
Q

Fod poisoning (C botulinum toxin) CP

A
  • nicotinic blockade (diplopia, dysphagia) and muscarinic blockade (dry mouth)
    • three ds: diplopia, dyspahgia, dysphonia
  • mech: toxin inhibits acetylcholine release from pe-synaptice nerve terminals at NMJ=prevent muscular contraction
  • partially overcome by high-rate repetitive nerve stim
  • toxin is produced by vegetative bacteria, remains intracellular until autolysis releases it into food
17
Q

UMN sign

A
  1. spastic paralysis
  2. clasp-knife rigidity
  3. HYPER-reflexia
  4. babinski sign
18
Q

LMN signs

A
  • flaccid paralysis
  • hypo-tonia
  • hypo-reflexia
  • muscle ATROPHY ND FASCI-CULATIONS
19
Q

Pupillary Light Reflex Pathway

A
  • upper midbrain contains naural structures taht mediate the direct and consensual papillary light reflex:
    • optic nerve
    • pretectal nuclei
    • EW nuclei
    • oculomotor nerve
20
Q

occipital lobe

A
  • contains primary visual cortex
  • unilat damage=contralat homonymous hemianopia
  • bilat lesions=cortical blindness
21
Q

parietal lobes

A
  • process and interpret visual, auditory, and motor signals reeived from other brain areas
  • damage=difficulties with spatial and visual perception
  • nondominant lesion=hemi-neglect and constructional apraxia
  • dominant lesions: Gerstmann syndrome (R-L confusion, agraphia, acalculia)
22
Q

pons

A
  • contains horizontal gaze center
    • helps mediate the oculocephalic (dolls eye) reflex
  • contains CN5 & 7 nerves (afferent and efferent limbs of corneal reflex)
  • bilat pontine injury=pinpoint pupils d/t damage of descending sympathetic fibers
23
Q

temporal lobe injury

A
  • memory-hippocampus
  • speech-Wernicke in dominant
  • vision-Meyer loop
  • hearing-primary auditory cortex
  • bilat amygdala damage: Kluver Bucy
    • hyperphagia, hperorality, hypersexuality
24
Q

thalamus

A
  • majory sensory relay station
  • VPL nucleus-somatic sensation of the body
  • VPM nucleus-facial sensation and taste
  • lategal geniculte-vision
  • medial geniculate-hearing
25
Q

medulloblastoma (#2 kiddies)

A
  • # 2 mc brain neoplasm of childhood
  • mc location: cerebellar vermis
    • s/s: INC ICP (morning HA, vom, lethargy)
    • cerebellar dysfunction as tumor compresses adjacent structures
  • histo: sheets of small, blue cells
  • PNET tumor, poorly differentiated, bad prognosis
26
Q

pilocytic astrocytoma (#1 kiddies)

A
  • also located in the cerebellum, like medulloblastomas
  • micro: pilocytic astrocytes and Rosenthal fibers
  • low grade tumors, better prognosis
27
Q

ependymomas (#3 kiddies)

A
  • walls of ventriculi
  • can hamper CSF flow, cause hydrocephalus
  • micro: ependymal cells form gland-like structures-ROSETTES
28
Q

p450 INHIBITORS

A

AAA Racks in GQ magazine

  • acute alcohol abuse
    • RITONAVIR (Isoniazid)
    • AMIODARONE
    • CIMETIDINE
    • KETOCONAZOLE (also: fluconAZOLE, omeprAZOLE…azole antifungals)
    • SULFONAMIDES
  • Grapefruit juice
  • Quinidine
    • MACROLIDES (except Azithro)
29
Q

p450 INDUCERS

A

chronic alcoholics steal Phen-phen and never refuse greasy carbs…enhance metab of X and DEC its serum concentration

  • chronic alc use
  • St. John’s wort
    • PHENYTOIN
    • PHENOBARBITAL
  • Nevirapine
  • Rifampin
  • Griseofulvin
  • Carbamazepine
30
Q

p450 substrates

A
  • OCP
  • warfarin
  • theophylline
  • anti-EPILEPTICS
  • metronidazole
31
Q

migraine vs. cluster vs. tension

A
  • migraine (POUND)
    • female, unilat, pulsatile/throb, 4-72h, assoc: aura, phobias, nausea
  • cluster
    • men, start d/r sleep, behind one EYE, excruciating sharp, 15-90 MINS
    • assoc s/s: sweating, flushing, congestion, lacrimation
  • tension
    • female, under stress, band like pattern, 30min-7d
    • assoc s/s: muscle tenderness in head, neck, shoulders
32
Q

LEMS vs MG

A
  • LEMS: prox mu weakness, better with use
    • assoc: SCLC
  • MG: ab vs AChR, worse during day–extraocular mu (ptosis, diplopia); THYMOMA and anterior mediastinal mass
33
Q

nml pressure hydrocephalus CP

A
  • d/t DEC CSF resorption
  • s/s progressive, d/t disruption of perventricular white matter tracts
    • gait difficulties early-magnetic gait
    • UMN sings (spasticity, hyperreflexia)
    • cognitive disturbances (difficulty concentrating, lack of attn)
    • urinary incontinence late (urgency d/t DEC inhibitory control of bladder contractions by the frontal lobe)
34
Q

frontotemporal dementia

A

young-onset dementia, CP personality changes and aphasia

35
Q

NON-communicating (obstructive) hydrocephalus

A

obstruction of CSF flow between vntricles and subarachnoid space

d/t: congenital abnml (aqueductal stenosis), tumors

cp: HA, N/V

CLINICAL PRESENTATION. MAJOR KEYS (8 decks)

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