Neuro Flashcards
What part of N. Meningitidis is in the vaccine?
Capsular polysaccharide
Describe the macroscopic findings in craniopharyngioma
Cysts that are derived from Rathke’s pouch and are filled with brownish-yellow, viscous fluid with cholesterol crystals
Describe the symptoms of serotonin syndrome
neuromuscular excitation, autonomic stimulation, altered mental status
From which amino acid is serotonin derived?
Tryptophan. Via tryptophan hydroxylase and amino acid decarboxylase
Name the amino acid precursors for GABA, histamine, cysteine, and thyroxine/DA/Epi/NE
Glutamic acid, histidine, methionine, Tyrosine
What is the treatment for serotonin syndrome?
supportive and cyproheptadine (histamine with nonspecific 5-HT1 and %-HT2 receptor antagonist properties)
Which cranial nerves are affected by Cavernous sinus thrombosis
CNs III,IV,V,VI
What is the classic triad of congenital toxoplasmosis?
Hydrocephalus
Intracranial calcifications
chorioretinitis
Can also have: hepatosplenomegaly, rash, seizures, altered mucle tone, and ocular movement defects
What is the most common complication that can occur after subarachnoid hemorrhage?
secondary arterial vasospasm (50%), leading to cerebral ischemia and new-onset confusion and/or focal neurological deficit 4-12 days after initial insult
What are the central adverse effects of L-Dopa? Peripheral?
Central: anxiety and agitation
Peripheral: N/V, Tachyarrhythmias, Postural hypotension, hotflashes
What reduces the peripheral adverse effect of L Dopa?
Dopa decarboxylase inhibitor (Carbidopa)
What is the pathogenesis of Guillain-Barre syndrome?
Antibodies cross-react with myelin and there is endoneurial inflammatory infiltrate
What is the action of pralidoxime?
Used for organophosphate poisoning, it regenerates AChE in the neuromuscular junction and affects both nicotinic and muscarinic ACh receptors
What is the most common cause of meningitis in adults of all ages? Discuss gram stain of said bacteria.
Strep Pneumo (lancet shaped gram + cocci in pairs)
What is the gram stain for Listeria?
motile gram + rods
What is the gram stain for H. Flu
non-motile gram - coccobacilli
Name two genetic disorders associated with Berry Aneurysm
Ehlers-Danlos, ADPKD
What part of the brain is supplied by the posterior cerebral artery?
CN III/IV, thalamus, medial temporal lobe, splenium of corpus collosum, parahippocampal gyrus, fusiform gyrus, and occipital lobe
What type of necrosis does the CNS undergo after infarct?
liquefactive necrosis. Most other tissues undergo coagulative necrosis after ischemic injury
What nerves and what is the division between the nerves that innervate the tongue?
Foramen cecum separates anterior 2/3rds from posterior 2/3rds
General sensory: Ant- mandibular branch of CN V, Post- CN IX
Taste: Ant- chorda tympani of CN VII, Post- CN IX
Usually postganglionic sympathetic neurons release norepi and epi on the target organ. What are the two exceptions?
Adrenal Medulla- releases norepi and epi directly into the blood stream
Eccrine sweat glands: postganglionic neurons are also cholinergic
Which anesthetics cause acute hepatitis?
Halogenated inhaled anesthetics
Halothane
The fluranes to a lesser degree
Which pathogen is most commonly associated with viral meningitis?
Enterovirus (cocksackievirus, echovirus, poliovirus) then arboviruses, then HSV2
Name the characteristic features of Friedrich Ataxia
progressive gait ataxia impaired joint and vibration sense spastic muscle weakness and babinski hypertrophic cardiomyopathy (most common cause of death) DM skeletal abnormalities
What is the most common cause of spontaneous lobar hemorrhage in adults over age 60?
Amyloid angiopathy. Recurrent hemorrhage that involves the occipital and parietal lobes.
Where is ACh made?
Basal Nucleus of Meynert
Tumor in a child with sheets of primitive cells and many mitotic figures
Medulloblastoma- located near cerebellum
Signs of PKU
ID, gait abnormality, must odor, eczema
What are the signs of hypocalcemia in DiGeorge syndrome?
Chvostek sign: twitching of the nose and lips
Trousseau sign: carpal spasm with blood pressure cuff inflation
What causes decerebrate (extensor) posturing?
Damage to the brainstem at or below the red nucleus (midbrain, pons, medulla)
What causes decorticate (flexor) posturing?
damage to neural structures above the red nucleus
What is the treatment for restless leg syndrome?
Dopamine agonists
What does the facial nerve control?
- motor- muscles of facial expression
- parasympathetic- lacrimal, submandibular, and sublingual glands
- Taste- anterior 2/3rds of tongue
- Somatic afferents from pinna and external auditory canal
What are the treatments for Alzheimer’s disease?
Cholinesterase inhibitors (donepizil), Antioxidants (vitamin E), NMDA receptor antagonists (memantine)
What symptoms are associated with opioid overdose?
Miosis, bradycardia, hypotension, and somnolence
What does the pudendal nerve innervate?
Skin around the anus and perineum
pelvic floor muscles
urethral and anal sphicters
What is DRESS syndrome and with which drugs is it associated?
Drug Reaction with eosinophils and systemic symptoms presents with rash, fever, generalized lymphadenopathy, and facial edema.
Common with Phenytoin, carbamazepine, allopurinol, sulfonamides, and antibiotics (minocycline, vanc)
What are some systemic causes of carpal tunnel syndrome?
Pregnancy (fluid accumulation) Hypothyroid (glycosaminoglycan buildup) DM (connective tissue thickening) Dialysis (Beta2 microglobulin deposition) RA (tendon inflammation)
What change are seen in the neuron during the axonal reaction?
It becomes swollen and rounded with the nucleus displaced to the periphery. The Nissl substance becomes fine, granular and is dispersed throughout the cytoplasm (24-48 hrs after injury)
What is neuroleptic malignant syndrome and what is the treatment?
Adverse reaction to antipsychotic with muscle rigidity, high fever, and autonomic instability
Rhabdo causes high CK, may lead to myoglobinuria and acute renal failure
Treatment: removal of drug, supportive care, dantrolene
What are the symptoms and histological features of HIV associated dementia?
Usually in CD4 count less than 200. Presents with subcortical dementia.
HIV infected monocytes cross the BBB and form perivascular macrophages. These macrophages for microglial nodules around necrotic tissue and may fuse to form multinucleated giant cells.
