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STEP 1 > Neuro > Flashcards

Neuro Flashcards

1
Q

Conversion disorder vs. somatic symptom disorder

A

Conversion has neurological involvement and often associated with acute stress

SSD: excessive anxiety around 1 or more symptoms

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2
Q

Schizophrenia vs. schizoaffective vs. schizophreniform

A

Schizophrenia: >2 symptoms for >6months
Brief psychotic d/o: <1month
Schizophreniform d/o: 1-6 months
Schizoaffective d/o: schizo + depression

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3
Q

Glaucoma drugs

A 
Sympathetic drugs (a ag, b antag) decrease Synthesis
chOlinomimetics increase Outflow

BimatoprOst, latanoprOst increase Outflow (iris darkening)

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4
Q

Vent treatment of increased ICP especially with trauma or acute

A

Hyperventilation -> decreased CO2 -> CNS vasoconstriction

CO2 is potent CNS vasodilator

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5
Q

Nissl substance

A

RER in neurons
Basophilic granules
Loss of nissl = apoptosis

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6
Q

Patterns of neural injury and findings:
Acute damage
Axonal loss
Neuronal atrophy

A

Acute: red dead, shrunken body/nuc, loss of Nissl, eos cyto
Axonal loss: big body, big nuc/nucleo, Nissl dispersion
Atrophy: loss of fxnal groups, reactive gliosis

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7
Q

POMC derivatives

A

ACTH
MSH
ß-endorphin (opioid)

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8
Q

Myotonic muscular dystrophy

A

AD - CTG repeat, anticipation
Abnormally slow relaxation of fibers
Can’t let go of doorknob, can’t let go of handshake

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9
Q

Buspirone

A

Non-benzo benzo
Slow onset
Good for GAD, bad for Panic Disorder/actue stuff

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10
Q

Mu, delta, and kappa opioid receptors are coupled to?

A

Inhibitory G protein

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11
Q

Effects of opioid analgesics on 1st and 2nd order neurons

A

1st (peripheral neuron): binds pre-terminal and inhibits voltage gated calcium
2nd (spinal cord neuron): binds post-terminal and stimulates K+ efflux out of cell

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12
Q

Cavernous malformation

A

Vascular malformation
Clusters of dilated, thin walled capillaries
Tend to bleed -> intracerebral hemorrhage
Hyperdense, bright mass on CT

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13
Q

Elevated 14-3-3 protein in CSF

A

Creutzfeldt-Jakob

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14
Q

Elevated hypocretin-1 in CSF

A

Narcolepsy

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15
Q 
Functional anatomy of cerebellum:
Lateral hemisphere
Intermediate hemisphere
Vermis
Flocculonodular lobe
A

Lateral hemisphere = motor planning
Intermediate hemisphere = motor execution via lateral descending systems
Vermis = motor execution via midial descending systems
FL = balance and eye movements

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16
Q

Headache followed by sudden unilateral blindness with a PMH of shoulder/hip pain?

A

Temporal arteritis
(with polymyalgia rheumatica)
Another sign = jaw claudication

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17
Q

Bilateral spastic paresis with elevated arginine

A

Arginase deficiency (produce urea, ornithine)
Urea cycle defect
Little to no hyperammonimia
Tx: low protein diet

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18
Q

First area of the brain that is damaged during global cerebral ischemia?

A

Hippocampus

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19
Q

Opsoclonus-myoclonus syndrome in a kiddo with an abdominal mass

A 
Neuroblastoma (vs. Wilms)
Can cross midline
Eye stuff = not wilms
N-myc
Catecholamine metabolites in urine
<4 years old
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20
Q

Dandy walker

A

Vermis agenesis. 4th ventricle dilation.
Fourth Fills Fossa
Non-communicating hydrocephalus

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21
Q

Chiari II (Arnold-Chiari)

A

Vermal herniation
Hydrocephalus (aqueductal stenosis)
Meningomyelocele

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22
Q

Chiari I

A

Tonsillar herniation

Associated with syrinx

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23
Q

Syringomyelia

A

Cape-like sensory loss (fine touch preserved)

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24
Q

Normal pressure hydrocephalus

A

Wet wobbly and wacky:

Urinary incontinence
Magnetic gait/ataxia
Cognitive dysfxn

Affects elderly, dilated ventricles, episodic

25
Q

Communicating hydrocephalus

A

Decreased CSF absorption by arachnoid granulations

Ex. scarring post-meningitis

26
Q

Non-communicating hydrocephalus

A

= obstructive

27
Q

Friedreich ataxia

A

AR -> (GAA)n frataxin gene
Loss of DTR’s, vib, prop
Staggering gait, falling, nystag, pes, DM, HCM, scoli

Staggering FRAT brother with a BIG, SWEET HEART

Kinda looks like vitamin E deficency

28
Q

Three elements of aphasia

A

Speech Fluidity
Comprehension
Repetition

29
Q

Aphasia basics

A

Arcuate fasciculus connects Broca’s and Wernicke’s
Any problem with AF = impaired repetition

Transcortical occur AROUND Broca’s (motor) and Wernicke’s (seonsory) therefore AF is fine

30
Q

SIG E CAPS

A 
Sleep disturbance
Interest (anhedonia)
Guilt, feeling worthless
Energy loss
Concentration problems
Appetite
Psychomotor retardation
Suicidal ideation
31
Q

DIG FAST

A 
Distractibility
Irresponsibility
Grandiosity
Flight of ideas
Activity/agitation
no Sleep
Talkativeness
32
Q

Adult primary brain tumors

A 
Glioblastoma
Meningioma
Hemangioblastoma
Schwannoma
ODG
pituitary Adenoma

Old MEN Go Home After School

33
Q

Childhood primary brain tumors + one in the abdomen

A 
Pilocytic astrocytoma
Medulloblastoma
Ependymoma
Craniopharyngioma
Pinealoma

Also:
Neuroblastoma - but not 1˚ brain (abdomen)

MEDium Pinetrees Excite People’s Christmas

34
Q

Structure affected with hemiballism

A

Hemiballism = wild, involuntary, unilateral movements

Damage to the subthalamic nucleus (lacunar stroke) which modulates BG output

35
Q

Lambert-Eaton Syndrome

A

Myasthenic syndrome
Antibodies against presyn Ca channels
Associated with lung cancer
Increase in muscle response with repetitive stim

36
Q

Extensor vs. flexor posturing

A

At or below red nucleus = extensor (midbrain, pons)

Above red nucleus = flexor (hemispheres, int. cap)

37
Q

Herniation syndromes

A

Subfalcine (ACA damage)
Central (basilar artery rupture, Duret hemorrhage)
Uncal (Blown pupil, down and out)
Tonsillar (Brain stem compression)

Speeding Colorado To Utah

38
Q

Brain findings post MI and v-fib death

A

Watershed zones = wedge shaped necrosis caused by hypoperfusion

Hypoxic-ischemic encephalopathy

ACA/MCA
MCA/PCA

39
Q

Frontal lobe syndromes

A

Changes to executive fxn/personality

Left side = more apathy and depression (Left=Lame)
Right side = disinhibited behavior (Right=Risky)

40
Q

Tetrodotoxin binds to?

A

Na channels preventing depolarization

41
Q

Group B personality disorder

A

Historically, Bad Ass Narcisstists (Wild)

Histrionic (attention seeking)
Borderline (unstable, suicide, splitting)
Antisocial (>18 -> <18=conduct d/o)
Narcissistic

42
Q

Personality disorders

A

Weird (paranoid, schizoid [d=distant], schizotypal [t=magical thinking]
Wild (histrionic, borderline, antisocial, narcissitic)
Worried (avoidant, OC, dependent)

43
Q

Globus sensation

A

Functional disorder
“feels like something stuck in throat”
Intermittent/persistent
Nothing on eval

44
Q

Craniopharnyomas arise in who?
From what?
Cause what classic symptom?

A

In kids
From Rathke’s pouch (calcified on exam)
Bitemporal hemianopsia

45
Q

Difference between acute and post-traumatic stress disorder?

A

Acute <1 month

PTSD >1 month

46
Q

Causes of Lhermitte’s sign

A

MS

Cobalamin deficiency

47
Q

Broca’s vs. Wernicke’s aphasia

A 
Broca = broken boca (mouth), comprehension okay
Wernickes = word salad, impaired comprehension
48
Q

Unmyelinated axons

A

Group C fibers
Autonomic postganglionic fibers
Heat sensation
Burning/dull visceral pain

49
Q

Normal pressure hydrocephalus

Triad

A 
Expansion of ventricles, elderly
Wet, wobbly, wacky
Urinary incontinence
Ataxia
Cognitive dysfunction
50
Q

Many many lobar hemorrhages?

A

Amyloid angiopathy

51
Q

ALS treatment?

A

Riluzole

52
Q

HIV dementia path findings

A

Microglial nodules

May fuse to form giant cells

53
Q

First sign of uncal herniation

A

Ipsilateral down and out eye

54
Q

Hypertensive brain bleeds at initial presentation:
Clean CT
Hyperdense area on CT

A

Both involve lenticulostiate vessels
Clean CT = arteriosclerosis, small rupture, will be present on CT later

Immediate CT changes = CB rupture, intraparenchymal hemorrhage

55
Q

Cerebellar lesions/bleeds

A 
Lateral = limbs
Medial/vermal = truncal ataxia (wide based gait)
56
Q

Hydrocephalus due to cortical loss?

A

Not increased CSF, but cortical atrophy

Hydrocephalus ex-vacuo

57
Q

Alz dz:
Neurotransmitter changes (where)
Atrophied regions

A

Decreased Ach in the nuclus basalis

Atrophied cortical and hippocampal areas

58
Q

Crutzfield Jakob

A

Prion dz
Rapidly progressive
Grey matter changes
Spongiform encephalopathy

59
Q

Cerebellar degeneration with extra-CNS cancer

A

Autoimmune attack
Classic: Small cell lung
Also: Breast/ovarian/uterine
Anti-Yo, anti-P/Q, anti-Hu

STEP 1 (11 decks)

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