Neuro 6 Flashcards
What are the three routes of botulism infection
food borne
wound
infant
Meningoencephalitis in HIv+ pts
cryptococcus neoformans.
latex agglutination detects polysaccharide capsule
round budding yeast
AE of Thioridazine
Low potency typical anti-psychotic
retinal deposits that resemble retinitis pigmentosa
AE of Chlorpromazine
Low potency typical anti-psychotic
corneal deposits
AE of Haloperidol
High potency typical anti-psychotic
extrapyramidal symptoms
AE of Ziprasidone
atypical antipsychotic
prolonged QT
AE of Olanzapine
atypical antipsychotic
weight gain
AE of Clozapine
atypical antipsychotic
agranulocytosis and seizures
MOA of buspirone
selective agonist of the 5HT1A receptor
only used for GAD, not panic disorder or specific phobias
takes up to two weeks to start working, can’t be used as needed
Which patients is buspirone especially useful in?
History of abuse of anti-anxiety drugs
minimal hypnotic effects, so less likely to be abused compared to benzos
Functions of CN IX
somatomotor: stylopharyngeus
Parasympathetic: inferior salivatory nucleus -> otic ganglion-> parotid gland secretion
general sensory: inner surface of tympanic membrane, Eustachian tube, posterior 1/3 of tongue, tonsiliar region, and upper pharynx, carotid body, and carotid sinus
Most common cause and location of lacunar infarcts
cause: hypertensive arteriosclerosis of small penetrating arterioles
location: basal ganglia, pons, internal capsule, deep white matter of brain
How is lithium excreted? What does that mean for it’s therapeutic window?
In the kidneys just like sodium
Means that renal injury, toxins and drugs that lead to increased proximal tubular absorption of sodium (thiazide diuretics, NSAIDS, ACE inhibitors) increase risk of toxicity
How do you acutely reduce blood lithium levels?
Hemodialysis
Drug of choice for trigeminal neuralgia
Carbamazepine
Can cause aplastic anemia and is a P450 inducer
Anti-epileptic and mood stabalizer (increases stability of inactive Na voltage gated channels)
What effect of Wernicke’s encephalopathy can be permenant
memory loss and confabulation
Major difference between serotonin syndrome and neuroepileptic syndrome
serotonin syndrome: myoclonus
NMS: presence of rigidity
Presentation of NMS
- hyperthermia
- extreme generalized rigidity
- autonomic instability
- altered mental status
What drugs are used to decreased mortality in NMS
bromocriptine (dopamine agonist)
Direct muscle relaxant (dantrolene)
Cause of weight gain, dry skin, hair loss, and constipation while on lithium therapy
lithium induced hypothyroidism
Lithium can also cause nephrogenic diabetes insipidus.
What brith defects can be caused by lithium
fetal cardiac malformations, esp Ebsteins anomaly of the tricuspid valve.
AE of Risperidone
atypical antipsychotic
symptoms of hyperprolactinemia: galactorrhea and amenorrhea
Microscopic findings in prion diseases
vacuoles in gray matter with no inflammatory changes
Where does CN V3 exit the skull? What muscles does it innervate?
foramen ovale
innervates muscles of mastication
Difference between neostigmine/edrophonium and physostigmine
physostigmine can cross BBB and decrease block cholinesterase in the CNS, while neostigmine/edrophonium cannot cross into CNS
Difference in findings between hydrocephalus and hydrocephalus ex vacuo
In ex vacuo, there is no increased pressure
capillary hemangioblastomas in retina/cerebellum
congenital cysts/neoplasms in kidney, liver, and pancreas
increased risk for bilateral renal cell carcinoma
von Hippel Lindau
Neurofibromas
optic nerve gliomas
Lisch nodules
cafe-au-lait spots
NF-1
bilateral acoustic neurommas and multiple meningiomas
NF-2
cutaneous facial angiomas leptomeningial angiomas mental retardation seizures hemiplegia skull radiopacities
Sturge-Weber
cutaneous angiofibromas (adeonoma sebaceum)
visceral cysts
other hamartomas
Tuberous sclerosis
congenital telangiectasias
epistaxis, GI bleeding, hematuria
Osler-Weber-Redu
What are the four first generation anti-histamines
hydroxyzine, promethazine, chlorpheniramine, diphenhydramine
What antibiotic is given for suspected listeria monocytogenes infection?
ampicillin
