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Neuro Flashcards

1
Q

Elevated AFP is seen in NTDs (except spina bifida oculta). What is a good confirmatory test?

A

Elevated AChE

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2
Q

What congenital abnormality are babies of mothers w/T1DM at risk for?

A

Anencephaly

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3
Q

What is syngomyelia a/w, besides trauma and tumors?

A

Chiari malformations

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4
Q

What is Chiari II a/w?

A

Lumbosacral meningomyelocele

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5
Q

Where in the neuron would Nissl not stain?

A

Axons (no RER in axons)

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6
Q

If you see a multinucleated giant cell in the CNS, what type of cells would it be made of?

A

Microglia

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7
Q

What is the difference b/w C and a-delta free nerve endings?

A 
C = slow, unmyelinated
a-delta = fast, myelinated
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8
Q

What nerve layer (endo, peri, epi-neurium) is inflamed in Guillain-Barre?

A

Endoneurium

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9
Q

Besides having decreased dopamine, what 2 NT’s are INCREASED in Parkinson dz?

A

Increased acetylcholine and serotonin

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10
Q

What controls EOM’s during sleep?

A

PPRF (paramedian pontine reticular formation / conjugate gaze center)

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11
Q

*What are the stages of sleep, in terms of EEG waveform?

A

at night, BATS Drink Blood

Beta (awake- eyes open)
Alpha (awake- eyes closed)
N1 (non-REM): Theta
N2 (non-REM): Sleep spindles + K complexes
N3 (non-REM): Delta
REM: Beta
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12
Q

In what stage of sleep do bedwetting, night terrors, and sleepwalking occur?

A

Stage N3 of non-REM

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13
Q

In what stage do dreaming, tumescence occur?

A

REM (may preserve memory function)

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14
Q

What are the functions of the limbic system?

A 
5 F's
Feeding
Fleeing
Fighting
Feeling
Fucking
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15
Q

What part of the brain, and what 2 NT’s are lost, in Huntington disease (c’some 4)?

A

CAG repeats

Caudate loses ACh and GABA
neuronal death via glutamate excitotoxicity of NMDA receptors

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16
Q

What are the sx of Gerstmann syndrome?

A 
(dominant parietal cortex lesion)
Agraphia
Acalculia
Finger agnosia
L-R disorientation

(w/nondominant parietal cortex lesion: hemispatial neglect syndrome of opposite side)

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17
Q

Wernicke’s triad of problems? (B1 def.)

A

come in a CAN of beer

  • Confusion
  • Ataxia
  • Nystagmus
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18
Q

In strokes look (towards/away) side of lesion, in seizures look (towards/away) lesion.

A 
Stroke = towards
Seizure = away
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19
Q

Is cerebral perfusion pressure proportional to CO2, O2, or neither?

A

CO2 (normally ~40)

Hypoxemia AKA low O2 only increases perfusion when below 50mmHg

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20
Q

What arteries feed the striatum and internal capsule?

A

Lenticulostriates (branch from MCA)

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21
Q

Disruption of what artery would give a Lateral medullary (Wallenberg) syndrome?
Main sx?

A

PICA “Don’t PICA horse that can’t eat”

  • Horseness
  • Dysphagia
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22
Q

Disruption of what artery would give a Lateral pontine syndrome?
Main sx?

A

AICA

“Facial droop means AICA’s pooped”

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23
Q

Occlusion of what a. would give you Locked-in syndrome?

A

Basilar a.

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24
Q

For a women in her 20’s with a HA, what must you worry about most/first?

A

Pseudotumor cerebri (idiopathic intracranial HTN)

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25
Q

What does “wet, wacky, and wobbly” refer to?

A

Triad in nl pressure hydrocephalus

  • Urinary incontinence
  • Cognitive dysfunction
  • Ataxia
26
Q

What congenital disease is a symmetrical version of polio? (anterior horn)

A

Werdnig-Hoffmann disease

27
Q

What gene can be mutated in ALS?

Tx?

A

Superoxide dismutase (SOD1)

riluzole

28
Q

What tracts are affected by B12 deficiency?

A

Subacute combined degeneration: SCD

  • Spinocerebellar (careful, not STT)
  • CST
  • DCP
29
Q

Mnemonic for Friedrich’s ataxia? C’some 9.

A

Friedrich’s a great frat (frataxin) brother: always staggering and falling (gait), but has a sweet (DM), big heart (HCM).

  • Frataxin is Fe-binding protein
  • Impaired mitochondrial functioning
  • Kyphoscoliosis
30
Q

What dermatome is at the inguinal ligament?

A

L1 is IL (inguinal ligament)

31
Q

Which dermatomes keep the penis off the floor?

A

S2, 3, 4

32
Q

What reflex do L1/L2 do?

S3/S4?

A 
L1/L2 = "testicles move"
S3/S4 = "(anal) winks galore"
33
Q

CN vessel pw’s?

A

Old SOFie’s ROS Is Just Horrible

Optic canal (II)
SOF (III, IV, VI)
Rotundum (V1)
Ovale (V2)
Spinosum (V3)
Internal auditory meatus (VII, VIII)
Jugular foramen (IX, X, XI)
Hypoglossal canal (XII)
34
Q

Which is a/w sensory vs. motor?

Nucleus solitarius vs. nucleus ambiguus

A

Solitarius: Sensory (VII, IX, X), also taste, carotid body/sinus

aMbiguus: Motor (IX, X)

  • Spinal nucleus of V (V, VII, IX, X) is most pain/sensation from face (V) + ear stuff
35
Q

What nerves pass thru the cavernous sinus?

- What artery?

A

III, IV, V1, (occ. V2), VI, symp (post-ganglionic)

- branch of ICA

36
Q

What is a cholesteatoma?

A

Desquamated keratin debris mass in middle ear (not a cancer, not cholesterol!)

37
Q

3 drugs that reduce aqueous humor? (2 autonomic)

A

Beta-blockers (nonselective-eg timolol)
Alpha-2 agonists (brimonidine)
CA inhibitors

38
Q

Sx of acute closure in closed/narrow angle glaucoma (lens pushes iris forward)?

What drug should you avoid?

A 
Painful red eye
Sudden loss of vision
Halos around lights
Rock-hard eyes
Frontal headache

Avoid epi (mydriatic effect)

39
Q

How do you test the obliques?

A

Obliques go Opposite (test left obliques w/pt gazing right)

IOU: IO tested looking up

40
Q

What lbe does Meyer’s loop go thru? (Pie in the Sky)

A

Temporal lobe

other pw to occipital lobe is thru parietal lobe, lower lesion

41
Q

What nucleus is a/w internuclear opthalmoplegia when gazing left and right?

A

MLF (6 -> MLF -> opposite 3)

42
Q

What can rapidly correcting hyponatremia cause?

What can rapidly correctly hyertnatremia cause?

A
  • Central pontine myelinolysis (Osmotic demyelination syndrome)
  • Cerebral edema/herniation

“from low to high, your pons will die”
“from high to low, your brain will blow”

43
Q

What’s the Charcot triad of MS?

A

Charcot’s triad of MS is a SIN

Scanning speech (like a drunkard)
Intention tremor
Nystagmus

44
Q

Briefly describe the type of neuropathy seen most commonly in Guillain-Barre.

A

Acute inflammatory demyelinating polyradiculopathy

  • Autoimmune
  • Schwann cells destroyed (ascending)
  • Majority recover
45
Q

What other disease must you r/o when you see MS sx?

A

Acute disseminated encephalomyelitis (post-infectious)

AKA ADEM

46
Q

What is Charcot-Marie-Tooth?

A

“Hereditary motor and sensory neuropathy” (HMSN)

  • Progressive (AD) nerve d/o
  • Defect proteins of myelin sheeth or peripheral nerves
  • Sx: pes cavus (foot arched), LE weakness, sensory deficits
47
Q

What is natalizumab, and what is the major SE to look out for?

A

MS tx

- A/w PML (eg JC virus)

48
Q

What is adrenoleukodystrophy’s inheritance pattern?
Pathology?
Sx?

A
  • XL (males)
  • Disrupted metabolism of very long chain FA’s (builds up in nervous system, adrenals, testes)
  • Progressive: coma, death, adrenal gland crisis
49
Q

What type of seizure is a grand mal seizure?

A

Tonic-clonic (alternating stiffness and movement)

50
Q

What is an atonic seizure?

A

“drop seizure” (tonic is stiffening)

- Falls to floor, often mistaken for fainting

51
Q

Most commons seizure causes for kids?
Adults?
Elderly?

A

Kids: Genetic; febrile…
Adults: Tumor; trauma…
Elderly: Stroke; tumor…

52
Q

Which type of HA is not b/l?

A

Tension (last > 30 min, typically 4-6 hrs; no photo- or phonophobia)

53
Q

What is pathognomonic for pilocytic astrocytoma? (kids)

A
  • Rosenthal fibers (eosinophilic, corkskrew)
  • Cystic lesion w/mural nodule

(nice prognosis)

54
Q

What is pathognomonic for medulloblastoma? (kids)

A
  • Homer-Wright rosettes, small blue cells

“‘Me dull? Blast!’ Said Mr. Burns to Homer”

55
Q

What is pathognomonic for ependymoma? (kids)

A
  • Perivascular rosettes

ependyma like to line ventricles, but they switched to vascular

56
Q

What is pathognomonic for craniopharyngioma? (kids)

A
  • Rathke’s pouch (r/o this 1st w/pit adenoma sx)
57
Q

What is pathognomonic for pinealoma? (kids)

A

Can cause Parinaud syndrome (vertical gaze palsy due to compressed tectum)
- Precocious puberty in males due to hCG production

58
Q

What is pathognomonic for GBM? (grade 4 astrocytoma- adults)

A
  • Pseudo-palisading cells border necrosis/hemorrhage
  • Butterfly lesion/GFAP+

(~1 year survival)

59
Q

What is pathognomonic for meningioma? (adults)

A
  • Look for dural attachment (“tail”)
  • Whorled pattern of spindle cells
  • Psammoma bodies

(common, benign)

60
Q

What is pathognomonic for hemangioblastoma? (adults)

A
  • A/w VHL

- Thin-walled capillaries (like name)

61
Q

What is pathognomonic for schwannoma? (adults)

A
  • Often CN VIII (vestibular)
  • A/w NF-2 (if b/l)
  • S-100+
62
Q

What is pathognomonic for oligodendroglioma? (adults)

A
  • Fried egg cells

use egg whites to make myelin for oligodendrocytes

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