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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
What does "wet, wacky, and wobbly" refer to?
Triad in nl pressure hydrocephalus - Urinary incontinence - Cognitive dysfunction - Ataxia
26
What congenital disease is a symmetrical version of polio? (anterior horn)
Werdnig-Hoffmann disease
27
What gene can be mutated in ALS? | Tx?
Superoxide dismutase (SOD1) | riluzole
28
What tracts are affected by B12 deficiency?
Subacute combined degeneration: SCD - Spinocerebellar (careful, not STT) - CST - DCP
29
Mnemonic for Friedrich's ataxia? C'some 9.
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
What dermatome is at the inguinal ligament?
L1 is IL (inguinal ligament)
31
Which dermatomes keep the penis off the floor?
S2, 3, 4
32
What reflex do L1/L2 do? | S3/S4?
``` L1/L2 = "testicles move" S3/S4 = "(anal) winks galore" ```
33
CN vessel pw's?
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
Which is a/w sensory vs. motor? | Nucleus solitarius vs. nucleus ambiguus
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
What nerves pass thru the cavernous sinus? | - What artery?
III, IV, V1, (occ. V2), VI, symp (post-ganglionic) | - branch of ICA
36
What is a cholesteatoma?
Desquamated keratin debris mass in middle ear (not a cancer, not cholesterol!)
37
3 drugs that reduce aqueous humor? (2 autonomic)
Beta-blockers (nonselective-eg timolol) Alpha-2 agonists (brimonidine) CA inhibitors
38
Sx of acute closure in closed/narrow angle glaucoma (lens pushes iris forward)? What drug should you avoid?
``` Painful red eye Sudden loss of vision Halos around lights Rock-hard eyes Frontal headache ``` Avoid epi (mydriatic effect)
39
How do you test the obliques?
Obliques go Opposite (test left obliques w/pt gazing right) IOU: IO tested looking up
40
What lbe does Meyer's loop go thru? (Pie in the Sky)
Temporal lobe | other pw to occipital lobe is thru parietal lobe, lower lesion
41
What nucleus is a/w internuclear opthalmoplegia when gazing left and right?
MLF (6 -> MLF -> opposite 3)
42
What can rapidly correcting hyponatremia cause? What can rapidly correctly hyertnatremia cause?
- 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
What's the Charcot triad of MS?
Charcot's triad of MS is a SIN Scanning speech (like a drunkard) Intention tremor Nystagmus
44
Briefly describe the type of neuropathy seen most commonly in Guillain-Barre.
Acute inflammatory demyelinating polyradiculopathy - Autoimmune - Schwann cells destroyed (ascending) - Majority recover
45
What other disease must you r/o when you see MS sx?
Acute disseminated encephalomyelitis (post-infectious) | AKA ADEM
46
What is Charcot-Marie-Tooth?
"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
What is natalizumab, and what is the major SE to look out for?
MS tx | - A/w PML (eg JC virus)
48
What is adrenoleukodystrophy's inheritance pattern? Pathology? Sx?
- XL (males) - Disrupted metabolism of very long chain FA's (builds up in nervous system, adrenals, testes) - Progressive: coma, death, adrenal gland crisis
49
What type of seizure is a grand mal seizure?
Tonic-clonic (alternating stiffness and movement)
50
What is an atonic seizure?
"drop seizure" (tonic is stiffening) | - Falls to floor, often mistaken for fainting
51
Most commons seizure causes for kids? Adults? Elderly?
Kids: Genetic; febrile... Adults: Tumor; trauma... Elderly: Stroke; tumor...
52
Which type of HA is not b/l?
Tension (last > 30 min, typically 4-6 hrs; no photo- or phonophobia)
53
What is pathognomonic for pilocytic astrocytoma? (kids)
- Rosenthal fibers (eosinophilic, corkskrew) - Cystic lesion w/mural nodule (nice prognosis)
54
What is pathognomonic for medulloblastoma? (kids)
- Homer-Wright rosettes, small blue cells "'Me dull? Blast!' Said Mr. Burns to Homer"
55
What is pathognomonic for ependymoma? (kids)
- Perivascular rosettes | ependyma like to line ventricles, but they switched to vascular
56
What is pathognomonic for craniopharyngioma? (kids)
- Rathke's pouch (r/o this 1st w/pit adenoma sx)
57
What is pathognomonic for pinealoma? (kids)
Can cause Parinaud syndrome (vertical gaze palsy due to compressed tectum) - Precocious puberty in males due to hCG production
58
What is pathognomonic for GBM? (grade 4 astrocytoma- adults)
- Pseudo-palisading cells border necrosis/hemorrhage - Butterfly lesion/GFAP+ (~1 year survival)
59
What is pathognomonic for meningioma? (adults)
- Look for dural attachment ("tail") - Whorled pattern of spindle cells - Psammoma bodies (common, benign)
60
What is pathognomonic for hemangioblastoma? (adults)
- A/w VHL | - Thin-walled capillaries (like name)
61
What is pathognomonic for schwannoma? (adults)
- Often CN VIII (vestibular) - A/w NF-2 (if b/l) - S-100+
62
What is pathognomonic for oligodendroglioma? (adults)
- Fried egg cells | use egg whites to make myelin for oligodendrocytes

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