Neuro Flashcards
how do infants with hydrocephalus precent
irritability, poor feeding, muscle hypertonia, and hyperreflexia (due to upper motor neuron injury)
narcolepsy with cataplexy is most often caused by the lack of 2 related neuropeptides:
hypocretin-1 (orexin-A) and hypocretin-2 (orexin-B)
detected in CSF
these promote wakefulness and inhibit REM sleep-related phenomena
clinical presentation of Wernicke encephalopathy
ataxia, nystagmus, ophthalmoplegia, and anterograde amnesia
vaccines for Neisseria meingitidis contains
capsular polysaccharides to induce production of protective anticapsular antibodies
what is physostigmine
cholinesterase inhibitor
can be used to treat atropine poisoning since atropine has antimuscarinic effects
ataxia telangiectasia- clinical findings
superficial blanching nests of distended capillaries
failure to repair DNA double strand breaks
in the E. coli strains that cause neonatal meningitis, what is their major virulence factor
K1 capsular antigen
_________ is a potent vasodilator of cerebral vasculature
carbon dioxide
tachypnea causes hypocapnia and cerebral vasoconstriction to decrease cerebral blood volume and intracranial pressure
3 treatment options for alzheimer’s disease
cholinesterase inhibitors (Donepezil), antioxidants (vitamin E), and NMDA receptor antagonists (eg memantine)
treatment for malignant hyperthermia
dantrolene-blocks ryanodine receptors to stop Ca release into the cytoplasm of skeletal muscle
malignant hyperthermia due to anesthetics and/or succinylcholine to genetically susceptible people
symptoms of serotonin syndrome
autonomic instability (hyperthermia, hypertension, tachycardia), alterned mental status, neuromuscular hyperactivity, GI symptoms and diaphoresis
what drug combo causes serotonin syndrome
monoamine oxidase inhibitor combined with serotonergic antidepressant
(Linezolid has MAOI activity)
symptoms of pinealoma
Parinaud syndrome (compress tectum–> limit upward gaze, bilateral eyelid retraction, and light-near dissociation), obstructive hydrocephalus, precocious puberty in males
“locked-in” syndrome due to _______ hemorrhage or tumor
pontine
______ and ________ are effective as monotherapy for treatment of spasticity secondary to both brain and spinal cord disease, including multiple sclerosis
Baclofen (GABA-B receptor agonist); Tizanidine (alpha-2 adrenergic agonist)
what is the area postrema and where is it?
located on dorsal surface of medulla at the caudal end of the fourth ventricle
receives blood from fenestrated vessels (no blood-brain barrier) so can sample chemicals in the blood
associated with vomiting with chemotherapy
paralysis of the ________ muscle results in hyperacusis (increased sensitivity to sound)
and what nerve innervates this muscle?
stapedius musle; stapedius nerve, a branch of the facial nerve
ornithine transcarbamylase deficiency–> leads to defect in __________
hepatic urea cycle–> ammonia to accumulate in blood–> lethargy, vomiting, seizures, cerebral edema
main treatment for urea cycle disorders
protein restriction
bell’s palsy presentation (unique ones)
decreased tearing, hyperacusis (sensitivity to sound), and /or loss of tase sensation over the anterior 2/3 of tongue
what drug can be prescribed for sedative hypnotic drugs with anxiolytic, muscle relaxant and anticonvulsant actions
benzodiazepines
cholinergic toxicity-muscarinic effects and nicotinic effects
muscarinic: DUMBELS
diarrhea/diaphoresis, urination, miosis, bronchospasm, bronchorrhea & bradycardia, emesis, lacrimation, and salivation
nicotinic: muscle weakness, paralysis & fasciculations
mechanism of action of organophosphates
inhibit cholinesterase in both muscarinic and nicotinic cholinergic synapses–> decreased acetylcholine degradation
treatment for cholinergic toxicity that would degrade excess acetylcholine and treats both muscarinic and nicotinic effects of the toxicity
pralidoxime- cholineseterase-reactivating agent
mechanism of action of ethosuximide
blocks T-type Ca channelsin thalamic neurons
mechanism of action of phenytoin and carbamazepine (antiseizure)
blocks Na channels
mechanism of action of valproic acid (antiseizure)
blocks Na channels and increase GABA levels
mechanism of action of benzodiazepine and phenobarbital
increase GABA-a action
mechanism of action of Levetiracetam (antiseizure)
modulates GABA and glutamate release
what nerve can uncal herniation compress?
ipsilateral third canial nerve–>develop ipsilateral oculomotor nerve palsy with a fixed dilated pupil
first area of the brain damaged during global cerebral ischemia
hippocampus
iliohypogastric nerve provides sensation to what regions and motor function to what muslces?
suprapubic and gluteal regions
anterolateral abdominal wall muscles
what to use after a subarachnoid hemorrhage to prevent cerebral vascular spasm that would lead to altered mental status as well as focal neurological deficits
Nimodipine (a calcium channel blocker)
what is “slasp-knife” spasticity? and is it a upper or lower motor neuron lesions?
initial resistance to passive extension followed by a sudden release of resistance
upper