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Neuro Flashcards

1
Q

Radial Nerve function

A

Extension of wrist arm and finger joints below shoulder! Forearm supination, thumb abduction.

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2
Q

Injury or Radial N

A

At passage through supinator canal (due to repetitive pronation/supination, direct trauma, or sublexation of radius)

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3
Q

Features or Fragile X

A

Neurobehavioral problem

Prominent forehead and chin

large ears

long, narrow face

Large testis

hyperlaxity of joints in hand

Cytogenic: small gap near tip of log arm of X chr

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4
Q

Fragile X Syndrome

A

X linked mutation of FMR1 gene

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5
Q

Huntington Disease

A

CAG trinucleotide repeats of huntington gene

Leads to gain of function mutation which is responsible for transcription repression via histone deacetylation

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6
Q

Cause of acute hypertensive intracerebral hemorrhage

A

Charcot-Bouchard aneurysm (chronic hypertension leads to progressive arteriolar hyalinization and fibrinoid necrosis)

Often involves deep structures (basal ganglia, thalamus, pons)

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7
Q

AVM

A

Most common cause of intracranial hemorrhage in children

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8
Q

Phenytoin

A

Seizure medication (blocks voltage gated sodium channels in neurons)

Side effects:

  1. gingival hyperplasia
  2. ataxia and nystagmus
  3. disruption of folic acid metabolism (megaloblastic anemia)
  4. p450 inducer
  5. coarse facial features, hirsutism
  6. fetal hydantoin syndrome
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9
Q

Locus Ceruleus

A

Located at posterior rostral pons near lateral floor of 4th ventricle

Responsible for producing almost all NE in brain

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10
Q

Ataxia-Telangiectasia

A

cerebellar ataxia
telangiectasia
sinopulmonary infections

mutation of ATM gene (AR) responsible for DNA Break Repair

cerebellar atrophy

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11
Q

Pink MacConkey agar

A

organisms that ferment lactose (e.coli, Klebsiella, Enterobacter)

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12
Q

Narcolepsy

A

Cataplexy (loss of muscle tone, abnormal facial movements)
Hypocretin-1 deficiency in CSF
REM sleep latency <15 min

Recurrent lapses into sleep multiple times within the same day at least 3*/week for 3 months

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13
Q

Cluster Headache

A

Behind one eye

15-90 minutes

Nasal congestion and lacrimation

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14
Q

Tension Headache

A

stress, band-like pattern (b/l), bull tight, persistent

Muscle tenderness

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15
Q

Femoral Nerve Block

A

At inguinal creases, anesthetizes skin and muscles of anterior thigh, femur, and knee

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16
Q

Gerstmann syndrome

A
  1. Agraphia (inability to write)
  2. Acalculia (inability to do math)
  3. finger agnosia
  4. left-right disorientation

Stroke of angular gyrus of dominant parietal lobe

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17
Q

s-100 positive tumors

A

Schwannoma and melanoma (derived from neural crest)

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18
Q

Wilson Disease

A

AR mut in ATP7B, hinders hepatocellular copper transport

Reduced secretion of ceruloplasmin and decreased secretion of copper

Copper, a pro-oxidant, causes hepatocellular injury

Neuro involvement includes movement abnl and psych symptoms

Rings around iris

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19
Q

HIV-associated dementia

A
  1. subcortical dementia (attention/memory problems, executive dysfunction)
  2. due to inflammatory activation of microglial cells
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20
Q

Intranuclear acidophilic inclusions

A

HSV

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21
Q

Intranuclear basophilic inclusion

A

CMV

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22
Q

Vitamin E Def neuro symptoms

A

Mimics Friedreich Ataxia

Loss of position and vibration sense
Loss of DTR
Ataxia

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23
Q

Friedreich Ataxia

A

AR degenerative dz
Loss of proprioception and vibration sense (damage to dorsal columns)

Ataxia (loss of spinocerebella tract)

Spastic weakness (loss of lateral corticospinal tract)

Hypertrophic cardiomyopathy

Kyphoscoliosis

high arched feet

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24
Q

Vitamin A Toxicity

A

Acute: nausea, vomiting, vertigo, double vision

Chronic: alopecia, dry skin, lyperlipidemia, hepatotoxicity, hepatosplenomegaly, visual difficulties pailledema

Teratogenic: microcephaly, cardiac anomalies, fetal death

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25
Q

Niacin deficiency

A

Pellagra (3 D’s)

  1. Dementia
  2. Dermatitis
  3. Diarrhea
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26
Q

Wernicke Encephalopathy

A

Chronic Thiamine deficiency (alcoholics)

  1. Opthalmoplegia
  2. Ataxia
  3. Confusion

Hemorrhage and necrosis of mammillary bodies

Baseline erythrocyte transketolase activity low

tx: thiamine supplementation with glucose infusion

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27
Q

Axonal Reaction

A

Change seen in neuronal body after axon is severed

  1. cellular edema
  2. nucleus displaced to periphery
  3. Nissl substance fine, granular, and dispersed throughout cytoplasm
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28
Q

Most common side effect of levodopa/carbidopa

A

Anxiety and agitation

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29
Q

N. meningitidis virulence factor that underlies disease severity

A

Lipooligosaccharide

endotoxin

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30
Q

Length and time constant

A
  1. Length constant: measure of how far along an axon electrical impulses can propogate without requiring active regeneration by ion channels
  2. Time constant:
    measure of time it takes for membrane potential to respond to membrane permeability

demyelination decreases length constant and increases time constant

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31
Q

Nerve responsible for sensation at suprapubic and gluteal region

A

Iliohypogastric nerve (L1 root)

Often injured during appendectomy

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32
Q

Common Peroneal Nerve

A

responsible for ankle dorsiflexion, eversion and toe extension

Sensory to lateral leg and dorsal foot

Damage (compression or fracture of lateral neck of fibula) leads to foot drop

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33
Q

Diabetic mononeuropathy

A

CNIII central ischemia

Ptosis, down and out gaze, normal light and accomodation

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34
Q

Berry aneurysm of COW

A

Often seen in ADPKD

Rupture causes subarachnoid hemorrhage

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35
Q

Epidural hematoma from

A

fracture of temporal bone and tear of middle meningeal artery

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36
Q

Medulloblastom

A

sheets of primitive cells and many mitotic figures

Located in cerebellum (vermis)

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37
Q

MLF

A

In pons

Lesion: impaired adduction of ipsilateral eye during conjugate horizontal gaze

38
Q

Subarachnoid Hemorrhage

A

Most commonly due to berry aneurysms

39
Q

Baclofen

A

Agonist at GABA-B receptor for spasticity (Spinal cord dz, MS)

40
Q

Tizanidine

A

alpha 2 agonist used for spasticity in spinal cord disease

41
Q

NF1

A

AD mutation of NF1 TS gene

  1. cafe au lait
  2. CNS neoplasms
  3. cutanous neurofibromas (from schwann cells/neural crest origin)
42
Q

Conversion disorder (functional neurologic symptom disorder)

A

Neurologic symptom incompatible with any known neurologic disease (often associated with stress)

43
Q

Spinal Muscle Atrophy

A

mutation in SMN1 (assembly of snRNPs)

Impaired spliceosome function leads to degradation of anterior horn cell sin spinal cord with flaccid paralysis

44
Q

Lobar hemorrhage

A

Cerebral amyloid angiopathy (beta amyloid deposition in vessel walls)

often occipital and parietal lobes

45
Q

Marcus Gun Pupil

A

afferent pupillary defect

often due to optic tract lesion

46
Q

Optic tract lesion

A

contralateral homonymous hemianopia and marcus gun pupil

47
Q

C. Botulinum toxin

A

Inhibits ACH release from presynaptic terminals at NMJ and decreases CMAP (electric response of muscles)

3 Ds: diplopia, dysphagia, dysphonia

48
Q

Pineal gland mass

A
  1. obstructive hydrocephalus (papilledema, h/a worse while lying, vomiting)
  2. Parinaud syndrome (limited upward gaze, b/ eyelid retraction, light-near dissociation)

Most commonly: germinoma

49
Q

Orbital floor fracture

A

damage to infraorbital nerve

numbness to upper cheek, upper lip, upper gingiva

50
Q

Battle sign

A

bruising over mastoid process

basilar skull fractures

51
Q

Guillain-Barre

A

Ascending symmetric weakness following febrile illness

demyelination due to molecular mimicry

inflammatory infiltrate within endomesium and lipid laden macrophages

52
Q

Thalamic stroke

A

contralateral pure hemisensory loss

VPL (spinothalamic and DCML input)

VPM (trigeminal)

53
Q

PCA infarct

A

contralateral hemianopia

contralateral paresthesia and numbness (involvement of thalamus)

54
Q

Middle cerebral artery stroke

A

mostly likely ischemic

contralateral motor and sensory deficits to upper > lower extremities and face

55
Q

Uhthoff phenomenon

A

MS symptoms worsen with increasing body temperature (exercise, hot shower)

56
Q

Risk factors of MS

A

HLA-DRB1

Location
Low vit D
Smoking

57
Q

Most common cause of sporadic encephalitis in adults

A

HSV type 1

58
Q

Temporal lobe edema

A

HSV type 1 encephaopathy

59
Q

VHL disease

A

AD

capillary hemangioblastomas in the retina and/or cerebellum,
congenital cysts in kidney, liver and pancreas

increased risk for renal cell carcinoma (b/l)

60
Q

Sturge-Weber Syndrome

A

cutaneous facial angiomas (overlyng V1 and V2 regions)

leptomeningeal angiomas

mental retardation
seizures
hemiplegia
skull radiopacities (tram-track calcifications)

61
Q

Jugular foramen contents

A 
Jugular vein
CN IX (taste post 1/3 tongue)
CN X (dysphagia/hoarseness, soft palate drop and deviation of uvula toward normal side)
CN XI (SCM and trapz paralysis)

Gag reflex (IX, X)

62
Q

Obturator nerve

A

Thigh adduction and sensation over distal, medial thigh (passes through obturator canal)

63
Q

Restless leg syndrome

A

due to iron deficiency, uremia, diabetes or idiopathic

Tx: Dopamine agonist (pramipexole)

64
Q

Tay Sachs

A

beta-hexosaminidase A deficiency

Accumulation of GM2 ganglioside in lysosomes

65
Q

Lesch Nyhan

A

deficient HGPRT (hypoxanthine-guanin phosphoribosyltransferase) .of purine salvage pathway

66
Q

Thiamine deficiency

A

Wernicke encephalopathy (ataxia, nystagmus, ophthalmoplegia, anterrograde amnesia)

Worsened with dextrose administration

Necrosis of mammillary body

67
Q

Hemiballism

A

Movement disorder with wild, involuntary, large amplitude flinging movements of proximal limbs

due to basal ganglia lesion (subthalamic nucleus)

often due to lacunar stroke of htn or dm

68
Q

Pancoast tumor

A

non-small cell lung cancers

Involvement of brachial plexus (ipsilat shoulder pain, upper limb parasthesia, areflexic arm weakness)

involvement of cervical sympathetic ganglia (ipsilateral ptosis, miosis, anhydrosis)

69
Q

Chemotherapy n/v

A

area postrema at dorsal surface of medulla and cauda end of 4th ventricle

70
Q

WNV neuro symptoms

A

Asymmetric flaccid paralysis

parkinsonian features (rigidity, bradykinesia, tremor, postural instability)

71
Q

Wilson Disease

A

AR mut of APT7B

hepatic copper accumuation, leak from damaged hepatocytes, deposits in other tissues

Clinical findings (hepatitis, cirrhosis, parkinsonism, gait disturbances, depression, personality changes)

Diagnosis: Low ceruloplasmin, high copper urinary excretion

Kayser fleischer rings

Tx: Chelators (D-penicillamine, trientine)
zinc (interferes wit copper absorption)

72
Q

Ventricles

A 
Lateral ventricle 
foramen of monro
third ventricle 
cerebral aqueduct
fourth ventricle
Magendie and luschka
73
Q

3 mutations associated with early onset alzheimers

A

APP gene (chr 21)
Prenselin 1 gene (chr 14)
Presenilin 2 gene (chr 1)

74
Q

Atrophy of alzheimers

A

Most pronounced in temporoparietal lobes and hippocampus

75
Q

Treacher Collins Syndrome

A

Abnl development of 1st and 2nd pharyngeal arches

craniofacial abnl airway compromise, feeding difficulties, abnl ossicles

76
Q

Peroxisome function

A

Oxidation of VLCFA

H2O2 degradation

77
Q

Proteasome function

A

degradation of ubiquinated proteins

78
Q

Zellweger sydrome

A

defected peroxisomal biogenesis

craniofacial abnl, hepatomegaly, neuro defects, elevated VLCFA and phytanic acid

79
Q

X-linked adrenoeukodystrophy

A

Defective transport of VLCFA into peroxisomes

Present later with neuro deterioration, adrenal insufficiency

80
Q

Normal pressure hydrocephalus

A

Wacky (dementia)
Wobbly (gait disturbances)
Wet (urinary incontinence due to stretching of descending cortical fibers))

81
Q

Huntington disease

A

Acute onset personality changes (agression, flat affect, decreased memoriy and concentration)

Movement disorder (jerky movmeent of extremities)

B/l atrophy of caudate and putatmen and loss of GABA neurons in brain

82
Q

Triptans

A

Serotonin agonists used for migraine tx

83
Q

Foot Drop

A

common peroneal nerve damage

84
Q

Parotid gland

A

CN VII courses through it

Motor innervation to muscles of facial expression (damage leads to facial droop)

85
Q

Vertical diplopia

A

Double vision when looking down (reading, walking down stairs)

Seen with trochlear nerve palsy (SO innervation)

86
Q

Neuroblastoma

A

px at 2 years with abdominal mass, ptosis, myoclonus, etc.

elevvated catecholamine metabolites (neural crest origin)

small round blue cells and homer wright rosettes

87
Q

Biochemical change seen in alzheimers

A

Decreased ACh levels in hippocampus and nucleus basalis of meynert

88
Q

Endogenous opioid peptides

A

Enkephalins, endorphins, dynorphins

89
Q

Derivatives of POMC

A
  1. beta-endorphins (endogenous opioid)
  2. ACTH
  3. MSH
90
Q

Chiari type 1

A

crebellar tonsils herniate through foramen magnum px in adulthood with paroxysmal occipital headaches and cerebellar dysfunction (dizziness, ataxia)

91
Q

Chiari type 2

A

downward displacement of cerebellum (vermis and tonsils) thorugh formen mangum

px in infants with aqueductal stenosis, dysphagia, stridor, lumbar myeomeningocele

92
Q

Dandy Walker malformation

A

hypoplasia/absense of cerebella vermis with cystic dilation of 4th ventricles and enlarged posterior fossa

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