Neuro 7 Flashcards
pt w Down syndrome is predisposed to early onset __
look for __ tangles and __ plaques
__ will accumulate in neurons
AD has dec Ach due to dec __ transferase
AD
neurofibrillary, AB
APP
__ accumulates in familial amyloid polyneuropathy or cardiomyopathy
influx of __ causes fusion of presynaptic vesicles to plasma membrane and release of Ach
nicotinic Ach receptors on postsynaptic cleft are ligand gated __/__ channels
inc conductance results in inc __ for depolarization
rapid __ influx causes upstroke of AP in sekeltal/cardiac/smooth muscle/perkinje fibers
rapid __ influx causes upstroke of AP in SA node
transthyretin
Na/K
potential
Na
Ca
Ach releease at NMJ depends on __ influx
Muscarinic agonists inc __ activity
endothelial surface has __ receptors, release NO to vasc smooth muscle
activates GC to inc __
this activates myosin __ phosphatase, resulting in smooth muscle __ an vaso__ and hypotension
other affects include detrusor __
__ intestinal peristalsis
M__
S__
Ca
PNS
M3
cGMP
light chain
relaxation, dilation
contraction
inc
salivation
miosis
__ receptors in cardiac muscle
dec in cAMP leads to opening of __
dec I/C
__ is transmembrane glycoprotein on presynaptic vesicle, neuroectoderm/endocrine cells
postive IR for synaptophysin indicates __ tumor
__ stain positive for GFAP
ie A/GM/O/E
M2
K channels
inotropy/chronotropy
synaptophysin
neuronal
gliomas
astrocytoma, glioblastoma multiforme, oligodendroglioma, ependymoma
C5/C6 nerves mediate __/__ reflexes
CN 9/10/11 pass through the __ in the skull
\_\_ syndrome is lesion of JF loss of taste from posterior 1/3 via \_\_ loss gag via CN \_\_ dysphagia va CN \_\_ hoarse via Cn \_\_ palate droop via CN \_\_ SCM/trapezius lost via CN \_\_
biceps/brachioradialis
JF
vernet 9 9/10 9/10 10 10 11
Neonatal IVH occurs in __ w/in first 5 days
can be asx or have dec C/__ movement
bulging __, __ posture, s/c
seen w low a/birth ___
originates in __ in subventricular zone
neurons/glial cells formed here before __ w
prematurity
conscious, spontaneous, AF, decerebrate, seizure, coma
age/weight
germinal matrix
32
optic nerves travel via optic tract to the __ of thalamus before reaching primary visual cortex
inferior __/__ part of auditory pathway
CPM presents w osmotic demyelination of the __ tracts
__ palsy due demyelination of CN __/__/__ w head/neck weakness/dysphagia/dysarthria
pseudobulbar bc _ remain intact
too rapid correction of hyperNa results in __
LGN
colliculus, MGN
CS
psuedobulbar, 9/10/11
neurons
cerebral edema
__ of parietal lobe is supplied by MCA
part of PAC to integrate __ information
lesion results in __ syndrome
A/A/finger __ and __ disorientation
injury to dorsolateral medulla can result in \_\_ syndrome lostof \_\_ loss \_\_/\_\_ of ipsi face and contra body ipsi \_\_ muscle weakness ipsi limb \_\_ and \_\_ syndroe
angular gyrus
multisensory
Gerstman
agraphia, acalculia, agnosia, LR
Wallenburg PICA pain/temp bulbar ataxtia/Horner
__ is inc resistance to muscle movement/inc in tonic reflexes
in MS, due to loss of inhibitory control from __ and inc __ activity
tx w B__ a GABAB agonist
or T __ an alpha 2 agonist for brain/spinal cord spasticity
1st gen __ have sig anticholinergic effects
__ muscle attaches to lens via zonular fibers
under PNS control from __ ganglion
if inhibited, __ is limited causing blurry vision for close objects
pupillary sphincter also receives PNS innervation from __, so anticholinergics can cause __
spasticity
UMN, LMN
baclofen
tizandine
antihistamines
ciliary muscle
EMN
accomodation
EWN, mydriasis
antihistamines can also block __ receptors and __ receptors
opioids work by binding _ coupled opioid receptors
long term activation can lead to inc __ via receptor d__ and d__
also upregulation of N__ receptors
results in T__ and pain sensation triggered by normal phenoms aka __ indced hyperalgesia
B__ is partial opioid agonist w low activity at receptor but binds w __
this, can act as opioid receptor __ w full agonists
this leads to ___
alpha adrenergic, serotonin
Gprotein
pain sensitivity, downregulation/decoupling
NMDA
tolerance
opioid
buprenorphine, high affinity
antag
__ is anesthetic used for induction/maintence of general/procedural sedation
rapid onset as preferentially distributed to area of high __ like brain
over time, redistributed to organs w less __, causing rapid termination
metabolized by __ w long half life
propofol
blood flow
blood flow
liver
ependymal layer of chorid plexus is simple ciliated __ w TJ bw cells
acute bacterial meningitis occurs w organism colonizing the __ and penentrating endothelium w spread to __ and finally entering the __
basilar skull fracture can lead to __ leakage
infection w __ then can result
columar epithelium
nasopharynx, blood, choroid
CSF
S pneumo
GBS caused by molecular mimicry to pathogen w __ like substannce in LPS layer
thus t cells/antibodies react w __ component in myelin/schwann cells
__ forms as SC ends at L2 in adults
Conus medullaris syndrome is lesion at __
flaccid paralysis of b_, I and saddle anesthesia (S3-5)
usually due to _ herniation, tumor, spinal fracture
__ results from rupture of IV disc/trauma to lower vertebrae
sx include __/__ pain, __ anesthesia, loss of __ reflex and ___ reflex w bowel/bldder problems
usually have lesion of S__/__
ganglioside
ganglioside
conus medullaris
L2
bladder, impotence
disc
CES
back/leg, saddle, anocutaneous/ankle
S2-4
__ concentration gradient reflects tissue solubility of anesthetic
if high, tissue solubility is __ meaning onset of action is __ and brain saturation is delayed\
lower periheral uptake/small AV gradient allows drug to __ in brain fast
AV
high, slow
equilibrate
__ nerve enters forearm anterior to lateral epicondyl
__ branch for sensory info, __ for motor info
as radial nerve passes in __ canal, deep branch allows for motor to __/__ extension
compression can occur w repetitive __/__ or dislocation of __
presents w dec finger/thumb __ finger drop
__ branches are preserved
damage at the __ of humerus causes loss of sensation as well as wrist drop
radial
superficial
deep
supinator
fnger/thumb
pronation/supination, radius
extension
sensory
midshaft
vomiting from chemo triggered by __ on dorsal surface of medulla near end of __ ventricle
region known as __, receives blood from __ and not BBB
CTZ
4th
area postrema
fenestrated vessels
__ is AR disorder w ataxia in early life
severe immunodeficiency w recurrent __ infections
hypersensitive to radiation due to lack of __ repair
Diabetic mononeuropathy most commonly affects CN __
acute onset __ w eye in __ position and ptosis
caused by __ damage
will have normal __/__ reflexes due to sparing of __ fibers
AT
sinopulm
DNA
3
diplopia, down/out
ischemic nerve
pupillary/accoodation, PNS
__ is necessary cofactor for T, S, D synthesis
used by tryptophan hydroxlase in breakdown of __
PKU usually due to PAH def, but can be due to BH4 def secondary to __ reductase def
results in __ accumulation and low levels of __
BH4, tyrosine, serotonin, DOPA
tryptophan
dihydropteridine
phenylalanin, serotonin
MS results in __ depletion and sparing of __
__ receptors are inotropic receptors that open w ligand binding
Ach receptors have 5 subunits and __ binding sites, opening when __ sites filled
activation causes __ release of Na/K/Ca
ohter receptors are __ w release of second messengers
oligodendrocyte, axons
nicotinic, 2
both
immediate
metabotropic
A1 receptors cause release of __ to inc IC Ca
B1/B2 receptors release __ and activate PKA
M1/M3 receptors use __ and PKC
M2 receptors use __ to dec cAMP conc
IP3
cAMP
IP3
cAMP
V/I/M/T along w odd chanin FA generate __
then converted to __
buildup results in __
pt presents w metabolic _ and K__
lethargy, hyptonia, vomiting
tx w low __
valine, isoleucine, methionine, threonine
propionic acid, methylmalonic acid
proprionic acidemia
acidosis, ketosis
protein diet
diabetic polyneuro occurs via nonenzymatic __ w thickness/hyalinization/narrowed arteries and eventially __ of arterioles
leads to _ nerve damage
can also have IC __ in PN
sorbitol/fructose accumulate leading to __ damage to axons/schwann cells
glycosylation
narrowed
ischemic
hypergly
osmotic
young onset dementia can be _ dementia w frontal/temporal lobe involvement
in NPH, look for __ enlargement OoP to __ enlargement
if pt survives SAH, many develop secondary __ 4-12 days later
pt will have c__ and focal neuro deficits
due to impaired __
will not be found on __ so use __
prevent w __ a CCB
frontotemporal
ventricular, sulci
arterial vasospasm
confusion
autoregulation
CT, doppler
nimodipine
__ is most severe comp of SAH
pt will develop sx of __ and will be seen on CT
migraine w out aura known as __
occipital morning HA seen w nonmalignant __
HA caused by tumor involves __
worse w ___
also see P/__ decline
Rebleed
SAH
common migraine
arterial HTN
entire head
recumbency
papilledema, cog
test attention/concentration via __ or reciting months __
__ memory tested via recalling words after 5 min
__ memory tested w prociding details of life events
test __ by having pt follow command
test __ fxn by having pt draw intersecting pentagons
counting down, backward
short term
long term
comprehension
visuospatial
congo red/apple green stain seen w __ such as __ in the brain
__ seen w AB around blood vessels
Pick disease aka __
silver stain shows round cytoplasmic inclusions w aggregates of __ known as Pick bodies
presence of glial scar and progressive dementia indicates __ dementia
amyloid, AD
amyloid angiopathy
FT dementia, tau protein
vascular
__ infection most likely in elderly w febrile illness, rash, encephalitis and flaccid paralysis
WNV is ss__+ F__
transmitted by female __ mosquito in summer
dx w CSF anti __ antibodies
WNV
RNA, flavivirus
Culex
WNV
following thrombosis/embols to brain, irreversible __ changes develop
__ enzymes released destroy tissue
forms a __ as astrocytes proliferate and form __
process known as __
ischemic
lysosomal
cystic cavity, glial scar
liquefactive necrosis
Warfarin can interract w __ a drug for anti-inflammation/depression
p450 inducing can dec warfarin levels, leading to inadequate __
p450 inducers C/B/P/R/G/S/C
p450 inhibs A/C/F/A/G/I/R/C
st johns wort
anticoag
carbamezipine, barbs, phenytoin, rifampin, griseofulvin, St john wort, cyclophos
amiodarone, cimetidine, fluoro, azole, GF J, isoniazid, ritonavir, clarithromycin
__ is AR condition w childhood ataxia, dec vibration/position sense, laterl CS involvement
number 1 cause of death is _
cardiac arrest leads to rapid cessation of __ w global __
__ is first area to be damaged, followed by __ of cerebellum
next most common areas are __ bw perfusion zones
Friedrich ataxia
cardiomyopathy
cerebral blood flow, ischemia
hippocampus
perkinje cells
watershed region
agitation, disorientation, pharyngospasm, photophobia, flu like sx all indicate __ as dx
may see D/H due to autonomic dysfxn
__ paralysis and coma follows
Rabies is a R__ ssRNA w bullet shaped capsule, studded w __ spikes
binds to __ Ach receptors, traveling retrograde via PN axons to __
rabies
dysphagia, hypersalivation
flaccid
rhbdoviridae, glycoprotein
nicotinic, CNS
__ targets integrins
_ virus targets CR2/CD21
__ targets CD4/CCr5/CXCR4
__ targets ICAM1 or CD54
CMV
EBV
HIV
Rhinovirus
