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STEP 1 RECALL > Neuro > Flashcards

Neuro Flashcards

1
Q

Anterior white commissures (what crosses here?)

A

Pain and temperature tracts (Commonly compressed in a syringomyelia — loss of pain and temp in upper extremities due to syrinx at C8-T1)

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2
Q

What do the lateral hypothalamic tracts contain?

A

Sympathetics to the face (lesion= Horner’s syndrome)

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3
Q

Signs of a LMN lesion?

A

Muscle weakness, atrophy, fasciculations, decrs tone & hyporeflexia

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4
Q

Signs of an UMN lesion?

A

Increased tone, hyperreflexia (spasticity),clonus, Babinski sign, posturing

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5
Q

Autosomal recessive, triplet repeats in the Frataxin gene Progressive damage to the nervous system Spinal nervous tissue degenerates over time causing ataxia, speech problems, muscle weakness, vision, hearing impairment Also assoc with development of diabetes and heart disease

A

Friedrich’s Ataxia

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6
Q

Secondary structures of proteins (alpha helices and beta sheets) are held in tact by what type of bond?

A

Hydrogen bonds

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7
Q

Melanocytes are derived from what?

A

Neural crest cells

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8
Q

a monocular scotoma is caused by a lesion ______

A

at the retina, optic disk or optic nerve (possible causes include Macular degeneration or optic neuritis)

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9
Q

Right anopia is caused by a lesion at the _____

A

right optic nerve (retinal artery or central vein occlusion)

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10
Q

Bitemporal hemianopia is caused by a lesion at the ______

A

Optic chiasm (pituitary tumor, craniopharyngioma or aneurysm of anterior communicating artery)

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11
Q

Right nasal hemianopia is caused by a lesion at the ________

A

right peri-chiasm (caused by a calcification or aneurysm of the internal carotid artery pressing on uncrossed lateral retinal fibers)

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12
Q

Left homonymous hemianopia (with a Marcu Gunn pupil) is caused by a lesion __________

A

Right optic tract or optic radiation (occlusion of anterior choroidal artery or MCA branch)

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13
Q

Left homonymous superior quadrantanopia is caused by __________

A

a lesion in the right temporal lobe (Meyer’s loop) – caused by a lesion / stroke in temporal lobe

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14
Q

Left homonymous inferior quadrantanopia is caused by __________

A

right parietal lobe lesion or stroke

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15
Q

left homonymous hemianopia w/ macular sparing caused by _________

A

right primary visual cortex (occipital lobe) – caused by a PCA occlusion, macula is spared b/c of collateral blood flow

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16
Q

What are the afferent & efferent nerves for the corneal reflex?

A

CN V (sensation of eye) , CN VII (reflex blink)

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17
Q

pt with hearing loss, tinnitus, asymmetric smile and loss of corneal reflex on same side—> a mass is most likely located ___________

A

at the cerebellopontine angle (the location of CN VIII…… CN V and VII are also nearby & could be affected)

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18
Q

Demyelination decreases the _________ constant

A

space (aka ‘length’) constant —> the distance along the axon the AP can propogate

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19
Q

Which muscle close the jaw?

A

masseter, medial pterygoid & temporalis muscles (supplied by the 3rd division of the Trigeminal n.–V3)

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20
Q

Which muscle opens the jaw?

A

Lateral pterygoid muscle (CN V3)

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21
Q

Which nerve roots produce ‘saddle anesthesia’ if pinched?

A

S3,4,5

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22
Q

low back pain radiating to legs, saddle anesthesia, loss of anocutaneous reflex, bowel & bladder dysfunction, loss of ankle jerk reflex and weak plantarflexion of the foot

A

Cauda equina syndrome (damage to the lumbar plexus nerve roots)

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23
Q

Man with short term memory loss, nystagmus, ophthalamoplegia & ataxia who’s breath smells like alcohol….. which of the structures is most likely damaged in this man’s brain?

A

B- the mammillary bodies –> he is experiencing Wernicke Encephalopathy and could progress to Korsakoff psychosis

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24
Q

CSF flows from the lateral ventricles to the 3rd ventricle via __________________ and then to the 4th ventricle via the _______________ and then out of the 4th and into the subarachnoid space through the __________ & __________

A

interventricular foramina of Monroe , cerebral aquaduct , lateral foramina of Luschka (2) or the medial foramin of Magendie

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25
Q

a condition that occurs in overweight young females and is related to decreased CSF outflow at the arachnoid villi & increased ICP causing headache/ vision changes

A

Psuedotumor cerebri

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26
Q

Increased CSF volume occuring when there is brain atrophy

A

Hydrocephalus ex vacuo

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27
Q

What is the structure with the black arrow? And what disease usually affects it?

A

the Putamen –> Wilson’s dz causes cystic degeneration of the putamen as well as other basal ganglia structures

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28
Q

Name structures A-E

A

A= Globus pallidus

B = Putamen

C= Internal Capsule

D = part of the Caudate

E= Amygdala

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29
Q

What supplies sensory innervation to the tongue?

A

Anterior 2/3 = mandibular div of trigeminal (V3)

Posterior 1/3 = CN IX

Tongue root = CN X

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30
Q

What supplies TASTE to the anterior 2/3 pf the tongue?

A

Corda tympani (from CN VII - facial nerve)

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31
Q

65 y.o. man with vision problems, exam shows small yellow lesions clustered around the macula and scotomas

A

Macular degeneration

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32
Q

Occlusion of the ACA (anterior cerebral artery) would lead to problems with what parts of the body?

A

legs

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33
Q

What arteries make up the circle of willis?

A
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34
Q

What feature of the capillaries in the brain prevents drugs from freely crossing the BBB?

A

Tight junctions btw the capillary endothelial cells

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35
Q

the CNS originates from _______________ & the PNS originates from _________________

A

CNS –> from neuroectoderm

PNS –> from Neural crest cells

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36
Q

What is the Nissl substance?

A

the RER in neurons

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37
Q

when an axon is injured and degenerates distally

A

Wallerian degeneration

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38
Q

Hypothalamus structures and functions

A

Supraoptic nucleus –> makes ADH

Paraventricular nucleus –> makes Oxytocin

Lateral hypothalamus –> hunger (Leptin inhibits)

Ventromedial hypothalamus –> satiety (Leptin increases)

Anterior hypothalamus –> cooling, parAsympathetic

Posterior hypothalamus –> heating, sympathetic

Suprechiasmiatic nucleus –> circadian rhythm (sleep)

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39
Q

Occlusion of which artery would cause Broca’s or Wernicke’s aphasia?

A

MCA (probably the LEFT MCA since most people are Left dominant)

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40
Q

Speech that is fluent and words that are well articulated but it is meaningless “word salad”, patient cannot understand you

A

Wernike’s aphasia

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41
Q

neuromuscular disease (ataxia, myopathy, decrs sensation) & hemolytic anemia indicate a deficiency of ___________

A

VITAMIN E

can happen in pts with Cystic Fibrosis due to malabsorption of fat soluble vitamins

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42
Q

a common feature of temporal arteritis (in > 50% of people with the dz)

A

Polymyalgia rheumatica (fever, neck, torso, pelvic & shoulder girdle pain and weight loss)

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43
Q

an old ischemic infarct of the brain will appear like a cystic space and will be lined by what kind of cells?

A

Astrocytes –> ischemic neurons undergo irreversible damage (become “red neurons”) and die, then macrophages move in and eventually the necrotic material is resorbed and a cystic cavity forms –> around the cavity Astrocytes proliferate (GLIOSIS)

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44
Q

What is usually the 1st symptom of alcohol withdrawal?

A

Tremulousness (“the shakes”)

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45
Q

a boy with significant kyphoscoliosis and high plantar arches, his brother had a neurologic disorder and dies of heart failure at a young age, what does the boy have?

A

Friedreich Ataxia

  • autosomal recessive, Frataxin gene mutation, trinucleotide repeat expansion
  • gait ataxia
  • dorsal column degeneration
  • kyphoscoliosis & foot abnormalities
  • Hypertrophic Cardiomyopathy
  • Diabetes (in 10%)
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46
Q

Most common complication of a subarachnoid hemorrhage (happens in > 50%)

A

secondary vasospasm around the ruptured aneurysm (leads to ischemia )

  • can prevent with Nimodipine
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47
Q

triad of tinnitus, vertigo and sensorineural hearing loss in the affected ear

A

Meniere’s disease

  • increased volume of endolymph in the inner ear
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48
Q

What is the most common site of a Subarachnoid hemorrhage (saccular berry aneurysm rupture)?

A

Circle of Willis – Anterior Communicating Artery

  • associted with ADPKD and Ehlers Danlos
  • artery doesn’t develop a media layer –> is weakend
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49
Q

man with lung cancer develops weakness getting up from a chair and fixing his hair–> he most likley has antibodies to __________________ __________

A

presynaptic calcium channels

  • ha has Lambert Eaton syndrome (like Myastenia gravis but assoc with cancer and gets better with activity)
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50
Q

what patients have a increased chance of developing Alzheimer’s by age 40?

A

Down Syndrome patients

  • gene for APP is on chromosome 21
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51
Q

Histologic & Gross findings in Alzheimer’s dz

A
  • extracellular senile plaques of **AB Amyloid **
  • intracellular neurofibrillary tangles of phosphorylated tau protein
  • grossly –> widespread cortical atrophy , narrow gyri & wide sulci, dilation of the ventricles (hydorcephalus ex vacuo)
  • decreased Ach levels in the hippocampus & nucleua basalis (b/c choline acetyltransferase decreased)
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52
Q
  • slow- onset dementia
  • no focal neurologic deficits
  • APOE 4 allele is assoc with incrs risk
  • AB amyloid plaques and tau tangles
A

Alzheimers dz

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53
Q

2nd most common cause of dementia

A

Vascular dementia

  • due to HTN, atherosclerosis, vasculitis
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54
Q
  • degeneration of the frontal and temporal cortex
  • round aggregates of TAU protein (Pick bodies) in the neurons
  • behavior and language changes early on
A

Pick disease (frontotemporal dementia)

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55
Q
  • loss of dopaminergic neurons in the substantia nigra pars compacta
  • loss of dopamine –> can’t initiate movement –> shuffling gait, frozen face, tremor, bradykinesia
A

Parkinson’s disease

  • Tremor at rest
  • Rigidity
  • Akinesia/ bradykinesia
  • Postural instability / shuffling gait

–the dementia should set in LATE in the dz ((if early on –> it’s Lewy Body dementia)

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56
Q

Histologic findings of Parkinson’s

A
  • round, eosinophilis inclusions (“Lewy bodies”) in the affected neurons
  • made of alpha- synuclein
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57
Q
  • loss of GABA neurons in the caudate nucleus
  • autosomal dominant , trinucleotide repeats of _______?
  • further expansion of repeats during _______leads to Anticipation
A
  • Huntington’s dz
  • CAG repeats
  • further expansion during spermatogenesis causes anticipation
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58
Q
  • urinary incontinence, gait instability, dementia
  • increased CSF causes dilated ventricles and streches the corona radiata causing the symptoms
A

“wet, wobbly, & wacky”

  • Normal Pressure Hydrocephalus
  • LP can relieve symptoms
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59
Q
  • PrPc (alpha helix) is converted to PrPsc (Beta sheet)
  • becomes resistant to proteases
  • rapidly progressive dementia , ataxia, startle myoclonus
A

Spongiform encephalopathy (ie: Creutzfeldt Jakob)

  • prion disease
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60
Q

what are the 3 most common sources of brain metastases?

A

1- Lung

2- Breast

3- Kidney

–mets are usually multiple and at the gray/white junction **

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61
Q

primary brain tumors are usually SUPRAtentorial in __________ and INFRAtentorial in _________

A

Adults , kids

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62
Q

most common malig brain tumor in adults

A

Glioblastoma Multiforme

  • crosses the corpus callosum (‘butterfly pattern”)
  • GFAP +
  • poor prognosis
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63
Q

most common BENIGN CNS tumor of adults

A

Meningioma

  • more in females
  • tumor of the arachnoid cells
  • psammona bodies may be present
64
Q

benign tumor at the cerebellopontine angle that presents w/ hearing loss, tinnitus, tumor cells will be S-100 +

A

Schwannoma

((if bilateral –> think NF-2))

65
Q
  • malignant tumor , presents w/ seizures
  • calcified tumor in white matter of frontal lobe
  • fried egg appearace
A

Oligodendroglioma

66
Q

most common BENIGN CNS tumor in kids

A

Pilocytic Astrocytoma

  • usually in cerebellum
  • cystic lesion w/ nodular mass
  • Rosenthal fibers
  • GFAP +
67
Q
  • malignant CNS tumor in children
  • derived from neuroectoderm
  • small, round blue cells & Homer-Wright rosetts
  • always in cerebellum
A

Medulloblastoma

68
Q

incomplete closure of the neural tube at week ______ will result in neural tube defects

A

week 4

69
Q

increased ________________ in maternal bld and amniotic fluid indicates a neural tube defect

A

AFP (alpha fetoprotein)

70
Q

most common cause of hydorcephalus in newborns

A

Congenital aqueduct stenosis

71
Q

What is shown in the photo?

A

Dandy-Walker Malformation

  • failure of cerebellar vermis to develop
  • huge, dilated 4th ventricle and no cerebellum
72
Q

cystic degeneration at C8-T1

  • loss of P&T in upper extremeties , spares dorsal columns
  • due to involvement of ant white commisures & spinothalamic tract
A

Syringomyelia

73
Q

congental herniation of the cerebellar tonsils thru the formamen magnum

A

Arnold- Chiari Malformation Type 2

74
Q
  • viral destruction of the anterior motor horns
  • fecal-oral spread
  • LMN signs
A

POLIO

75
Q

autosomal recessive degeneration of the anterior motor horns

  • “floppy baby” at birth
A

Werdnig -Hoffman

76
Q

atrophy and weakness of the hands is an early sign of __________

A

ALS

  • will get both UMN & LMN signs eventually
77
Q
  • tract that carries Pain & Temp from the body
  • cell body in DRG –> immed crosses in Ant white commisure –> ascends to thalamus
A

Spinothalamic tract

78
Q

tract that carries fine touch, vibration, pressure, & proprioception

  • cell body in DRG –> crosses in medulla , ascends via medial lemniscus to thalamus
A

Dorsal Columns

79
Q

tract that carries voluntary movement from cortex to body

  • pryamidal neurons in cortex descend, cross over in medullary pyramids –> synapse on anterior motor horn cells (UMN) –> then travels to LMN on muscle cells
A

Lateral Corticospinal tract (Pryamidal)

80
Q

inflammation of the leptomeninges (pia & arachnoid) , can be due to bacterial, viral or fungal infection

A

Meningitis

  • most common causes in neonates: Listeria, E.coli & GBS (“LEG”)
81
Q

do diagnose Meningitis, do an LP by placing the needle between ____ & ____

A

L4 & L5 (level of the Iliac crests)

-spinal cord ends at L2 in adults

82
Q

viral meningitis in children

A

coxsackievirus

  • fecal-oral
  • CSF will have lymphocytes with normal glucose
83
Q

CSF findings inbacterial meningitis

A

neutrophils w/ decreased glucose

84
Q

CSF findings in Fungal meningitis

A

lymphocytes and decreased glucose

85
Q

most strokes are ____________________

A

**ischemic (85%) –> ischemia that lasts longer than 24 hours is a stroke **

can be caused by:

  • Thrombus — pale infarct
  • Emboli – hemorrhagic infarct
  • Lacunar strokes – 2nd to hyaline arteriolosclerosis
86
Q

ischemic stroke results in ___________ necrosis

A

liquefactive necrosis

87
Q

the earliest change after an ischemic stroke is the presence of ______________

A

RED NEURONS (12 hrs after infarct)

88
Q

rupture of a Charcot- Bouchard microaneurysm will cause a ____________________ hemorrhage

A

Intracerebral hemorrhage –> bleeding into the parenchyma

  • these are a result of HTN
  • lenticulostriate arteries in the basal ganglia are the most common sites
89
Q

LP shows xanthochromia

A

Subararchnoid hemorrhage

  • yellow due to the breakdown of bilirubin
90
Q

blood btw dura and skull, lens shaped clot, lucid interval then LOC

A

EPIDURAL HEMATOMA

-due to rupture of the Middle meningeal artery

91
Q

blood btw dura & arachnoid , due to tearing of bridging veins, crescent shaped lesion on CT

A

SUBDURAL HEMATOMA

92
Q

uncal herniation (displacemnet of the temporal lobe uncus under the tentorium cerebelli) causes compression of CN ______

A

CN III

  • eye moves down & out
  • dilated pupil
93
Q

Name the types of herniations

A

1= Uncal herniation

2= Central (transtentorial)

3= Cingulate (subfalcine)

4= Transcalvarial

5= Upward (upward cerebellar or upward transtentorial)

6= Tonsillar (downward cerebellar)

94
Q

galactocerebroside accumulates in macrophages in this autosomal recessive dz

A

Krabbe’s dz

  • deficicency of galactocerebroside beta-galactosidase
95
Q

impaired addition of Coenzyme A to long chain FA’s

A

Adrenoleukodystrophy

96
Q

Diagnosis of MS is made by:

A
  • LP and a T2 weighted MRI
  • LP will show lymphocytes, immunoglobulins w/ **oligoclonal IgG bands **
97
Q

Subacute sclerosing panencephalitis is due to persistant _________ infection

A

MEASLES

98
Q

Central pontine myelinolysis is due to

A

rapid IV correction of hyponatremia

  • clinically presents as “locked in syndrome”
  • focal demyelination of the pons
99
Q

an ACA infarct will affect what part of the body? and an MCA occlusion will affect what parts?

A

ACA — legs

MCA – upper extremeties, face (including Broca’s and Wernicke’s areas)

100
Q

spatial neglect syndrome (agnosia of the entire left side)

A

lesion of the right parietal lobe

101
Q

affects 1 area of brain, preceded by aura, can be simple or complex

A

Partial seizures

  • Simple Partial = no LOC
  • Complex Partial = impaired consciousness
102
Q

nucleus of the thalamus that gets sensory from the body

A

VPL

103
Q

nucleus of the thalamus that gets sensory from the face

A

VPM

104
Q

Lateral geniculate nucleus gets input from CN _____ to relay ______

A

CN II to relay vision input

105
Q

Medial geniculate nucleus gathers input from olives & inferior colliculus to relay _______ info

A

hearing

106
Q

lesion at the cerebellar vermis causes ______

A

truncal ataxia & dysarthria

107
Q

damage to PPRF causes________

damage to frontal eye fields causes __________

A

PPRF —- eyes look away from lesion side

FEF — eyes to toward lesion side

108
Q

PICA infarct causes …..

A

**Lateral Medullary (Wallenberg) syndrome **

  • vertigo, nystagmus, voimiting
  • decrs P&T to limbs and face
  • dysphagia, hoarseness
  • IPSI Horner’s syndrome
  • Ataxia
109
Q

PCA infarct at the occipital lobe causes _______

A

contralateral hemianopsia w/ macular sparing

110
Q

Hemisection of the spinal cord (ie: after getting stabbed in the back) will cause __________

A

Brown -Sequard Syndrome

  • IPSI UMN signs below the lesion
  • IPSI loss of fine touch, vib, prop.. below lesion
  • CONTRA P&T loss below lesion
  • IPSI loss of ALL sensation at the level of the lesion
  • LMN signs at the level of lesion

** and if above T1 – will also have Horner’s syndrome

111
Q

CN V exits the skul via what foramen??

A

V1 -Superior Orbital Fissure

V2- Rotundum

V3- Ovale

“Standing Room Only”

112
Q

abnormal Rinne (BC >AC) and Weber localizes to affected ear

A

Conductive hearing loss

113
Q

Sensorineural hearing loss

A

normal Rinne test and Weber localizes to the normal ear

114
Q

feared side effect of Buproprion (antidepressant and smoking cessation drug)

A

Seizures! (esp in pt’s with bulimia)

115
Q

woman with bipolar and new onset seizures, what drug can help both of her conditions?

A

**Valproic acid **

  • anticonvulsant and a mood stabilizer
  • increases GABA in the CNS
  • Carbamazepine is also both a mood stabilizer and an anticonvulsant **
116
Q

mechanism of Dantrolene

A

blocks Ryanodine receptors and prevents Ca+ release into the cyoplasm of skeletal muscle

117
Q

man working in his yard suddenly develops flushed skin, dry mouth, dilated pupils–> what did he get in to and what can reverse it?

A

Jimson weed poisoning (“gardener’s mydriasis”) –belladonna alkaloid that produces strong anticholinergic symptoms

  • similar to Atropine overdose (hot as a hare, dry as a bone, mad as a hatter…)
    • antagonize by increasing Ach in the synaptic cleft (ex: Physostigmine) *
118
Q

man with long standing diabetes who has recent diplopia, right eye is fixed down and out but PERRLA—> what happened to the nerve?

A

Diabetic neuropathy causes ISCHEMIC CN III Neuropathy…

  • the somatic motor function is lost but the parasympathetics are fine b/c they have different blood supply
  • **if the nerve was being compressed, however, the eye would be ‘down & out’ and the pupils would not be reacting to light
119
Q

Pramipexole, Ropinerole, Bromocriptine & Pergolide are all ___________

A

**Dopamine agonists **

-treat Parkinson’s

((Bromocriptine also treats Prolactinomas ))

  • Pramipexole & Ropinerole are non-ergot cmpds
  • Bromocriptine & Pergolide are ergot cmpds
120
Q

Which part of Wernicke-Korsakoff is permanent?

A

memory loss and confabulation (Korsakoff’s psychosis)

121
Q

What are the treatment options for Alzheimer’s?

A

1- Cholinesterase inhibitors

2- Antioxidants (vit E)

3- NMDA receptor antagonists (memantine)

122
Q

endoneural inflammatory infiltrate after a viral illness

A

Guillain - Barre

  • ascending weakness / paraysis
  • after vaccination, allergic rxn or illness (campylobacter infection)
123
Q

What is 1st line treatment for Glaucoma?

A

Prostaglandins (ie: Latanoprost)

  • incrs the outflow of aq. humor
  • cause iris to become brown

(Other treatments include Epinephrine, TImolol, Acetazolamide – to decrs the production of aq humor – and cholinomimetics like pilocarpine to incrs the outflow)

124
Q

Morphine, Fentanyl, Heroin, Codeine are all ________

A

Opioids – most act at the opiod mu receptor (G-protein receptor)

  • decrease synaptic transmission (open K+, close Ca+ channels)
  • Toxicity = pinpoint pupils, resp depression*, constipation – treat overdose with NALOXONE!!

*note: Tramadol is also an opioid agonist (weakly) and also incrs NE & serotonin – treats Pain

125
Q

1st line for Tonic Clonic seizures (grand mal)

A

Phenytoin, Carbamazepine or Valproic acid

  • all increase Na+ channel INACTIVAION
  • Valproic acid also increases GABA
126
Q

1st line therapy for a Simple Partial seizure

A

**carbamazepine **

  • incrs Na+ channel INACTIVATION
  • also 1st line for Trigeminal neuralgia
127
Q

1st line therapy for a Partial Complex seizure

A

Carbamazepine

128
Q

What is the mechanism of the drug used to treat Absence seizures?

A

Ethosuxamide – blocks thalamic Ca+ channels

129
Q

What drug is used to PREVENT status epilepticus and what drug is used in the acute setting??

A

Prophylaxis –> Phenytoin (Na+ channel INactivation)

Acute treatment –> Diazepam or Lorazepam (incrs GABA)

130
Q

1st line therapy for pregnant women & children with seizures

A

Phenobarbital (incrs GABA)

131
Q

Most serious side effects of anti-epileptic drugs

A

-Fulminant hepatitis

**- Bone marrow suppression **

some others:

Carbamazepine –> agranulocytosis, anemia, SJS, teratogen…

Phenytoin –> gingival hyperplasia, Lupus like syndrome, teratogen

Valproic acid –> liver toxicity , teratogen

132
Q

Treat overdoses of ________ with Flumazenil

A

Benzodiazepines (generally end in “-lam , -pam”..)

-benzo’s increase GABA by increasing the frequency of Cl- channel opening

(as opposed to Barbs which incrs GABA by increasing the duration of Cl- channel opening)

133
Q

which cause LESS respiratory depression, barbiturates or benzodiazepines?

A

Benzodiazepines

134
Q

a General anesthetic is faster acting if it is _________

A
  • low solubility in blood (gets ‘pushed’ into tissues) = fast induction
  • low Minimun alveolar concentration (MAC)
  • high lipid solubility (high potency)
135
Q

barbiturates (like Thiopental) have short acting times as IV anesthetics b/c they rapidly shift from the brain to ___________

A

skeletal muscle & fat

136
Q

Why do you need to use more local anesthetic in infected tissue compared to healthy tissue??

A

infected tissue is acidic –> alkaline anesthetics are charged and cannot penetrate easily

137
Q

What is the order that the local anesthetics (lidocaine, procaine, cocaine…) affect nerve fibers (from 1st to last)?

A

Small myelinated fibers (beta) > small (a delta) unmyelinated > large myelinated > large unmyelinated

138
Q

Depolarizing neuromuscular blocker – can cause hypercalcemia & -kalemia and malignant hyperthermia

A

SUCCINYLCHOLINE

(the curare derivatives are non-depolarizing and can be reversed with AchE inhibitors)

139
Q

fairly new anticonvulsants that are used for treating refractory partial seizures (not responding to other meds)

A
  • Lamotrigine
  • Tiagabine
  • Topiramate
  • Vigabatrin
  • Gabapentin

**BEWARE OF SKIN RASH

140
Q

1st line treatment for symptoms of alcohol withdrawal?

A

Benzodiazepines

-Long acting Diazepam or Chlordiazepoxide are the first line

141
Q

Medications used to abort a migraine headache have what effect at receptors?

A

**stimulate the post-synaptic Serotonin receptor **

-Triptans are serotoin 5HT 1B /1D agonists that inhbit the release of vasoactive peptides (like substance P), promote vasoconstriction, & block pain pathways

142
Q

antidepressant that does NOT have sexual side effects

A

**Bupropion **

  • good antidepressant, no sexual effects
  • also helps treat nicotine dependence
143
Q

Common drugs that can cause Serotonin Syndrome (clonus, rigidity, hyperthermia, tachycardia, tremor, sweating, agitation, mydriasis, diarrhea…)

A
  • SSRI’s, SNRI’s, MAOIs, TCA’s
  • Tramadol
  • Ondansetron
  • Linezolid (an ABX)
  • Triptans
144
Q

TCA overdose cause of death

A
  • arrythmias, refractory hypotension
  • inhibition of the fast Na+ channels in the heart is to blame
145
Q

What is the antidote / treatment for Serotinin Syndrome?

A

Cyproheptadine

  • antihistamine w/ anti-serotonin properties
146
Q

Main side effects of Scopolamine (antimuscarinic drug for motion sickness)

A

Antimuscarinic – so you will have signs of decrs Ach/ parasympathetic activity

- blurry vision

**-dry mouth **

- palpitations

**-urinary retention & constipation **

147
Q

P450 INDUCERS

A
  • Barbiturates
  • St John’s Wart
  • Phenytoin
  • Rifampin
  • Griseofulvin
  • Carbamazepine
  • Chronic alcohol use

“Barb Steals Phen-phen and Refuses Greasy CArbs CHronically”

148
Q

Almost all volitile (inhaled) anesthetics increase blood flow to the __________

A

brain

  • this is NOT a good thing though b/c it increases ICP
  • inhalation anesthetics also decrs resp rate and cardiac rate & decrs GFR
149
Q

Side effects of PHENYTOIN

A
  • gingival hyperplasia
  • generalized lymphadenopathy (“pseudolymphoma”)
  • hisutism & coarsening of the facial features, acne
150
Q

Which antidepressants are most likley to cause urinary retention and other antimuscarinic SE’s?

A

TCA’s

  • they act at several different receptors and have many side effects
151
Q

Preferred treatment for people with combined Absence and Tonic-Clonic seizures

A

Valproic acid (Valproate)

152
Q

Pt on an antidepressant, ate at an Italian restaurant and developed severe HTN, tachycardia…

A

Hypertensive crisis

-man was on MAOI and ate tyramine containing foods (wine, cheese…)

153
Q

Thiopental (and other barbiturates) has a short period of action b/c it ___

A

rapidly redistributes from the brain to muscle and fat

154
Q

Male with ADPKD has severe headache –> admitted to hospital –> several days later he complains of right sided weakness…. what drug could have been used to prevent the sequalae that occurred?

A

This pt had a Subarachnoid bleed (predisposed to berry aneurysm’s due to ADPKD)

  • he then had a secondary VASOSPASM which could have been prevented with a Calcium channel blocker (Nimodipiine**)
155
Q

Used as chemoprophylaxis for all contacts of a person sick with bacterial meningitis

A

RIFAMPIN

  • must be given to all close contacts within 2 weeks
156
Q
A

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