neuro Flashcards

1
Q

Spinal shock may result in bladder distension and acute urinary retention (AUR) if the injury occurs above the lumbosacral plexus. Management of spinal cord injuries in an emergency setting involves obtaining vital signs, airway stabilization, immobilization of the neck and body, a thorough neurological examination, and insertion of a urinary catheter. This patient has no bulbocavernosus reflex, which indicates that he will develop AUR unless catheterized. Therefore, the most appropriate next step would be to place a Foley catheter. Resolution of spinal shock, and return of the reflex usually occurs within 2–3 days of the injury. Persistence of the loss of the bulbocavernosus reflex would suggest a conus medullaris injury.

A

This patient has signs and symptoms of spinal shock, including flaccid, areflexic paralysis, hypotension, bradycardia, and no bulbocavernosus reflex.

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2
Q

one year child devp

A

By the end of one year, most children can stand without support, walk with support, know 1–3 words, and follow one-step commands with gestures. This child only has the gross motor development and speech development of a 6-month-old (sitting without support, monosyllabic speech). The fine motor development (pincer grip) and social development (e.g., willingness to engage in play by giving objects, separation anxiety) are appropriate for a 1-year-old child. The ability to feed onself with a spoon is only expected by the age of 15 months.

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3
Q

drugs that trigger porphyria

A

Barbiturates (like primidone) trigger acute intermittent porphyria by inducing synthesis of cytochrome P-450 enzymes that contain heme components, thereby reducing heme levels and leading to stimulation of δ-aminolevulinate synthase, which is part of the heme synthesis pathway. δ-aminolevulinate synthase stimulation leads to increased levels and accumulation of δ-aminolevulinate and porphobilinogen, causing the characteristic symptoms (e.g., abdominal pain, peripheral neuropathy, confusion, and elevated levels of aminolevulinic acid and porphobilinogen) seen in this patient.

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4
Q

paget disease activates

A

Paget disease of the bone is caused by RANKL-RANK receptor activation, which triggers downstream NF-κB signaling and increases osteoclast activity.

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5
Q

brain tumor neuronal origin stains for

A

synaptophysin
synaptophysin include neurocytomas, medulloblastomas, small cell carcinomas of the lung, and carcinoid tumors. Neurons also stain positive for neurofilaments, which are part of the neuronal cytoskeleton.

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6
Q

txt for organophosphate poisoning

A

Following atropine administration, an oxime (e.g., pralidoxime) and a benzodiazepine should be administered. In addition, decontamination of the patient (e.g., remove clothes, wash skin) is important to prevent absorption of the offending agent through the skin.

pralidoxine — acholinesterase reactivator

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7
Q

how can alcoholism cause hypocalcemia

A

Magnesium is necessary for proper calcium absorption and balance; hypomagnesemia is associated with PTH resistance and reduced secretion of PTH. Chronic excessive alcohol intake causes hypocalcemia by two main mechanisms: vitamin D deficiency from malnutrition and alcohol-induced increase in urinary excretion of magnesium. Although this patient should also receive calcium replacement, hypocalcemia with hypomagnesemia will not improve until the magnesium level is corrected.

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8
Q

Decreased pinch strength and sensory deficits over the little finger and palmar surfaces of the medial aspect of the right hand are suggestive of ulnar nerve entrapment at the level of the wrist.

A

fracture of hook hamate

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9
Q

This man has a pelvic ring fracture with decreased sensation over the right medial thigh. This is consistent with an obturator nerve injury.

A

adduction of hi[

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10
Q

absent cremasteric reflex

A

genitofemoral nerve

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11
Q

A spinal disc herniation is caused by prolapse of the nucleus pulposus which develops from a different embryologic layer. derived from

A

notochord

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12
Q

caudal regressions yndrome

missing lumbo sacral area

A

diabetic mother

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13
Q

phenytpin teratogeninc

A

neural tube defects

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14
Q

neurons with eosinophilic cytoplasm and pyknotic nuclei.

A

12-24 hrs after ischemoa

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15
Q

Neutrophilic infiltration with central necrosis is seen on histopathologic examination of brain

A

1-3 days

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16
Q

Infiltration of macrophages (microglia) with local tissue destruction is seen on histopathologic examination of brain

A

3-5 days

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17
Q

n chromosome 9, which encodes an iron-binding mitochondrial protein

A

fraxatin

friedrich ataxia

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18
Q

upper eyelid droop

A

occulomotor injury
diabetic patient
microischemia

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19
Q

A child presenting a triad of preceding viral illness, hepatomegaly, and acute encephalopathy (vomiting due to elevated ICP, lethargy, and confusion) can be diagnosed with Reye’s syndrome caused by

A

aspirin

low does decreases uric acid excretion

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20
Q

ndicated for the prevention of seizure recurrence in status epilepticus and for short-term (< 5 days) treatment of epilepsy.

A

phenytoin

increases sodium efflux

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21
Q

status epilipticus

A

lorazepam to abort seizure

then phytoin for ecurrence

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22
Q

including diplopia, hepatotoxicity, and hyponatremia (probably due to associated SIADH), all of which are seen in this patient. Other possible side effects include Stevens-Johnson syndrome, ataxia, CYP-450 induction, and blood count abnormalities (agranulocytosis, aplastic anemia).

A

carbamezapine

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23
Q

An abnormal breathing pattern characterized by crescendo-decrescendo pattern of tidal volumes followed by a period of apnea.

A

cheyene stokes
galop rhhytm
heart failure

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24
Q

partial vs complete central DI

A

In partial central DI, urine osmolality increases by approximately 10%, while in complete central DI, urine osmolality increases by over 50%. This patient’s urine osmolality increased from 310 to 355 mOsm/kg H2O, an approximate 15% increase, which is sufficient to diagnose partial central DI.

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25
Q

PSAMMOMA

A

papillary carcinoma of thyroid, mesothelioma, and serous papillary cystadenocarcinoma of ovary and endometrium.

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26
Q

origin of meningioma

A

arachnoid cells

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27
Q

origin of hemangiobblastoma

A

blood vessels

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28
Q

he inhibition of arabinosyltransferase, which subsequently inhibits the synthesis of arabinogalactan,

A

for CELLWALLLLLLL

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29
Q

A similar pattern of spinal cord degeneration is seen in subacute combined degeneration due to vitamin B12 deficiency. and ??

A

in CTG
chr 9
fraxitin gene
freidrich ataxia

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30
Q

Charcot-Bouchard aneurysms (microaneurysms of the lenticulostriate arteries) suggest chronic hypertension. The finding of bilateral zona glomerulosa hyperplasia indicates that primary hyperaldosteronism (i.e., Conn syndrome) is the underlying cause of this patient’s chronic hypertension.
what other sympptoms can this pt have

A

primary hyperald
muscle weakness — hypokalemia

rmmber no edema dua to aldosterone escape by ANP BNP —–natriuresis

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31
Q

csf changes in guillane bare

A

increase in protein but not similar increase in WBC

due to disruption of blood brain barrier

cross-reactive antibodies against gangliosides (e.g., anti‑GM1 antibodies) or other unknown antigens of peripheral Schwann cells, which leads to segmental demyelination and axonal degeneration.

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32
Q

eyelid closure nerve

A

CN 7

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33
Q

eyelid openin

A

CNIII

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34
Q

combination of Potter sequence and hepatic involvement suggests a different renal pathology.

A

cystic dialltation of collecting duc t

seenin APKD on chr 6

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35
Q

cataplexy in narcolepsy treatmen

A

sodium oxybate

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36
Q

Lipohyalinotic thickening of penetrating cerebral vessels

A

pure motor lacunar infarct

post limb of internal capsuel

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37
Q

narcolepsy diagnosis

A

rapid onset betawaves

normally only seen in REM and wakeful stte

38
Q

post herpatic neuralgia

pt has urinary retention and constipation

A

TCA
desipramine
amytriptaline
gabapentine

39
Q

Enthesitis causes tenderness at the insertion of the Achilles tendon, another common manifestation of

A

reactive arthritsi

40
Q

reactive arthritsi

A

This patient’s urethritis (dysuria), asymmetric oligoarticular arthritis, and conjunctivitis comprise the classic triad of reactive arthritis, a condition commonly triggered by diarrheal illness.

41
Q

reactive arthritsi

A

This patient’s urethritis (dysuria), asymmetric oligoarticular arthritis, and conjunctivitis comprise the classic triad of reactive arthritis, a condition commonly triggered by diarrheal illness.

42
Q

Histology shows densely packed, thin-walled capillary vessels surrounded by large stromal cells with intracytoplasmic lipid inclusions

A

hemangio

VHL

43
Q

DRESS syndromw

A

Increased absolute eosinophil count is seen in DRESS (drug rash with eosinophilia and systemic symptoms) syndrome, which is a potentially fatal drug-induced hypersensitivity reaction that can occur 1–8 weeks after exposure to a substance such as an antiepileptic drug (e.g., lamotrigine, phenytoin, carbamazepine), allopurinol, or antibiotics (e.g., sulfonamide). As seen in this patient, DRESS is characterized by systemic inflammation with typical involvement of the skin (e,g., itching rash and facial edema), liver (e.g., elevated liver function tests, hepatomegaly), lymphoid tissue (e.g., diffuse lymphadenopathy), and blood (e.g., thrombocytopenia, atypical lymphocytosis, eosinophilia).

44
Q

Fever, facial edema, a diffuse morbilliform rash, lymphadenopathy, and hepatomegaly within some weeks after initiating treatment with an anticonvulsant agent are suggestive of

A

DRESS

45
Q

n open cranial vault and absence of the forebrain

A

anencephaly

increase alpha fetoprtein and acetylcholinastraes

46
Q

superior division MCA

inf division MCA

A

sup — frontal

inf—- temporal

47
Q

natalizumab

A

Natalizumab is a recombinant monoclonal antibody that targets integrin alpha-4 surface subunitsa

48
Q

adrenal leukodystrphy

A

Rapidly deteriorating vision, hearing, motor abilities, and cognition in the presence of spasticity, sensory loss, and adrenal insufficiency (suggested by hyperpigmented skin) in a young boy are characteristic of adrenoleukodystrophy. A family history of what was likely the same condition in a maternal relative supports the diagnosis of this X-linked recessive condition.

49
Q

This patient has had a massive ischemic stroke. The GFAP-positive cells described here are most likely astrocytes, which are derived from the neuroectoderm.

A

reactive gliosis

10 days

50
Q

Multiple episodes of unresponsiveness lasting less than a minute with eyelid fluttering and concomitant early morning tonic-clonic seizures is suggestive of juvenile absence epilepsy. The first-line medication for long-term management is an antiepileptic drug that can also be used as a mood stabilizer in bipolar disorder.

A

valproate

51
Q

the eggs of Taenia solium

A

neurocystecercosis

52
Q

The patient’s acute, painless, unilateral loss of central vision (central scotoma), together with his history of gradual loss of central vision and fundoscopic findings of a subretinal hemorrhage and grayish-green retinal discoloration, are characteristic of wet age-related macular degeneration.

A

ranibizumab

anti vegf

53
Q

anticodies in GRAVES

A

Graves disease is caused by thyrotropin-receptor autoantibodies (TRAbs) that activate the TSH receptor. TRAbs induce hyperthyroidism by stimulating follicular epithelial cells to produce abnormally high amounts of triiodothyronine (T3) and thyroxine (T4). As seen

54
Q

triad of vertigo, tinnitus, and sensorineural hearing loss (normal Rinne test, lateralization to the unaffected side) is characteristic of Ménière disease.

A

Endolymphatic hydrops, which results in accumulation of endolymph within the membranous labyrinth, is the underlying mechanism of Ménière disease.

55
Q

njured during radical prostatectomy.

A

cavernous nerve

EDysf

56
Q

an antidepressant that also stimulates appetite

A

mitarzipine

a2 antag

57
Q

antiparkinson drug wth SE livedo reticularis
ortho hypoT
edema
ataxia

A

amantadine

increases dopamine release

58
Q

Blood in the sphenoid sinus and a transverse fracture on imaging are indicative of an anterior fracture of the middle cranial fossa. Anterior middle cranial fossa fractures may involve the orbital apex, superior orbital fissure, and clinoid processes.

A

inward dev of eye

sphenoid blood collection anterior cranial fossa fracture

59
Q

carbidopa avoids the side effects like

A

ortho hypotension

60
Q

vit E anemia

A

hemolytic

dec haptoglobin

61
Q

age 2 what can a baby do

A

By the age of 2 years, most children can run and can walk up and down stairs (gross motor). They can copy a line but would not be expected to draw a circle or a plus sign (fine motor). They know at least 6 words and can speak in 2-word sentences (language). In their interactions with others, they exhibit selfish behavior and they would not be expected to dress themselves yet (social). This child’s gross motor skills and language are therefore delayed. Her fine motor skills and social development are normal, though

62
Q

meningomyelocele or other neural tube defects are linkd to wch type of chiari

A

CHIARI 2

63
Q

The patient’s findings of enophthalmos (posteriorly displaced eye) and infraorbital rim tenderness are suggestive of an orbital floor fracture (orbital blowout fracture). The mechanism of this injury can lead to downward displacement of orbital fat and inferior rectus muscle entrapment, which in turn can cause impaired upward gaze

A

clouding of max sinus

64
Q

The patient’s findings of enophthalmos (posteriorly displaced eye) and infraorbital rim tenderness are suggestive of an orbital floor fracture (orbital blowout fracture). The mechanism of this injury can lead to downward displacement of orbital fat and inferior rectus muscle entrapment, which in turn can cause impaired upward gaze

A

clouding of max sinus

65
Q

virulence factor of n.meningitidis that is the first step in fectin

A

fimbrae

capsule – protects fromy protecting it from antibody-/complement-mediated killing and inhibiting phagocytosis

66
Q

Chocolate agar is sheep blood that is slowly heated until red blood cells lyse and release factors V (NAD) and X (hematin).

A

hem influenza

67
Q

episode of cough when otuching inner ear

A

cranial nerve X vagus

68
Q

vagus damage can present as

A

ipsilateral vocal cord palsy

contralateral uvula deviation

69
Q

schwan cells

A

S100

neural crest cells

70
Q

Hypercellular areas of spindle cells and hypocellular areas of myxoid stroma are characteristic findings of

A

schwanoma

71
Q

Whorls of densely packed cells with areas of lamellated calcification

A

meningioma

72
Q

Small blue cells arranged in rosettes around a central neuropil, known as Homer-Wright rosettes,

A

medulloblastoma

73
Q

oy has a history consistent with fat-malabsorption (persistent diarrhea that improved on a low-fat diet), vitamin E deficiency (muscular weakness and myopathy, spinocerebellar dysfunction), vitamin A deficiency (night blindness), and failure to thrive. Acanthocytes in the blood smear and extremely low cholesterol levels strongly suggest

A

abetalipoproteinemia

74
Q

headache, abdominal pain, altered mental status, tachycardia, shortness of breath, bright red skin tone, and breath smelling of bitter almonds with a normal pulse oximetry is most likely caused by

A

cyanide poisoning

75
Q

atropine only reverse muscarinic effects what else must be added for nicotinic

A

pralidoxine

76
Q

Drooping of the ipsilateral eyelid

A

CN III palsy

77
Q

nic agonist commonly given for postoperative or postpartum urinary retention.

A

bethanechol

78
Q

entacapone

A

peripheral

COMT inhibitors

79
Q

treatment for CMV retinits

A

gancyclovir

80
Q

responds to high frequency sounds in ear

A

base cochlea

81
Q

cranial nerve 3 damage para vs symp

A

symp — middle of nerve– in diabetes — doqn and out gaze… motor output problem

para— pcom aneurysm/ uncal herniation…. doqn and out gaze

82
Q

external branch of sup laryngeal nerve

A

supplies cricothyroid
hoarsness
close to sup thyroid artery

83
Q

recurrent laryngeal nerve

A

close to inf thyroid

84
Q

pelvic fracture most common cause of which nerve injury

A

obturator

85
Q

genitofemoral nerve

A

L1 L2

cremestric reflex

86
Q

acts by postsynaptic blockade of dopamine D2 receptors and also inhibition of serotonin 2, α-adrenergic, and histamine H1 receptors.

A

clozapine

87
Q

A lumbar disc herniation between the vertebral bodies L5 and S1 is a common cause of S1 radiculopathy

A

weak achilles tendon reflex

88
Q

myoclonus (jerky, repetitive, twitching movements) and rapidly-progressive dementia associated with aphasia and agnosis.

A

creutzfelt jacob

89
Q

il12 il23

A

IL-12 induces Th1-cell differentiation and IFN-γ production, whereas IL-23 plays a role in controlling TH17 development
ustekinumab

90
Q

tumor assoc with tuberous sclerosis

A

astrocytoma

91
Q

presentation of atrophy restricted to the thenar eminence is a common early sign of

A

ALS

92
Q

nucleus acuumbens

A

nucleus accumbens is a basal forebrain structure that has a role in the reward pathway