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board vitals psychiatry > neuro > Flashcards

neuro Flashcards

1
Q

area of brain/lobe assoc w language devel

A

wernicke’s/L temporal

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2
Q

area of brain/lobe assoc w speech production

A

broca’s/L frontal

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3
Q

largest lobe

A

frontal

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4
Q

microglia vs macroglia fxn

A

MICRO (macrophages) = clean debris of CNS
MACRO: oligodendrocytes = myelinate CNS, schwann = myelinate PNS, astrocytes = nutrients, support endothelial cells of BBB, repair/scar, ependymal = CSF, radial = progenitors, scaffold for migration

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5
Q

absence sz EEG finding

A

3Hz spike wave

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6
Q

possible dx of EEG 3Hz spike wave

A

absence sz

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7
Q

possible dx of EEG slow spike wave or polyspike/wave

A

akinetic sz, Lennox-Gastaut

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8
Q

possible dx of EEG hypsarrhythmia

A

status epilepticus, West synd (childhood spasms)

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9
Q

possible dx of EEG phantom spike wave

A

normal variant

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10
Q

MCC facial pain

A

dental

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11
Q

% kids who sleepwalk

A

10-30% (up to 50% of those w sleepwalking or night terrors have OSA??)

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12
Q

parasomnias usually happen in what phase of sleep cycle

A

slow-phase (earlier)

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13
Q

alcohol causes what type of sleep disorder

A

insomnia (early sedative effect w deep sleep x3-4h, then inc WAKEFULNESS & restless sleep)

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14
Q

management of TIA

A

eval, ID, tx all possible risk factors to prevent stroke/vasc events

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15
Q

how much stenosis to do enarterectomy

A

70%

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16
Q

CSF finding in 95% MS

A

oligoclonal bands (ltd Ab classes). may also find elev IgG, min elev-nml cell #, nml protein

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17
Q

REM: EEG, % total sleep, when do periods start & last longest

A

EEG: mixed voltage (~stage 1 sleep w rapid phasic eye mvmts, absent mm tone except intmt phasic mm twitches)
20-25% total sleep
start: 90-120min after onset
longest: 2nd half of night (AM hours, get longer twd end)

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18
Q

area of hypothalamus for wakefulness/sleep, action

A

VentroLateral PreOptic Nucleus: inhib brainstem wakefulness areas

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19
Q

where melatonin is made

A

pineal gland

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20
Q

myotonic dystrophy 1 (steinert’s dz) vs 2 presentation + genetic abn

A 
1 = autosomal dom trinucleotide repeat CTG on DMPK gene: weakness of face/neck/forearm/hand (grip myotonia)/foot dorsiflex weakness (foot drop), mm pain, resp mm inv, dysphagia, dysarthria, cataracts, cardiac cond abn, infertility, insulin resist
2 = tetranucleotide repeat CCTG on ZNF9/CNBP gene: mild weakness, mm pain, but rarely resp mm inv, dysphagia, dysarthria
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21
Q

cogn sxs in SCZ

A

working memory, attn

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22
Q

neuro FDA indications for cymbalta

A

diabetic periph neuropathy, fibromyalgia, chronic MSK pain (in addition to MDD, GAD)

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23
Q

first line tx for TD

A

valbenazine/ingrezza

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24
Q

meige synd presentation + tx

A

blepharospasm, oromandibular dystonia w sore jaw&raquo_space; botox, DBS

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25
Q

most common childhood epilepsy and anatomical source

A

benign rolandic sz, occur @ night, higher risk fatal aspiration, usually remits by 16yo, central sulcus @centrotemporal area

dx by EEG

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26
Q

4 parasomnias in DSM5

A

REM sleep behav do, nonREM sleep arousal do, RLS, nightmare do

27
Q

major neurotransmitters affected in alz & anatomy

A

n basalis of meynert, ACh

locus ceruleus, NE

28
Q

binswangers dx

A

dementia +
>=2:
HTN or vasc dz,
subcortical dsfxn (neurogenic bladder, musc rigidity, gait abn),
bilat leukoaraiosis or attenuation of white matter on MRI/CT

neuro signs: pyramidal (refl asym, rigid, ataxia), syncope due to hypoperf, PB palsy

29
Q

kluver bucy synd?

A

hyperorality, hypersexuality, placidity seen in picks/FTD

30
Q

CT findings in huntingtons

A

caudate atrophy, enlarged ventricles, gen cortical atrophy

31
Q

EEG findings in absence sz, CJD, coma/enceph

A

absence: 3-4hz spikes & slow wave complexes
CJD: bi/triphasic DCs
coma: theta/delta

32
Q

lead vs mercury poisoning

A

lead: basophilic stippling, hypochromic microcytic anemia, gum lines, wrist/foot drop, irritability, sz, coma
merc: GI ulcer, renal necrosis/calcif prox conv tubules, proteinuria, stomatitis, CNS

33
Q

cluster HA vs paroxysmal hemicrania

A

cluster: M>F, >30min, less freq, tx O2, triptan, verapamil, botox?

PH: F:M 2:1, 2-30min, multiple daily, autonomic (horner, conj inj, lacrimation), neck movements trigger, tx indomethacin

34
Q

LBD clinical vs biomarker dx

A

clnical: cogn imp + >2 fluctuating fluctuating cogn, VH, parkinsonism (later), REM sleep behav (can be before cogn imp)
biomarker: dec DA transporter uptake @basal gang on SPECT/PET, low 123iodine-MIBG uptake on myocardial scintigraphy, REM sleep w/o atonia on polysomnogram

35
Q

interaction w tramadol + SSRIs?

A

sz, serotonin synd

36
Q

med complications of catatonia, nonmalignant vs malign

A

nonmal: aspiration, burns, cachexia, dehydration, PNA, clot, urinary incont/ret
mal: limb strictures, arrhythmias, MI

37
Q

age of peak prevalence of sleepwalking do

A

8-12yo

38
Q

MCC & MC etiological factor assoc w temp lobe epilepsy

A

MCC: mesial temp + hippocampal sclerosis & temp lobe atrophy
etiological: prolonged febrile convulsion of childhood, anoxia @birth….. less common temp lobe infxn ie herpes & mass ie astrocytoma

39
Q

chronological criteria for narcolepsy

A

3x weekly x3m

40
Q

prevalence of sleep terror do in adults

A

<1%

41
Q

sxs basilar migraine

A

transient HA, quadriplegia, stupor, psychosis, blindness, several hour coma

42
Q

trigeminal neuralgia tx

A

CBZ, phenytoin, GPN

43
Q

what is damaged in WK & why

A

malnut/starvation commonly from etoh > thiamine/B1 defic > mamillary body damage

44
Q

thiamine/B1 deficiency, causes + clinical features

A

etoh > neurop, weakness, mm wasting, cardiomeg, ophthalmoplegia, confab (beriberi)

45
Q

niacin/B3 deficiency, causes + clinical features

A

etoh, B6 defic (etoh, INH), riboflavin/B2 defic, tryptophan defic > Ds Dermatitis of sun exposed skin, Disorientation, Dementia/memory, Diarrhea, red tongue

46
Q

pyridoxine/B6 deficiency, causes + clinical features

A

etoh, INH > seb derm, infl tongue, neurop, confusion, depr, micro anemia

47
Q

folate/B9 deficiency, causes + clinical features

A

etoh, sulfasalazine, pyrimethamine, triamterene > shrunken tongue, meg anemia, high homocysteine

48
Q

cobalamin/B12 deficiency, causes + clinical features

A

gastric bypass/atrophy, ilial dz, vegan > DORSAL (post + lat) column white matter w loss of vib/position (subacute combined degen of spinal cord), ataxia, dementia, bowel incont, ED, meg anemia

49
Q

FDA approved meds for tourettes

A

haldol, abilify, pimozide

OFF label clonidine, prolixin, risperdal, tetrabenazine
*seroquel assoc w tics

50
Q

describe homeostatic/circadian sleep drive levels

A

homeostatic SD lowest on waking & increases through day then lessens again once asleep. as it decreases during sleep, circadian SD increases to maintain sleep 2nd half of night, REM increased as well

51
Q

MRI SCZ

fMRI of working memory in SCZ

A

MRI: dec vol prefrontal, thalamic, hippocampal, sup temp gyrus. inc lat/3rd vent vol & BG
fMRI: abn DL PFC, dec blood flow in frontal lobes

52
Q

pathophys of huntingtons

A

huntingtin (synaptic vesicle assoc protein) overprod > NMDA rec med excitotox > neostriatum (caudate + putamen) degen

53
Q

chronic selenium poisoning

A

garlic breath, GI do, hair loss, nail sloughing, fatigue, irritability, neuro damage

54
Q

chronic arsenic poisoning

A

HA, conf, diarrhea, drowsiness then convulsions, leukonychia striatae nail pigment, mees lines (leuchoparnychia = while bands over width of nails)

55
Q

chronic mercury poisoning

A

periph neurop, skin discoloration (pink cheeks, fingers/toes), edema, desquamation

56
Q

chronic lead poisoning

A

lead thru GI/resp tracts ie batteries, paint > enz inhib & interferance w essential cations ie Ca Fe Zn to alter memb structure > CNS deficits, periph neurop, nephrop, HTN, anemia, short term mem loss, depr, nausea, abd pain, burton/lead lines

57
Q

chronic iron poisoning

A

stomach pain, n/v, liver failure

58
Q

fxn of post/lat dorsal columns of spinal cord

A

vibration/position

59
Q

fxn of tectospinal tract

A

midbrain tectum to cervical spinal cord&raquo_space; head/eye movement coordination

60
Q

fxn of ant trigeminothalamic tract

A

pain/temp from face/head/neck

61
Q

fxn of ant corticospinal tract

A

weakness

62
Q

MCD criteria cognitive domains

A

complex attn, exec fxn, learning/memory, language, perceptual motor, social cogn

63
Q

alz early v late onset mutations

A

early: presenilin I/II, amyloid precursor protein (APP)
late: apolipoprotein (ALP) E4

board vitals psychiatry (10 decks)

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