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Maddy - First Aid > Neuro > Flashcards

Neuro Flashcards

1
Q

frontal lobe lesion sx

A

disinhibition and deficits in concentration, orientation, judgement

may have reemergence of primitive reflexes

difficulty “describing the difference between a watch and a ruler”

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2
Q

front eye fields lesion sx

A

eyes look towards brain lesion (away from side of hemiplegia)

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3
Q

paramedian pontine reticular formation lesion sx

A

eyes look away from lesion (toward side of hemiplegia)

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4
Q

MLF lesion sx

A

internuclear ophthalmoplegia

  • impaired adduction of ipsilateral eye
  • nystagmus of contralateral eye w/ abduction

**MS

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5
Q

dominant parietal cortex lesion sx

A

agraphia (inability to write)

acalculia (loss of ability to do simple math)

finger agnosia (loss in the ability to distinguish, name, or recognize the fingers)

left-right disorientation

**Gerstmann syndrome

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6
Q

nondominant parietal cortex lesion sx

A

agnosia (inability to interpret sensations and hence to recognize things) of contralateral side of the world

**hemispatial neglect syndrome

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7
Q

bilateral hippocampus lesion sx

A

anterograde amnesia (inability to make new memories)

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8
Q

basal ganglia lesion sx

A

tremor at rest, chorea, athetosis

**parkinson, huntington, wilson’s disease

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9
Q

subthalamic nucleus sx

A

contralateral hemiballismus (intermittent flinging movements on one side)

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10
Q

bilateral mammillary bodies lesion sx

A

wernicke-korsakoff syndrome (confusion, ataxia, nystagmus, ophthalmoplegia), memory loss, congabulations, personality changes

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11
Q

bilateral amygdala lesion sx

A

kluver-bucy syndrome (disinhibited behavior - hyperphagia, hypersexuality, hyperorality)

**HSV-1 encephalitis

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12
Q

dorsal midbrain lesion sx

A

parinaud syndrome (vertical gaze palsy, pupillary light-near dissociation, lid retraction, convergence-retraction nystagmus)

**pinealoma

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13
Q

reticular activating system (midbrain) lesion sx

A

reduced levels of arousal and wakefulness

**coma

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14
Q

cerebellar hemisphere lesion sx

A

intention tremor, limb ataxia, loss of balance

**cerebellar hemispheres are located laterally –> affect lateral limbs

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15
Q

cerebellar vermis lesion sx

A

truncal ataxia (wide-based, “drunken sailor” gait)

nystagmus

**vermis is located centrally –> affects central body

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16
Q

red nucleus (midbrain) lesion sx

A

decorticate (flexor) posturing - lesion above red nucleus

decerebrate (extensor) posturing - lesion at or below red nucleus

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17
Q

histologic features of brain 12-24 hours after ischemic event

24-72 hours

3-5 days

1-2 weeks

> 2 weeks

A

12-24: eosinophilic cytoplasm + lack of Nissl bodies + pyknotic nuclei (red neurons - shrunken)

24-72 hours: necrosis + neutrophils

3-5 days: macrophages

1-2 weeks: reactive gliosis (astrocytes) + vascular proliferation

> 2 weeks: glial scar

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18
Q

MCA stroke sx

A

contralateral paralysis and sensory loss in face and upper limb

dominant hemisphere: aphasia

nondominant hemisphere: hemineglect

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19
Q

ACA stroke sx

A

contralateral paralysis and sensory loss in lower limb

urinary incontinence

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20
Q

lenticulostriate artery stroke sx

A

contralateral paralysis

absence of cortical signs (neglect, aphasia, visual field loss)

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21
Q

ASA stroke sx

A

contralateral paralysis of upper and lower limbs

decreased contralateral proprioception

ipsilateral hypoglossal dysfunction (tongue deviates ipsilaterally)

**medial medullary syndrome

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22
Q

PICA stroke sx

A

dysphagia, hoarseness, decreased gag reflex, hiccups

vomiting, vertigo, nystagmus

decreased pain and temp from contralateral body and ipsilateral face

ipsilateral horner, ataxia, dysmetria

**lateral medullary syndrome (wallenberg)

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23
Q

blood supply of medial medulla

A

ASA

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24
Q

blood supply of lateral medulla

A

PICA

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25
Q

blood supply of medial pons

A

basilar

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26
Q

blood supply of lateral pons

A

AICA

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27
Q

blood supply of medial midbrain

A

PCA

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28
Q

blood supply of lateral midbrain

A

PCA

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29
Q

medial cranial nerves and where they come out of

A

3, 4 - midbrain

6 - pons

12 - medulla

30
Q

lateral cranial nerves and where they come out of

A

5, 7, 8 - pons

9, 10, 11, 12 - medulla

31
Q

AICA stroke sx

A

paralysis of face

decreased lacrimation, salivation, taste from anterior 2/3 tongue

decreased pain and temp contralateral body and ipsilateral face

ipsilateral horner, ataxia, dysmetria

**lateral pontine syndrome

32
Q

basilar artery stroke sx

A

quadriplegia

loss of horizontal eye movements

**medial pontine syndrome (‘locked in” syndrome)

33
Q

PCA stroke sx

A

contralateral hemianopia (blindness in 1/2 visual field) with macular sparing

34
Q

damage to the arcuate fasciculus causes what

A

conduction aphasia

  • fluent speech
  • good comprehension
  • poor repetition
35
Q

transcortical motor

transcortical sensory

transcortical mixed

A

transcortical motor: affects frontal lobe around Broca but spares Broca

transcortical sensory: affects temporal lobe around wernicke but spares wernicke

transcortical mixed: broca, wernicke, arcuate fasciulus remain intact, surrounding watershed areas affected

36
Q

what is a tonic-clonic (grand mal) seizure

A

alternating stiffening and movement

postictal confusion, urinary incontinence, tongue biting

37
Q

what is a myoclonic seizure

A

quick, repetitive jerks

38
Q

patient with involuntary, rhythmic jerking of an extremity that lasts 1 minute, remains fully alert

A

simple focal (partial) onset seizure

39
Q

dopamine, acetycholine, and GABA levels in huntington’s

A

increased dopamine

decreased Ach and GABA

40
Q

histo and gross findings alzheimers

A
  • AB amyloid plaques in gray matter
  • neurofibrillary tangles made of tau
  • hirano bodies (intracellular eosinophilic proteinaceous rods in hippocampus)
41
Q

inclusions in frontotemporal dementia are made of what

A

hyperphosphorylated tau (pick bodies) or ubiquitinated TDP-43

42
Q

sx CJD

A

rapidly progressive dementia with myoclonus (startle myoclonus) and ataxia

43
Q

sx pseudotumor cerebri (idiopathic intracranial hypertension)

A

increased ICP with no obvious findings on imaging

headache, tinnitus, diplopia, no change in mental status

44
Q

what is charcot-marie-tooth disease

sx

mutation

A

defective production of proteins involved in structure and function of peripheral nerves or myelin sheath

foot deformities (pes cavus, hammer toe)

LE weakness (foot drop)

sensory deficits

PMP22 gene duplication

45
Q

what is sturge weber syndrome

sx

A

congenital nonhereditary anomaly of neural crest derivatives due to somatic mosaicism of activating mutation in one copy of GNAQ gene

port-wine stain in CN V1/V2 distribution

ipsilateral leptomeningeal angioma –> seizures

intellectual disability

early onset glaucoma

46
Q

sx tuberous sclerosis

A

H: hamartomas in CNS and skin

A: angiofibromas

M: mitral regurgitation

A: ash-leaf spots

R: cardiac rhabdomyoma

M: mental retardation

A: renal angiomyolipoma

S: seizures, shagreen patches

47
Q

sx von hippel lindau dz

A

hemangioblastomas in retina, brainstem, cerebellum, spine

angiomatosis

bilateral renal cell carcinoma

pheochromocytomas

48
Q

sx NF1

A

cafe au lait spots

intellectual disability

cutaneous neurofibromas

lisch nodules (pigmented iris hamartomas)

optic gliomas

pheochromocytomas

seizures

49
Q

treatment for ALS

A

rilouzole

50
Q

sx brown sequard syndrome

A

1) ipsilateral loss of all sensation at level of lesion
2) ipsilateral LMN signs at level of lesion
3) ipsilateral UMN signs below level of lesion
4) ipsilateral loss of proprioception, vibration, light touch below level of lesion
5) contralateral loss of pain and temp below level of lesion

51
Q

sx friedreich ataxia

A

staggering gait

frequent falling

nystagmus

DM

hypertrophic cardiopmyopathy

52
Q

CN V motor lesion sx

A

jaw deviates towards side of lesion

53
Q

CN X lesion sx

A

uvula deviates away from lesion

54
Q

CN XI lesion sx

A

weakness turning head to contralateral side of lesion

55
Q

CN XII lesion sx

A

tongue deviates toward side of lesion

56
Q

compare upper and lower motor neuron facial nerve lesions

A

UMN:

  • lesion located in the connection between the motor cortex and the facial nucleus in the pons
  • affects contralateral lower muscles of facial expression
  • forehead is spared

LMN:

  • lesion located anywhere along CN VII after facial nucleus in pons
  • affects ipsilateral upper and lower muscles of facial expression
  • forehead is affected
57
Q

first line treatments for alzheimers

A

donepezil, rivastigmine, galantamine, memantine

58
Q

first line treatment for huntington dz and moa

A

tetrabenazine

inhibits vesicular monoamine transporter (VMAT) which decreases dopamine vesicle packaging and release

59
Q

memantine MOA

A

NMDA receptor antagonist

60
Q

first line treatment for ALS and moa

A

riluzole

decreases neuron glutamate excitotoxicity

61
Q

thiopental MOA and indications

A

barbiturate (facilitates GABAa)

anesthesia induction, short surgical procedures

62
Q

ketamine effect on cerebral blood flow

A

increased

63
Q

MOA local anesthetics

lidocaine, mepivacaine, bupivacaine, ropivacain

A

block Na+ channels

64
Q

what is the order of nerve blockade with local anesthetics

A

small diameter fibers > large diameter fibers

myelinated fibers > unmyelinated fibers

size predominates over myelination

small myelinated fibers > small unmyelinated fibers > large myelinated fibers > large unmyelinated fibers

65
Q

MOA succinylcholine

A

ACh receptor agonist –> produced sustained depolarization and prevents muscle contraction

66
Q

MOA atracurium, cisatracurium, pancuronium, rocuronium, tubocurarine, vecuronium

A

competitive ACh antagonist

67
Q

baclofen MOA and indication

A

GABA-B agonist in spinal cord

muscle spasticity, dystonia, MS

68
Q

cyclobenzaprine MOA and indication

A

acts within CNS mainly at brain stem

muscle spasticity

69
Q

dantrolene MOA and indications

A

prevents Ca2+ release from sarcoplasmic reticulum by inhibiting ryanidine receptor

malignant hyperthermia and neuroleptic malignant syndrome

70
Q

tizanidine MOA and indications

A

a2 agonist

muscle spasticity, MS, ALS, cerebral palsy

Maddy - First Aid (23 decks)

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