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COMLEX Level 1 > Neuro > Flashcards

Neuro Flashcards

1
Q

Cranial nerve pathways

A 
CNI → cribiform plate
CNII → optic canal
CNIII → superior orbital fissure
CNIV → superior orbital fissure
CNV1 → superior orbital fissure
CNV2 → foramen rotundum
CNV3 → foramen ovale
CNVI → superior orbital fissure
CNVII → internal auditory meatus
CNVIII → internal auditory meatus
CNIX → jugular foramen
CNX → jugular foramen
CNXI → jugular foramen
CNXII → hypoglossal canal
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2
Q

Cranial nerves

A 
CNI → olfactory
CNII → optic 
CNIII → oculomtor
CNIV → trochlear
CNV1 → trigeminal (ophthalmic)
CNV2 → trigeminal (maxillary)
CNV3 → trigeminal (mandibular)
CNVI → abducens
CNVII → facial
CNVIII → vestibulocochlear
CNIX → glossopharyngeal
CNX → vagus
CNXI → spinal accessory
CNXII → hypoglossal

Oh oh oh to touch and feel virgin girls vagina and hymen

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3
Q

Eye muscle innervations

A

III oculomotor → medial, sup, inf rectus, inf oblique
IV trochlear → superior oblique
VI abducens → lateral rectus

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4
Q

Epidural hematoma

A

Middle meningeal artery

biconvex

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5
Q

Subdural hematoma

A

Crescent shaped

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6
Q

Subarachnoid hemorrhage

A

worst headache of my life

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7
Q

Middle cerebral artery stroke

A

contralateral paralysis and sensory loss

face and upper limb

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8
Q

Anterior cerebral artery stroke

A

contralateral paralysis and sensory loss

lower limb and urinary incontinence

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9
Q

Lenticulostriate artery stroke

A

contralateral paralysis

pure motor stroke

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10
Q

Posterior Inferior Cerebellar Artery (PICA) stroke

A

dysphagia, hoarseness, ↓ gag,
↓ pain and temp contralateral body, ipsilateral face
don’t PICA horse that can’t eat

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11
Q

Anterior Inferior Cerebellar Artery (AICA) stroke

A

paralysis of face

↓ pain and temp contralateral body, ipsilateral face

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12
Q

basilar artery stroke

A

Locked in syndrome (can only move eyes)

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13
Q

Broca’s aphasia

A

Comprehensive
nonfluent, repetitive

broken speech = broca’s

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14
Q

Wernicke apahasia

A

Fluent
Poor comprehension, repetitive

Word salad = wernicke

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15
Q

Transcortical sensory aphasia

A

Fluent, not repetitive

Poor comprehension

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16
Q

Transcortical motor aphasia

A

Comprehensive

nonfluent, but not repetitive

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17
Q

Conduction aphasia

A

Comprehensive and fluent

repetitive

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18
Q

Parkinson disease

A

Tremor (pill rolling)
Cog wheel rigidity
bradykinesia
Shuffling gait

↓ dopaminergic neurons in substantia nigra
Lewy bodies made of α-synuclein

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19
Q

Huntington disease

A 
Trinucleotide repeat of CAG
Aggression, depression, dementia
athetosis, chorea
↑ dopamine
↓ ACh and GABA
atrophy of caudate and putamen
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20
Q

Alzheimer disease

A

Widespread cortical atrophy, particularly in the hippocampus

ß-amyloid plaques from amyloid precursor protein (APP)

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21
Q

Normal pressure hydrocephalus

A

elderly patients

expansion of ventricles with normal pressure CSF

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22
Q

MS

A

autoimmune inflammation and demyelination of CNS
↑IgG in CSF
paraventricular plaques

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23
Q

Charcot-Marie-Tooth disease

A

pes cavus, hammer toe, foot drop

hereditary motor and sensory neuropathy

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24
Q

Tuberous sclerosis

A 
TSC1 (chromosome 9) or TSC2 (chromosome 16)
Harmartomas
Angiofibromas
Mitral regurg
Ash leaf spots
Rhabdomyoma
Mental retardation
Angiomyolipomas
Seiuzures
Shagreen patches
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25
Q

Neurofibromatosis type I

A 
NF1 (chromosome 17)
cafe-au-lait spots
mental retardation
cutanous neurofibromas
Lisch nodules (on iris)
optic gliomas
pheochromocytoma
siezures
bone lesions
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26
Q

Neurofibromatosis type II

A 
NF2 (chromosome 22) all 2's
bilateral vestibular schwannomas
juvenile cataracts
meningiomas
ependymoma

2 eyes, 2 eyes, 2 parts of brain

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27
Q

vin Hippel-Lindau disease

A 
VHL (chromosome 3)
Hemangioblastoma (brain, retina, spine)
Angiomatosis
Renal Cell carcinoma
Pheochromocytoma
HARP
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28
Q

Friedreich ataxia

A 
trinucleotide repeat of GAA
staggering gait, frequent falling
DM
hypertrophic cardiopmyopathy
scoliosis
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29
Q

CN V lesion

A

jaw deviates toward

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30
Q

CN XII

A

tongue deviates toward (lick your wounds)

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31
Q

CN X

A

uvula deviates away

32
Q

benzodiazepines

A 
-pam, -lam
↑ GABA by ↑ frequency of Cl- channel opening
Anxiety. panic
status epilepticus (1st line acute)
eclampsia
33
Q

Carbamazepine

A

partial (focal) seizures and trigeminal neuralgia
Blocks Na+ channels

AA: tons
bone marrow suppression
liver
taratogen
SIADH
ataxia
diplopia
34
Q

Ethosuximide

A 
Absence seizures (staring off, thinking "this sux")
blocks Ca+2 channels (thalamic, T-Type)
35
Q

Phenobarbital

A

↑ GABA by ↑ duration of Cl- channel opening

sedative for anxiety, seizures, insomnia

36
Q

Phenytoin

A

Blocks Na+ channels
First line for tonic-clonic seizures
recurrent seizure prophylaxis in epilepsy

Hirsutism
enlarged gums
nystagmus
yellow-brown gums
teratogen
osteopenia
neuropathy
SLE-like syndrome
DRESS syndrome
37
Q

Valproic acid

A

↑ Na+ channel inactivation
↑ GABA concentration
first line for tonic-clonic seizures

38
Q

Zolpidem, Zaleplon, esZopiclone

A

used for insomnia (Zzzzz…)

↑ GABA (BZ1 receptor agonist)

39
Q

Triptans

A

used for acute migraine, cluster headache

stimulate trigeminovascular seratonin receptors

40
Q

Posterior cerebral artery stroke

A

contralateral homonymous hemianopia with macular sparing

41
Q

Bethanechol

A

Cholinomimetic

↑ bladder smooth muscle

42
Q

Carbachol

A

carbon copy of ACh
constricts pupil
↓ IOP for open angle glaucoma

43
Q

Pilocarpine

A

Cholinomimetic
Open angle and closed angle glaucoma
stimulates sweat, tears, saliva

44
Q

Neostigmine

A 
AChE inhibitor
↑ ACh
relieves post-op ileus
myasthenia gravis tx
Neo = no CNS penetration
45
Q

Physostigmine

A

AChE inhibitor
↑ ACh
Phreely crosses BBB
antidote for anti-cholinergic toxicity (atropine overdose)

46
Q

Pyridostigmine

A

AChE inhibitor
↑ ACh
gets RID of myasthenia gravis

47
Q

Atropine

A 
muscarinic antagonist
↑ body temp
dry flushed skin
constipation and urinary retention
cycloplegia (hyperopia)
dilated pupils
disorientation
48
Q

glycopyrrolate

A

muscarinic antagonist

GI and respiratory specific

49
Q

Hyoscyamine

A

muscarinic antagonist

GI

50
Q

dicyclomine

A

muscarinic antagonist

GI

51
Q

Ipratroprium

A

Muscarinic antagonist

Respiratory

52
Q

Tiotroprium

A

Muscarinic antagonist

Respiratory

53
Q

Scopolamine

A

Muscarinic antagonist

CNS, motion sickness

54
Q

oxybutynin

A

Muscarinic antagonist

Reduces urinary incontinence

55
Q

solifenacin

A

Muscarinic antagonist

Reduces urinary incontinence

56
Q

Tolterodine

A

Muscarinic antagonist

Reduces urinary incontinence

57
Q

Benztropine

A

Muscarinic antagonist
Parkinson disease
prevents tremor and ridgidity

58
Q

Bromocriptine

A

dopamine agonist

Parkinson disease

59
Q

Amantadine

A

↑ dopamine release, ↓ reuptake

Parkinson disease

60
Q

Levodopa/carbidopa

A

↑ brain dopamine
inhibits peripheral conversion of L-Dopa → Dopamine, which cannot cross BBB (but L-dopa can)
Parkinson disease

61
Q

Selegiline, rasagiline

A

↓ dopamine breakdown
inhibits MAO
Parkinson disease

62
Q

Donepezil, rivastigmine, galantamine

A

AChE inhibitor

Alzheimer disease

63
Q

Tetrabenazine

A

↓ dopamine release
inhibits VMAT
Huntington disease

64
Q

inhaled anesthetics

A

-ane
mechanism unknown
can cause malignant hyperthermia

65
Q

Thiopental

A

IV anesthetics, barbituate
↑ GABA
short surgical procedures

66
Q

Midazolam

A

IV anesthetic, benzodiazepine

↑ GABA

67
Q

Propofol

A

IV anesthetic
↑ GABA
Rapid anesthesia induction
short procedures, ICU sedation

68
Q

Ketamine

A

IV anesthetic

NMDA receptor antagonist

69
Q

Local anesthetics

A

-caine
block Na+ channels
esters → one i (procaine)
amides → two i’s (lidocaine)

70
Q

Succinylcholine

A

strong ACh agonist
Depolarizing neuromuscular blocking drug by causing sustained AP
reversed with AChE inhibitors

71
Q

Non-depolarizing neuromuscular drugs

A

-cur- (AtraCURium)
ACh antagonist
Reverse with neostigmine

72
Q

baclofen

A

GABA agonist in spinal cord (backlofen)

used for muscle spasticity, MS

73
Q

Cyclobenzaprine

A 
used for muscle spasticity
Centrally acting (brain stem)
74
Q

Tramadol

A

slight opioid agonist + SNRI

used for chronic pain

75
Q

Glaucoma meds

A 
ß-blockers → ↓aqueous humor synthesis
α-agonists → ↓aqueous humor synthesis
     - epi 
     - brimoninidine, aproclonidine (α2)
Prostaglandins → ↑outlfow (latanoprost)
M3 → ↑outflow (pilocarpine, carbachol, physostigmine,)
76
Q

Opioid MOA

A

close presynaptic Ca+2 channels

open postsynaptic K+ channels

COMLEX Level 1 (13 decks)

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