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Boards Path > Neuro Cards 1 > Flashcards

Neuro Cards 1 Flashcards

1
Q

Maternal Diabetes leads to what birth defect?

A

Anencephaly, Dextrocardia, Transposition GV Colobamina. Increased risk for nearly all cardiac and neural defects

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2
Q

Causes of polyhydramnios in utero

A

Anencephaly, TE fistula, Duodenal Atresia

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3
Q

Oxytocin is made in what hypothalamic structure

A

Paraventricular

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4
Q

ADH is made in what hypothalmic structure

A

Suprachiasmatic

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5
Q

Most common S/E with TCA related to what actions

A

Anticholinergic. Most common cause of death is arrythmias

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6
Q

Pt has damage to thalamus, BG, and Cortical Ribbon. EEG shows bursts of high voltage slow waves. What is the diagnosis

A

-Crutzfeld-Jacob disease. Progression over 6 months. BG, Thalamus, and cortical ribbon are Gray matter, which is preferentially targeted. EEG bursts are indicative of myoclonus.

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7
Q

Pt comes in with hyperphagia, hyperexuality, and docility. What is the diagnosis

A

-Kluver Bucy. Damage to amygdala. Most commonly with HSV. Commonly seen in AIDS pts.

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8
Q

What is the mechanism behind visual disturbances and anosmia

A

-Foster Kenedy: Increased ICP leads to damage to optic nerve and olfactory tracts.

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9
Q

Anterior Cerebellar outputs vs Posterior Cerebellar Outputs

A
  • Anterior is to descending tracts (rubrospinal, reticulospinal) balance (alcohol stumbling gait)
  • Posterior is to cerebral cortex and coordination (dysdiadechkinesis)
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10
Q

Cause of neuronal cell death in huntingtons. Levels of NT

A
  • Glutamate excitotoxicity.

- Reduced GABA and Ach

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11
Q

Sensation innvervation of Oropharynx

A

V3- Anterior tongue general sensation. Taste via lingual nerve and chorda tympani (VII)
XI- posterior tongue and superior pharynx including eustachian tube
X- Inferior pharynx and larynx

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12
Q

Most Common tumor of pineal gland

A

-Germinoma: Can lead to precocious puberty in childhood. Also will see paralysis of upward gaze.

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13
Q

Newborn with Rhinorrhea, Diahrrea, Tremors, Siezures

A

-Neonatal opiate withdrawl. Treat with small dose of opium and wean off

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14
Q

Pramipexole, Ropimerole

A

-D2 agonists used to treat parkinsons. Non Ergot. Ergot agonists like bromocriptine and pergolide also exist

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15
Q

Use of ampicillin in meningitis emperical treatment

A

-Covers Listeria Monocytogenes. Used in infants and immunocompromised

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16
Q

Physiologic adaptaions to alcohol

A
  • Decrease GABAa R, Increase, Increase excitatory NT

- Can treat withdrawls with BZ and centrally acting alpha2 agonists

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17
Q

Sequence of alcohol withdrawl

A

Initially tachycardia, tremors, HTN

Progress to hallucinations, siezures, hypersomnolence

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18
Q

RAS

A

-Located in midbrain, has cholinergic and adrergic projections, one to intralaminar nuclei.

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19
Q

Damage to hippocampus symptoms

A

Anterograde amnesia (rich in NMDAR)

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20
Q

Internal Capsule Structures

A

Anterior-Relay between Cerebellum, BG, Cortex

  • Genu: Corticobulbar
  • Posterior: Motor
  • Occlusion of lenticulostriate arteries and lacunar infarcts
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21
Q

Spinal 5 damage

A

PICA, AICA. Pain and Temp to face

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22
Q

Inferior Cerebellar peduncle

A

PICA, AICA (Horners in both)

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23
Q

Distinguish PICA from AICA

A

PICA- Gag (9,10)

-AICA (Facial and Cochlear)

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24
Q

PCA Paramedian Branches

A
  • 3,4, UMN 7

- Occular palsy (eye will be abducted, also loss of contralateral face)

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25
Q

Abducens damage

A

-Anyerusism of Superior Cerebellar or PCA, also from medial pontine (Basilar)

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26
Q

Anteiror Communicating Anyeurism Symptoms prior to rupture

A

-Compress chiasm. Bitemporal Hemianopia

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27
Q

Posterior Communicating Anyeurism Symptoms prior to rupture

A

-Compress CN3

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28
Q

Subarachnoid Hematoma and complications

A
  • Berry Anyeurism (AVM)

- 2-3 days post bleed can cause vasospasm and rebleed (Tx with nimodipine (ca channel blockers).

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29
Q

Risk Factors for intraparenchymal hemorrhage

A
  • HTN, Diabetes, Vasculitis, Neoplasia

- Amyloid angiopathy

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30
Q

Bright on noncontrast CT

A

-Areas of hemorrhage. tPA is contraindicated

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31
Q

Symptoms in NPH caused by

A

-Stretching of the corona radiata (continuation of internal capsule)

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32
Q

Organization of Spinothalamic Tract anc Corticospinal

A

Legs are lateral arms are medial

-DCML (gracilus is medial (Legs) and cuneatus is lateral (arms)

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33
Q

Divisions of the spinothalamic tract

A

-Anterior is pressure, crude touch, Lateral is pain/temp

34
Q

Riluzole

A

ALS, Na channels and decrease glutamate release

35
Q

Tract involved in subacute combined degenerations

A

Corticospinal, Spinocerebellar, Dorsal Columns

-Ataxia and parethesias, usually no pain

36
Q

Tabes Dorsalis Symptoms

A
  • Loss of DTR, Charcot joint, Shooting pain,
  • Sensory Ataxia with positive rhomberg
  • Dorsal columns and dorsal roots
37
Q

Newborn with tongue fasiculations and hypotonia

A

-Werdnig Hoffman (SMA). Death of LMN in anterior horn.

38
Q

Freidrichs ataxia

A
  • Trinucleotide repeat in frataxin (Fe-S mitochondria)
  • Pez cavus, kyphoscoliosis, ataxia
  • Die of hypertrophic cardiomyopathy
  • Degeneration of cerebellum and spinocerebellar tracts.
39
Q

Cause of symptoms in pinealoma

A
  • Compression of superior colliculus causes upward gaze palsy.
  • Most common is germinoma which can secrete hormones and cause precocious puberty.
40
Q

PPRF Lesion

A

Deviation away from side

-Medial pons

41
Q

Frontal Eye fields

A

-Deviation towards lesion

42
Q

Causes of Cranial Nerve 3 Palsy

A
  • Infarction of paramedian PCA that supplies the midbrain
  • Transtentorial (uncal herniation) mass occupying lesion including epidural hematoma
  • Anyeurism of posterior communicating and carotid in cavernous sinus.
  • Compression between superior cerebellar and posterior cerebral arteries
43
Q

CN IV Pathology

A
  • Arises from the dorsal aspect and crosses over

- Vulnerable to head trauma

44
Q

CNV injury

A
  • Towards lesion (lateral pterygoid)
  • Tensor tympani paralysis leads to hyperascusis
  • Spinal trigeminal with pain will cross over, contralateral in AICA and PICA lesions
45
Q

CN VI injury

A
  • Long course leaves it vulnerable to many insults (meningitis, trauma, syphilis) most common
  • Horizontal diplopia and medial strbismus
46
Q

Hereditery Stroke

A

-CADASIL, Notch 3 mutation. Seen in young people

47
Q

Fixed Dilated pupil

A

Cavernous Sinus

48
Q

Causes of Retinitis

A

CMV, HSV, HZV, Toxo

49
Q

Central Retinal artery occlusion

A

-Painless, cherry red spot

50
Q

Vision changes in open angle glaucoma

A

-Slowly and progressive. Loss of peripheral vision before central

51
Q

Risk Factors for glaucoma

A

-African American, Steroid use

52
Q

Cataract Risk factors

A
  • Trisomies

- Congenital infections

53
Q

Pathways of pupillary dilation and constriction

A
  • Constriction: Ed west to ciliary ganglion to short ciliary

- Dilation: Post hypothalamus to IML (Center budge), To superior cervical ganglion, then on IC to long cilliary

54
Q

Pupillary light reflex pathway

A
  • CN2 to pretectal nuclei to bilateral Ed West.

- Defect (retinal detachment or damage) there will not be consensual

55
Q

Cause of damage to CN3 motor neurons

A

Diabetes (sorbitol pathway)

56
Q

Retinal Detachment

A
  • More common in myopia, detachment of retina from pigment epithelium. Curtain drawn down.
  • increase risk with diabetes and myopia
57
Q

Location of Drusen

A

Below pigment epithelium

58
Q

Measure of Alzhiemers severity

A
  • Neurofibrillary Tangles

- Tx: Donepazil

59
Q

How to detect Tau and NF tangles

A

Silver Stain

60
Q

Lewy Body

A
  • Hallucinations
  • Personality before parkinson effects
  • Lewy Bodies (a synuclein in cortex)
61
Q

Picks Dementia

A
  • Frontotemporal
  • Early change in personality progressing to aphasia and other dementia signs
  • Spherical tau aggregates (not NF tangles) balooned neurons
  • Effects layers 2,4 not 3,5,6
62
Q

CSF Findings in guillan bare

A

-Increased protein without cells (albuniocytologic dissociation)

63
Q

Treatment of Guillan Bare

A
  • IVIG and Plasmaphoresis if severe and indicated

- Generally treatment is supportive

64
Q

Adrenoleukodystrophy

A

-Defect in peroxisome formation, leads to accumulation of long chain FA and leukodystrophy

65
Q

Charcot Marie Tooth (hereditery sensory and motor)

A
  • Defect in myelin protein leads to demylination
  • Effects motor neurons and posterior colums (proprioception)
  • Pez Cavus and foot drop.
66
Q

Acute Demhyelinating Encephalopathy

A
  • Scattered demylination following viral illness

- Idiopathic

67
Q

Metachormatic Leukodystrophy

A
  • AR defect in arylsulfatase A leads to accumulation of sulfatides.
  • sulfatides cause breakdown of myelin sheath
68
Q

Krabbes

A

-Defect in galactocerebrosidase, leukodystrophy

69
Q

Position Testing in vertigo

A
  • Central Vertigo will show immediate, strong, and variable direction nystagmus
  • Peripheral vertigo will be delayed and unidireectional
70
Q

Port Wine Stain following CNV1

A
  • Sturge Webber: De novo sporadic mutation allowing for proliferation of capillaries
  • Occurs in brain and eyes causing mass effect.
  • Can lead to siezures, glaucoma.
71
Q

Lack of melanin in spots on face and mitral regurgitation

A
  • Tuberous Sclerosis
  • AD hamartomas throughout body and lack of melanin on face (Ash leaf spots)
  • Focal neurological findings (siezures)
72
Q

Bilateral Renal Cell Carcinoma

A
  • VHL. AD mutation in TSG leads to cavernous hemangioma formation
  • Focal neurologic signs and polycythemia (HIF 1a metabolism)
73
Q

Cafe Au Lait Spots, Lisch Nodules

A
  • AD defect in RAS associated gene

- cutaneous neurofibromas (100% penetrant with variable expressivity)

74
Q

Estrogen R positive brain tumor (more common in women)

A

-Meningioma

75
Q

Calcified intraparenchymal tumor in adults

A

-Oligodendroglioma

76
Q

Cystic and Solid Brain Tumor in kids

A

-Pilocytic astrocytoma

77
Q

Drop Metastasis

A

Medulloblastoma

-May also compress 4th ventricle and cause hydrocephalus (less common than ependymoma, but possible)

78
Q

Highly vascularized foamy cells in brain tumor

A
  • Hemangioblastoma
  • Most commonly associated with VHL. Polycythemia common in these cases.
  • More common in kids
79
Q

Oily mass with tooth enamel

A

Craniopharyngoma
Rathkes pouch
Bitemporal hemianopia

80
Q

Trauma causes herniation of cerebellum through foramen magnum

A

-Death due to compromise of respiratory and cardiac centers

81
Q

Anorexia and failure to thrive (hypothalamus)

A

Lateral Area (normally inhibited by leptin)

82
Q

Hyperphagia and aggresion

A

Ventromedial (activated by leptin)

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