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Misc. Notes Year 3 > Neuro Misc. > Flashcards

Neuro Misc. Flashcards

1
Q

What is Nissl substance

A

Rough endoplasmic reticulum

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2
Q

What are the two types of Golgi axons and what is the difference between them

A

Golgi type 1 - long axons

Golgi type 2 - short axons

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3
Q

Which cells produce myelin in the CNS and PSN respectively

A

CNS - oligodendrocytes

PNS - Schwann cells

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4
Q

What is the ratio of oligodendrocytes to axons they produce myelin for

A

1 oligodendrocyte covers many neurons

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5
Q

What is the ratio of Schwann cells to axons they produce myelin for

A

Many Schwann cells cover 1 neuron

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6
Q

The influx of which two ions cause depolarisation

A

Na+

Ca2+

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7
Q

The influx of which ion causes hyperpolarisation

A

Cl-

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8
Q

The efflux of which ion causes hyperpolarisation

A

K+

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9
Q

What do hyperpolarisation and depolarisation cause with regards to excitation and inhibition

A

Depolarisation –> excitation

Hyperpolarisation –> inhibition

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10
Q

Name the main excitatory neurotransmitter

A

Glutamate

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11
Q

Name the two main inhibitory neurotransmitters

A

GABA, Glycine

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12
Q

What is the distribution of GABA and Glycine neurons in the brain

A

GABA is widespread

Glycine mostly in brainstem and spinal cord

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13
Q

Name the 4 main types of sensory neuron

A

Aα
Aβ
Aδ
C

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14
Q

Which of the types of sensory neuron has the most myelination

A

Aα

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15
Q

A higher degree of myelination correlates to what speed of conduction

A

Fast conduction

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16
Q

What do Aα neurons perceive

A

Proprioception of skeletal muscle

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17
Q

What do Aβ neurons perceive

A

Skin mechanoreceptor information

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18
Q

What do Aδ neurons perceive

A

Pain and temperature

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19
Q

What do C neurons perceive

A

Pain, temperature and itch

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20
Q

Which corpuscle has a higher two-point discrimination value, Meissner’s or Pacinian

A

Meissner’s

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21
Q

Where do the DCML, Corticospinal and Spinothalamic tracts decussate

A

DCML at Medial Lemniscus
Spinothalamic at a segmental spinal level
Corticospinal - 85% at Medullary pyramids, 15% segmentally

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22
Q

What are the 4 Brodmann areas

A

1, 2, 3a, 3b

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23
Q

Define a “motor neurone pool”

A

All the alpha motor neurones which innervate a single muscle

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24
Q

Explain reciprocal inhibition using the hamstrings and quadriceps as an example

A

1a fibre supplying alpha motor neurone of quadriceps inhibits the alpha motor neurone of the hamstrings via inhibitory interneurons

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25
Q

What is the difference between ionotropic and metabotropic receptors

A

Ionotropic - direct, rapid response

Metabotropic - indirect, slow response via a signalling molecule

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26
Q

Out of GABAa and GABAb, which is ionotropic

A

GabaA

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27
Q

What are allodynia and hyperalgesia

A

Allodynia - Pain from a stimulus which is not normally painful
Hyperalgesia - Pain beyond expected from a normally painful stimulus

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28
Q

What is the Meningismus triad of symptoms

A

A headache, Neck stiffness, photophobia

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29
Q

What is the empirical treatment for Bacterial Meningitis

A

IV Ceftriaxone 2g Bd (+ IV ampicillin if suspected Listeria)
Chloramphenicol + Vancomycin if allergy

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30
Q

Which gene is implicated in Parkinson’s

A

LRRK2 gene

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31
Q

Parkinson’s triad

A

Pill rolling resting tremor
Brady/Akinesia
RIgidity (cog-wheel or lead pipe)

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32
Q

What can Levodopa be given with for treatment of Parkinsons’s

A

Carbidopa

Prevents the breakdown of levodopa in the bloodstream so more levodopa can enter the brain

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33
Q

Which cells undergo reactive gliosis and what does this involve

A

Astrocytes
Hypertrophy + Hyperplasia
1-2 weeks post-trauma

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34
Q

Which reaction do neurons undergo in response to hypoxia/ischemia and how long does this take

A

Red Neuron reaction

12-24 hours

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35
Q

What are Lewy Bodies made of

A

Alpha-synuclein

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36
Q

What are the two histopathological hallmarks of Alzheimer’s

A

Neurofibrillary tangles

Plaques

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37
Q

What are the tangles and plaques made up of in Alzheimer’s disease

A

Neurofibrillary *Tangles –> hyperphosphorylated *Tau protein
Plaques –> Beta-amyloid protein

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38
Q

Name 2 drugs that can be given for Alzheimer’s and how they work

A

Rivastigmine –> Cholinesterase inhibitor

Memantine –> Voltage-dependant NMDA receptor antagonist

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39
Q

What are Pick’s Cells and Pick’s bodies and which disease are they seen in

A

Pick’s cells –> Swollen Neurons
Pick’s bodies –> Filamentous inclusions
Both seen in Frontotemporal dementia

40
Q

What is the normal range of intracranial pressure

A

9-11 mmHg

41
Q

What occurs during a sub-falcine herniation

A

Cingulate gyrus herniates under the flax cerebri

42
Q

What occurs during a Transtentorial herniation

A

Medial temporal lobe herniates under tentorium cerbelli

43
Q

What occurs during a tonsillar herniation

A

Cerebellar tonsils herniate through the foramen magnum

44
Q

What is Cushing’s triad and what does it suggest

A

Increase in Systolic Bp, Decrease in heart rate and Abnormal breathing
suggests tonsillar herniation

45
Q

Which disease will cause oligoclonal bands on electrophoresis of CSF

A

Multiple Sclerosis

46
Q

What are the Uhthoff phenomenon and L’hermitte sign and which disease can they be seen in

A

Uhthoff phenomenon –> Worsening of vision symptoms following a rise in body temperature
L’hermitte sign –> Upper limb paraesthesia on neck flexion

47
Q

How does curare affect the neuromuscular junction

A

Blocks Ach receptor at NMJ

48
Q

Curare is only harmful if administered via which routes

A

IM or IV

49
Q

How does botox affect the neuromuscular junction

A

Cleaves proteins involved in Ach vesicle formation

50
Q

Antibodies to which structures are created in Lambert Eaton syndrome

A

Pre-synaptic Ca channels

51
Q

Antibodies to which structures are created in Myasthenia gravis

A

Post-synaptic Ach Receptor

52
Q

What is the commonest muscular dystrophy

A

Myotonic Dystrophy

53
Q

The levels of which neuropeptide will be low in CSF in Narcolepsy

A

Hypocretin

54
Q

Which tracts carry ‘fast’ and ‘slow’ pain respectively

A

Fast pain –> Spinothalamic tract

Slow pain –> Spinoreticular tract

55
Q

Which sensory neuron types carry ‘fast’ and ‘slow’ pain respectively (think about the degree of myelination)

A

Aδ –> fast pain

C –> slow pain

56
Q

Which 3 brainstem regions are important in pain modulation

A

Peri-aqueductal gray
Locus coeruleus
Nucleus raphe magnus

57
Q

Which brainstem region provides profound analgesia when excited

A

Peri-Aqueductal Gray (PAG)

58
Q

Which brainstem region produces endogenous opioids and what are they called

A

Enkephalins –> produced by Nucleus Raphe Magnus

59
Q

What are the 3 kinds of opioid receptors and which ones do opioid analgesics mostly work on

A

Mu –> most analgesic action of opioids work on these
Delta
Kappa

60
Q

Name the basal ganglia

A 
Putamen 
Globius palladius
Subthalmic nucleus 
Caudate nucleus 
Substantia nigra
61
Q

A hot-cross bun sign on MRI suggests which disease

A

Multi-system atrophy

62
Q

What are the classical symptoms of multi-system atrophy

A

Parkinsonism
Autonomic dysfunction
Cerebellar dysfunction

63
Q

How is Cerebral Perfusion Pressure calculated

A

Mean Arterial Pressure - Intra Cranial pressure

64
Q

What is Split Hand syndrome and which disease can it be seen in

A

Preferential wasting of thenar muscles

seen in ALS

65
Q

What type of dementia is ALS associated with

A

Frontotemporal dementia

66
Q

How could you differentiate between ALS and PLS

A

ALS has upper motor neurone signs in the legs and lower motor neurone signs in the arms
PLS has no lower motor neurone features

67
Q

What is the only drug available for Motor Neurone Disease

A

Riluzole

68
Q

Which type of dementia is suggested if a patient presents before the age of 65

A

Frontotemporal dementia

69
Q

What is Hoffman’s sign

A

holding the middle finger at the joint closest to the fingernail
“flicking” the nail of the person’s middle finger, using their other hand.
If there is no movement in the index finger or thumb after this motion, the person has a negative Hoffman’s sign. If the index finger and thumb move, the person has a positive Hoffman’s sign

70
Q

If a patient presents within 7days of a suspected TIA, what should you do

A

300mg Aspirin and specialist review in 24hours

71
Q

Anti-psychotics should be avoided in patients with which disease

A

Parkinson’s

72
Q

If someone is seizuring in the community for longer than 5 minutes, what should be administered

A

Rectal Diazepam 10mg

73
Q

Which cause of status epilepticus should be ruled out first

A

Hypoxia

74
Q

Which epilepsy drug causes inhibition of the P450 system

A

Sodium Valproate

75
Q

Aphasia as a symptom suggests a stroke in which artery

A

Dominant hemisphere middle cerebral artery

Usually left

76
Q

Name 5 sinister signs of a headache

A 
Vomiting >1 
Neuro deficit
Decreased GCS 
A progressive headache plus fever
Positional/ Valsalva headache
77
Q

What is the gold standard test for diagnosing Degenerative Cervical Myelopathy

A

MRI

78
Q 
What does a triad of 
Ataxia
Dementia
Urinary incontinence 
suggest?
A

Normal pressure hydrocephalus

79
Q

What is the recommended treatment for Bell’s Palsy and is it an upper or lower motor neurone disease

A

Prednisolone and lubricating eye drops

Lower Motor Neurone

80
Q

What is Todd’s Paresis and which disease is it seen in

A

Post-Ictal weakness seen in focal seizures

81
Q

What is Hereditary Sensori-Motor Neuropathy also known as and how many types are there

A 
Charcot-Marie-Tooth Disease 
2 type (type 1 - Autosomal Dominant)
82
Q

What does sinusitis + fever + focal neurology suggest

A

Cerebral Abscess

83
Q

What is Saturday Night Palsy

A

Compression of radial nerve against humeral shaft causing wrist drop

84
Q

Which neurological condition are tetracycline antibiotics associated with

A

Idiopathic Intracranial Hypertension

85
Q

What are 3 treatments for Idiopathic Intracranial Hypertension

A

Weight loss
Acetazolamide
Topiramate

86
Q

Name the 4 ipsilateral and 1 contralateral symptom involved in lateral medullary syndrome

A

Ataxia
Nystagmus
Dysphagia
Cranial nerve palsy

Contralateral hemisensory loss

87
Q

Autonomic dysreflexia can only occur above which vertebral level

A

T6

88
Q

What sort of symptoms occur in autonomic dysreflexia

A

Extreme hypertension, sweating & flushing above the level of the cord lesion

89
Q

What are Shagreen patches and which disease are they seen in

A

Rough patches of skin over the lumbar spine

seen in Tuberous Sclerosis

90
Q

What is hyposmia and which neurology condition could it be an early sign of

A

it is a reduced ability to smell and to detect odors

Can be a sign of Parkinson’s

91
Q

What should you give for suspected Listeria Meningitis if the patient is allergic to penicillin

A

Co-trimoxazole alone

92
Q

Which symptom of Normal Pressure Hydrocephalus precedes all the others

A

Ataxia

93
Q

In Normal Pressure Hydrocephalus Ataxia, do people tend to fall backwards or forwards

A

backwards

94
Q

Hyperhidrosis is an early feature of which neuro condition and why does it happen

A

A feature of early-stage syringomyelia

Indicates hyperactivity in pre-ganglionic neurons

95
Q

What is the treatment for cerebral venous thrombosis

A

Heparin/Warfarin for 6 months

lifelong if already prothrombotic

Misc. Notes Year 3 (25 decks)

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