Neuro/Psych 7

Question 1

What does the middle cerebral artery supply in the brain?

Answer 1

• Face/arms of motor and sensory cortex
• Broca and Wernicke speech areas
• Frontal eye field

Question 2

What is Broca aphasia?

Answer 2

• Inability to speak or write
• ## Preserved comprehension of spoken/written word

Question 3

Occlusion of the MCA

Answer 3

• Hemiparesis of contralateral arm > leg

- can also have aphasia

Question 4

Adjustment disorder

Answer 4

• ^ed anxiety, depression or disturbed behavior
• Develops w/in 3 months of an identifiable stressor
• Lasts no more than 6m

No psychosis

Question 5

Schizophreniform disorder

Answer 5

• Psychotic symptoms (delusions, hallucinations, disorganized speech & behavior, negative sxs)
• Last 1-6 months

Question 6

Blotchy red muscle fibers on Gomori trichome stain

Answer 6

Mitochondrial myopathies

“red ragged” muscle fibers are seen in mitochondrial disease

Question 7

Antidepressant monotherapy in a person w/ bipolar risk/disease

Answer 7

• Can induce mania

- Especially in those with unrecognizable bipolar disorder

Question 8

Bacterial meningititis CSF `labs

Answer 8

• ^ PMN
• ^ protein
• v glucose

Question 9

Leading cause of bacterial meningitis in adults

Answer 9

S pneumo

Question 10

Gram stain of S pneumo

Answer 10

• Lancet shaped

- G(+) cocci in pairs

Question 11

Key features of paranoid personality disorders

Answer 11

• Suspicious
• Distrustful
• Hypervigilant

Question 12

Key features of schizoid

Answer 12

• Prefers to be a loner
• Detached
• Unemotional

Question 13

Schizotypal

Answer 13

• Eccentric

- Odd thoughts, perceptions, behaviors

Question 14

Antisocial

Answer 14

• Disregard & violation of rights of others

Question 15

Borderline

Answer 15

• Chaotic relationshiops
• Sensitivity to abandonment
• Labile mood
• Impulsivity
• Inner emptiness
• Self-harm

Question 16

Histrionic

Answer 16

• Dramatic
• Superficial
• Attention-seeking

Question 17

Narcissistic

Answer 17

• Grandiosity

- Lack of empathy

Question 18

Avoidant

Answer 18

• Avoidance due to fears of criticism and rejection

Question 19

Dependent

Answer 19

• Submissive
• Clingy
• Needs to be taken care of

Question 20

OCD

Answer 20

• Rigid
• Controlling
• Perfectionistic

Question 21

Tricyclic antidepressants MOA and SEs

Answer 21

• Strong anticholinergic properties

SEs:

• confusion
• constipation
• urinary retention

Treat w/ caution in elderly due to comorbid conditions, decreased hepatic/renal clearance and higher burden of SEs

Question 22

Acoustic neuromas

Answer 22

• Schwann cell-derived tumors
• Typically arise from the vestibular portion of the vestibulocochlear nerve (CNVIII)
• Commonly located at cerebellopontine angle (between cerebellum and lateral pons)

Presents with:

• sensorineural hearing loss
• tinnitus

Question 23

Characteristic microscopic findings of Creutzfeldt-Jakob disease

Answer 23

• Abnormal prion protein
• Vacuoles in gray matter w/ NO inflammatory changes

Aka
Spongiform encephalopathy

Question 24

Why do you get bradykinesia and rigidity with Parkinson disease?

Answer 24

Reduced activity of the thalamus & its projections to the cortex

Question 25

Where do you do high-frequency deep brain stimulation for medically intractable symptoms of Parkinson disease?

Answer 25

- Globus pallidus internus - Subthalamic nucleus Promotes thalamo-cortical disinhibition

Question 26

Non-rhythmic conjugate eye movements Myoclonus

Answer 26

Describes opsoclonus-myoclonus syndrome Associated with neuroblastoma in young kids

Question 27

Neuroblastoma

Answer 27

- Most common extracranial childhood cancer - Develops from neuroblasts of adrenal medulla - Mean age = 2yo - Increased # of copies of N-myc gene

Question 28

Where does the trigeminal nerve arise in the brainstem?

Answer 28

- Middle cerebellar peduncle @ lateral aspect of mid-pons

Question 29

Infarcts involving anterior portion of medial pons

Answer 29

- Affect trigeminal nerve - Dysarthria - Contralateral ataxic hemiparesis Facial n. is CAUDAL

Question 30

Ischemic stroke microscropic changes - 12-24hrs

Answer 30

"Red neurons" Eosinophilic cytoplasm, pyknotic nuclei, loss of Nissl substance

Question 31

Ischemic stroke microscropic changes - 24-72 hrs

Answer 31

Neutrophilic infiltration

Question 32

Ischemic stroke microscopic changes - 3-7 days

Answer 32

Macrophage/Microglia infiltration Phagocytosis begins

Question 33

Ischemic stroke microscropic/macroscopic changes - 1-2 weeks

Answer 33

Micro: Reactive gliosis & vascular proliferation around necrotic area Macro: - Liquefactive necrosis

Question 34

Ischemic stroke micro/macroscropic changes >2 weeks

Answer 34

Micro: - Glial scar formation Macro: - Cystic area surrounded by dense glial fibers

Question 35

Liquefactive necrosis

Answer 35

- Complete digestion & removal of necrotic tissue - With formation of cystic cavity Hypoxic CNS injury is often followed by liquefactive necrosis

Question 36

CSF w. spherical yeast forms w/ thick capsules

Answer 36

Think Cryptococcus neoformans Associated w/HIV and starts as a lung infection

Question 37

Generation and propogation of APs

Answer 37

B/c of voltage-gated Na channels

Question 38

Once Na (AP) reaches axon terminal, what happens

Answer 38

Voltage-gated Ca channels open Allow influx of Ca Causes fusion and release of NT vesicles into synaptic cleft

Question 39

Myotonic dystrophy

Answer 39

AD Caused by ^ed # of CTG repeats on myotonia-protein kinase gene Sustained myotonia w/ wkness and atrophy is common Cataracts, frontal balding, gonadal atrophy

Question 40

Damage to optic nerve

Answer 40

- Light in that eye will cause neither pupil to constrict (nerve can't see shit) Contralateral is normal