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ID/LC Step Review > Neuro/Psych 8 > Flashcards

Neuro/Psych 8 Flashcards

1
Q

Congenital hydrocephalus presentation in an infant

A
  • Poor feeding
  • Cannot roll over from supine position or sit unsupported (developmental delay)
  • macrocephaly (nl at birth though)
  • Bulging fontanelle
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2
Q

Imaging of congenital hydrocephalus

A

Significant dilation of lateral ventricles

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3
Q

What happens when congenital hydrocephalus goes untreated?

A
  • Spasticity & Hyperreflexia due to periventricular pyramidal tract stretching
  • Developmental delays
  • Seizures
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4
Q

Go look at a coronal slice of the brain and review anatomy

A

Including amygdala, caudate nucleus, globus pallidus, internal capsule, and putamen

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5
Q

Wilson disease

A

Cystic degeneration of putamen & other basal ganglia

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6
Q

Propionic acidemia presentation

A

Newborn

  • Poor feeding
  • Vomiting
  • Hypotonia
  • Lethargy
  • Dehydration
  • Anion gap acidosis

Due to inability to breakdown propionic acid

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7
Q

Propionyl CoA derivatives (aka propionic acid)

A
  • Valine
  • Isoleucine
  • Methionine
  • Threonine
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8
Q

Common peroneal nerve lesion

A
  • Due to injury of lateral neck of fibula (compression fracture)

Wkness on foot dorsiflexion (foot drop) & toe extension — deep peroneal branch

Impaired foot eversion, sensory loss of lateral leg and dorsolateral foot — superficial peroneal branch

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9
Q

L5 (L5/S1) radiculopathy

A

Sensory loss:

  • buttocks
  • posterolateral thigh
  • anterolateral leg
  • dorsal foot

Weakness:

  • Foot dorsiflexion & inversion
  • Foot eversion
  • Toe extension

No DTR

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10
Q

Fragile X

A

X-linked

  • Most common inherited intellectual disability
  • CGG expansion on FMR1

Key physical findings:

  • Large jaw
  • Protruding ears
  • Macroorchidism
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11
Q

Interscalene nerve block

A
  • Anesthetizes brachial plexus (C5-T1) as it passes through scalene triangle
  • Provides anesthesia for shoulder/upper arm

Almost all pts develop transient ipsilateral diaphragmatic paralysis due to involvement of phrenic nerve roots as they pass through the interscalene sheath

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12
Q

Treatment for toxoplasmosis

A

Pyrimethamine & sulfadiazine

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13
Q

Charcot-Bouchard aneurysms

A
  • Associated w/ HTN
  • ## Location: basal ganglia, cerebellum, thalamus, pons
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14
Q

Saccular (berry) aneurysms

A
  • Associated w/ ADPKD, Ehlers-Danlos, HTN
  • Circle of Willis
  • Variable size (2-25mm)
  • Subarachnoid hemorrhage
  • Sudden severe HA
  • Focal neuro deficits are UNCOMMON
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15
Q

Function of morphine on mu receptors

A
  • G protein linked
  • Causes activation of K conductance
  • K efflux increases and causes hyperpolarization of postsynaptic neurons => blocks pain transmission
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16
Q

CNS ischemia in brain after 3-7 days

A
  • Microglia move in

- Phagocytosis begins

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17
Q

Shoulder dislocation & strenuous UE activity (baseball pitching) affects which nerve?

A

Musculocutaneous nerve (C5-C7)

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18
Q

Musculocutaneous nerve innervation

A

Motor:

  • Forearm flexors (biceps brachii, brachialis)
  • Coracobrachialis (flexes/adducts arm)

Sensory:
- lateral forearm

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19
Q

Acute extrapyramidal symptoms and cause

A
  • Dystonic reactions
  • Akathisia (restlessness)
  • Parkinsonism

D2 blockage in nigrostriatal pathway

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20
Q

Which drugs causes acute extrapyramidal SEs?

A

First-gen high-potency antipsychotics

  • Haloperidol
  • Fluphenazine
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21
Q

Oxidation of very long chain FAs and phytanic acid

A

Think peroxisomal disease in newborn

Leads to neuro defects from improper CNS myelination

22
Q

Vitamin B12 deficiency

A
  • Presents w/ megaloblastic anemia (impaired DNA synthesis)
  • Neuro defects (impaired myelin synthesis)
  • Subacute degeneration of dorsal column and lateral corticospinal tract
23
Q

Which molecules are elevated in Vit B12 deficiency?

A

Serum methylmalonic acid and homocysteine

24
Q

Clinical presentation of epidural hematoma

A
  • “lucid interval” — doc I feel fine

- Followed by LOC

25
Epidural hematoma blood accumulation is where?
Between bone and dura mater
26
First gen H1-histamine receptor antagonists
- Penetrates BBB and accumulates in CNS - Do not use with other sedatives (e.g. benzos) Examples: - Diphenhydramine (benadryl) - Chlorpheniramine
27
Phrenic n. nerve roots
C3-C5 innervates the diaphragm (C3, 4, 5 keeps you alive)
28
PTSD
- Exposure to life-threatening trauma - Nightmares, flashbacks, intrusive memories - Avoidance of reminders, amnesia for event - Emotional detachment, negative mood, anhedonia - Sleep disturbance, hypervigilance, irritability - >1 month
29
Treatment for PTSD
- SSRIs, SNRIs | - Trauma focused CBT
30
Thiopental
- Short-acting barb - Used for inducing anesthesia - Lipid soluble => accumulates in skeletal muscle and adipose tissue
31
lateral geniculate body
Think visual
32
Medial geniculate body
Think auditory
33
Damage to temporal hemiretina
Disrupts info along ipsilateral: - Optic n - Lateral optic chiasm - Optic tract - Lateral geniculate body - Optic radiations - Primary visual cortex
34
Organophosphate poisoning
Farmers Inhibits muscarinic and nicotinic synapses Decrease Ach degradation (^ [Ach] at synaptic cleft) Presentation: DUMBELS (muscarinic), muscle paralysis (nicotinic)
35
DUMBELS
All muscarinic (not nicotinic) - Diarrhea - Urination - Miosis - Brochospasm - Emesis - Lacrimation - Salivation
36
How to reverse DUMBELS?
Atropine
37
How to reverse all SEs from organophosphate poisoning?
Pralidoxime Does both muscarinic and nicotinic
38
Paranoid personality disorder
- Pervasive pattern of distrust and suspiciousness - Begins in early adulthood - Interprets comments as threats, reacts angrily - Grudges - Questions loyalty of partner w/o justification
39
Loss of GABA-containing neurons
Huntington disease - ^ed trinucleotide repeats on chromosome 4
40
Essential tremor
- Most common movement disorder - slowly progressive, symmetric postural and/or kinetic tremor - Commonly affects UEs - AD inheritance TX: propranolol
41
Wallerian degeneration
- Axonal degeneration and breakdown of myelin sheath - occurs at distal injury site - Does not occur in CNS b/c of persistence of myelin debris, secretion of neuro inhibitory factors, and development of dense glial scarring
42
Normal pressure hydrocephalus
- Occurs in elderly - TRIAD: ataxic gait, urinary incontinence, then dementia - Due to periventricular white matter distortion and descending cortical fibers
43
Clinical presentation of measles
Prodrome: - fever, malaise, anorexia - Conjunctivitis, coryza, cough, Koplik spots Exanthem: - Blanching maculopapular rash - Cephalocaudal & centrifugal spread - Spares palms/soles
44
Complications of measles
- Pneumonia - Secondary bacterial infections - Neuro crap: encephalitis (days), acute disseminated encephalomyelitis (weeks), subacute sclerosing panencephalitis (years)
45
Tracts affected by Vit B12 deficiency
- Dorsal column - Lateral corticospinal tracts Loss of position, vibration sensation, ataxia, spastic paresis
46
HIV associated dementia histopathologic findings
Microglial nodules: - Groups of activated macros/microglial cells formed around small areas of necrosis - May fuse to form multinucleated giant cells
47
CN through superior orbital fissure
III, IV, V(1), VI Also: - ophthalmic vein - sympathetic fibers
48
CN through foramen rotundum
V(2) - maxillary
49
CN through foramen ovale
V(3) - mandibular
50
Classic triad for bacterial meningitis
- Fever - Stiff neck - Altered mentation
51
Benefits of methadone
- Potent - Long-acting opioid agonist - Good bioavailability - Once-daily dosing - Prolonged effects suppress withdrawal sx and cravings

ID/LC Step Review (19 decks)

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