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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
Q

Epidural hematoma blood accumulation is where?

A

Between bone and dura mater

26
Q

First gen H1-histamine receptor antagonists

A
  • Penetrates BBB and accumulates in CNS
  • Do not use with other sedatives (e.g. benzos)

Examples:

  • Diphenhydramine (benadryl)
  • Chlorpheniramine
27
Q

Phrenic n. nerve roots

A

C3-C5

innervates the diaphragm (C3, 4, 5 keeps you alive)

28
Q

PTSD

A
  • 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
Q

Treatment for PTSD

A
  • SSRIs, SNRIs

- Trauma focused CBT

30
Q

Thiopental

A
  • Short-acting barb
  • Used for inducing anesthesia
  • Lipid soluble => accumulates in skeletal muscle and adipose tissue
31
Q

lateral geniculate body

A

Think visual

32
Q

Medial geniculate body

A

Think auditory

33
Q

Damage to temporal hemiretina

A

Disrupts info along ipsilateral:

  • Optic n
  • Lateral optic chiasm
  • Optic tract
  • Lateral geniculate body
  • Optic radiations
  • Primary visual cortex
34
Q

Organophosphate poisoning

A

Farmers

Inhibits muscarinic and nicotinic synapses

Decrease Ach degradation (^ [Ach] at synaptic cleft)

Presentation: DUMBELS (muscarinic), muscle paralysis (nicotinic)

35
Q

DUMBELS

A

All muscarinic (not nicotinic)

  • Diarrhea
  • Urination
  • Miosis
  • Brochospasm
  • Emesis
  • Lacrimation
  • Salivation
36
Q

How to reverse DUMBELS?

A

Atropine

37
Q

How to reverse all SEs from organophosphate poisoning?

A

Pralidoxime

Does both muscarinic and nicotinic

38
Q

Paranoid personality disorder

A
  • 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
Q

Loss of GABA-containing neurons

A

Huntington disease

  • ^ed trinucleotide repeats on chromosome 4
40
Q

Essential tremor

A
  • Most common movement disorder
  • slowly progressive, symmetric postural and/or kinetic tremor
  • Commonly affects UEs
  • AD inheritance

TX: propranolol

41
Q

Wallerian degeneration

A
  • 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
Q

Normal pressure hydrocephalus

A
  • Occurs in elderly
  • TRIAD: ataxic gait, urinary incontinence, then dementia
  • Due to periventricular white matter distortion and descending cortical fibers
43
Q

Clinical presentation of measles

A

Prodrome:

  • fever, malaise, anorexia
  • Conjunctivitis, coryza, cough, Koplik spots

Exanthem:

  • Blanching maculopapular rash
  • Cephalocaudal & centrifugal spread
  • Spares palms/soles
44
Q

Complications of measles

A
  • Pneumonia
  • Secondary bacterial infections
  • Neuro crap: encephalitis (days), acute disseminated encephalomyelitis (weeks), subacute sclerosing panencephalitis (years)
45
Q

Tracts affected by Vit B12 deficiency

A
  • Dorsal column
  • Lateral corticospinal tracts

Loss of position, vibration sensation, ataxia, spastic paresis

46
Q

HIV associated dementia histopathologic findings

A

Microglial nodules:

  • Groups of activated macros/microglial cells formed around small areas of necrosis
  • May fuse to form multinucleated giant cells
47
Q

CN through superior orbital fissure

A

III, IV, V(1), VI

Also:

  • ophthalmic vein
  • sympathetic fibers
48
Q

CN through foramen rotundum

A

V(2) - maxillary

49
Q

CN through foramen ovale

A

V(3) - mandibular

50
Q

Classic triad for bacterial meningitis

A
  • Fever
  • Stiff neck
  • Altered mentation
51
Q

Benefits of methadone

A
  • 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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