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2024 - élo - usmle rx qbank > neuro2 > Flashcards

neuro2 Flashcards

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USMLE® Step 1 flashcards
1
Q

Streptococcus pneumoniae, which is the leading cause of meningitis starting at

A

> 6 months

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2
Q

Increases γ-aminobutyric availability at the postsynaptic junction

A

valproic acid

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3
Q

ethosuximide SE

A 
EFGHIJ
Fatigue
GI
Headache
Itching
Steven Johnson
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4
Q

dry eye, dry mouth, decreased taste sensation, retroauricular pain, sensitivity to noise, and facial paralysis

A

bells paolsy

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5
Q

A lesion of the right vagus nerve (X)

A

uvula and soft palate to deviate to the left

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6
Q

Decreased sensation of the left upper cheek

A

v2 trigeminal maxillary branch

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7
Q

The postsynaptic receptors for the deficient neurotransmitter are located in what basal ganglia structure (Parkinson)

A

rmmber the tract substantia niagra to straitum

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8
Q

Direct (excitatory) pathway

A

Substantia nigra input stimulates the striatum (D1), stimulating the release of GABA, which inhibits GABA release from the GPi, disinhibiting the thalamus via the GPi (thereby increasing movement)

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9
Q

Indirect pathwya

A

Substantia nigra input stimulates the striatum (D2), releasing GABA that disinhibits STN via GPe inhibition, and STN stimulates GPi to inhibit the thalamus (thereby decreasing movement).

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10
Q

The nucleus cuneatus (medulla)

A

light touch, vibration, and proprioceptive senses

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11
Q

seizing for > 5 mins diagnosis and txt

A

status epilepticus
start with benzos to terminate seizures
phenytoin to stop recurrence

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12
Q

first-line drug for the treatment of generalized tonic-clonic seizures

A

alproic acid and vigabatrin both act by inhibiting GABA transaminase,

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13
Q

musculocuteous nerve innervates

A

biceps and skin lateral forearm

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14
Q

what nerve fibers are carried in cranial nerve 7

A

afferent taste fibers from ant 2/3 tongue
general touch/pain around ear
motor function to facial muscles and stapedes
parasymp to ipsilateral lacrimal and submand gland

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15
Q

bells palsy signs

A

loss of taste, post aur pain, lack of facial exp, dry eyes mouth

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16
Q

lderly man has an unsteady gait (shuffling), trouble smiling (masked facies), and a rhythmic tremor while resting (pill-rolling tremor at rest).
whjere are the post synapctic neurotransmitter recepetors present in this condition

A

this is Parkinson

remember dopamine is released form subs niagra to striatum (putamen and caudate)

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17
Q

Receptors for the neurotransmitter that is deficient in parkinson are most concentrated in which of the following brain regions

A

putamen

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18
Q

binding to the inactive form of sodium channels, stabilizing them in a closed conformation

A

phenytoin

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19
Q

the medial part of the hand (hypothenar);

A

ulnar nerve

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20
Q

Gonococcal conjunctivitis

A

from birth to around 5th day of life … bilateral conjunctival injection and mucopurulent discharge. Erythromycin eye drop

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21
Q

large cells transmitting cerebellar cortical activity to deep cerebellar nuclei

A

purkinje cells … secrete GABA

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22
Q

uncal herniatation

A

affects medial temporal lobe … CNIII palsy down and out pupil

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23
Q

Falx cerebri herniations

A

cingulate gyrus and may compress the anterior cerebral artery, resulting in lower limb weakness and urinary incontinence

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24
Q

posterior pituitary herniation, called a central or transtentorial herniation

A

basilar artery may rupture and cause an abducens nerve palsy.

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25
Q

pt has diarrhea and ankle knee strength is 3/5 diag it and what is the acid base imbalance

A

guillane barre … leads to resp failure so RESP ACIDOSI

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26
Q

anion-gap metabolic acidosis can be remembered with the mnemonic MUDPILES

A

Methanol, Uremia, Diabetic ketoacidosis, Propylene glycol/parcetamol (acetaminophen), Infection/iron/isoniazid, Lactic acidosis, Ethylene glycol, Salicylates).

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27
Q

Phentolamine

A

antag alpha1 and 2`

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28
Q

hypertension, hypercholesterolemia, and advanced age; other risk factors include cigarette smoking and diabetes mellitus are risk factors for which type of stroke

A

ischemic stroke

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29
Q

Treatment for ischemic stroke

A

thrombolytics (if given <4.5 hours after stroke onset), antiplatelet agents such as aspirin, and anticoagulants such as warfarin.

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30
Q

contralateral hemianopia with possible macular sparing.

A

PCA stroke

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31
Q

how to differentiate encephalitis vs meningitis

A

Patient’s with encephalitis are more likely to present with behavioral and neurological signs that are associated with the area of the brain infected as is seen in this patient’s problems with memory.
sporadic HSV1 .. affects temporal lobes

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32
Q

HSV1 encephalitis can include

A

gingivostomatitis (with lesions around the lips and gums), keratoconjunctivitis, and herpes labialis

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33
Q

amytriptaline mechanism and other drug that has same mechanis,

A

y inhibiting presynaptic neuronal reuptake of norepinephrine (NE) and serotonin (5-HT).

cocaine

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34
Q

colanzapine

A

atypical antipsychotic that blocks postsynaptic dopamine and 5-HT receptors

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35
Q

es of 0–6 months, the three most common causes of meningitis are

A

grp b sterpt
e coli
listeria

36
Q

first-line therapy for spasticity in patients with MS

A

baclofen
ctivating GABAB receptors and inhibiting the transmission of both monosynaptic and polysynaptic reflexes at the level of the spinal cord

37
Q

meningitis in a young college student living in a dormitory

A

n.meningitidis most likely

38
Q

ind to the 30S ribosomal subunit, inhibiting formation of the initiation complex

A

gentamycin neomycoin

amnoglycsdes

39
Q

Wilson disease.

A

ATP7B gene

decreased secretion of copper in the biliary systme

40
Q

Dysmetria, or lack of coordination, is a type of limb ataxia that localizes to

A

IPSILATERAL cerebellar hemi

41
Q

A slipped disc at the L5-S1 level will typically compress the

A

S1 root
decreased sensation of the posterior leg and lateral foot, a diminished ankle-jerk reflex, and weakness of plantarflexion, toe flexion, and foot eversion

42
Q

weakness of dorsiflexion of foot

A

L4 L5

43
Q

weakness plantar flexion and dec achilles tendo reflex

A

L5 S1

44
Q

autosomal dominant disorder of neural crest migration failure from the first pharyngeal arch, involving craniofacial abnormalities characterized by an underdeveloped mandible and hypoplastic zygomatic bones

A

treacher Collins

resulting in abnormal facial expression

45
Q

feature of DiGeorge syndrome.

A

3rd 4th pharyngeal POUCHES

hypocalemia

46
Q

external auditory meatus is a derivative of

A

first branchial CLEFT

47
Q

Swallowing due to stylopharyngeus muscle is a derivative of

A

third branchial arch

48
Q

all antipsychotics can caus EPS like akathisia, rigidity dystonia etc but why

A

they block dopamine rec in nigrostriatal pathway

49
Q

mesocortical pathway

A

dopaminergic pathway
ventral tegmental area in midbrain to cerebral cortex
involved in motivation and action
damage shows negative symp of schizo

50
Q

mesolimbic pathway

A

connets ventral tegmental area in midbrain to nucleus acuumbens in ventral striatum

51
Q

Erection is mediated by the parasympathetic nervous system via the pelvic splanchnic nerves,

A

S2S3

52
Q

S2 S4

A

keep penis off the floor

and anal wink

53
Q

Emission—

A

sympathetic hypogastriv nerve

expulsion of sperm from epidydimims to prostatic urethra

54
Q

aneurysm compresses the posterior communicating artery,

A

N III palsy, presenting as mydriasis (“blown pupil”), ptosis, or a “down and out” ey

55
Q

first line agent in cluster headaches

A

Verapamil is the first-line agent for prophylaxis

56
Q

Pheochromocytomas are the most common tumors of the adrenal medulla in adults

A

chromaffin cells of the adrenal medulla, which are derived from embryonic neural crest cells.

57
Q

neuroectoderm derivatives include

A

eurohypophysis, central nervous system neurons, oligodendrocytes, astrocytes, ependymal cells, retina, and the pineal gland.

58
Q

Surface ectoderm

A

adenohypophysis, lens of the eye, epidermis, and the epithelial linings of the skin, ear, eye, and nose

59
Q

lateral medullary syndrome,

A

PICA or wallenberg

60
Q

PICA

A

CNX — uvula hoarsness
symoathetic compromise—- Horner
trigeminal—– ipsilateral facial numbness or pain
spinothalamic tract —- contralateral limb loss of pain/tmp
vestibular nuclei —– disequilibrium diplopia

61
Q

sedation, postural hypotension, and atropine-like (anticholinergic) side effects including tachycardia, urinary retention, and dry mouth

A

TCA

62
Q

Broca aphasia, occurs with a lesion in Broca’s area, most likely located

A

left inferior frontal gyrus f

63
Q

Right angular gyrus damage results in

A

Gerstmann syndrome or hemineglect, along with difficulty writing, calculating, and planning movement

64
Q

high fever, muscle clonus, tremor, autonomic instability (diaphoresis, hyperthermia, diarrhea), and altered mental status.

A

serotonin syndrome

SSRI and MAOI

65
Q

MAO-A,

A

breaks down tyramine, serotonin, norepinephrine, and dopamine,

66
Q

pt switches from SSRI to tranylcypromine in a week …. develops clonus fever and diarrhea
why

A

must wait atleast two weeks before starting a MAOI

67
Q

gh fever, muscle rigidity (“lead pipe rigidity”), altered mental status and rhabdomyolysis. (inc CK)

A

NMS

txt dantrolene

68
Q

Hair cells on the proximal region of the organ of Corti

A

responsible for high freq sounds
like YOUR WIFE talking
damage can lead to presbycusis

69
Q

how to diff facial nerve palsy and stroke

A

ask pt to furrow forehead

incase cant do it —- LMN lesion of the nerve

70
Q

isited the Adirondacks on a 4-day excursion. He is unable to smile, close his left eye, or wrinkle his forehead on the left side, but has no other neurologic deficits

A

lyme

71
Q

pathophysiology of NMS

A

blockade of dopamine receptors in the basal ganglia, hypothalamus, muscles, and postganglionic sympathetic neurons
muscle rigidity, fever, autonomic instability, and elevated creatine kinase

72
Q

young patient with seziures … takes new med … devps agranulocytosis
what is this med

A

carbamezapine … blocks Na channels
inactivates sodium channels and inhibits N-methyl-D-aspartate receptors
Cp450 induction

73
Q

Blocking T-type calcium channels

A

ethosuximide

74
Q

progressive, asymmetric muscle weakness in his upper and lower extremities with no clear precipitant (eg, no recent trauma). Bowel and bladder function are intact.

A

ALS
microscopically – small, angular fibers indicative of muscular atrophy due to lack of neuronal input (denervation atrophy

75
Q

eosinophilic intracytoplasmic inclusions in neurons

A

negri bodies

rabies

76
Q

Endomysial inflammation with lymphocytic infiltration

A

polymyositis

77
Q

to damage to the left medial longitudinal fasciculus.

A

Palsy of the left medial rectus with attempted right lateral gaze
e left MLF connects the right nucleus of cranial nerve (CN) VI with the left subnucleus of CN III.

78
Q

painless, subacute visual loss due to mutations in mitochondrial DNA

mother and brother became blind BUT non of the brothers kids experienced this

A

Leber hereditary optic neuropathy (LHON)

79
Q

pt forgets to take insulin on time… problems going grocery on his own…. needs helo with paying bills … been progressive over 2 months

A

alzheimers

80
Q

overflow incontinence (as indicated with the patient’s distended bladder and urinary incontinence with deep palpation), lancinating lower extremity pain, Argyll Robertson pupil, and sensory ataxia (indicated by the Romberg sign and loss of vibratory and position sensation). what could be cause of death

A

cause of death is endarteritis obliterans

tertiary syphilis

81
Q

what does a positive romberg test suggest

A

problem with proprioception or vestibular apparatus

medial lemniscus ….carries info on proprioception touch and vibration

82
Q

VHL characterised by

A

blood vessel grwoth ,,,, hemangiomas/hemangioblastomas in the retina that can rupture —–retinal dettachment

83
Q

seizures, benign hamartomas, subependymal brain tubers, intellectual disability, renal angiomyolipomas, cardiac rhabdomyomas, astrocytomas, pulmonary lymphangioleiomyomatosis, and cutaneous manifestations (eg, hypopigmented ash-leaf spot, shagreen patch, and facial angiofibromas).

A

Tuberous sclerosis

84
Q

1 month old boy cannot keep his head up when in prone psition… weak cry cant keep his posture
muscle atrophy and reduced reflexes
diag

A

spinal muscular dystropy .
in the anterior horn of spinal cord
SM1 gene

85
Q

anhedonia (loss of pleasure in enjoyable activities), weight changes, feelings of inadequacy, and depressed mood. These are among the classic symptoms of

A

depression

SIGECAPS

2024 - élo - usmle rx qbank (29 decks)

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