neuro2 Flashcards
Streptococcus pneumoniae, which is the leading cause of meningitis starting at
> 6 months
Increases γ-aminobutyric availability at the postsynaptic junction
valproic acid
ethosuximide SE
EFGHIJ Fatigue GI Headache Itching Steven Johnson
dry eye, dry mouth, decreased taste sensation, retroauricular pain, sensitivity to noise, and facial paralysis
bells paolsy
A lesion of the right vagus nerve (X)
uvula and soft palate to deviate to the left
Decreased sensation of the left upper cheek
v2 trigeminal maxillary branch
The postsynaptic receptors for the deficient neurotransmitter are located in what basal ganglia structure (Parkinson)
rmmber the tract substantia niagra to straitum
Direct (excitatory) pathway
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)
Indirect pathwya
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).
The nucleus cuneatus (medulla)
light touch, vibration, and proprioceptive senses
seizing for > 5 mins diagnosis and txt
status epilepticus
start with benzos to terminate seizures
phenytoin to stop recurrence
first-line drug for the treatment of generalized tonic-clonic seizures
alproic acid and vigabatrin both act by inhibiting GABA transaminase,
musculocuteous nerve innervates
biceps and skin lateral forearm
what nerve fibers are carried in cranial nerve 7
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
bells palsy signs
loss of taste, post aur pain, lack of facial exp, dry eyes mouth
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
this is Parkinson
remember dopamine is released form subs niagra to striatum (putamen and caudate)
Receptors for the neurotransmitter that is deficient in parkinson are most concentrated in which of the following brain regions
putamen
binding to the inactive form of sodium channels, stabilizing them in a closed conformation
phenytoin
the medial part of the hand (hypothenar);
ulnar nerve
Gonococcal conjunctivitis
from birth to around 5th day of life … bilateral conjunctival injection and mucopurulent discharge. Erythromycin eye drop
large cells transmitting cerebellar cortical activity to deep cerebellar nuclei
purkinje cells … secrete GABA
uncal herniatation
affects medial temporal lobe … CNIII palsy down and out pupil
Falx cerebri herniations
cingulate gyrus and may compress the anterior cerebral artery, resulting in lower limb weakness and urinary incontinence
posterior pituitary herniation, called a central or transtentorial herniation
basilar artery may rupture and cause an abducens nerve palsy.
pt has diarrhea and ankle knee strength is 3/5 diag it and what is the acid base imbalance
guillane barre … leads to resp failure so RESP ACIDOSI
anion-gap metabolic acidosis can be remembered with the mnemonic MUDPILES
Methanol, Uremia, Diabetic ketoacidosis, Propylene glycol/parcetamol (acetaminophen), Infection/iron/isoniazid, Lactic acidosis, Ethylene glycol, Salicylates).
Phentolamine
antag alpha1 and 2`
hypertension, hypercholesterolemia, and advanced age; other risk factors include cigarette smoking and diabetes mellitus are risk factors for which type of stroke
ischemic stroke
Treatment for ischemic stroke
thrombolytics (if given <4.5 hours after stroke onset), antiplatelet agents such as aspirin, and anticoagulants such as warfarin.
contralateral hemianopia with possible macular sparing.
PCA stroke
how to differentiate encephalitis vs meningitis
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
HSV1 encephalitis can include
gingivostomatitis (with lesions around the lips and gums), keratoconjunctivitis, and herpes labialis
amytriptaline mechanism and other drug that has same mechanis,
y inhibiting presynaptic neuronal reuptake of norepinephrine (NE) and serotonin (5-HT).
cocaine
colanzapine
atypical antipsychotic that blocks postsynaptic dopamine and 5-HT receptors
es of 0–6 months, the three most common causes of meningitis are
grp b sterpt
e coli
listeria
first-line therapy for spasticity in patients with MS
baclofen
ctivating GABAB receptors and inhibiting the transmission of both monosynaptic and polysynaptic reflexes at the level of the spinal cord
meningitis in a young college student living in a dormitory
n.meningitidis most likely
ind to the 30S ribosomal subunit, inhibiting formation of the initiation complex
gentamycin neomycoin
amnoglycsdes
Wilson disease.
ATP7B gene
decreased secretion of copper in the biliary systme
Dysmetria, or lack of coordination, is a type of limb ataxia that localizes to
IPSILATERAL cerebellar hemi
A slipped disc at the L5-S1 level will typically compress the
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
weakness of dorsiflexion of foot
L4 L5
weakness plantar flexion and dec achilles tendo reflex
L5 S1
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
treacher Collins
resulting in abnormal facial expression
feature of DiGeorge syndrome.
3rd 4th pharyngeal POUCHES
hypocalemia
external auditory meatus is a derivative of
first branchial CLEFT
Swallowing due to stylopharyngeus muscle is a derivative of
third branchial arch
all antipsychotics can caus EPS like akathisia, rigidity dystonia etc but why
they block dopamine rec in nigrostriatal pathway
mesocortical pathway
dopaminergic pathway
ventral tegmental area in midbrain to cerebral cortex
involved in motivation and action
damage shows negative symp of schizo
mesolimbic pathway
connets ventral tegmental area in midbrain to nucleus acuumbens in ventral striatum
Erection is mediated by the parasympathetic nervous system via the pelvic splanchnic nerves,
S2S3
S2 S4
keep penis off the floor
and anal wink
Emission—
sympathetic hypogastriv nerve
expulsion of sperm from epidydimims to prostatic urethra
aneurysm compresses the posterior communicating artery,
N III palsy, presenting as mydriasis (“blown pupil”), ptosis, or a “down and out” ey
first line agent in cluster headaches
Verapamil is the first-line agent for prophylaxis
Pheochromocytomas are the most common tumors of the adrenal medulla in adults
chromaffin cells of the adrenal medulla, which are derived from embryonic neural crest cells.
neuroectoderm derivatives include
eurohypophysis, central nervous system neurons, oligodendrocytes, astrocytes, ependymal cells, retina, and the pineal gland.
Surface ectoderm
adenohypophysis, lens of the eye, epidermis, and the epithelial linings of the skin, ear, eye, and nose
lateral medullary syndrome,
PICA or wallenberg
PICA
CNX — uvula hoarsness
symoathetic compromise—- Horner
trigeminal—– ipsilateral facial numbness or pain
spinothalamic tract —- contralateral limb loss of pain/tmp
vestibular nuclei —– disequilibrium diplopia
sedation, postural hypotension, and atropine-like (anticholinergic) side effects including tachycardia, urinary retention, and dry mouth
TCA
Broca aphasia, occurs with a lesion in Broca’s area, most likely located
left inferior frontal gyrus f
Right angular gyrus damage results in
Gerstmann syndrome or hemineglect, along with difficulty writing, calculating, and planning movement
high fever, muscle clonus, tremor, autonomic instability (diaphoresis, hyperthermia, diarrhea), and altered mental status.
serotonin syndrome
SSRI and MAOI
MAO-A,
breaks down tyramine, serotonin, norepinephrine, and dopamine,
pt switches from SSRI to tranylcypromine in a week …. develops clonus fever and diarrhea
why
must wait atleast two weeks before starting a MAOI
gh fever, muscle rigidity (“lead pipe rigidity”), altered mental status and rhabdomyolysis. (inc CK)
NMS
txt dantrolene
Hair cells on the proximal region of the organ of Corti
responsible for high freq sounds
like YOUR WIFE talking
damage can lead to presbycusis
how to diff facial nerve palsy and stroke
ask pt to furrow forehead
incase cant do it —- LMN lesion of the nerve
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
lyme
pathophysiology of NMS
blockade of dopamine receptors in the basal ganglia, hypothalamus, muscles, and postganglionic sympathetic neurons
muscle rigidity, fever, autonomic instability, and elevated creatine kinase
young patient with seziures … takes new med … devps agranulocytosis
what is this med
carbamezapine … blocks Na channels
inactivates sodium channels and inhibits N-methyl-D-aspartate receptors
Cp450 induction
Blocking T-type calcium channels
ethosuximide
progressive, asymmetric muscle weakness in his upper and lower extremities with no clear precipitant (eg, no recent trauma). Bowel and bladder function are intact.
ALS
microscopically – small, angular fibers indicative of muscular atrophy due to lack of neuronal input (denervation atrophy
eosinophilic intracytoplasmic inclusions in neurons
negri bodies
rabies
Endomysial inflammation with lymphocytic infiltration
polymyositis
to damage to the left medial longitudinal fasciculus.
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.
painless, subacute visual loss due to mutations in mitochondrial DNA
mother and brother became blind BUT non of the brothers kids experienced this
Leber hereditary optic neuropathy (LHON)
pt forgets to take insulin on time… problems going grocery on his own…. needs helo with paying bills … been progressive over 2 months
alzheimers
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
cause of death is endarteritis obliterans
tertiary syphilis
what does a positive romberg test suggest
problem with proprioception or vestibular apparatus
medial lemniscus ….carries info on proprioception touch and vibration
VHL characterised by
blood vessel grwoth ,,,, hemangiomas/hemangioblastomas in the retina that can rupture —–retinal dettachment
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).
Tuberous sclerosis
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
spinal muscular dystropy .
in the anterior horn of spinal cord
SM1 gene
anhedonia (loss of pleasure in enjoyable activities), weight changes, feelings of inadequacy, and depressed mood. These are among the classic symptoms of
depression
SIGECAPS
