neurology Flashcards
What is a gliobastoma multiforme?
grade 4 astrocytoma, located in the cerebral hemisphere, can cross the corpus calosum
histo: GFAP+, Pseudopalisading cell
Oligodendroglioma is?
location: frontal lobe
histo: oligodendrocytes, fried egg, chicken-wire apillery pattern
meningioma is?
location parasagittal region, histo: arachnoid cells, spindel cells concentrically arranged in a whorled pattern, psammona bodies (laminated calcification)
hemanglioblastoma is?
location: mostly cebellar, associ. with hippel-lindau sy. when found in the retinal angiomas. can poroduce erythopoetin.
hist: blood vessel, closely arranged thin walled capillaries
schwannoma is?
location cerbellopontine angle, invol. CN 7,8
histo: s100. hyper/hypocellular areas containing spindel cell, myxoid areas
Charcot-Marie-tooth disease
usul atosom. domi. associ. with foot deformities. CMT1A and caused by pm22 gene
barbiturates
-bital, facilitate gaba by action by increasing the duration cl- channel opening
induces cytochrome 450
benzos
-pam and chlodiazepoxide
facilitate gaba by increasing the frequency of opening
nonbezos hynotics
ZZZ, zolpidem
acts by bz1 subtype gaba receptor
Chiari I malformation
Ectopia of cerebral tonsils inferior to foramen magnum. associ. with spinal cavitations (eg synringomyelia)
Chiari Il malformation
Herniation of cerebral vermis and tosils
Basal ganglia brain lesion
results in tremor, chorea, athetosis . Parkison, Huntington
caused by the lenticulostriate artery
Hippocampus brain lesion
anterograde amnesia— inability to make new memory
Dominant parietal cortex brain lesion
Gerstmann syndrome, agraphia, acalculia, left-right disoritation
subthalamic nucleus
controlateral hemibalismus
mammillary body bilateral
Wernicke- Korsakoff syndrome-Confusion
Ataxia, Nystagmus, Othalmoplegia
Amygdala
Klüver-Bucy: disinhib. behavior—-> HSV1 encephalitis
Read nucleus/midbrain
decorticate posturing: fexors of the upper and lower ext. extensors
Decerebrate is the opposite
Cecebrall vermis
Truncal ataxia, drucken sailer, Nystagmus
Epidural hemorrhage
middle meningeal artery—lentiform
Subdural hemorrhage
bridging veins—-cresent shape
Subarachnoid hemorrhage
aneurysm or trauma—
intraparenchymal hemorrhage
hypertension
Charcot- Bouchard
BASilry artery stroke
Locked in syndrome (locked in the BASement)
SY: quadrplagia, loss of voluntery eye movement, consiousness
Broca
inf. frontal gyrus
expressive, Broca= Broken Boca
Wernicke
suprior temporal gyrus
receptive, Wernicke=Word salad
Saccular aneurysm
Also known as berry aneurism /biforcation at the circle of willi, Ehlers, hypertension etc
Charcot- bouchard aneurysm
Common, chron. hypert. not visible on angio.
Cluster H.
unilateral, periorbital sometimes with Horne Syndrome
Migraine
unilateral pulsating pain, photophobia
Tension
bilateral, steady band like pain
Parkinson
Lewy bodies: composed od alpha-syneuclein (intracell. eosinophilic inclusions
Huntington
autsom. dominane trinucleotide CAG, repeat expasion in huntingtin (HTT) gene chrom. Dopamin increase, GABA decrease and ACh decrease. Death of NMDA-receptors
CAG
Caudate loses ACh and GABA
Atrophy of the caudate and putamen
Alzheimer
most common. Down syn. APP is located on chrom 21.
altered proteins: Apo2 decreased, Apo4 increased
APP (Amyloid precursor protein), presenilin1 and 2: familial form
Neurofibrillary tangles, tau protein
Senile plaques in gray matter: extracellular beta amyloid core
Frontotemporal Dementia
Formerly known as Pick disease. Early changes in personality and behavior, or aphasia. May be associ. with movement disorders. FT Lobe degeneration
Lewy body dementia
Intracellular Lewy bodies in the cortex. Visual hallucination ‘HaLEWYcination’, dementia with fluctuating cognition/ altertness, REM sleep behavior disorder and parkinsonism
Vascular dementia
Result of multiple arterial infarts and or chronic ischemia, Step-wise decline. MRT: Cortical or Sucortical infarcts
Creuzfelt-Jakob disease
rapid progr. demtia with myoclonus and ataxia, Spogiform cortex Prion PrPc beta-plat-sheet resistant to protease
EEG sharp waves and increased 14-3-3 protein in CSF
idiopathic intracranial hypertension
aka pseudotumor cerebri. Increased ICP on imagings.
SY: Headache, tinnitus, diplopia, CN VI palsy—->pailleedema
normal pressure hydrocephalus
elderly, CSF openin pressure is nomal
triad: urinary in., gait ataxia, cognitive dysfunction
Acute inflammatory demyelinating polyradiculopathy
subtype: Guillain- Barre syndrome
Tuberous sclerosis
AD variable expr.
TSC1 Mutation on Chromosome 9
TSC2 mutation on chromosome 16
Tumer Suppressor genes.
HAMARTOMASS in the CNS
Harmatomas, Angiofibrosi, Mitral regurgitation, Ash-leaf spots, cardiac Rhabdomyoma (Tuberous sclerosis), auto. dOminant; Mental retardation, renal Angiomyolipoma, Seizures, Shagreen patches.
Neurofibromatosis type I
AKA von Recklinghausen
AD 100% penetrance, NF1 Mutation in tumor supressor gene
CICLOPSS
Cafe au lait spots, Interl. dis., Cutaneous neurofibromtas, Lish nodules (pigmented iris harmatos) Optic gliomas, Pheochromocytoma, Seizues/ focal neurologic Signs (often form meningioma), bone lesions (eg, sphenoid dysplasia)
Neurofibromatosis II
AD. Mutation in NF2 tumor suppressor gene on chromosome 22.
Bilat. vestibular schwannomas, juvenile cataracts, meningiomas, ependymomas
NF2 affects 2ears 2 eyes and 2 parts of the brain
Sturge-Weber-Syndrome
Congenital nonhereditary anomaly of neural crest derivatives.
Somatic mosaism of activating mutation in one copy of the GNAQ gene.
SSTURGGE:
Sporadic, port-wine Stain, Tram track calcifications, Unilateral, interl. dis. (Retardation), Glaucoma, GNAQ gene, Epilepsy
von Hippel lindau
VHL=3 Letters (Chrom.3p), HARP
Hemangioblastoma, Angiomatosis, bil. Renal cell carcimoa; Pheochromacytomas
Polio
anterior horn LMN
Friedreich Ataxia
AR Trinucl. repeat dis. GAA on chrom 9
degeration of most tracts
Staggering gait, DM, HYPERTROPHIC CARDIOMYOPATHY
Kyphoscoliosis
jaw deviation towards the side of the lesion
CN V
Uvula deviation away from the lesion
CN X
head move controlat. to the lesion
CN XI Trapezius
tonugue deviates toward the lesion
CN XII
Conduction hearing loss
towards the affected
Rinne test: BONE>AIR
Sensorineural hearing loss
localized towards unaffected ear
Rinne test: Reduced bilaterally; AIR>BONE
Horner Sy. associ. lesion
1rst neuron: pontine hemorrhage, lat. medullary syndrome, spinal cord lesion T1: Brown Sequard Syn., late stage of synringomylia)
2nd neuron: stellate ganglion compression by Pancoast tumor
3rd neuron: carotid dissection (painful)
Miosis
The SHORT ciliary nerves SHORten the pupil diameter
Pupillary reflex
message sent via CN II (pretectal nuclei), to the Westfal (midbrain)
Mydriasis
Long ciliary
Leukoria
Loss of the red reflex—–>retinoblastoma, cong. cataract, toxocariasis
Pailledema
Optic disc swelling due to ICP increase, 2°mass effect. Enlarged Optic disc
Retinits pigmentosa
Inheri. retinal degen. night blindness. Bone spicule-shaped deposits around macula
Central retinal artery occlusion
Acute, painless monocular vision loss. Retina loudy with attenuated vessels an d cherry red spot at the fovea. Embolic Sorce evaluation.
rentinal detachment
seperation of the neurosensory layer of the retina from the pigmented.
2° DM, effusions. inflamm.
flashes and floaters
Hypertensive retinopathy
uncrontrolled HTN
Flamed shaped retinal hemorrhages, av nicking,
