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ACVIM General Boards - 2022 > Neurology > Flashcards

Neurology Flashcards

1
Q

Which organ is a specialized ganglion in which the preganglionic fibers innervate this organ directly?

A

Adrenal medulla - Preganglionic fibers innervate the chromaffin cells directly.

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2
Q

What hormones does the adrenal medulla secrete (and in what proportion)?

A

Epinephrine (80%)

Norepinephrine (20%)

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3
Q

Where are nicotinic receptors located?

A
  1. Autonomic ganglia (sympathetic and parasympathetic)
  2. Neuromucular junctions
  3. Adrenal medulla
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4
Q

Where are muscarinic receptors located?

A
  1. Heart
  2. Smooth muscle
  3. Glands
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5
Q

What are the three type of glial cells?

A
  1. Astrocytes
  2. Oligodendrocytes
  3. Microglial cells
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6
Q

What are astrocytes?

A

Supply metabolic fuels for neurons, secrete trophic factors and synthesize neurotransmitters

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7
Q

What are oligodendrocytes? What about Schwann cells?

A

Synthesize myelin in the CNS. Schwann cells synthesize myelin in the PNS.

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8
Q

What are microglial cells?

A

Proliferate following neuronal injury - scavenge for cellular debris

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9
Q

What are first-order neurons in the sensory pathway?

A

Primary afferent neurons that receive transduced signal and transmit it to the CNS.

Cell bodies in the dorsal root or spinal cord ganglia

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10
Q

What are second order neurons?

A

Located in spinal cord or brainstem - Transmit info from first order neurons to the thalamus (cross the midline).

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11
Q

What are third order neurons?

A

Relay sensory info from thalamus to cerebral cortex

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12
Q

What are fourth order neurons?

A

The received information results in a conscious perception of the stimulus

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13
Q

What retinal cells are better for night vision?

A

Rods

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14
Q

What retinal cells are better for color vision?

A

Cones

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15
Q

What decussates at the optic chiasm?

A

Neurons from the nasal hemiretina on each side.

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16
Q

What organ contains receptor cells for auditory stimuli?

A

Organ of Corti - inner ear

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17
Q

Lesions of what structures lead to paradoxical vestibular syndrome?

A

Cerebellum - Floculonodular node or caudal cerebellar peduncle

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18
Q

With paradoxical vestibular syndrome, what direction is the head tilt? What side postural reactions are affected?

A
  1. Head tilt is away from the lesion

2. Postural reaction deficits are ipsilateral

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19
Q

True or false - Paradoxical vestibilar syndrome is alway central.

A

True - Specifically cerebellum (floculonodular lobe, caudal cerebellar peduncle)

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20
Q

What are seizures?

A

Synchronized discharges are generated by the grey matter of the cerebral cortex

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21
Q

Do forebrain lesions affect gait?

A

No - The generators of gait are below the thalamus

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22
Q

In vestibular disease, the head tilt is (towards/away) the lesion and the fast phase of nystagmus is (towards/away) from the lesion.

A

Head tilt towards the lesion

Nystagmus fast phase away from the lesion

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23
Q

What are medical treatments for congenital hydrocephalus?

A

Acetazolamide/omeprazole - dec CSF production

Glucocorticoids

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24
Q

What are surgical treatments for congenital hydrocephalus? Prognosis?

A

Ventriculoperitoneal shunt - 85% have long term improvement

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25
Q

How does surgical treatment of meningioma for dogs vs cats vary in terms of prognosis?

A

Feline - Sx may be curative

Dogs - Debulk (Sx often not curative) + radiation/chemo

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26
Q

How does hypercapnia affect cerebral bloodflow?

A

Causes vasodilation

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27
Q

What is gabapentin’s MOA?

A

Inhibition of voltage-gated Ca++ channels

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28
Q

Phenobarbital MOA

A

Gaba-chloride channel

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29
Q

Which anticonvulsant has been associated with blood dycrasias?

A

Phenobarb - bone marrow toxicity, pancytopenia, d/c pheno fast and should see improvement

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30
Q

How is pregabalin (Lyrica) similar to gabapentin?

A

Greater affinity for α2δ-subunit of voltage-gate Ca channels than gabapentin

More effective as both analgesic and anticonvulsant

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31
Q

Which is the only anti-epileptic drug that is specifically approved for dogs in the US?

A

Primidone

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32
Q

What is Keppra’s MOA?

A

Inhibits to SV2A (Calcium channel blocker)

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33
Q

How does phenobarbital affect the metabolism of Keppra?

A

Phenobarb increases Keppra’s metabolism

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34
Q

What is Zonisamide’s MOA

A

Blocks T-type Ca and voltage gated Na channels in the brain,

facilitates dopaminergic and serotonergic neurotransmission,

free radical scavenging,

enhancing GABA activity,

inhibition of glutamate,

and inhibition of carbonic anhydrase

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35
Q

What is a potential side effect of zonisamide?

A

Hepatotoxicity

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36
Q

What medications can cause PERIPHERAL vestibular signs?

A

Aminoglycosides, furosemide, chlorhex topical ear cleaning solutions

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37
Q

What endocrinopathy can cause peripheral vestibular signs?

A

Hypothyroidism

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38
Q

What medication can cause CENTRAL vestibular disease?

A

Metronidazole

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39
Q

What gene is associated with degenerative myelopathy

A

SOD1 - Superoxide desmutase

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40
Q

AA lux in small breed dogs is usually (congenital/acquired)

A

Congenital - malformation of the dens of the atlas

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41
Q

AA lux in large breed dogs is usually (congenital/acquired)?

A

Acquired - trauma

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42
Q

What is the signalment for osseous Wobbler’s?

A

Young, giant breed dog (great danes)

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43
Q

What is the signalment for disk associated Wobbler’s?

A

Middle aged, large breed dogs (Dobermans)

44
Q

Chiari-like malformation is associated with herniation of what structure?

A

Cerebellum

45
Q

What dog breed is predisposed to lumbosacral stenosis?

A

German Shepherd

46
Q

What is the treatment of choice for lumbosacral stenosis?

A

Dorsal laminectomy

47
Q

What is congenital myesthenia gravis?

A

Hereditary disorder resulting in deficiency of Ach receptors on the postsynaptic membrane.

48
Q

What is the prognosis for congenital myasthenia gravis?

A

Very poor - Treatment with pyridostigmine may be helpful, some animals may live up to 12 - 24 months

49
Q

What tick has been associated with tick paralysis in the USA?

A

Dermacentor spp

50
Q

What is the pathogenesis behind tick paralysis?

A

Female tick; saliva -> toxin in circulation-> NMJ: interfere with calcium function in release
of Ach

51
Q

How long after tick attachment does tick paralysis occur?

A

5-9 days after tick attachment

52
Q

What is the difference between acute coonhound paralysis vs. botulism?

A

Botulism - Both smooth and skeletal muscle affected (weakness and autonomic signs)

ACP - Only skeletal muscle affected

53
Q

What are the clinical signs of botulsim?

A

LMN tetraparesis/plegia
Cranial nerves often involved
Autonomic signs (mydriasis, dysphonia, megaesohpagus)

54
Q

What is the toxin associated with botulism?

A

Type C botulism toxin

55
Q

How does the botulism toxin affect the neuromuscular junction?

A

Cleaves SNAP-25 and prevents ACH release

56
Q

What is the pathogenesis of coonhound paralysis (acute canine polyradiculoneuritis)

A 
Production of autoantibodies against axons
and myelin (esp. against the ventral motor nerve root)
57
Q

What are the clinical signs of coonhound paralysis?

A

LMN signs

NO smooth muscle involvement (no megaesophagus)

58
Q

What is the prognosis of coonhound paralysis?

A

Once dog stabilized, can take between 2
weeks and 6 months to improve.

Most recover fully

59
Q

Which LMN diseases have megaesophagus?

Myasthenia gravis
Coonhound paralysis
Botulism
Tick paralysis

A

Myastheniag ravis

Botulism

60
Q

Which LMN diseases DO NOT have megaesophagus?

Myasthenia gravis
Coonhound paralysis
Botulism
Tick paralysis

A

Coonhound paralysis

Tick paralysis

61
Q

What is the pathogenesis of CONGENITAL myasthenia gravis?

A

Defect in the acetylcholine receptor (NOT immune-mediated)

62
Q

What breed has been predisposed to congenital myasthenia gravis?

A

Jack Russell Terrier

63
Q

How is masticatory muscle myositis diagnosed?

A

Biopsy of temporalis muscle, or

Antibodies to type IIM fibers

64
Q

What is dermatomyositis? What age does it occur?

A

Familial immune mediated inflammatory disease of striated muscle, skin, and microvasculature in collies/sheepdogs/collie-crossbred commonly

Occurs within 6 months of age

65
Q

How is myasthenia gravis diagnosed?

A 
Tensilon test (Edrophonium)
Acetylcholice receptor antibody test
66
Q

What is a long term treatment for myasthenia gravis?

Pyridostigmine or edrophonium?

A

Pyridostigmine

67
Q

What breeds are predisposed to necrotizing encephalitis?

A

Pugs - NME
Maltese - NME
Yorkie - NLE

68
Q

How is immune-mediated polymyositis diagnosed?

A

Muscle biopsy

CK levels are NORMAL

69
Q

What are the spinal cord segments for the hypogastric nerve?

A

L1-L4

Sympathetic innervation to bladder

70
Q

What provides sympathetic innervation to the bladder?

A

Hypogastric (L1-L4)

71
Q

What nerve provides parasympathetic innervation to the bladder?

A

Pelvic nerve (S1-S3)

72
Q

What nerve innervates the external urethral sphincter?

A

Pudendal nerve

73
Q

How is rabies definitively diagnosed?

A

Detection of rabies virus antigen in brain tissue by direct FA

Also presence of intracytoplasmic inclusion bodies (Negri bodies) in neurons

73
Q

How is rabies definitively diagnosed?

74
Q

How does the tetanus toxin work?

A

Tetanospasmin blocks release of inhibitory neurotransmitters such as glycine and GABA

75
Q

Does the tetanus antitoxin reverse tetanus?

A

No - Toxin binding is irreversible. New axons must form. Antitoxin prevents further toxin from binding

76
Q

What is the pathogenesis of coonhound paralysis?

A

Immune mediated demyelination and axonal degeneration. Occurs at nerve roots (ventral) and peripheral nerves

77
Q

How is coonhound paralysis diagnosed? EGM?

A

Based on clinical signs.

EMG - Fibrillation potentials, bizarre high frequency potentials (unique to this disease)

78
Q

Which of the following may have increased sensitivity to muscle palpation?

Myasthenia gravis
Coonhound paralysis
Tick paralysis
Botulism

A

Coonhound paralysis

79
Q

What are clinical signs of steroid-responsive meningitis-arteritis?

A

Neck pain, fever

Neurologic deficits usually not present

80
Q

What is the typical signalment for steroid-responsive meningitis-arteritis?

A

Young (<2 years old)
Beagles
Boxers

81
Q

What are CSF findings for steroid responsive arteritis-meningitis?

A

Increased protein
Neutrophilic pleocytosis
Elevated IgA

82
Q

What is the mechanism of anticonvulsant bromide?

A

Bromide migrates through neuronal chloride channels - hyperpolarizes the cell

83
Q

What is the half-life of bromide?

A

LONG half life (3 weeks) - it takes about 3 months to reach steady state

84
Q

What is a contraindication to bromide therapy?

A

Renal disease

85
Q

What are some endocrine side effects of phenobarbital?

A

Can decrease thyroid levels (due to increased clearance)

86
Q

Phenobarb induces metabolism of what drugs?

A 
Lysodren
Steroids
Ketoconazole
Theophylline
Digoxin
Propranolol
87
Q

What is the antidote for organophosphate toxicity?

88
Q

Which nerve fibers are the slowest at conducting?

A

C fibers (non-myelinated)

89
Q

Lesion localization - Limp tail, hyperreflexive patella, diminished sciatic

A

S1-S3 (patella hyper-reflexive due to weak sciatic - pseudohyperreflexia)

90
Q

How is masticatory muscle myositis best diagnosed if the patient has been on steroids?

91
Q

What therapy is contraindicated in TBI?

A

Methylprednisolone

92
Q

Which lower motor neuron disease has NORMAL spinal reflexes?

Myasthenia gravis
Coonhound paralysis
Tick paralysis
Botulism

A

Myasthenia gravis

93
Q

What branch of the trigeminal nerve causes a dropped jaw?

A

Mandibular

94
Q

What ion current causes release of acetylcholine?

A

Influx of calcium

95
Q

What percentage of animals that have cerebrovascular events are hypertensive?

96
Q

You have a boxer with signs suspicious for steroid-responsive meningitis-arteritis. How do you confirm the diagnosis?

A

CSF IgA titers

97
Q

What uncommon drug can be used for urinary incontinence?

A

Ephedrin - adrenergic agonist

98
Q

How do seizures in cats start?

A

Complex focal

99
Q

How do you confirm congenital myasthenia gravis?

100
Q

What is the localization for a two engine gait?

101
Q

What is the most common neurotransmitter in post ganglionic sympathetic nerves?

A

Norepinephrine

102
Q

Neurotransmitters (Excitatory/inhibitory):

Glutamate
GABA
Glycine

A

Glutamate - Excitatory
GABA - inhibitory (brain)
Glycine - Inhibitory (spinal cord)

103
Q

How does CO2 concentration affect cerebral blood flow?

A

Increased CO2 causes vasodilation

104
Q

How does oxygenation affect cerebral perfusion?

A

Decreased O2 causes vasodilation

105
Q

What is cytotoxic brain edema?

A

Arises secondary to ischemia - decreased ATP leads to edema within the cells

106
Q

What is vasogenic brain edema?

A

Increased vascular permeability - Edema is in interstitium

ACVIM General Boards - 2022 (16 decks)

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