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STEP1-FirstAid > Neurology > Flashcards

Neurology Flashcards

1
Q

Forebrain Origin? (embryology)

A

Prosencephalon

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2
Q

Midbrain Origin? (embryology)

A

mesencephalon

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3
Q

Hindbrain Origin? (embryology)

A

rhomboencephalon

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4
Q

2 derivatives of prosencephalon? (embryology)

A

Telencephalon and Diencephalon

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5
Q

2 derivatives of rhomboencephalon

A

metencephalon

myelencephalon

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6
Q

Embryology origin of Medulla?

A

myelencephalon (from rhomboncephalon)

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7
Q

Embryology origin of Thalamus?

A

Diencephalon (from proseencephalon)

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8
Q

Embryology origin of Cerebral hemisphere?

A

Telencephalon (from proseencephalon)

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9
Q

Embryology origin of Lower part of 4th ventricle?

A

myelencephalon (from rhomboncephalon)

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10
Q

Embryology origin of Lower part of lateral ventricle?

A

Telencephalon (from proseencephalon)

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11
Q

Embryology origin of 3rd ventricle?

A

Diencephalon (from proseencephalon)

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12
Q

Embryology origin of midbrain?

A

mesencephalon

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13
Q

Embryology origin of cerebral aqueduct?

A

mesencephalon

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14
Q

Embryology origin of pons?

A

metencephalon (from rhomboncephalon)

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15
Q

Embryology origin of cerebellum?

A

metencephalon (from rhomboncephalon)

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16
Q

Embryology origin of Upper part of 4th ventricle?

A

metencephalon (from rhomboncephalon)

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17
Q 
Neuroectoderm Derivatives (in the brain)
(name 4)
A

CNS Neurones
Ependymal Cells (inner lining of netricles)
Oligodendroglia
Astrocytes

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18
Q

Neural Crest Derivatives (in the brain)

[name 2]

A

PNS neurones

Schwann Cells

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19
Q 
Mesoderm Derivatives  (in the brain)
[name 1]
A

Microglia

just like microphages, which are also from mesoderm

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20
Q

Axons making up free nerve endings?

A

C (slow, unmyelinated)

A.delta (fast, myelinated)

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21
Q

In which Fibers do vibration and pressure travel?

A

Pacinian Corpuscles

-found in deep skin layers (hypodermis), ligaments and joints

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22
Q

In which Fibers do pressure, deep static touch (e.g. shapes, edges), and proprioception travel?

A

Merkel’s discs

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23
Q

In which Fibers do Pain and Temperature travel?

A

Free nerve endings

A.delta and C fibers

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24
Q

In which Fibers do dynamic, fine/light touch; proprioception travel?

A

meissner’s corpuscles

-in glaborous (hairless) skin

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25
Q

In the brain, which nucleus/nuclei produces serotonin or 5-HT?

A

Raphe Nucleus (pons)

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26
Q

In the brain, which nucleus/nuclei produces dopamine?

A

ventral tegmentum

substantia nigra (pars compacta)…in the midbrain

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27
Q

In the brain, which nucleus/nuclei produces norepinephrine?

A

Locus Ceruleus (pons)

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28
Q

In the brain, which nucleus/nuclei produces AcetylCholine?

A

Basal Nucleus of Meynert

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29
Q

In the brain, which nucleus/nuclei produces GABA?

A

Nucleus Accumbens

reward center, pleasure,addiction, fear

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30
Q

Functions of the hypothalamus

mnemonic is hypothalamus wears “TAN HATS”

A

T= Thirst and water balance
A= adenohypophysis (regulates anterior pituitary)
N=neurohypohysis (releases hormones made in the hypothalamus)

H= hunger
A= autonomic reglation
T= temperature regulation (prostaglandins cause 
      fever)
S= sexual drive
31
Q

Cavernous Sinus Contents

A

CNs: III, IV, VI, V1 and V2 branches of CNV
Post-ganglionic sympathetic fibers
internal carotid sinus

32
Q

Sinus surrounding the cavernous sinus?

A

Sphenoid

33
Q

Name the blood vessels that are damaged in the 3 main types of cranial hematomas.

A

Epidural Hematoma = Middle Meningeal Artery

Subdural Hematoma = Bridging Veins

Subarachnoid Hematoma = Rupture of an aneurysm (e.g. berry aneurysm). Patient presents with sudden onset of headache and describes it classically as WHOML!! Treated with Nimodipine

34
Q

Causes of Meningitis in different age group

A

Neonates: Group B strep (Agalactiae)
Ecoli
Listeria

Ages 1-2: S. Pneumonieae

Adolescents/Young Adults: N. Meningiditis

Older People: S. Pneumoniae

35
Q

Name the two sources of parasympathetic outflow

A

Cranial Nerves: III, VII, IX, X

Pelvic Splanchnics: S2, S3, S4

36
Q

Kluver-Bucy Syndrome?

aka Russel Brand’s Condition

A

Caused by BILATERAL lesion of the Amygdala

  • Hyperorality
  • Hypersexuality
  • Disinhibited Behavior

*Condition is associated with HSV-1

37
Q

Wernicke-Korsakoff Syndrome

A

Caused by BILATERAL lesion to Mamillary Bodies

  • memory loss (anterograde and retrograde amnesia)
  • Confusion
  • Opthalmoplegia
  • Ataxia
  • Confabulation
  • Personality Changes

*Condition is associated with Thiamine deficiency (vitamin B1) and also, as a secondary factor: Alcohol Abuse

38
Q

Where is ADH made in the brain?..be specific and precise

A

Made in the SUPRAOPTIC NUCLEUS of the hypothalamus…that’s where the thrst centers are located to
then stored in the posterior pituitary
***NB: suprachiasmatic nucleus regulates the circardian

39
Q

Where is oxytocin made in the brain?..be specific and precise

A

Made in the PARAVENTRICULAR NULCEUS

** but stored in the posterior pituitary

40
Q

Inputs to the Hypothalamus?

A

1) OVLT—senses changes in osmolarity

2) Area Postrema—vomit center i.e. it responds to emetics

41
Q

Functions of Hypothalamic Nuclei:

Only the 5 major nuclei

A
  1. Lateral= Hunger center…BILATERAL lesion
    leads to anorexia. Inhibited by Leptin
  2. Ventromedial= Satiety center. Stimulated by leptin
  3. Anterior= Cooling and stimulating
    Parasympathetic
  4. Posterior= Heating and stimulating sympathetic
  5. Suprachiasatic Nucleus= Circadian Rhythym
42
Q

Name 3 common brain herniation syndromes and the structures that are affected

A
  1. Subfalcine herniation (cingulate gyrus goes under the falx cerebri)—-affects the ACA
  2. Uncal herniation aka Transtentorial herniation (uncus of the medial temporal lobe goes cmpresses against the free margin of the tentorium)—-affects CN III and PCA to a lesser extent
  3. Tonsilar herniation (through the foramen magnum)….hugs against the brainstem/medulla and leads to cardiorespiratory arrest
43
Q

Multiple Sclerosis symptoms
(mnemonic = S.I.I.N)
and other classic symptoms?

A 
S= Scanning speech
I= Incontinence 
I= internuclear opthalmoplegia i.e. MLF syndrome
N= Nystgmus

OTHER classic syptoms:

  • optic neuritis
  • relapse and remitting course
44
Q

Treatment for Multiple Sclerosis

A
  • B-inteferon
  • immmunosuppression
  • natalizumab
  • symptomatic treatment for neurogenic bladder (catheterization or muscarinic antagonists)
45
Q

Name the 4 types of refractive errors (correctable by glasses) of the eye

A
  1. Myopia..image focuses in front of the retina
  2. Hyperopia (far sightedness)..image focus behind the retina
  3. Astigamatism= abnormal shape of the cornea resulting in different refractive powers at different axes
  4. Presbyopia= decreasing focusing ability during accomodation
46
Q

UVEITIS:

  • definition?
  • structures?
  • associated disorders?
A

DEF:inflammation of the uveal coat of the eye

STRUCTURES: choroid (layer between retina and sclera), ciliary body, iris

ASSOC. DISORDERS: systemic iflamtion disorders: sarcoidosis, RA, juvenile idiopathic arthritis, TB, HLA-B27-assoated conditions

47
Q

RETINITIS:

  • definition?
  • structures?
  • associated disorders?
A

DEF:retinal edema and necrosis, leading to scarring
STRUCTURES: Retina

**Caused by virus usually: HSV, HZV,CMV

ASSOC. DISORDERS: Immunosuppression

48
Q

Marcus-Gunn Pupil?

A

Pupil with Afferent Pupillary Defect
(CNII is OK, but CN II is damaged due to either retinal detachment or optic nerve damage)
Bottomline: No pupillary constriction in both eyes when light is shone in the affected eye

49
Q

Argyll-Robertson Pupil?

A

**aka Prostitute’s Pupil
***Associated with Neurosyphillis
Eye does not react to light, but is able to accommodate.

50
Q

Treatment for Age-Related Macula Degeneration (ARMD)?

A

1)Dry ARMD===treat with multivitamin and antioxidatives (in this form of ARMD, yellowish ECM fluid is deposited beneath the retinal epithelium and vision loss occurs gradually)

2) Wet ARMD====treat with anti-VEGF or Laser
(In this form of ARMD, there is neovascularization of the choridal layer of the eye)

51
Q

Causes of Retinal Detachment?

Name 3 common ones

A
  1. Retinal Tear/break….due to vitroretinal traction
  2. diabetic traction: abnormal blood vessels replaced by scar tissue. scar tissue contracts–lift retina–detachment.
    3) inflammatory effusions: no visible break or tear. Inflammation leads to break or tear
52
Q

Name the 8 ‘common’ types of spinal cord lesions

A
  1. Tabes Dorsalis (due to neurosyphylis)
  2. Poliomyelitis or Werdnig/Hoffman Syndrome (LMN disease)
  3. Anterior Spinal Artery occlusion (affects front 2/3 of spinal cord)
  4. ALS- Lou Gherig Disease (both UMN and LMN affected)
  5. Multiple Sclerosis (scatterd demyelianation in random spots)
  6. Syringomyelia (associated with Chiari I malformation if congenital)
  7. Brown-Seqard Syndrome (due to trauma)
  8. Subacute Combined Degeneration -due to Vt B12 or E deficiency (Affects doral columns, spinocerebellar tracts, lateral corticospinal tracts). Also caused by AIDS or pernicious anemia
53
Q

CMV:
Histologic Characteristics?
Brain Localization?
Presentation?

A

HISTOLOGIC CHARACTERISTICS: Both distinct nuclear and ill-defined cytoplasmic inclusions

BRAIN LOCALIZATION: Paraventricular subepyndymal regions

PRESENTATION:
-Encephalitis

-Occurs in imunocompromised patients.
Presn

54
Q

HSV1:
Histologic Characteristics?
Brain Localization?
Presentation?

A

HISTOLOGIC CHARACTERISTICS: Cowdry Type A inclusions in the nucleus of neurons and glia

BRAIN LOCALIZATION:

  • temporal lobes
  • i.e. nuclei of neurones and glia

PRESENTATION: Encephalitis (its the most common cause of this) and hemorrhage of temporal lobes

55
Q

HIV:
Histologic Characteristics?
Brain Localization?
Presentation?

A

HISTOLOGIC CHARACTERISTICS: Giant-multinucleated cells
–and microglial nodules

BRAIN LOCALIZATION: the subcortical white matter, diencephalon, and brainstem

PRESENTATION: Chronic HIV Encephalitis

56
Q

TOXOPLASMOSIS:
Histologic Characteristics?
Brain Localization?
Presentation?

A

HISTOLOGIC CHARACTERISTICS: Ring-enhancing brain lesions–these are abscesses.
-crescentic microorganisms at edge of lesion and necrosis

BRAIN LOCALIZATION: no preference

PRESENTATION: Common in immunocompromised pts. esp HIV. Present with: seizure, altered mental status, focal deficits, necrotiing encephalitis, dysarthria If congenital, triad = chorioretinitis, hydrocephalus, intracranial calcifications

57
Q

RABIES:
Histologic Characteristics?
Brain Localization?
Presentation?

A

HISTOLOGIC CHARACTERISTICS:

  • Negri Bodies, which are:
  • elongated eosinophilic intracytoplasmic inclusions

BRAIN LOCALIZATION: Purkinje cells of Cerebellum

PRESENTATION: Fever, Malaise, Agitation, photophobia, hydrophobia, paralysis, coma, death

58
Q

PML:
Histologic Characteristics?
Brain Localization?
Presentation?

A

HISTOLOGIC CHARACTERISTICS:
Greatly enlarged oligodendrocyte nuclei with glassy amorphic viral inclusions (JC virus)

BRAIN LOCALIZATION:Preferentially infects oligodendroglia

PRESENTATION: Occurs in immunocompromised patients (es HIV) and it is a demyelinating disease

59
Q

What are the 7 common primitive reflexes?

A
  1. Rooting reflex=(turning head towards side that is stroked
  2. Sucking Reflex= sucking if roof of mouth is stroked
  3. Moro Reflex = abducting/Extending limbs and then drawing together, when startled {hang on to dear life}
  4. Galant Reflex= when supine, flexing body towards the same side, when the side of the spine is stroked
  5. Plantar Reflex= Positive Babinski sign
  6. Palmar Reflex= curling fingers when palm is stroked
  7. Glabellar Reflex= blinking in responds to tapping of the forehead

NB: Primitive reflexes reappear in adulthood if there is damage to the UMN (which normally inhibits reflexes)

60
Q

What are the 5 clinical reflexes and their nerve roots?

A
  1. Biceps= C5
  2. Triceps= C7
  3. Patellar= L4
  4. Achilles=S1
  5. Babinski=must be negative if no UMN lesion
61
Q

Which disease(s) is/are associated with Hirano bodies?

A

Alzheimers

and
Creutzfeldt-Jakob Disease

62
Q

Dfferences in the memory deficits in lesioning the hippocamus versus the mamillary bodies?

A

Mamillary lesion:
—both anterograde and retrograde amnesia e.g. as seen in Wernicke-Korsakoff syndrome caused by deficiency in Thiamine (B1)…which is also used as a co-factor by yruvate dehydrogenase

Hippocamus:
—-Inability to form new memories (anetrograde amnesia)

63
Q

Which 2 conventional drugs are prescribed for treatment of intention tremors?

And what’s the UNCONVENTIONAL treatment that patients often use to self-medicate?

A

CONVENTIONAL:

  • primidone
  • B-blocker e.g. propanolol

UNCONVENTIONAL:
-sef medication with alcohol

64
Q

Mechanism of action of FLUMAZENIL?

Use of flumazenil?

A

Antagoist of GABA-a chloride channel.

Used in the overdose of Benzodiazepams

65
Q

Which drug has these properties:

  1. Anxiolytic
  2. Muscle Relaxant
  3. Anticonvulsant
  4. Amnestic Effects
A

Benzodiazepams!!!

Mechanism: increase frequency of opening of the Cl- channel on the GABA receptor

Overdose treated with flumazenil

66
Q

Which drug is used to treat 1) Malignant hypothermia induced by anesthetics and 2) Neuroleptic Malignant syndrome induced by antipsychotic drugs?

What is the mechanism of this drug?

A

DANTROLENE!!

Mechanism: Blocks release of Ca2+ from the sarcoplasmic reticulum

NB: NMS is also treated with D2 agonists such as bromocriptine

67
Q

Hyperthermia, Confusion, myoclonus, cardiovascular collapse, flushing, diarrhea, and seizures are side effects of which drug(s)?

What is the antidote?

A

SEROTONIN SYNDROME…

toxicity of SSRIs ike Fluoxetine.

Antidote= CYPROHEPTADINE (a 5-HT2 antagonist)

68
Q

At which stage of the sleep cycle does BRUXISM occur?

Whuch wave forms are associated with this stage of sleep?

A

Deeper stage (N2) ie. prior to N3–the deepest

K-complexes and spindle fibers are present

69
Q

In which stage of sleep do vivid experiences like erections, and variable BP occur?

Which wave forms are associated with this stage of sleep?

A

REM sleep!!

–BETA waves

70
Q

Theta waves are associated with which stage of sleep?

A

Light sleep–first stage (N1)

71
Q

During REM sleep, what gives rise/controls the rapid eye movements?

Which wave forms do we see?

A

The conjugate gaze center in the brain (PPRF)
-REM cycle is ~ 90min

REM has Beta waves

NB: REM is also associated with loss of motor tone and increased brain oxygen use and memory is belived to be processed in this stage too

72
Q

When one is awake, which wave forms are seen on an EEG?

A

if eyes are open = beta waves

if eyes are closed= alpha waves

sleep is controlled by the circardian rhythm which is controlled by the SCN of the hypothalamus. The SCN itself is controlled by the environment–ege light

73
Q

Drug used to treat enuresis

A

DDVAP (desmopressin)

It mimics ADH

74
Q

Which stage of sleep is associated with night terrors, sleep walking and enuresis?

Which sleep waves do you see?

A

Deepest stage (N3)

-associated with Delta waves

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