Neurology Flashcards
1
Q
Symptoms of cerebellar infarct/hemorrhage (4)
A
Dizziness, inability to walk, gaze palsy w/o hemiplegia
2
Q
Juvenile Huntington’s dz is ______ dominant from the father
A
Autosomal
3
Q
Med to start on patient with TIA and hypercholesterolemia hx
A
Aspirin (get that anti-platelet therapy started!)
4
Q
CT Scan findings for Huntington’s
A
Diffuse cerebral atrophy
5
Q
Healthcare worker w/ anisocoria (9 mm dilated) and normal extraocular motility; etiology is usually driven by ____
A
pharmacologic mydriatics
5
Q
Most common non-heritable genetic cause of intellectual disability
A
Trisomy 21
5
Q
If elderly pt on oral rivastigmine has intolerable GI sx (N/V), what would be next step?
A
Switch to transdermal patch of rivastigmine
5
Q
Felbamate (AED) causes these adverse side effects which leads to it being a last resort med (2)
A
Liver failure, aplastic anemia
5
Q
Those with vascular NCD usually sees issues with _____ function earliest in dz course
A
Executive
5
Q
Klein-Levin Syndrome Sx (3)
A
hypersomnia, aggressive, overly sexual behavior
5
Q
Tx for Klein-Levine Syndrome
A
Modafanil for sleep-wake d/o
5
Q
T/F: All of the cholinesterase inhibitors have been found to be equally effective in the treatment of NCD due to Alzheimer’s disease
A
True
6
Q
T/F: Rivastigmine is hepatically metabolized
A
False. Metabolized through kidney
6
Q
T/F: Due to drug-drug interactions, galantamine should not be prescribed concurrently with memantine
A
False. Galantamin + Memantine combo is the SOC for AD.
6
Q
MOCA examines this with trails B, cube/clock drawing
A
Executive Functioning
6
Q
Repeating 5 words and recalling them after a short period of time tests _____
A
delayed recall
7
Q
Naming as many words that start with a specific letter tests ____
A
language
8
Q
Serial 7’s tests and spelling world backwards tests this
A
Attention
9
Q
Defining similarities between objects (orange-apple) tests this
A
Abstraction
10
Q
Drug that can reduce functional impairment in ALS pt
A
Edaravone
11
Q
Lambert Eaton dx is most commonly associated with this type of cancer
A
small lung cell
12
Q
What tends to be spared in Lambert Eaton syndrome as opposed to myasthenia gravis?
A
Cranial nerves (with an exception of a mild ptosis)
13
Q
Most common neuropathy associated with HIV
A
Distal symmetric axonal polyneuropathy
14
Q
When is neonatal cerebral myelination completed?
A
2 years postpartum
15
Regions of the brain most affected by HIV dementia (2)
Basal ganglia and hippocampus
16
Hyperphosphorylated tau protein in the hippocampus is most associated with this dx
Alzheimer's Disease
17
Dx with 14-3-3 protein or tau in cerebrospinal fluid (CSF)
Creutzfeldt-Jakob disease
18
Brain MRI Imaging findings for Creutzfeldt-Jakob dz
hyperintensities on FLAIR and T2 weighted images in the cortex, corpus striatum, and putamen.
19
Hoover's sign
no counterpressure felt in the physician's hand under the affected leg while the patient attempts to lift the unaffected leg (psychogenic origin of sx)
20
Syndrome associated with mutation of MECP2 gene on X chromosome
Rett Syndrome
21
Pt with DM, HTN presenting with 3rd cranial nerve palsy with pupils being spared. Likely dx?
Cranial nerve III ischemia
22
T/F: Posterior communicating artery aneurysm would affect pupillary fibers first.
True
23
Syndrome with variable quadriparesis due to compression of the corticospinal and spinothalamic tracts. Upper extremities are more severely involved than the lower extremities, and there is some degree of sensory sparing.
Central Cord Syndrome
24
Artery that can be found in the anterior median grove of the pons
Basilar
25
Areas of the brain implicated in stimulating urges in patients with pathological gambling (2)
Ventral Striatum, and ventromedial prefrontal cortex
26
Initial tx for polymyositis
High dose oral corticosteroids
27
When is IVIG considered for polymyositis?
If trial with oral steroids is not effective
28
Stiff person syndrome is associated with these antibodies
Anti- glutamic acid decarboxylase (GAD) antibodies
29
Stiff person syndrome has a significant association with this medical condition
insulin-dependent Diabetes mellitus
30
In comparison to adolescents with substance use disorders, those with internet addiction have **low/high** harm avoidance
High
31
Neurocognitive disorder that presents with fluctuating levels of cognitive function
Neurocognitive disorder with Lewy Bodies
32
Lewy body dementia can be mistaken for _____
Delirium
33
Process by which there is a decreased response to a repeated stimulus over time
Habituation
34
Process that enhances the strength of synaptic transmission
Facilitation
35
Physical changes in the brain that represent a memory
Memory traces or engrams
36
During migraine, platelet serotonin levels dramatically **decrease/increase** during headache phase while urine levels **increase/decrease**
decrease, increase
37
The cavity of this structure forms the superior part of the fourth ventricle
Metencephalon
38
Todd's paralysis
Brief paralysis following a seizure
39
Acetylcholine can go down up to __% in some areas of the brain due to Alzheimer's Disease
90
40
Patient with hypersomnolence and altered behavior during wakefulness in adolescence must be considered for this neurological condition
Klein-Levin Syndrome
41
Which neurotransmitter is associated with inhibition of aggression? Dopamine or Glycine
Glycine
| Dopamine is associated with the INDUCTION of aggresssion
42
Glutamate is a precursor to _____
GABA
43
Damage to the MEDIAL frontal lobe region leads to ____
An apathy syndrome
44
Damage to the DORSOLATERAL frontal lobe region leads to
Extensive executive functioning deficits
45
A lesion to the LEFT prefrontal cortex would lead to this psychiatric symptom
Depression (Lesion to the Left Leads to Lack of Laughter)
46
A lesion to the RIGHT prefrontal cortex would lead to this psychiatric symptom
Euphoria/laughter
47
The six biogenic amine neurotransmitters
H A N D E S
Histamine, Acetylcholine, Norepinephrine, Dopamine, Epinephrine, Serotonin
48
3 receptors associated with glutamate
NMDA, kainate, AMPA
49
MAO-A degrades ____ and _____
serotonin, norepinephrine
50
MAO-B degrades
dopamine
51
_____ is an adjunct neurotransmitter for glutamate
Glycine
52
The highest concentration of glycine are found in the _____
spinal cord
53
Increased dopaminergic activity in the _____ is linked to the development of tics in Tourette's syndrome
Caudate
54
Dopamine is removed from the synaptic cleft primarily by this mechanism
Neuronal transport via DAT
55
Synapse formation peaks around ___ years old
2
56
NMDA receptors open when bound by 2 ____ molecules, and 1 ___ molecule
Glutamate, Glycine
57
Neurotransmitter located in basal forebrain, responsible for memory, attention, and executive functioning
Acetylcholine
58
Nucleus basilis of Meynert produces _____
Acetylcholine
59
GHB works on the GABA __ receptor
B
60
Medial temporal lobe atrophy is associated with these conditions (2)
Alzheimer's disease and depression
61
Where do generalized seizures usually originate
Thalamus or other sub cortical structure
62
Inactivation of the ___ channels leads to the absolute refractory period
Na+
| Prevents another action potential from occurring.
63
In Frontotemporal lobar degeneration, there is minimal ____ apraxia in the early stagess
Constructional
| Ability to copy a 3 dimensional object
64
Treatment of Parkinson's Disease could lead to this impulse control disorder
Gambling Disorder
65
Off-label med to treat fatigue in patients with MS
Amantadine
66
If MS related fatigue is refractory to amantadine, this med is used off-label
Modafanil
67
Damage to the hippocampus leads to ____ amnesia
Anterograde
68
Damage to the thalamus leads to ___ amnesia
Retrograde
69
Assessment tool that has the best sensitivity in detecting mild neurocognitive disorder due to HIV/AIDS
MOCA
70
Main limitation of International HIV dementia screen
Cannot differentiate between different subtypes of neurocognitive disorders
71
Seizure semiology involving swallowing, salivation, mastication, epigastric aura, and speech arrest, often associated with clonic facial movements, suggests involvement of the this frontal lobe structure
operculum
72
The ______, part of the limbic system, is primarily involved in regulating pain and emotion
Cingulate gyrus
73
The _______ is involved in planning and coordinating complex movements
supplementary motor area
74
The most effective target for DBS in Parkinson's disease is the ______
Subthalamic Nucleus
75
Aβ1-__ is believed more prone to aggregation and possibly more pathogenic in the setting of Alzheimer's Dz
42
76
Long term consequences of Wernicke's encephalopathy include memory deficits and ___-
Heart failure
| Thiamine deficiency can lead to wet beriberi
77
Brain MRI findings for CJD (2)
basal ganglia hyperintensities and cortical "ribboning" hyperintensities on diffusion-weighted imaging or FLAIR imaging
78
Kleine-Levin Syndrome resolves by the time the patient is in their ____
40's
79
__ ___ are a hallmark of Parkinson's dz and can be found within neurons on autopsy
Lewy bodies
80
A pallidotomy creates a lesion in the ___ ___ ; this is a procedure reserved for patients with Parkinson's dz to assist with voluntary movement
Globus pallidus (helps to reduce tremors, rigidity, and bradykinesia)
81
___ deficiency can mimic subacute combined degeneration (weakness, loss of proprioception and vibration). It is most commonly seen in patients who are status post gastric bypass, but can also be seen in those taking excessive amounts of zinc.
Copper
82
Mesial temporal lobe epilepsy syndrome (MTLE) is the most common epilepsy syndrome associated with complex partial seizures. It involves the sclerosis of the ____
Hippocampus
83
median survival time after symptom onset in patients with behavioral-variant frontotemporal neurocognitive disorder
6 to 11 years
84
The neuroimaging finding of Progressive Nonfluent aphasia is atrophy of the left posterior _____ and ____ regions of the brain.
Frontoinsular, perisylvian
85
Right hemispheric anterior temporal atrophy would result in impairments in _____ memory such as music and drawing.
Non-verbal
86
Left asymmetric anterior and lateral temporal atrophy is found in semantic dementia type of Lv-FTD in which there is decreased ____ comprehension and object naming.
single word
87
Left hemispheric frontoparietal ischemic infarct occurs after left middle cerebral artery stroke leading to right-sided _____ and Broca's aphasia.
motor weakness
88
Best way to confirm Huntington's Dx
PCR
89
After kiddo has breathrough absence sz with ethosuximide, what med next?
Depakote
90
Classic tetrad of acalculia, agraphia (without alexia), right and left confusion, and finger agnosia
Gerstmann's Syndrome
91
Cluster headaches normally occur at this time of day
Nighttime
92
Abnormal elevalted lvels of ____ is associated with increased risk of stroke in patients under 50
homocysteine
93
___ inclusion bodies are most commonly associated with frontotemporal dementia with motor neuron disease
Ubiquitin
