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USMLE Step 1 > Neurology > Flashcards

Neurology Flashcards

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USMLE® Step 1 flashcards
1
Q

supraoptic nucleus of hypothalamus

A

ADH production

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2
Q

paraventricular nucleus of hypothalamus

A

oxytocin

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3
Q

lateral area of hypothalamus

A

hunger, destruction–>anorexia, failure to thrive (infants). Inhibited by leptin.

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4
Q

ventromedial area of hypothalamus

A

Satiety, destruction (eg craniopharnygioma)–>hyperphagia. Stimuated by leptin.

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5
Q

anterior hypothalamus

A

cooling, parasympathetic

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6
Q

posterior hypothalamus

A

heating, sympathetic

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7
Q

suprachiasmatic nucleus

A

circadium rhythms

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8
Q

Sleep cycle regulation

A

at night, nocturnal release of ACTH/prolactin/melatonin/NE: SCN–>NE release–>pineal gland–>melatonin

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9
Q

extraocular movement during REM are due to..

A

activity of PPRF (conjugate gaze center)

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10
Q

VPL of thalamus

A

input from spinothalamic and dorsal columns/medial lemniscus; pain/temp, pressure/touch, vibration/proprioception; transmits signals to primary somatosensory cortex

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11
Q

VPM of thalamus

A

input from trigeminal and gustatory pathway; face sensation and taste; primary somatosensory cortex

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12
Q

LGN of thalamus

A

input from CNII; vision; signals to calcarine sulcus

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13
Q

MGN of thalamus

A

input from superior olive and inferior colliculus of tectum; hearing; signs to auditory cortex of temporal lobe

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14
Q

VL of thalamus

A

input from basal ganglia, cerebellum; motor; signals to motor cortex

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15
Q

Lateral lesions of cerebellum

A

control voluntary movement; tendency to fall toward ipsilateral side

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16
Q

medial lesions of cerebellum

A

truncal ataxia, nystagmus, head tilting; wide based cerebellar gait; deficits in truncal coordination; bilateral motor deficits

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17
Q

lateral to medial deep nuclei of cerebellum

A

dentate, emboliform, globose, fastigial (don’t eat greasy foods)

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18
Q

MCP of cerebellum

A

receives input via contralateral cortex

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19
Q

ICP of cerebellem

A

receives ipsilateral proprioceptive information (spinal cord) via climbing and mossy fibers

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20
Q

SCP of cerebellum

A

output tract, purkinje cells–>deep nuclei–>contralateral cortex via SCP

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21
Q

Direct pathway of basal ganglia

A

D1 receptor; facilitates movement; cortex–>putamen–>GPi–>thalamus–>cortex

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22
Q

Indirect pathway of basal ganglia

A

D2 receptor; inhibits movement; cortex–>putamen–>GPe–>STN–>GPI–>thalamus–>motor cortex

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23
Q

excitation of GPe:

A

increase in movement via inhibition of STN and resultant decrease in inhibitory signals from GPi to thalamus

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24
Q

excitation of GPi:

A

decrease in movement via inhibition of thalamus and a resultant decrease in stimulatory signals to cortex

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25
Q

sudden, wild flailing of 1 arm +/- ipsilateral leg

A

hemiballismus; contralateral subthalamic nucleus (lacunar stroke)

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26
Q

sudden, jerky, purposeless movements

A

chorea; basal ganglia–huntingtons

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27
Q

slow, writhing movements; esp in fingers

A

athetosis; basal ganglia–huntingtons

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28
Q

sudden, brief, uncontrolled muscle contraction

A

myoclonus; jerks/hiccups common in metabolic abnormalities like renal/liver failure

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29
Q

sustained, involuntary muscle contractions

A

dystonia

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30
Q

action tremor, exacerbated by holding posture/limb position

A

essential tremor (postural tremor); genetic predisposition, patients often self medicate with EtOH; tx with B blockers and primidone

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31
Q

uncontrolled movement of distal appendages; tremor alleviated by intentional movement

A

resting tremor; parkinson disease (pill rolling) tremor

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32
Q

slow zigzag motion when point/extending toward target

A

intention tremor; cerebellar dysfunction

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33
Q

hyperorality, hypersexuality, disinhibited behavior

A

Kluver Bucy syndrome, bilateral amygdala lesion; associated with HSV-1

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34
Q

disinhibition and deficits in concentration, orietation, judgment, emergence of primitive reflexes

A

frontal lobe lesion

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35
Q

spatial neglect syndrome (agnosia of contralateral side of the world)

A

right parietal-temporal cortex

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36
Q

agraphia, acalculia, finger agnosia, left/right disorientation

A

left parietal temporal cortex; gerstmann syndrome

37
Q

reduced levels of arousal and wakefulness (coma)

A

reticular activating system in midbrain

38
Q

confusion, ataxia, nstagmus, memory loss (anterograde and retrograde amnesia), confabulation, personality changes

A

Wernicke Korsakoff, bilateray mammillary bodies

39
Q

contralateral hemiballismus

A

subthalamic nucleus

40
Q

anterograde amnesia

A

hippocampus, bilateral

41
Q

eyes looking away from side of lesion

A

PPRF

42
Q

eyes look toward lesion

A

frontal eye fields

43
Q

nonfluent aphasia with intact comprehension

A

broca aphasia (brocas area–inferior frontal gyrus of frontal lobe)

44
Q

fluent aphasia with impaired comprehension and repetition

A

Wernicke aphasia–superior temporal gyrus of temporal lobe

45
Q

non fluent aphasia with impaired comprehension

A

global aphasia; both broca and wernicke lesioned

46
Q

poor reptition but fluent speech, intact comprehension

A

conduction aphasia; caused by damage to left superior temporal lobe and or left supramarginal gyrus

47
Q

nonfluent aphasia with good comprehension and repetition

A

transcortical motor

48
Q

poor comprehension with fluent speech and repetition

A

transcortical sensory

49
Q

nonfluent speech, poor comprehension, good repetition

A

mixed transcortical

50
Q

MCA stroke

A

motor cortex–upper limb/face; sensory cortex–upper limb and face; temporal lobe (Wernicke area); frontal lobe (Broca area)

51
Q

ACA stroke

A

motor cortex–lower limb; sensory cortex–lower limb

52
Q

lenticulostriate artery stroke

A

striatum, internal capsule; lacunar infarcts

53
Q

ASA stroke

A

lateral corticospinal tract; medial lemniscus; caudal medulla–hypoglossal nerve

54
Q

PICA stroke

A

lateral medulla–vestibular nuclei; lateral spinothalamic tract; spinal trigeminal nucleus; nucleus ambiguus, sympathetic fibers, inferior cerebellar peduncle

55
Q

AICA stroke

A

lateral pons–cranial nerve nuclei; vestibular nuclei; facial nucleus; spinal trigeminal nucleus, cochlear nuclei, sympathetic fibers; middle and inferior cerebellar peduncles

56
Q

PCA stroke

A

occipital cortex, visual cortex

57
Q

basilary artery stroke

A

pons, medulla, lower midbrain, corticospinal and corticobulbar tracts, ocular cranial nerve nuclei, PPRF

58
Q

ACOM stroke

A

can impinge CNII, ocular defects

59
Q

PCOM stroke

A

CN III palsy (eye is down and out) with ptosis and mydriasis

60
Q

contralateral paralysis–upper limb and face, contralateral loss of sensation–upper limbs and face; aphasia if in dominant hemisphere; hemineglect if in nondominal hemisphere

A

MCA stroke

61
Q

contralateral paralysis–lower limb, contralateral loss of sensation–lower limb

A

ACA stroke

62
Q

contralateral hemiparesis/hemiplegia

A

lenticulostriate artery strok; lacunar infarcts 2ndary to unmanaged HTN

63
Q

contralateral hemiparesis–upper and lower limbs; decreased contralateral proprioception; ipsilateral hypoglossal dysfunction (tongue deviates towards lesion)

A

ASA stroke, medial medullary syndrome (infarct of paramedian branches of ASA and vertebral arteries)

64
Q

vomiting, vertigo, nystagmus; decreased pain and temp sensation from ipsilateral face and contralateral body; dysphagia/hoarsness; decreased gag reflex; ipsilateral horner syndrome; ataxia/dysmetria

A

PICA stroke; lateral medullary syndrome (Wallenberg); nucleus ambiguus effects are specific to PICA lesions (dysphagia, hoarseness)

65
Q

vomiting, vertigo, nystagmus, paralysis of face, decreased lacrimation, salivation, decreased taste from anterior 2/3 tongue, decreased corneal reflex; ipsilateral loss of hearing/Horner syndrome

A

AICA stroke; facial nucleus effects specific to AICA lesions

66
Q

contralateral hemianopia with macular sparing

A

PCA

67
Q

Poliomyelitis and spinal muscular atrophy (werdnig hoffman disease)

A

LMN lesions only due to destruction of anterior horns; flaccid paralysis

68
Q

Multiple sclerosis

A

demyelination; affects posterior columns/ random white matter; scanning speech/intention tremor/nystagmus

69
Q

amyotrophic lateral sclerosis

A

combined UMN/LMN deficits with no sensory, cognitive or oculomotor deficits

70
Q

enzyme deficiency that can cause ALS?

A

superoxide dismutase I

71
Q

tx for ALS?

A

riluzole; decreases presynaptic glutamate release

72
Q

absence of DTRs and + romberg

A

tabes dorsalis–teritary syphilis affecting posterior columns

73
Q

bilateral loss of pain/temp sensation usually C8-T1

A

syringomyelia; syrinx expands and damages anterior white commissure of spinothalamic tract (2nd order neurons)

74
Q

ataxic gait, paresthesia, impaired position sense, vibration sense

A

subacute combined degeneration–demyelination of dorsal columns and lateral corticospinal tracts; VitB12 or E deficiency

75
Q

Friedrich ataxia

A

AR; GAA repeat on chromosome 9 in gene that codes frataxin–mitochondrial functioning impairment; staggering gait, frequent falling, nystagmus, dysarthria, pes cavus, hammer toes, hypertrophic CM (cause of death); childhood kyphoscoliosis

76
Q

Parinaud syndrome

A

paralysis of conjugate vertical gaze due to lesion in superior colliculi

77
Q

Cribiform plate

A

CNI

78
Q

middle cranial fossa–through sphenoid bone

A

CN 2-6

79
Q

optic canal

A

CN2, opthalmic artery, central retinal vein

80
Q

superior orbital fissue

A

CN 3, 4, V1, 6, opthalmic vein, sympathetic fibers

81
Q

foramen rotundum

A

CN V2

82
Q

foramen ovale

A

CN V3

83
Q

foramen spinosum

A

middle meningeal artery

84
Q

Posterior cranial fossa through temporal or occipital bone

A

CN 7-12

85
Q

internal auditory meatus

A

CN 7, 8

86
Q

jugular foramen

A

CN 9, 10, 11, jugular vein

87
Q

hypoglossal canal

A

CN12

88
Q

foramen magnum

A

spinal roots of CN9, brain stem, vertebral arteries

USMLE Step 1 (36 decks)

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