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USMLE Step1 > Neurology > Flashcards

Neurology Flashcards

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USMLE® Step 1 flashcards
1
Q

brain anomaly in maternal type I DM

A

anencephaly

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2
Q

In syringomyelia, UMN lesion of lower limb due to

A

lateral CS tract

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3
Q

myelination in CNS

A

oligodendroglia

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4
Q

physical support of CNS

A

astrocyte (kind of fibroblast of brain)

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5
Q

microglia origin

A

mononuclear

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6
Q

vomiting of chemotherapy

A

area postrema (CTZ)

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7
Q

NE from brain: which area

A

locus ceruleus (pons)

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8
Q

5-HT from brain: which area

A

raphae nuclei (brain stem)

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9
Q

satiety center

A

VM area of HT

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10
Q

thalamus is generally for

A

senses and motor

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11
Q

VPL

A

spinothalamic tract

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12
Q

from low to high

A

your pons will die

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13
Q

DOC for benign essential tremor

A

primidone

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14
Q

hemiballismus site

A

contralateral subthalamic nuclei

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15
Q

what aneurism in c/c hypertension

A

Charcot-bouchard aneurism in deep brain structures

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16
Q

Middle MA: bleeding and shape

A

epidural hematoma (biconvex)

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17
Q

bridging veins: bleeding and shape

A

subdural hematoma(crescent)

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18
Q

berry aneurism: bleeding

A

subarachnoid hge (worst head ache of my life)

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19
Q

foramen of monroe

A

lateral to third ventricle

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20
Q

muscle to open jaw

A

lateral pterygoid

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21
Q

what produces aqeuous humor

A

ciliary body

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22
Q

what collects aqeuos humor from anterior chamber

A

trabecular meshwork

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23
Q

Iris dilator and contrictor nerves

A

dilate alpha 1 and spinctor: M3

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24
Q

Effect of myelin in length and time constant

A

increases length const and decreases time const

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25
Q

DOC trigeminal neuralgia

A

carbamazepine

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26
Q

classes of glucoma drug: decreases synthesis

A

alpha agonists, beta blockers and diuretics

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27
Q

classes of glucoma drug: increases outflow

A

cholinomimetic and prostaglandins

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28
Q

gingival hyperplasia SE of

A

phenytoin

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29
Q

common between lamotrigine and valproate

A

simple, complex, tonic-clonic, absence and as a mood stabilizer

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30
Q

shot acting frenzodiazepines

A

ATOM (alprazolam, Triazolam Oxazepam and Midazolam)

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31
Q

malignant hyperthermia seen with (what is the exception)

A

inhaled anesthetics (but not N2O) and succinyl choline

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32
Q

antidote benzodiazepines

A

flumazenil

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33
Q

Drugs that increase outflow of aqueous humor

A

cholinomimetics and prostaglandin

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34
Q

MM of opioid drugs (channels)

A

open K and close Ca channels

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35
Q

opioid toxicity pupil

A

pin point

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36
Q

Indication of butorphanol

A

severe pain (migraine labor)

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37
Q

Ethosuximide MOA

A

blocks thalamic type Ca channels

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38
Q

important side effects of phenytoin

A

nystagmus diplopia ataxia

gingival hyperplasia hirsuitism

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39
Q

gabapentin MOA

A

inhibit voltage activated Ca channels (originally designed as GABA analog)

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40
Q

local anaesthetics MOA

A

block Na channels

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41
Q

two classes of neuromuscular blocing drugs

A

depolarizing (succinyl choline)

non-depol (curiums)

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42
Q

dandtrolne MOA

A

prevent release of Ca from SR

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43
Q

baclofen MOA

A

activates GABA receptors t spinal cord level

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44
Q

cyclobenzaprine what?

A

centrally acting sk muscle relaxant

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45
Q

name dopamine agonist

A 
bromocriptine pergolide (ergot)
pramipexole ropinirole
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46
Q

which drug increase dopamine release

A

amantidine

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47
Q

drug that inhibit dopa decarboxyase

A

carbidopa

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48
Q

comt inhibitors used in parkins

A

tolcapone

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49
Q

MAO-B inhibitor used in parkins

A

selegiline

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50
Q

use of benztropine

A

antimuscarinic in parkins

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51
Q

what is memantine

A

NMDA receptor antagonists for alzheimers

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52
Q

principle of treatment in huntingtons disease

A 
block dopamine 
VMAT inhibitor (tetrabenazine and reserpine)
D2 antagonist (haloperidol)
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53
Q

triptans MOA

A

5-HT 1B/1D agonists

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54
Q

thalamic syndrome nuclei involved

A

VPL and VPM

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55
Q

Zopiderm what and MOA

A

non-benzodiazepam hypnotics

GABAa receptor agonists

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56
Q

Notochord becomes

A

N pulposus

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57
Q

neuroectoderm divides to

A

neural tube and neural crest

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58
Q

primary vesicles of brain

A

prosen,mesen,rhomben

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59
Q

prosen becomes

A

telen and dien (tele= hemispheres)

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60
Q

rhomben becomes

A

meten adn myelen

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61
Q

mesencephalon becomes

A

pons and cerebellum

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62
Q

neural crest develops to

A

PNS neurons and schwann cells

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63
Q

rathkes pouch becomes

A

ant pituitary and craniopharyngioma

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64
Q

confirmatory test for neural tube defect

A

Ach E in amniotic fluid

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65
Q

in meningocele, subarachnoid space

A

outside

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66
Q

anencephaly risk

A

Type 1DM

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67
Q

holoprosencephaly gene and risk factor

A

sonic hedgehog signalling

patau adn fetal alcohol syndrome

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68
Q

dandy walker- 2 features

A

cerebellar vermis agenesis

cystic enlargement of 4th ventricle

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69
Q

chiari 1, age and feature

A

adult with headache, tonsils herniate

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70
Q

hydromelia

A

Resmy ask me

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71
Q

syringomyelia tracts involved

A

anterior spinal commisure (spinothalamic)

lateral CS tract

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72
Q

taste sensation which nucleus

A

solitary nucleus

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73
Q

genioglossus and styloglossus

A

protrusion and trough maaking

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74
Q

palatoglossus N and function

A

X,elevates posterior tongue

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75
Q

hyoglossus function

A

retract and depress tongue

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76
Q

BBB and repair and K+ metabolism

A

astrocyte

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77
Q

saltatory conduction is possible becuase of — channels

A

Na+

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78
Q

myelin- space constant and conduction velocity

A

both increases

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79
Q

acoustic neuroma, additional nerves

A

facial and trigeminal

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80
Q

schann cell and neuron ratio

A

1:1

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81
Q

oligodendroglia- histology

A

fried egg

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82
Q

oligodendroglia- involved diseases

A

MS,PML, leukodystrophy

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83
Q

meissner corpuscles

A

hairless skin (only one to remember)

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84
Q

merkel disc

A

finger tip

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85
Q

ruffini

A

slippage along surface

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86
Q

paccini

A

pressure adn vibration

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87
Q

free n endings

A

pain and temp

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88
Q

endo and perineurium clinical connection

A

GB syndrome, micro surgery

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89
Q

glioma marker

A

GFAP

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90
Q

depression neurotransmiter

A

all down (NE,dopamine,serotonin)

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91
Q

anxiety what increased

A

nor epinephrine

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92
Q

Ace the

A

Base

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93
Q

No locus

A

I am scared

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94
Q

Dop teg

A

the nigra

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95
Q

sero sympathy for

A

raphael

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96
Q

GABA cumben is

A

fat

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97
Q

CAG- huntington

A

caudate looses ACH and GABA

dopamine increased

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98
Q

Ach decreased in

A

Alzhemiers

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99
Q

CTZ location

A

caudate end of 4th ventricle

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100
Q

hunger (lateral) is the

A

top priority

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101
Q

OVLT location and function

A

hypothalamus and osmosensor

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102
Q

paraventricular senate

A

oxytocin

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103
Q

PPRF which part of sleep

A

REM

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104
Q

melatonin pathway

A

SCN- Nor- pineal- melatonin

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105
Q

treatment for bedwetting and sleep terror/walking

A

ADH and benzodiazines

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106
Q

b waves- sleep

A

REM (penis) and open eye

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107
Q

chew your

A

sleep spindles and K complexes

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108
Q

beta vs delta

A

low amplitude and high frequency is beta

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109
Q

non REM sleep

A

TSD (sleep walking, tremor, bed wetting)

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110
Q

VPM and VL of thalamus

A

face and taste

VL= motor

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111
Q

VPL of thalamus

A

limb sensation

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112
Q

what is not relayed in thalamus

A

olfaction

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113
Q

ant and post part of limbic system

A

angulate gyrus adn hippocampus

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114
Q

limbic system function

A

feeding, feeling, fleeing, fighting

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115
Q

locked in syndrome

A

CPM (also involve 1X,X,X1 neres)

aks ODS

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116
Q

deep nuclei from lateral to medial

A

DEGF

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117
Q

2 input and 1 output of cerebellem

A

ICP and MCP

Output is SCP(purking- nucleus-SCP)

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118
Q

cerebellem represents — in lesions

A

body
lateral- limbs, falls to ipsilateral side
midline- trunkal ataxia

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119
Q

what constitutes vestibulo cerebellum

A

inf vermis adn flocculonodular lobe (nystagmus and vertigo)

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120
Q

direct pathway inhibit GPi

A

directly

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121
Q

indirect pathway activate GPi

A

indirectly thru STN inhibition

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122
Q

lentiform nucleus is

A 
lenti shaped (putamen and GP)
stiatum is putamen and caudate
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123
Q

choreoathetosis define and disease

A

chorea- jerky
athetosis- writhing
huntingtons disease

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124
Q

drug causing dystonia

A

metochlopramide

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125
Q

DOC for benign essential tremor

A

primidone (b blockers too), metabolised to phenobarbital

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126
Q

tremors

A

resting-parkinson
intention- cerbellum
essential- anxiety and posture

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127
Q

hemiballismus diagnosis

A

C/L subthalamic nuclei (lacunar stroke)

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128
Q

eg of myoclonus

A

hiccups

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129
Q

pathology of parkinson

A

lewy bodies (a synuclein- intra cellular eosinophilic inclusions)

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130
Q

genetics of huntington and frederick

A

AD (fred is recessive)

4 (fred is 9)

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131
Q

neuronal death in huntington

A

NMDA-R binding and glutamate toxicity

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132
Q

MRI in huntingtons

A

caudate atrophy with exuacuo dilatation of frontal horns

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133
Q

mixed transcortical aphasia

A

nonfluent, poor comprehension, intact repitition

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134
Q

kluver bucy syndrome which apart and virus

A

amygdala, HSV1

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135
Q

frontal lobe syndrome

A

disorganized, disinhibited and apathetic

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Perfectly
136
Q

hemispatial neglect syndrome

A

non dominant parietal

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137
Q

dominant parietal

A

agraphia and acalculia

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138
Q

hippocampus lesion

A

anterograde amnesi

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139
Q

frontal eye field lesion

A

think frontal lobe look towards lesion

PPRF- opposite

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140
Q

severe hypertension- upper arm

A

upper leg weakness

watershed area

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141
Q

basilar art formed by

A

vertebral art

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142
Q

branches of MCA

A

lenticulostriate, ant choroidal

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143
Q

pontine arteries come from

A

basialr art

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144
Q

three branches of basilar art

A

pontine, sup cerebellar, AICA

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145
Q

cerebral flow Co2 and O2

A

Co2= 90, O2= 50

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146
Q

therapeutic hyperventillation for

A

cerebral edema and panic attacks

direct relations hip between Co2 and cerebral flow

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147
Q

CPP=

A

MAP- ICP, when o, no flow

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148
Q

internal capsule blood supply

A

lenticulostriate Art

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149
Q

ASA infarct

A

medial medullary synd

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150
Q

medial medullary synd 3 involved

A

lateral CS tract
medial leminiscus
hypoglossal n (tongue same side imp)

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151
Q

ACA infarct

A

lateral med syndrome (wallenberg)

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152
Q

specific feature of PICA infarct

A

hoarsness and dysphagia (horse- eating)

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153
Q

lateral pontine synd whicha rt and specific feature

A

AICA (paralysis of face and facial N)

decreased salivation and lacrimation

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154
Q

basialr art infarct

A

locked in syndrome

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155
Q

N involved in communicating art

A

anterior- optic

posterior- occulomotor

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156
Q

risk for berry aneurysm

A

ADPKD,ehler- danlos,black,age, HT,smoking

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157
Q

central post stroke pain syndrome

A

thalamus

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158
Q

epi and subdural shape and cause

A

appi- crescent

MMA and bridging veins

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159
Q

epidural hematoma and suture line

A

can’t cross

160
Q

shaken baby which hematoma

A

subdural

161
Q

temporal bone fracture which hematoma

A

epidural

162
Q

2 complications of SAH

A

spasm (doppler, nimodipine)

bleed (CT)

163
Q

recurrent lobar hemorrhagic stroke

A

amyloid angiopathy (elderly)

164
Q

ischemia hypoxia- which area

A

hippocampus

165
Q

irreversible damage- stroke- time

A

5 min

166
Q

red neurons- time frame

A

12- 48 hrs

167
Q

most common site of hge

A

basal ganglia

168
Q

TIA- MRI will be

A

negative

169
Q

CSF is made in

A

ependymal cells of choroid plexus

170
Q

pseudotumor cerebri which nerve

A

6 (papilledema+, imaging normal)

171
Q

treatment for pseudotumor cerebri

A

weight loss, lumbar puncture

acetazolamide

172
Q

2 types of non obstructive hydrocephalus

A

communicative and normal pressure

173
Q

caus of communicating hydrocephalus

A

obliteration of subarachnoid villi

174
Q

big venricles and wet wobbly and wacky

A

normal pre hydrocephalus

175
Q

in Exvacuo, ICP is

A

normal

176
Q

spinal nerve exit

A

corneal- above vertebrae

others- below vertebrrae

177
Q

CSF space between

A

L2 and S2

178
Q

legs are lateral in

A

lateral tracts (both corticospinaland spinothalamic)

179
Q

F gracilis (part and location)

A

leg and medial

180
Q

pain and temp can’t wait

A

they synapse in gray matter and crosses right away in ant commisure

181
Q

werdning hoffman synd

A

spinal muscualr atrophy like polio

tongue fascicualtion+

182
Q

ALS UMN or LMN

A

both

183
Q

caus of death in ALS

A

aspiration pneumonia

184
Q

U disease (ALS)

A

defect in superoxide dismutase
Lon Gehrig disease
rilouzole
glutamate antagonist

185
Q

artery of adam kiewics supply

A

ASA below T8 (thorax watershed)

186
Q

tabes dorsalis finding

A

absent DTR and positive rhomberg

187
Q

CSF in polio

A

Increased WBC

188
Q

polio virus isolated from

A

throat or stool

189
Q

frataxin

A

iron binding protein (mitochondria dysfunction in F ataxia)

190
Q

2 non CNS findings in F ataxia

A

diabetes, HCM

191
Q

horner syndrome Brown seq syndrome

A

lesion is above T1

192
Q

T4, T7 and T10

A

nipple, xiphoid, umbilicus

193
Q

L1 and L4

A

inguinal lig,knee

194
Q

S2,S3,S4

A

erection and sensation of penile and anal zones

195
Q

cremasteric reflex

A

L1,L2 (remember L1 area)

196
Q

anal wink reflex

A

S3,S4 (remember anal area)

197
Q

galant reflex

A

lower body move to stroked side

198
Q

2 nerve on pons upper border

A

abducens and trigeminal (at MCP level)

199
Q

factors of 12 except 1 and 2

A

midline nerves 3,4,6,12

200
Q

multiple rooted nerve

A

12

201
Q

spinal roots for what nerve

A

eleven (accessory)

202
Q

parlaysis of conjugate vertical gaze

A

superior colliculi (parinaud syndrome pinealoma)

203
Q

pinealoma

A

precocious puberty (germinoma), parinaud synd and hydrocephalus

204
Q

nuclei of cranial nerve

A

mid- 3, 4
pons- 5,6,7,8
medulla- 9,10,12
spinal-11

205
Q

cranial nerve nuclei medial nuclei

A

motor (basal plate) m form

206
Q

cranial nerve lateral nuclei

A

sensory (alar plate)

sulcus limitans

207
Q

CN 5 goes out in

A

SRO

208
Q

superior orbital fissure contacts

A

V1 and other nerves

opthalmic veins and symp fibres

209
Q

optic canal contents

A

CN 11, CRV, opthalmic art

210
Q

internal auditory meatus

A

CN7, 8

211
Q

jugular foramen syndrome

A

in malignancy

9,10,11,jugular vein

212
Q

some say marry money but

A

my brother says big brain matters most

213
Q

parotid gland supplied by

A

glossopharyngeal N (facial N other glands)

214
Q

sphincter pupillae which receptor

A

muscarinic

215
Q

X1 nerve

A

accesory (SCM,trapezius)

216
Q

X11

A

hypoglossal (tongue except palatoglossus)

217
Q

Name vagal nuclei

A 
N solitarius (sensations) V11, IX,X
N ambigous(motor)- IX,X,XI ie, jugular foramen
Dorsal motor N- parasympathetic- X
218
Q

corneal reflex

A

V1- nasociliary branch

V11- temporal branch- O. oculi

219
Q

lacrimal reflex-

A

V 1 and V11

220
Q

gag reflex

A

1X, X

221
Q

to turn right which SCM

A

left

222
Q

Jaw and tongue- same side

A

uvula- opposite side

223
Q

componenets of GP nerve

A

motor- stylopharyngeus
sensory-inner surface of tympanic and carotid body and sinus
para- parotid gland

224
Q

cavernous sinus syndrome- unexpected

A

V1,V2 involvement and horner syndrome

225
Q

Lopex- wide

A

frequency- low

226
Q

OVT of ear

A

oval window,scala vestibuli, scala tympani

227
Q

weber in sensory and conduction

A

sensory- unaffected

conduction-affecte

228
Q

noise induced what happens

A

damage to sternociliated cells in the organ of corti (little old age)

229
Q

keratin debri middle ear

A

cholesteatoma

230
Q

stapedius supply

A

facial (tensor tympani is V3)

231
Q

lateral pterygoid

A

lowers the jaw

232
Q

macula contains

A

cones 9no blood vessels)

233
Q

a1,b and M3 of eye

A

M3- sphincter and ciliary muscle
a1- dilator
b- ciliary epithelium (makes humor)

234
Q

during accomodation, lens becomes

A

more convex (old age problem)

235
Q

secondary closed angle glaucoma

A

hypoxia leading to vasoproliferation in iris

236
Q

drug CI in acute closure

A

epinephrine

237
Q

parts of uvea

A

chorioid, iris

238
Q

uveitis associated with

A

systemic inflammatory disorder

239
Q

metamorphosia and scotoma seen in

A

age related macualr degeneration

240
Q

wet is dirty

A

rapid loss of vision, rare, neovascularization

241
Q

wet and dry translates to

A

proli and non proli in DM

242
Q

splaying and paucity of retinal vessels

A

detachment

243
Q

dot and flame shaped hge

A

hypertension (fibrinous necrosis)

A-Vnicking, copper silver wiring, cotton wool spots

244
Q

why cherry red in CRA occlusion

A

macula supplied by choroid art

245
Q

bone spicule shaped deposits around macula

A

retinits pigmentosa (rods affected 1st0

246
Q

retinitis

A

edema and necrosis leading to scar

247
Q

optic disc swelling and enalrged blind spot

A

papilledema

248
Q

pupillary reflex (major things)

A

pre tectal- EW nucleus- ciliary ganglion

249
Q

pupillary reflex- afferent does not involve

A

LGN

250
Q

sympathetic nerve to eye

A

hypothalamus- ciliospinal center of budge- superior cervical ganglion- long ciliray nerve

251
Q

marcus gunn pupil

A

afferent defect and swinging flash ligh

GUN

252
Q

horner sydnrome ptosis

A

superior tarsal muscle

253
Q

both obliques are tested when

A

adducted (opposite direction to teh name)

254
Q

central motors

A

DM affect inner motor fibres since vessels are outside nerves

255
Q

s. oblique damage

A

problem going downstairs

256
Q

temporal mayor’s lingual skills

A

mayor loop through temporal lobe loop in the sky lingual gyrus

257
Q

pie on the floor when

A

DOR is broke

258
Q

in INO, convergence is normal, which eye nystagmus

A

abducting eye

259
Q

cortical and — atrophy in alzhemiers

A

hippocampus

260
Q

early onset alzhemiers risk

A

APP, presenilin 1 and presenelin 2

261
Q

senile plaque and neurofibrillary tangles

A

amylod b and intracellular hyperphosphorylated tau protein

262
Q

pick bodies are seen in

A

frontotemporal dementia (silver staining spherical tan)

263
Q

characteristic of pick disease

A

socially inappropriate behavior

264
Q

halewyanations seen in

A

lewy body dementia (sensitive to neuroleptics)

265
Q

rapid dementia with myoclonus

A

C J disease

266
Q

pathology of C J disease

A 
spongiform cortex (vacoules)
prPc- PrPsc
267
Q

PrPsc is resistant to

A

b pleated sheets resistant to protease

268
Q

vascualr dementia

A

stepwise decline and neuro deficit

269
Q

HIV dementia

A

microglial nodules (lot of microglia)

270
Q

cystic degeneration of putamen

A

wilsons disease

271
Q

which enzyme is deficient in alzhemiers

A

choline acetyl transferase (CAT)

272
Q

myelin increases everything except

A

time constant

273
Q

triad of MS (SIN)

A

scanning speech, intention tremor, INO, incontinence, nystagmus

274
Q

incontinence in MS

A

urge

275
Q

MRI_MS

A

periventricular plaques

276
Q

CSF- MS

A

oligoclonal bands (increased IgG)

277
Q

treatment for MS

A

b- interferon

nalalizumab (a4 integrin)

278
Q

albuminocytological dissociation

A

GB syndrome

279
Q

which infection with GBS

A

campylobactor jejuni

280
Q

MS can present with optic neuritis

A

decreased vision and pain around eye

281
Q

multiple periventricualr inflammation and demyelination after infection

A

ADEM 9measles or VZV or vacciantion)

282
Q

nerve disorder associated with scoliosis and foot deformities

A

charcot marie tooth (HMSN)

283
Q

progressive multifocal encephalopathy- pathology and risk

A

destruction of oligodendrocytes

JC virus reaction in HIV and after rituximab and natalizumab

284
Q

opposite of GBS

A

progressive multifocal leukoencephalopathy

285
Q

adrenoleukodystrophy organs involved and pathology

A

adrenal gland, testes, nervous system, decreased metabolism of VLCFA

286
Q

area involved in partial seizures

A

medial temporal lobe

287
Q

complex seizures means

A

impaired conscious ness

288
Q

absence seizures vs atonic

A

absence - staring

atonic- drop to floor

289
Q

no postictal confusion in

A

absence seizure

290
Q

clonic means

A

movement
myoclonus- hicupps
myoclonic epilepsy

291
Q

heat sensitivity- hot shower weakness

A

MS

292
Q

male headache with lacrimation/rhinorrhea

A

cluster headache (O2 and sumatriptan)

293
Q

Bil headache is

A

tension headache

294
Q

migraine prophylaxis

A

propranolol, topiramate

triptain is abortive

295
Q

brushing, eating leading to headache

A

trigeminal neuralgia (carbamazepine)

296
Q

tinnitus, vertigo, S N deafness

A

meniers disease (increased endolymph)

297
Q

positional testing in central vertigo

A 
immediate nystagmus (central must be immediate)
periphearl is delayed horizontal nystagmus
298
Q

von hippel landau

A

hemangioblastoma plus two
bil renal cell ca
pheochromocytoma

299
Q

neurofibromin functions

A

negative regulator of RAS

300
Q

pigmented iris hamartoma

A

lisch nodules (NF1)

301
Q

2 MR in t sclerosis

A

mitral regurgitation

mental retardation

302
Q

3 skin features in t sclerosis

A

ASA
angiofibroma
shagreen patches
ash leaf spots

303
Q

3 tumors in t sclerosis

A

ARA
rhabdomyoma
angiomyolipoma of kidney
astrocytoma

304
Q

tuberous sclerosis codes

A

ASA,ARA and MR

305
Q

portwine stain and tram track calcification

A

sturge weber synd

306
Q

sturge weber synd gene

A

activating mutation of GNAQ

307
Q

sturge weber location

A

portwine stain
brain angioma- seizure
sclera- glaucoma

308
Q

ataxia telengectasia 3rd feature

A

sinopulmonary infections (decreased IgA)

309
Q

neural marker

A

synaptophysin

310
Q

G multiforme is

A

grade IV astrocytoma

311
Q

butterfly glioma is

A

G multiforme

312
Q

microscopy - G multiforme

A

pseudopalisading

313
Q

meningioma arises from

A

arachnoid cells (have tail)

314
Q

meningioma micro

A

psammoma

315
Q

S 100 +ve tumors

A

melanoma and schwanommaq

316
Q

oligodendroglioma- egg conncetion

A

chicken wire capillary pattern

fried egg cells and calcification

317
Q

childhood tumors code

A

PMEC
pilocytic (low grade) astrocytoma
medulloblastoma, epidymoma, craniopharyngioma

318
Q

3 C of craniopharyngioma

A

calcification
cystic componanent
cholesterol crystals

319
Q

most common childhood supratentorial tumor

A

craniopharyngioma

320
Q

rosenthal fibres

A

pilocystic astrocytoma

321
Q

sheets of small blue cells and brain tumor

A

medulloblastoma in child, drop metastasis
homer wright rosette
very malignant (hammer)

322
Q

perivascualr rosette adn brain tumor

A

ependymoma

323
Q

falx cerebri herniation is

A

cingulate gyrus (ACA) compression

324
Q

2 types of trans tentorial

A

brain stem- duret haemorrhage

uncus- CN 111

325
Q

3 components of uncal herniation

A

ipsilateal CN 111, ipsilateral PCA and contralateral crux cerebri (false localization sign)

326
Q

glaucoma treatment ABCD

A

a agonists- vasoconstriction and decreased synthesis
b blockers- reduced synthesis
cholinomimetics- increased outflow (contraction of ciliary muscle)
diuretics- acetazolamide

327
Q

MOA of latanoprost (PGF2a)

A

increased outflow (browning of iris)

328
Q

brimonidine MOA

A

decreased synthesis a 2

329
Q

opiod analgesics MOA

A

increased K+efflux and close ca+ channels

330
Q

opiod- how to remember toxicity

A 
respiratory depression (remember dextromethorphan)
miosis and constipation (remember no tolerance to these features)
331
Q

heroid addicts treatment is

A

opiod (buprenorphine- partial agonist)

332
Q

loperamide in children SE

A

toxic megacolon (for diarrhea)

333
Q

butorphenol MOA

A

k agonist- Mu partial agonist

can cause competition with full agonist and withdrawal

334
Q

tram it all with tramadol

A

opiod, 5HT, nor epinephrine

335
Q

butorphanol indication and advantage

A

labor, migraine (less resp depression)

336
Q

Na channel inactivation

A

PVC ToLa
pheytoin, valproate, carbamazepine,
topiramate and lamotrigine

337
Q

GABA inducers (GABA-A)

A

2 groups adn 2 names
benzodiazepines, barbiturates
tiaGABine, viGABAtrin

338
Q

GABA cheater is

A

GABApentin (actually inhibits ca channels)

339
Q

ethosuximide MOA

A

block thalamic t type calcium channels

340
Q

phenytoin SE

A

gingival hyperpalsia, pseudolymphoma

341
Q

SJ syndrome- anti seizure

A

lamotrigine (must titrate)

342
Q

seizure drug for bipolar

A

valproic acid (valparin), LFT neural tube defects

343
Q

carbamazepine SE

A

agranulocytosis, aplastic anemia

liver toxicity and SIADH

344
Q

barbiturates overdose treatment

A

supportive

345
Q

ATOM is short acting

A

alprazolam,triazolam,oxazepam,midazolam (higher addiction)

346
Q

bridge to SSRI

A

diazepam

347
Q

zolpiderm MOA

A

BZ1 subtype of GABA receptor short duration because of liver metabolism
less addiction and less drowsiness

348
Q

potency of inhaled anaesthetic

A

inversely proportional to MAC

349
Q

less in blood and more in lipid

A

less in blood- fast

more in lipid- potent

350
Q

N2O is fast but not potent (not soluble in both)

A

Halothane potent but not fast, halothane has high blood gas partition coefficent

351
Q

inhaled anaesthetic decreases everything except

A

cerebral blood flow and ICP

352
Q

malignant hyperthermia treatment

A

dantrolene

353
Q

thiopental re distributes to

A

sk muscle and fat

354
Q

common benzo anaesthetic

A

midazolam

355
Q

PCP like anaesthetic MOA

A

ketamine (dissocciative anaesthesia, block NMDA receptor

356
Q

propofol MOA

A

potentiate GABA (p for P)

357
Q

local anaesthetic MOA and groups

A

block Na channels

amides will have 2 I in their name

358
Q

importance of amides

A

enter as unchanged

given if allergic to esters

359
Q

one factor favoring and another not favoring local anaesthesia

A

vasoconstriction- favors

infected tissue does not favor

360
Q

order of neurons local

A

small and myelinated (size important)

361
Q

local order of loss

A

PTTP

362
Q

SE of LA

A

cardiovascular

benzocaine- methhemoglobinemia

363
Q

2 types of NM blockers

A 
depolarizing (succ choline)
non depolar (tubocurarine)
364
Q

which channel inactivated in S choline

A

Na channels

365
Q

phase 1and 11 of s choline

A

1- potentiated by choline estrase inhibitors

11- antidote is cholineesterase inhibitor

366
Q

treatment for non depolarizing NM blockers

A

neostigmine with atropine

367
Q

most imp concern of s choline

A

hyperkalemia (don’t give in myopathies)

368
Q

dantrolene MOA

A

prevent release of ca from SR

369
Q

baclofen MOA and indication

A

potentiate GABA- b at spinal cord

muscle spasm secondary to CNS disease

370
Q

cyclobenaprine MO and indication

A

TCA- like

centrally acting muscle relaxant

371
Q

dopamine agonist

A

ergot- bromocriptine and pergolide
non ergot- pramipexole, ropinirole
pramipexole- preferred (pr for pr)

372
Q

increased dopamine avaialbility

A

amantadine (ataxia, livido reticualris)

373
Q

increase L dopa availability

A

carbidopa- decarboxylase

entracapone/tolcapone- COMT

374
Q

decrease dopamine breakdown

A

selegiline- MAOB

tolcapone- COMT

375
Q

SE of l dopa and pathology

A

on- off phenomenon

nigro striatal degeneration

376
Q

memantine is like – which like –

A 
ketamine, PCP
memantine- NMDA antagonist for alzhemiers
dogarita for alzhemiers
donepezil, galabamine
rivastigmine, tacrine
Ache inhibitors
377
Q

huntington disease treatment think dopamine

A

VMAT inhibitor- tetrabenazine, reserpine

D2 antagonist- haloperidol

378
Q

sumatriptan MOA

A

5 HT 1B/1D agonist

vasoconstiction adn trigeminal inactivation

379
Q

vasoactive peptide

A

relaxes vessels

380
Q

microscopy red neurons

A

eosinophilic cytoplasm, pyknotic nuclei, loss of nissl substance

381
Q

juvenile myoclonic epilepsy

A

genetic

sleep deprivation risky

382
Q

thalamic syndrome

A

c/c sensory loss

383
Q

microatheroma and lipohyalinosis

A

lacuanr infarct

384
Q

thalamus is supplied by

A

PCA

385
Q

biphasic growth pattern

A

schwannomma

386
Q

status drug

A

lorazepam, phenytoin, phenobarbital

387
Q

fish bones damage

A

internal laryngeal N

388
Q

DRESS syndrome

A

drug reaction with eosinophilia and systemic symptoms

after anticonvulsant, allopurinol and sulphonamides

389
Q

capsaicin causes release of

A

substance P

390
Q

fracture of orbital floor N and muscle

A 
infra orbital (max N)
inferior rectus
391
Q

familial retinoblastoma association

A

sarcoma (osteosarcoma)

392
Q

red nucleus is seen in

A

midbrain

393
Q

decerebrate rigidity

A

extensor posture (below or at red nucleus)

394
Q

cortex inhibit

A

flexor response

395
Q

all afferent are myelinated except

A

heat, slow pain, olfaction

396
Q

all efferents are myelinated except

A

post ganglionic autonomic

USMLE Step1 (19 decks)

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