Neurology Flashcards
What brain lesion contains within it corkscrew fibers and located in the posterior fossa?
Piocystic Astrocytoma – solid and cystic w/ Rosenthal Fibers
What brain lesion would present with hydrocephalus and vascular rosettes?
Ependymonas – lateral ventricles ependymial cell overgrown and block flow of CSF
What brain lesion presents with solid sheets of small blue cells with hyperchromic nuclei reverting to a embryonic formation?
Medulloblastoma – Homer-Wright Rosettes (Pseudorosettes without vascular center)
– cerebellum location, poor prognosis
What medication is exclusively used for absent seizures?
Ethosuximide
What medication can be used for patients with both absent seizures and tonic-clonic seizures?
Valproic Acid
What nuclei of the thalamus is responsible for hunger?
Lateral Nuclei
What is the Paraventricular nuclei of the thalamus responsible for?
Production of Hormones
- ADH, GnRH, CrH, Oxytocin, TrH
What region of the thalamus does Leptin stimulate?
Ventromedial
What region of the thalamus does Leptin inhibit?
Lateral Nuclei
What region of the thalamus is responsible for inhibiting release of prolactin?
Arcuate – produces Dopamine
If your circadian rhythm is off, what region of thalamus is dysfunctional?
Supraoptic
What neurotransmitters are dysregulated and their levels in Huntington’s Disease?
Decreased GABA and ACh
Increased Dopamine
What are the physiologic changes associated with Huntington’s Disease?
Bilateral Caudate/Putaman (Striatum) degradation
- Dilation of the Lateral Horns
If a patient has numerous CAG repeats on Chromosome 4, what is a likely symptom/
Choreiform Movement
- Depression – Suicide
What syndrome is associated with Macrosomia, increased jaw/ear size with a long thin face and mental retardation?
Fragile X-Syndrome
What syndrome is associated with CGG repeats on the X-chromosome?
Fragile X-syndrome
If a patient has been experiencing chronic abdominal pain for decades and has been completely worked up without any etiology of their symptoms. The patient frequently visits ERs and the office; they are not on any addictive medications and does not seem to have any motivational force of their visits?
Somatic Symptom Disorder
- Need Regular scheduled frequent office visits for reassurance and improve their everyday function
What common occurs in the internal capsule causing impaired motor function and ataxia with a normal CT Scan at onset of symptoms?
Lacunar Infarction
- small vessels become hylinized and occlude the internal capsule – ischemic infarction
- Hypertensive Arteriole Sclerosis
HTN Risk Factor + DM
Where are high frequency sounds best heard in the cochlea?
At the base, near oval/round window
Where are low frequency sounds best heard in the cochlea?
Low frequency sounds propogate further into the cochlea to the apex – helicotrema (meeting of the scala vestibuli and scala tympani)
If the Arcuate Fasciculus is lesioned from a small stroke, what will be the problem?
Poor Repetition
– Good Understanding and Fluency
What pathways are considered C-fibers?
Unmyelinated
- Slow Pain
- Heat Sensation
- Olfaction
- Post ganglionic
If a child is experiencing ataxia and frequent falls and a mass is discovered in the posterior fossa, what might histology look like?
Medullablastoma
- Sheets of small cells with deep basophilic nuclei and minimal cytoplasm
- neuroectoderm origins
If a patient is diagnosed with a mass in their lungs and develop progressive ataxia with visual disruptions, what might be occuring?
Paraneoplastic Cerebellar Degeneration -- Bilateral*** symptoms due to cross reactivity of immune response damaging the Purkinje cells (+)Anti-yo (+)Anti-P/Q (+)Anti-Hu
If a patient is experiencing a change in personality and forgetfulness over the past several months and a biopsy shows vacoules between neurons - spongiform, what might be occuring?
Creutzfeldt-Jakob Disease
- Prion
- Rapid onset Dementia
What is the difference between Avoidant and Schizoid personality disorder?
Avoidant – Afraid of what people think and avoid situations where people can judge them.
Schizoid – Deteched from social life and like it that way, are perfectly content. Limited intimacy.
What would the results of testing be if a patient has conductive hearing loss?
Bone > Air Loudness with tuning fork
Lateralizes to THAT ear with conduction loss, due to the nerve being MORE sensitive to sound
Which direction does the lateralizing tuning fork go if a patient has decreased hearing in the left and has neural hearing loss?
To the RIGHT – since that side is the one working
What would be found in the amniotic fluid of a neonate with neural tube defect?
- Elevated Alpha-Feto Protein
- - Elevated Acetylcholinesterase
What is the underlying etiology of a patient who has had multiple stroke-like episodes with diffuse muscle weakness at the age of 35?
MELAS – mitocondrial encephalopathy with stroke-like episodes
2 days after an ischemic MCA stroke, what might you expect to find histologically?
Infiltration of PMN/Macro cells into the tissue
Red Nuclei – within hours of ischemia
How does morphine and other opiods work?
Binds Mu-receptor, via G-coupled receptor
– activated potassium channels to EFFLUX, which causes hyperpolarization of the membrane making it more difficult to depolarize (dulling pain)
What is a side effect of Carbamazepine (other than inducing P450)?
Syndrome of inappropriate ADH release
If a patient had a few days of diarrhea with intermittent blood present, then a week or two later develops a change in sensation and weakness in the right foot, what might be found in histology?
Guillain-Barre’
- segmented demyelination of peripheral nerves that ascends the body
- Endoneural inflammation infiltrate
