Neurology Flashcards
What is the MOA of ethosuximide?
blocks T-type Ca2+ channels
What is the MOA of carbamazepine?
Na+ channel blocker
What is the MOA of valproic acid?
Na+ channel blocker
inhibit GABA transaminase
What is the MOA of gabapentin?
blocks Ca2+ channels
GABA analogue
What is the MOA of Topiramate?
Na+ channel blocker
What are the MOAs of tigabine?
inhibits GABA transaminase
inhibit GABA reuptake
What is the function of the notochord?
induce ectoderm to differentiate into neuroectoderm
What two things does the neural plate give rise to?
neural crest cells
neural tube
Is the alar plate dorsal or ventral?
dorsal
Is the alar plate motor or sensory?
sensory
Is the basal plate dorsal or ventral?
ventral
Is the basal plate motor or sensory?
motor
What two structures does the prosencephalon give rise to?
telencephalon and diencephalon
What two structures does the telencephalon give rise to in adults?
cerebral hemispheres
lateral ventricles
What two structures does the diencephalon give rise to in adults?
thalamus
3rd ventricle
What two structures does the mesencephalon give rise to in adults?
midbrain
cerebral aqueduct of sylvius
What two structures does the rhomboencephalon give rise to?
Metencephalon
Myelencephalin
What three structures does the Metencephalon give rise to?
pons
cerebellum
upper part of 4th ventricle
What two structures does the Myelencephalon give rise to?
medulla
lower part of 4th ventricle
Which epithelial layer gives rise to microglia?
mesoderm
During what week of development would the neuropores fail to close during a neural tube defect?
4th week
What enzyme can be elevated during a neural tube defect?
AchE
Maternal Diabetes is associated with what neural development defect?
anencephaly
What specific structure is defective during Anencephaly?
anterior neural tube
What lab value would be affected by Anencephaly?
increased AFP
What would be noticeable during pregnancy regarding anencephaly? Why?
polyhydramnios
swallowing center
What signaling pathway may be implicated during Holoprosencephaly?
sonic hedgehog
What two structures herniate during a Chiari Type II?
cerebellar tonsils and vermis
What other pathology is Chiari Type Two associated with? Causing?
lumbar myelomeningocele
paralysis below defect
Which specific structure undergoes agenesis during Dandy-Walker?
cerebellar vermis
What two diseases are associated with Dandy-Walker?
hydrocephalus
spina bifida
Between which two vertebral levels is syringomyelia most common?
C8-T1
Which disease is Syringomyelia associated with?
Chiari Type One
What two complaints would be consistent with the manifestation of Syringomyelia?
headaches
cerebellar symptoms
What nerve provides sensation to the anterior 2/3 of the tongue? Taste?
V3
taste = seven
Muscles of the tongue are derived from which myotomes?
occipital
What is the function of genioglossus?
protrude tongue
What is the function of hyoglossus?
retract tongue
What is the function of palatoglossus?
push tongue to palate
Do dendrites send or receive signals?
receive
Do axons send or receive signals?
send
What stain can be used on neurons? What organelle is targeted?
Nissl
RER
What two parts of a neuron are stained by Nissl?
cell body and dendrites
During Wallerian degeneration, does the distal or proximal end of the axon degenerate?
distal degenerates
During Wallerian degeneration, does the distal or proximal end of the axon retract?
proximal retracts
What cell in the brain is responsible for potassium metabolism?
Astrocytes
Which cell in the brain stores glycogen?
astrocyte
Which cell participates in gliosis?
astrocyte
What is the function of microglia?
CNS phagocytes
Which HIV-infected cells fuse to form multinucleated giant cells in CNS?
Microglia
What cell does the JC Virus infect?
Oligodendroglia
Can Schwann Cells or Oligodendroglia myelinate multiple cells?
oligodendrocytes
What cell is destroyed during Guillain-Barre Syndrome?
Schwann cells
What is the function of Meissners Corpuscles?
fine/light touch
What is the function of Pacinian Corpuscles?
vibration
What is the function of Merkel Discs?
pressure
Where are Meissners Corpuscles located?
hairless skin
Where are pacinian corpuscles located?
deep skin layers
Where are Merkel discs located?
basal epidermal layer
What layer of the nerve is affected during Guillain-Barre?
Endoneurium
Which layer of nerve is the permeability barrier?
Perineurium
What brain center is norepinephrine synthesized?
locus ceruleus
What happens to norepinephrine levels during anxiety?
increase
What happens to norepinephrine levels during depression?
decrease
What two structures in the brain represent the sites of dopamine synthesis?
ventral tegmentum
Sustantia nigra pars compacta
Does dopamine increase or decrease in Huntingtons disease?
increase
Does dopamine increase or decrease in depression?
decrease
What structure synthesizes serotonin?
raphe nucleus
What is the level of serotonin in Parkinsons?
increased
What is the level of serotonin in Anxiety?
decreased
What is the level of serotonin in Depression?
decreased
Where is acetylcholine made in brain?
Nucleus Basilis of Meynert
What is the level of acetylcholine in Parkinsons?
increased
What is the level of acetylcholine in Alzheimers?
decreased
What is the level of acetylcholine in Huntington?
decreased
Where in the brain is GABA made?
nucleus accumbens
What happens to GABA levels during Huntingtons?
decreased
What is the function of the Nucleus Accumbens in the brain?
pleasure center
What area of the brain is responsible for osmotic sensing? Stands for?
OVLT
organum vasculosum of lamina terminalis
Which nucleus of the hypothalamus synthesizes ADH?
supra-optic
Which nucleus of the hypothalamus synthesizez oxytocin?
paraventricular
What is the function of the Lateral Area of the hypothalamus?
hunger
What does destruction of the Lateral Area of the hypothalamus result in?
anorexia
What is the function of the Ventromedial nucleus of the hypothalamus?
satiety
What does destruction of the Ventromedial of the hypothalamus result in?
hyper-phagia
What part of the hypothalamus can a craniopharyngioma obstruct?
ventromedial
What is the function of the Anterior nucleus of the hypothalamus?
parasympathetic cooling
What is the function of the Posterior nucleus of the hypothalamus?
sympathetic heating
What structure regulates eye movements during REM sleep?
paramedian pontine reticular formation
What neurotransmitter cause the pineal gland to release melatonin? Released from?
norepinephrine
SCN
Awake with eyes open corresponds to what EEG wave form?
beta
Awake with eyes closed corresponds to what EEG wave form?
alpha
N1 corresponds to what EEG wave form?
theta
N2 corresponds to what EEG wave form?
sleep spindles
N3 corresponds to what EEG wave form?
delta
Which wave on the EEG occurs during REM sleep?
beta
Which ‘N’ would bedwetting occur?
N3
Which ‘N’ would sleep walking occur?
N3
Which ‘N’ would night terrors occur?
N3
The VPL of the thalamus receives input from which two ascending pathways?
Spinothalamic
DCML
The VPM of the thalamus receives input from which two structures?
trigeminal
gustatory
What input does the Lateral Geniculate Nucleus receive?
visual
Where does the Lateral Geniculate Nucleus project?
calcarine sulcus
What are the two inputs to the Medial Geniculate Nucleus?
superior olive
inferior colliculus
What are the two inputs to the Ventral Lateral nucleus of the thalamus?
basal ganglia
cerebellum
Where does the cerebellum receive contralateral information? Via what structure?
cortex
middle cerebellar peduncle
Where does the cerebellum receive ipsilateral information? Via what structure?
spinal cord
inferior cerebellar peduncle
From medial to lateral, what are the nuclei of the cerebellum?
F,G,E,D
What two structures compose the Striatum?
putamen and caudate
What two structures compose the Lentiform?
putamen and globus pallidus
Is the cortex inhibitory or excitatory on the striatum?
excitatory
What neurotransmitter does the striatum release?
GABA
Does the globus pallidus externa or interna communicate with the subthalamic nucleus? Inhibitory or excitatory?
externa
inhibitory
Which globus pallidus does the subthalamic nuclei communicate with? Inhibitory or excitatory?
globus pallidus internal
excitatory
Which layer is the output of the globus pallidus?
globus pallidus interna
Is the pallidum excitatory or inhibitory on the thalamus?
inhibitory
Is the thalamus inhibitory or excitatory on the cortex?
excitatory
Are Lewy Bodies intracellular or extracellular?
intracellular
What causes neuronal cell death during Huntingtons?
excessive glutamate
What atrophies during Huntingtons?
caudate
What is hemiballismus?
sudden flailing movements of one arm and leg
A lesion to what structure could produce hemiballismus?
subthalamic nucleus
contralateral
What kind of stroke can cause hemiballismus?
lacunar
What is chorea?
purposeless movements
What is athetosis?
writhing movements in fingers
What is an essential tremor? What do patients self-medicate with?
action tremor
alcohol
What exacerbates an essential tremor?
holding a position
Which type of tremor can alcohol decrease the severity of?
essential tremor
What two drugs can be used to treat an essential tremor?
β-blockers
primdone
What type of drug is primidone?
barbiturate
Which virus is associated with Kluver Bucy Syndrome?
HSV-1
Hyperorality is associated with what CNS syndrome?
kluver bucy
Resurgence of primitive reflexes may be indicative of lesions to where?
frontal lobe
What part of the brainstem is the Reticular Activating System present?
Midbrain
What part of the brain is responsible for Spatial Neglect Syndrome?
right parietal-temporal
Agraphia/Acalculia/ would be indicative to lesions where in the brain? What is this called?
DOMINANT-parietal temporal cortex
Gerstmann Syndrome
What can precipiate Wernicke-Korsakoff Syndrome?
glucose without thiamine
Would damage to the hippocampus result in retrograde or anterograde amnesia?
anterograde
Where do the eyes look with a lesion to the Paramedian Pontine Reticular Formation?
away
Where do the eyes look with a lesion to the Frontal Eye Field?
toward
From low to high your brain will?
die
From high to low your brain will?
blow
What is the only muscular movement that is retained during central pontine myelinosis?
vertical gaze
What is the problem during Conduction Aphasia?
poor repitition
In what two ways would hypotension manifest regarding the watershed regions of the brain?
upper arm/leg weakness
visual processing
PO2 has to drop below what pressure to stimulate cerebral blood flow?
50 mm Hg
Cerebral blood flow increases in response to increased PCO2 until what pressure?
90 mm Hg
What two structures are supplied by the Lenticulostriate Arteries?
Striatum and Internal capsule
Does the tongue deviate in an ipsilateral or contralateral direction in relation to a lesion?
ipsilateral
Medial Medullary Syndrome is caused by an occlusion by what specific part of what specific artery?
paramedian branches of
What three tracts/nerves are disrupted during Medial MEdullary Syndrome?
Hypoglossal
medial lemniscus
corticospinal
What artery supplies the Lateral Medulla?
PICA
Where are two forms of pain lost during Lateral Medullary Syndrome?
ipsilateral face
contralateral body
Horner Syndrome could be caused by an occlusion to what artery?
PICA
What are the two most common presenting symptoms with Lateral Medullary Syndrome?
Hoarseness
Dysphagia
What artery supplies the lateral Pons?
AICA
Which artery supplies the Middle and Inferior Cerebral Peduncles?
AICA
What type of aneurysm can form on the ACom Artery?
Berry
What nerve can be impinged by an ACom ANeurysm?
optic
What type of aneurysm can form on the PCom Artery?
Saccular
What nerve can be impinged by an PCom Aneurysm?
CN three
What two directions does the eye move during a CN three lesion?
down and out
What junction is the most common for development of a Berry Aneurysm?
ACom and ACA
What type of hemorrhage would the rupture of a Berry Aneurysm produce?
Subarachpoid
What are the three genetic conditions that increase the risk of a Berry Aneurysm?
Marfan
ADPKD
Ehlers-Danlos
What two locations would be affected by a Charcot-Bouchard Microaneurysm?
Basal Ganglia and Thalamus
Central Post-Stroke Pain Syndrome causes pain due to lesions in what location? How does this present?
thalamus
tingling progressing to allodynia
Which Intracranial Hemorrhage can present with a lucid period?
middle meningeal
What CANT an epidural hematoma cross?
suture lines
What CAN an epidural hematoma cross?
falx cerebrum
tentorium cerebelli
What CANT an subdural hematoma cross?
falx or tentorium
What CAN an subdural hematoma cross?
suture lines
Rupture of a berry aneurysm would produce what type of intracerebral hemorrhage?
subarachnoid
Rupture of an AVM would produce what type of intracerebral hemorrhage?
subarachnoid
What type of intracerebral hemorrhage would have bilirubin or blood on a spinal tap?
subarachnoid
What is the most serious complication of SAH?
vasospasm
What drug is used to treat SAH vasospasm? MOA of this drug?
Nimodipine
CCB
What are the two most common locations of an Intraparenchymal Hemorrhage?
thalamus and internal capsule
What three locations are most common for hypoxia to produce irreversible damage?
neocortex
hippocampus
cerebellum
When over the time-frame of a stroke would MRI produce a bright image?
bright = early ischemia
What is the single most vulnerable area for hypoxia to produce damage?
hippocampus
What structure of the brain is most commonly affected during a hemorrhagic stroke?
basal ganglia
Which vessel is most commonly effected by a Thrombotic Stroke?
MCA
What are the three causes of hemorrhagic stroke?
cancer
anti-coagulation
HTN
What is the pathophysiology of a Communicating Hydrocephalus?
decreased absorption of CSF by arachnoid granulations
What is the most common cause of a Communicating Hydrocephalus?
post-meningitis scarring
What gets compressed during a Normal Pressure Hydrocephalus?
corona radiata
What is Hydrocephalus Ex Vacuo?
appearance of hydrocephalus due to cortical atrophy
How many spinal nerves are there?
31
Do cervical nerves exit above or below their corresponding vertebrae?
above
Do thoracic/lumbar nerves exit above or below their corresponding vertebrae?
below
Where does the DCML decussate?
medulla
What structure does DCML use to reach thalamus?
medial lemniscus
Where is the 2nd order neuron for the DCML?
VPL
Where does the spinothalamic decussate?
anterior white commissure
Where is the 2nd order neuron of spinothalamic tract?
VPL of thalamus
Where does the lateral corticospinal tract decussate?
caudal medulla
Where part of the spine does polio effect?
LMNs
Where part of the spine does Werdnig-Hoffman Disease effect?
anterior horn neurons
What part of the spine is effected during Tabes Dorsalis?
Dorsal Column
What three tracts are affected by Subacute Combined Degeneration?
DCML
lateral corticospinal
spinocerebellar
What is the pathological process responsible for the symtpoms seen during Subacute Combined Degeneration?
Demyelination
What two locations does polio replicate?
Oropharynx and small intestine
By what mechanism is polio spread to the CNS?
hematogenously
What is the main symptom of Polio presentation?
LMN signs
Where is Polio virus recovered from?
stool or throat
What are the two characteristics of CSF during Polio?
increased WBC
slightly increased protein
What muscle fasiculates during Werdnig-Hoffman Disease?
tongue
What is the mode of inheritance of Werdnig-Hoffman?
autosomal recessive
What is the mode of inheritance of Friedrich Ataxia?
autosomal recessive
What is the repeat of Fiedrich Ataxia?
GAA
What chromosome is frataxin located on?
9
What is the function of frataxin?
mitochondrial iron handling
What is notable about the foot during Friedrich Ataxia?
pes cavus
What is the cause of death during Friedrich Ataxia?
hypertrophic cardiomyopathy
Which nerve innervates the cricothyroid?
external laryngeal
Which nerve carries sympathetic fibers to the eye?
long ciliary nerve
What is the dermatome of the inguinal ligament?
L1
What is the dermatome of the xiphoid?
T7
What vertebral levels compose the cremasteric reflex?
L1/L2
What vertebral levels compose the anal wink reflex?
S3/S4
What is touched during the suckling reflex?
roof of mouth
What is Galant Reflex?
sidebending towards stroking on back
Which cranial nerves lie medially at the brain stem?
three
six
twelve
Are the eyes or ears associated with the superior colliculus?
eyes
Are the eyes or ears associated with the inferior colliculus?
ears
Where is the conjugate vertical gaze center located?
superior colliculus
What is Parinaud Syndrome?
loss of conjugate vertical gaze due to impingement of superior colliculus
What is contained in the Edinger-Westphal Nucleus?
PANS fibers destined for eye
Which nerve provides pain sensation for the anterior 2/3 or the tongue?
trigeminal
Which salivary glands are innervated by the Facial Nerve?
submandibular and sublingual
Which cranial nerve mediates eyelid closing? Via what muscle?
facial
orbicularis oculi
What nerve innervates the parotid gland?
glossopharyngeal
What nerve innervates the stylopharyngeus?
glossopharyngeal
What is the function of the stylopharyngeus?
elevates pharynx/larynx
What nerve innervates the soft palate?
vagus
Is the alar plate medial or lateral?
lateral
Is the alar plate motor or sensory?
sensory
Is the basal plate medial or lateral?
medial
Is the basal plate motor or sensory?
motor
What is the function of the sulcus limitans?
separate sensory from motor cranial nerve nuclei
What is the afferent limb of the corneal reflex?
V1
What is the efferent limb of the corneal reflex?
seven
What is the afferent limb of the lacrimation reflex?
V1
What is the efferent limb of the lacrimation reflex?
Seven
What is the afferent limb of the gag reflex?
nine
What is the efferent limb of the gag reflex?
ten
What three cranial nerves compose the nucleus solitarius?
seven
nine
ten
What is the function of the NTS?
sensory
What three cranial nerves are house in the Nucleus Ambiguus?
nine
ten
eleven
Does a high firing rate of aortic and carotid baroreceptors occur during a high or low pressure state?
high
What will high firing rate of aortic and carotid baroreceptors do to PANS outflow?
increase
What nerves transverse the cavernous sinus?
three
four
Vone
Vtwo
six
What nerve is most often impinged during Cavernous Sinus Syndrome?
six
Does the jaw deviate towards or away the lesion? What muscle causes this?
towards
pterygoids
Does the uvula deviate towards or away from the side of the lesion?
away
Which SCM contracts to turn the head to the left?
right
Does the tongue deviate towards or away from side of lesion?
toward
Is low or high frequency sound heart at the apex of the cochlea?
low
Is low or high frequency sound heart at the base of the cochlea?
high
Which part of the organ of corti is responsible for hearing loss?
Organ of Corti
Is the upper or lower face spared during a facial UMN lesion? Why?
lower
bilateral LMNs to lower face
What infectious disease can cause a facial nerve palsy?
Lyme disease
Which two viruses can cause a facial nerve palsy ?
herpes simplex
herpes zoster
Which autoimmune disease can cause a facial nerve palsy?
sarcoidosis
Which pterygoid opens the jaw?
lateral
Which pterygoid closes the jaw?
medial
Is the eye too short or too long during Hyperopia?
short
Where is light focused during Hyperopia?
behind the retina
Is the eye too short or too long during Myopia?
too long
Where is light focused during Myopia?
in front of retina
Which two Autoimmune diseases can cause uveitis?
sarcoid and rheumatoid
Which infectious disease can cause uveitis?
TB
Which HLA haplotype can be associated with uveitis?
HLA-B27
Which three viruses are associated with retinitis?
CMV/HSV/HZV
What is non-proliferative Diabetic Retinopathy?
damaged vessels leak lipid and fluid
What is proliferative Diabetic Retinopathy?
chronic hypoxia results in new blood vessel formation
What anti-AB can be used to treat proliferative diabetic retinopathy?
anti-VEGF
What atrophies during glaucoma?
optic disk
What line of vision is lost during glaucoma?
peripheral
What race is predisposed to open-angle glaucoma?
African americans
What is the cause of primary closed/narrow angle glaucoma?
forward displacement of lens against iris
Why is the pathophysiology against secondary closed/narrow angle glaucoma?
hypoxia produces vasoproliferation and enlargement of iris
Prolonged administration of what drug could cause cataracts?
corticosteroids
Which two genetic metabolic diseases could result in cataracts?
galactosemia
galactokinase deficiency
Which molecule could cause cataracts during diabetes?
sorbitol
What direction does the eye point during an optic nerve lesion?
down and out
Where does the eye move during a trochlear nerve lesion?
upward
Does the head tilt toward or away from the affected trochlear nerve lesion side? Going down stairs?
toward
stairs = opposite
Which ciliary nerve contains PANS fibers?
short
Which ciliary nerve contains SANS fibers?
long
Which structure mediates the afferent cranial nerve pupillary light reflex?
Pretectal nucleus
What does the pretectal nucleus activate during the pupillary light reflex?
Edinger-Westphal nucleus
Which two layers of the retina are separated during retinal detachment?
rods/cones
photoreceptor layer
Which is located on the exterior of the retina, pigmented layer or rods/cones?
pigmented
Beneath which membrane is extracellular material deposited during dry macular degeneration?
Bruch
Quadrantic anopia is downstream of what vessel?
MCA
Is upper or lower quadrantic anopia projections found in the temporal lobe?
upper
Is upper or lower quadrantic anopia projections found in the parietal lobe?
lower
Hemianopia is downstream of what vessel?
PCA
Does Meyer Loop correspond to upper or lower retina?
lower retina
What does Meyers loop wrap across?
inferior horn of lateral ventricle
Through what structure does the superior retina projection pass through?
internal capsule
What is normal during INO?
convergence
Why does MLF get affected so quickly during MS?
heavily myelinated
Which chromosome is Presenelin-1 located on?
14
Which chromosome is Presenelin-2 located on?
1
Which chromosome is ApoE located on?
19
What structure that develops during Alzheimers correlates with disease severity?
tau protein tangles
What shape is Tau during Pick Disease?
spherical
Which happens earlier in Pick disease, personality changes or dementia?
personality changes
What gets spared during Pick Dementia?
posterior 2/3 of temporal gyrus
What is the first symptom of Lewy Body Dementia?
Dementia
What follows the dementia during Lewy Body Dementia?
visual hallucinations
What follows the visual hallucinations during Lewy Body Dementia?
parkinsonian symptoms
What is the pathological protein found during Lewy Body Dementia? Where?
α-synuclein
all over cortex
Which neuro-pathological disease features startle myoclonus?
Creutzfeld-Jakob
Which neuro-pathological disease features EEG sharp waves?
Creutzfeld-Jakob
What is the secondary structure of Creutzfeld-Jakob?
β-pleated sheet
Lack of which three B vitamins can cause dementia?
B1/B3/B12
Which type of hydrocephalus can cause dementia?
NPH
What does SIIN stand for regarding MS?
Scanning speech
intention tremor
INO
nystagmus
What imaging modality is used for MS?
MRI
What two activities make up the plaques in MS?
oligodendrocyte loss
reactive gliosis
What antibody is used to treat MS? What does it target?
Natalizumab
α4-integrin
What two drugs are used to treat spasticity during MS?
baclofen and benzos
Which virus can cause AIDP?
CMV
What is the treatment for AIDP?
plasmapharesis IV immunoglobulin
What drug can be used to treat PML?
natalizumab
Which four viruses can cause Acute Disseminated Encephalomyelitis?
Measles
Shingles
Smallpox
Rabies
Are central, peripheral or both types of nerves demyelinated during Metachromatic Leukodystrophy?
peripheral and central
What is another name for Charcot-Marie-Tooth Disease?
hereditary motor and sensory neuropathy
What is the pathophysiology of Charcot-Marie-Tooth Disease?
defective proteins involved in myelin synthesis
What two skeletal pathologies are associated with Charcot-Marie-Tooth Disease?
scoliosis
foot deformities
Which enzyme is defective during Krabbe Disease?
Galactocerebrosidase
What two products accumulate during Krabbe Disease?
galactocerebroside and psychosine
What is destroyed during Krabbe Disease? What type of cell appears?
myelin sheath
globoid
What is the mode of inheritance for Adrenoleukodystrophy?
X-linked
What is the pathophysiology of Adrenoleukodystrophy?
metabolic defect of VERY LONG CHAIN fatty acids
In what three locations do long chain fatty acids buildup during Adrenoleukodystrophy?
CNS
adrenal gland
testes
What lobe do most seizures arise?
temporal
What should one do with a febrile seizure in an infant?
look for source
What would be seen on physical exam during a cluster headache?
lacrimation
rhinorrhea
What type of headache may induce Horner Syndrome?
cluster
What are the two treatments for Cluster Headaches?
oxygen and sumatriptan
Which tricycyclic is used to treat migraines?
Amitriptyline
Which β-blocker is used to treat migraines?
propranalol
How long does Trigeminal Neuralgia usually last?
less than 1 minute
Where is the pathology for Peripheral Vertigo?
inner ear
Where is the pathology for Central Vertigo?
brainstem or cerebellum
How does Sturge-Weber arise?
sporadically
Which cells are defective during Sturge-Weber Syndrome?
neural crest
What gene is involved in Sturge-Weber? What type of mutation?
GNAQ
activating
Would would be seen in the meninges during Sturge-Weber Syndrome? Causing what?
leptomeningeal angioma
increased ICP
Which disease can present with an Episcleral Hemangioma?
Sturge Weber
What is increased during Sturge-Weber? What can this lead to?
Intraocular pressure
early onset glaucoma
Where does Tuberous Sclerosis produce hamartomas?
skin and CNS
What type of fibroma is seen during Tuberous Sclerosis?
Angiofibromas
Which two cardiac pathologies can be seen during Tuberous Sclerosis?
Mitral regurgitation
Rhabdomyoma
Which renal pathology can bee seen during Tuberous Sclerosis?
Angiomyolipoma
Which brain tumor is pathogonomic for Tuberous Sclerosis?
subependymal astrocytoma
Why can Tuberous Sclerosis present with ash leaf spots?
hypo-pigmentation
Neurofibromin is a negative regulator of what oncogene?
Ras
What are Lisch Nodules?
iris hamartomas
What type of neoplasm can NF1 produce in the eye?
Optic nerve glioma
Which of the NF disease can present with pheochromocytoma?
NF1
Skin tumors in NF1 are derived from which cell type?
Neural crest cells
Which renal pathology can VHL present with?
bilateral renal cell carcinoma
Which two types of hemanigio defects can VHL present with?
Cavernous hemangioma
Hemangioblastoma
In which three locations can VHL produce a hemangioblastoma?
retina
brainstem
cerebellum
Which adrenal pathology can VHL present with?
pheochromocytoma
Is HIF constantly on or constantly being degraded during VHL disease?
degraded
What is the stain for glioblastoma multiforme?
GFAP
Glioblastoma Multiforme is a malignant proliferation of what cell type?
astrocytes
“Pseudopalisading” is indicative of what brain cancer?
Glioblastome Multiforme
What cell type does a meningioma arise from?
Arachnoid cell
What brain tumor can attach to the dura?
meningioma
Which brain tumor can present with psammoma bodies?
meningioma
Which brain tumor can produce EPO?
hemangioblastoma
Which brain tumor has thin walled capillaries?
hemangioblastoma
What is the stain for a schwannoma?
S100
In what lobes are oligodendrogliomas most often located?
frontal
What is the capillary pattern of oligodendroglioma?
chicken-wire
Round nuclei with a clear cytoplasm is indicative of what brain tumor?
oligodendroglioma
Which brain tumor can often be calcified?
oligodendroglioma
Where is a pilocytic astrocytoma most often found?
posterior fossa
What is the stain for Pilocytic Astrocytoma?
GFAP
What tumor has rosenthal fibers? What do they look like?
pilocytic astrocytoma
corkscrews
Cystic mass with a mural nodule is indicative of what tumor?
pilocytic astrocytoma
Where in the brain does a medulloblastoma often arise?
cerebellum
From which cells does a medullablastoma arise?
neuroectoderm
What tumor can send ‘drop metastasis’?
medullablastoma
Homer-Wright rosettes are indicative of what tumor?
medulloblastoma
Where do ependyomas most often arise? What age?
4th ventricle
four years old
Subfalcine herniation can compress what cerebral artery?
anterior cerebral artery
Why can a cerebellar tonsil hernia cause death?
inhibition of respiration
How does epinephrine produce a decrease in aqueous humor synthesis?
vasoconstriction
What are the two indirect cholinomimetics that decrease aqueous humor synthesis?
physostigmine
echothiophate
What prostaglandin releives glaucoma? By what mechanism?
Latanoprost
increase outflow
Which glaucoma drug can darken the iris? What is this drug an analogue of?
Latanoprost
PGF-2alpha
Which two channels do opioids act on?
potassium and calcium
Tolerance to which two side effects dont develop during opioid addiction?
miosis and constipation
What two receptors is butorphanol active what?
mu partial agonist
kappa full agonist
What is the potential unwanted effect of butorphanol?
cant reverse with naloxone
What are the three MOAs of tramadol?
weak opioid agonist
inhibits reuptake or NE and 5HT
What are the two main adverse effects of tramadol?
decreases seizure threshold
serotonin syndrome
Which two antiepileptics are contraindicated in pregnancy?
valproate and carbamazepine
What are the four short acting benzos?
alprazolam
triazolam
oxazepam
midazolam
What are the three non-benzodiazepine hypnotics?
Zolpidem
Zaleplon
eszopiclone
Which subtype do the non-benzodiazepine hypnotics function?
BZ1
What do inhaled anesthetics do to cerebral blood flow?
increased
Which general anesthetic is nephrotoxic?
methoxyflurane
Which general anesthetic is pro-convulsant?
enflurane
Malignant hyperthermia is a condition associated with the use of general anesthetics and what other drug?
Sucinylcholine
What does thiopental do to cerebral blood flow?
decrease
What is the only anesthetic that doesnt lower BP?
ketamine
What is the MAO of propofol?
potentiates GABA-A
Do local anesthetics bind to activated or inactivated sodium channels? Who does this mean?
activated
better target rapidly firing neurons
Which local anesthetic has cardiotoxicity effects?
bupivicaine
What is the MOA of non-depolarizing neuromuscular blockers?
Ach competitive antagonists
Which two drugs are used to reverse non-depolarizing neuromuscular blockers?
neostigmine and atropine
What are the three dopamine agonists?
Bromocriptine
Pramipexole
Ropinirole
What are the two COMT inhibitors?
Entacapone and Tolcapone
Which two features of Parkinsons does Benztropine treat?
tremor and rigidity
What is the toxicity of L-DOPA?
arrhythmias
Which NMDA antagonist is used during Parkinsons? To prevent?
Memantine
Ca2+ toxicity
What are the three AchE Inhibitors used during Parkinsons?
Donepezil
Galantamine
Rivastigmine
What three drugs are used to treat Huntingtons?
Reserpine
Tetrabenazine
Haloperidol
Sumatriptan is an agonist at which two receptors?
5HT1B and 5HT1D
When would sumatriptan be contraindicated?
CAD and prinzmetal angina
Which CNS cells has a friend egg appearance?
oligodendrocyte
What structure in the brain controls conjugate gaze?
paramedian pontine reticular formation
What is the output tract of the cerebellum?
superior cerebellar peduncle
Does the cerebellum send output to the ipsilateral or contralateral cortex?
contralateral
What is the only output cell of the cerebellum?
purkinje cell
Why can morphine cause vasodilation?
increased release of histamine
What cranial nerve can be affected during an Epidural Hematoma?
three
What is the most common reason for intraparenchymal hemorrhage?
systemic HTN
What imaging modality is used for an acute stroke?
MRI
How does an acute stroke look on MRI?
bright
What imaging modality is used for an stroke post-12 hours?
noncontrast
How does a stroke look on noncontrast CT?
dark
Where does DCML decussate?
medula
What two structures does the medial lemniscus connect?
medulla to VPL
What drug is used to treat ALS? MOA?
Riluzole
decreases presynaptic glutamate release
What is the first physical manifestation of Friedreich Ataxia?
Kyphoscoliosis
What nerve is the External Laryngeal Nerve a branch of?
Superior laryngeal nerve
What muscle does the External Laryngeal Nerve supply?
cricothyroid
Damage to the External Laryngeal Nerve or cricothryoid results in what type of voice?
monotone
What ganglion does Horner Syndrome use?
superior cervical ganglion
Which dermatome is a turtle neck?
C3
Which dermatome is a skullcap?
C2
Which structure detects muscle length?
spindle afferents
Which carnail nerve nuclei are located in the spinal cord?
accessory
What structure sends PANS autonomic fibers to the heart, lungs and upper GI?
dorsal motor nuclei
Which nerve provides sensory for posterior part of external ear canal?
Auricular branch of vagus
What is the treatment for facial nerve palsy?
corticosteroids
Which field of vision is blocked during glaucoma?
peripheral
How is the superior oblique tested?
look down and aDDuct
What are the four major causes of ring enhancing lesions?
Toxo
GB
Lymphoma
Abscess
Which pathway is associated with the positive signs of schizophrenia?
mesolimbic
Which pathway is associated with the negative signs of schizophrenia?
mesocortical
What vessel of the brain is responsible for prosopagnosia?
non-dominant PCA
What nucleus of the thalamus would produce a motor defect?
ventro-lateral
What are the two inputs to the ventro-lateral nucleus of the thalamus?
basal ganglia and cerebellum
What is the destination of the ventro-lateral nucleus of the thalamus?
motor cortex
Which nerve innervates the lacrimal gland? Branch of which cranial nerve?
greater petrosal
seven
What cell in the brain doesnt stain with Nissl?
microglia
Which in the brain cell removes excess neurotransmiter?
astrocyte
Which protein can be stained for identification of presynaptic nerve terminals?
Synaptophysin
What is the function of GTOs?
to inhibit excessive muscle contraction
What is the function of intrafusal muscle fibers?
stretch reflex
Which specific structure is affected during Wilsons disease?
Putamen
Which hormone induces REM Sleep?
acetylcholine
Which hormone inhibits REM Sleep?
Norepinephrine
Which hormone induces sleep?
serotonin
Which hormone produces arousal and wakefullnes?
Dopamine
Where does the lateral geniculate nucleus project?
calcarine sulcus
Which peduncle transmits information into the cerebellum from the cortex? Ipsilateral or contralateral side?
middle
contralateral
Which peduncle transmits information into the cerebellum from the spinal cord? Ipsilateral or contralateral side?
inferior
ipsilateral
Which peduncle transmits information into the cortex from the cerebellum? Ipsilateral or contralateral side?
superior
contralateral
What are the only output cells of the cerebellum? What neurotransmitter?
Purkinje
GABA
What causes neuronal death in Huntingtons?
NMDA toxicity
Which two neurotransmitters are decreased in Huntingtons?
GABA and Acetylcholine
What is apraxia?
inability to make purposeful movements
What is Aprosodia?
inability to understand emotion in speech
What is agnosagnosia?
inability to recognize oneself
What is prosopagnosia?
inability to recognize known faces
What are the two characteristics of Transcortical Motor Aphasia?
Brocas with intact repitition
What are the two characteristics of Transcortical Sensory Aphasia?
fluent aphasia with intact repitition
What is the only thing a person with Mixed Transcortical Speech can do?
repeat
What two parts of the brain are affected by Cerebral Amyloid Angiopathy?
occipital and parietal lobe
At what partial pressure does oxygen cause cerebral vasodilation?
A stroke of which vessel effects the tongue?
Anterior spinal
Xanthochromia is indicative of what stroke?
SUbarachnoid
Which sinus contains arachnoid granulations?
superior sagittal
Which brain tumor can cause an non-communicating hydrocephalus? Which specific structure is affected?
Pinealoma
cerebral aqueduct of sylvius
What is the MOA of Ketamine?
NMDA antagonist
Pseudotumor Cerebri can impinge which cranial nerve?
six
What are the two pharmacological causes of Pseudotumor Cerebri?
Vitamin A and danazol
Which nerve mediates the afferent and efferent branch of the jaw jerk reflex?
V3
Microglial nodules in the brain are indicative of what disease?
HIV
What is Ramsay Hunt Syndrome?
facial nerve paralysis in setting of zoster reactivation
Does a LMN lesion to cranial nerve seven effect the upper face, lower face or both?
both
What are Cholesteatomas comoposed of?
squamous cell debris
What week would Neural Tube Defects present?
4th
What is the MOA of baclofen?
GABA agonist
Paraneoplastic Cerebellar Degeneration is seen during which three cancers?
breast
ovarian
small cell
Which virus can produce a slowly progressive demyelinating syndrome?
HTLV1
What is an advantage of Butorphanol over morphine?
less respiratory depression
Decerebrate posturing reflects a lesion to where?
pons or below
Decorticate posturing reflects a lesion to where?
midbrain or above
Which three benzos are the preferred for patients with liver disease?
Oxazepam
Trazolam
Lorazepam
Do almost all INHALEd anesthetics increase or decrease cerebral blood flow?
increase
In order, what four senses are lost due to local anesthetics?
Pain>temperature>touch>pressure
What is the toxicity of amantadine?
ataxia
What is the central COMT Inhibitor?
Tolcapone
Is dopamine increased or decreased during Huntingtons?
increased
Does ASA Syndrome produce ipsilateral or contralateral extremity symptoms?
contralateral
Which papillary muscle has two blood supplies?
antero-lateral papillary muscle
What stage of sleep does Bruxism occur in?
N2
Which local anesthetic can cause methemoglobinemia?
benzocaine
What protein does alpha-synuclein interact with?
tubulin
