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STEP1 2015 > Neurology > Flashcards

Neurology Flashcards

1
Q

Acute disseminated postinfectious encephalomyelitis

A

multifocal periventricular inflammation and demyelination after infection (VZV and measles common), or certain vaccinations (rabies, smallpox)

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2
Q

Charcot- Marie- TOoth

A

hereditary motor AND sensory neuropathy (HMS), progressive hereditary nerve disorder due to defective neuronal proteins in volved in structure and function of peripheral nerve and/or myelin sheath. AD inhetirance, scoliosis and foot deformities are common.

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3
Q

Krabbe

A

galactoverebrosidase deficiency leads to galactocerebroside build up in the myelin sheath.
findings: peripheral neuropathy, developmental delay, optic atrophy, globoid cells

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4
Q

Metachromatic leukodystrophy

A

AR lysosomal storage disease, commonly due to arylsulfatase A deficiency. Sulfatides build up and impair production. destroy myelin sheath. Central and peripheral demyelination result with ataxia and dementia

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5
Q

Progressive multifocal leukoencephalopathy

A

Demyelination of CNS due to destruction of oligodendrocytes. Associated with JC virus. Seen in 2-4% of AIDS patients (reactivation of latent viral infection. Rapidly progressive and usually fatal. Increased risk associated with natalizumab, rituximab.

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6
Q

Pricking pain (fast, myelinated)

A

A-delta fibers

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7
Q

Burning or dull pain and itch (slow, unmyelinated)

A

C- polymodal fibers

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8
Q

vibration and pressure, rapid adapting

A

Pacinian corpuscle

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9
Q

dynamic/ changing light, discriminatory touch, superficial

A

Meissner corpuscle

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10
Q

static/ unchanging light touch, superficial

A

Merkel receptor

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11
Q

propioception, muscle length monitoring

A

muscle spindle

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12
Q

propioveption, muscle tension monitoring

A

Golgi tendon organ

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13
Q

CSF changes in Guillain Barre

A

normal cell count with increase in protein

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14
Q

Guillain Barre syndrome

A

symmetric ascending mucle weakness (Schwann cells affected), facial paralysis, preceded by infection (campylobacter usually), sensation intact

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15
Q

Parkinson disease

A 
tremor- resting or pill- rolling tremor
rogidity- cogwheel rigidity
akinesia or hypokinesia
postural instability
mask- like facies
festinating gait
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16
Q

Neurotransmitters in Huntington

A

decreased ACh
decreased GABA
increased dopamine

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17
Q

treat glaucoma

A

prostaglandins, beta blockers, alpha agonists, carbonic anhydrase inhibitors, cholinergic agonists

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18
Q

alternate routes for mediation of voluntary movement

A

reticulospinal and rubrospinal tracts

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19
Q

pain and temperature sensation

A

lateral spinothalamic tract

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20
Q

important for postural adjustments and head movements

A

vestibulospinal tract

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21
Q

propioceptive information to the cerebellum

A

dorsal and ventral spinocerebellar tracts

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22
Q

BPPV

A

debris, otoliths in vestibular apparatus. Dx Hallpike, Epley for treatment

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23
Q

Meniere triad

A

imbalance of fluid and electrolyte composition of endolymph. triad:
vertigo
tinnitus
hearing loss

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24
Q

central vertigo

A

brainstem and cerebellar lesions damaging the vestibular nuclei. or posterior fossa tumor

25
Q

How is hair transmitted?

A

tympanic membrane vibrates with sound waves, and the vibration is transmitted to the cochlea via middle ear ossicles.
cholinergic signals in the olivocochlear bundles stiffen the outer hair cells, thereby sensitizing the inner hair cells to a partiular frequency. Outer hair cells are where aminoglycosides (streptomycin, gentamicin) cause damage.

Hair cells and cochlea turn the sound signal into a nercous impluse, which travels from the cell body to the cochlear gangion,
to cochlear nuclei in brainstem
decussation to contralateral superior olivary nucleus
to lateral lemniscus
to inferior colliculus
to medial geniculate body
to primary auditory cortex in the temporal lobe

26
Q

pathogens most commonly associated with AOM

A

strep pneumo

h. influenza
m. catarrhalis

27
Q

most commonly associated with acute otitis externa

A

p. aeruginosa

28
Q

cholesteatoma

A

noncancer, non- cholesterol overgrowth of desquamated keratin debris within the middle ear space that may eventually erode the ossicular chain and the mastoid air cells.

may be 2/2 neg middle ear pressure (chronic retraction pocket), 2/2 eustachian dysfunction or direct growth of epithelium through a TM perforation

commonly associated with chronic middle ear infection

Tx- surgical removal via tympanomastoidectomy and reconstruction of the ossicular chain.

29
Q

intranuclear inclusions seen in HSV encephalitis

A

Cowdry type A

30
Q

cytoplasmic inclusions pathognomonic of rabies

A

negri bodies

31
Q

neuronal inclusions characteristic of Parkinson Disease

A

Lewy bodies

32
Q

Cytoplasmic inclusion bodies associated with aging

A

Lipofuscin granules

33
Q

Dark cytoplasmic pigment in neurons of the substantia nigra and locus coruleus, not seen in patients with Parkinson

A

melanin

34
Q

Eosinophilic, rod- like inclusions in hippocampus of Alzheimer patients

A

Hirano bodies

35
Q

Diagnosis of AD

A

Neurofibrillary plaques and tangles

36
Q

Filamentous inclusions that stain with silver, do not survive neuronal death

A

Pick bodies

37
Q

Filamentous inclusions that stain with PAS and ubiquitin

A

Lewy bodies

38
Q

dementia plus visual hallucinations

A

Lewy Body dementia

39
Q

dementia plus progressive aphasia

A

FTD (Pick)

40
Q

dementia plus ataxia and loss of pupillary light reflex

A

tertiary syphilis

41
Q

dementia plus megaloblastic anemia and peripheral neuropathy

A

B12 deficiency

42
Q

dementia plus resting tremor and bradykinesia

A

LBD or Parkinson

43
Q

dementia plus uninhibited social behavior

A

frontotemporal lobe dementia

44
Q

dementia plus urinary incontinence and magnetic gait

A

NPH

45
Q

dementia plus syncopal episodes

A

LBD

46
Q

dementia plus dysarthria and liver disease

A

Wilson disease

47
Q

dementia plys myoclonus

A

CJD

48
Q

delirium

A 
visual hallucinations
fluctuating level of consciousness
acute onset
disturbances in sleep-wake cycle
decreased attention span
decreased level of arousal
acute changes in mental status
disorganized thinking
usually reversible (unlike dementia)
abnormal EEG

Causes:
drugs especially with anticholinesterase function, UTI,

49
Q

dementia workup

A 
RPR
HIV
TSH
Vit B12 deficiency
MRI of brain

CBC, etc

50
Q

Down syndrome and AD

A

Trisomy 21. APP gene on chromosome 21

51
Q

Drugs that treat AD mechanisms

A 
Cholinesterase inhibitors (prolong ACh)
Memantine is an antagonist at the NMDA glutamate receptor
52
Q

most common cause of dementia

A

AD

53
Q

second most common cause of dementia

A

Vascular dementia

54
Q

Extracellular amyloid deposits in the grey matter

A

AD

55
Q

Intracellular deposits of hyperphosphorylated tau protein

A

AD

56
Q

Intracellular spherical aggregates of tau protein seen on silver stain

A

These are PICK bodies, and this is FTD

57
Q

multiple sclerosis presenting symptoms

A 
scanning speech 
intention tremor
nystagmus
bowel and bladder incontinence
internuclear opthalmoplegia
optic neuritis
58
Q

diseases that affect the anterior motor horn

A

polio, WNV, ALS, Werdnif- Hoffman disease (spinal muscle dystrophy)

STEP1 2015 (30 decks)

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