Neurology Flashcards
Neurotransmitter that is decreased in Huntington’s dementia and Alzheimer’s dementia
ACETYLCHOLINE
Neurotransmitter found in locus ceruleus of pons
NOREPINEPHRINE
Neurotransmitter found in the substantia nigra
DOPAMINE
Neurotransmitter found in the median raphe of the brainstem
SEROTONIN
Main inhibitory neurotransmitter found in spinal interneurons
GLYCINE
Main inhibitory neurotransmitter found in the brain
GABA
Output pathway from reward and punishment centers, lesions here will produce anterograde amnesia
HIPPOCAMPUS
Helps search memory storehouses, lesions here will produce retrograde amnesia
THALAMUS
Cranial nerve for general sensation (e.g. pain) of the anterior 2/3 of the tongue
CN V
Highly characteristic of posterior fossa brain tumors
VOMITING THAT PRECEDES HEADACHE
Dominant symptom in temporal (giant cell) arteritis
HEADACHE
Most common primary headache syndrome
MIGRAINE, TENSION-TYPE HEADACHE, AND CLUSTER HEADACHE
Key pathway for pain in migraine
TIGEMINOVASCULAR INPUT FROM THE MENINGEAL VESSELS
Most disabling headache
MIGRAINE
Mainstay of pharmacologic treatment in migraine
JUDICIOUS USE OF ONE OR MORE DRUGS THAT ARE EFFECTIVE IN MIGRAINE
Most important factor in selection of the optimal regimen for a migraine patient
SEVEREITY OF THE ATTACK
Most efficacious of the triptans
RIZATRIPTAN AND ELETRIPTAN
Core feature of cluster headache
PERIODICITY
Most satisfactory treatment in cluster headache
ADMINISTRATION OF DRUGS TO PREVENT CLUSTER ATTACKS UNTIL THE BOUT IS OVER
Most serious cause of secondary headache
SUBARACHNOID HEMORRHAGE
Classic headache associated with a brain tumor
MORE EVIDENT IN THE MORNING AND IMPROVES DURING THE DAY
Preferred diagnostic test for any patient suspected of having a brain tumor
CRANIAL MRI and should be performed with gadolinium contrast administration
The only test necessary to diagnose a brain tumor
NEUROIMAGING
Glucocorticoid of choice for brain tumors because of its relatively low mineralocorticoid activity
DEXAMETHASONE
Most common primary brain tumor of childhood
GRADE 1 ASTROCYTOMAS: PILOCYTIC ASTROCYTOMAS
Most common primary brain tumor overall
MENINGIOMAS
Most common malignant brain tumor of childhood
MEDULLOBLASTOMAS
Most common malignant tumor overall
GRADE IV ASTROCYTOMA (GLIOBLASTOMA)
Meningiomas are most commonly located ove the
CEREBRAL CONVEXITIES
Main differential diagnosis of meningioma
DURAL METASTASIS
Most common schwannomas
VESTIBULAR SCHWANNOMAS OR ACOUSTIC NEUROMAS
Most common site of brain metastases
GRAY MATTER-WHITE MATTER JUNCTION
85% opf all brain metastases are
SUPRATENTORIAL
Most common sources of brain metastases
LUNG AND BREAST CANCER
Malignancy with greatest propensity for brain metastasis, found in 80% of patients at autopsy
MELANOMA
Malignancies with propensity to metastasize to the dura and can mimic meningioma
PROSTATE AND BREAST CANCER
Arises in prostate and breast cancer, which have strong propensity to metastasize to axial skeleton
SPINAL CORD COMPRESSION
Braion metastases are best visualized on
MRI
3 Cancers with greatest propensity to bleed
MELANOMA, THYROID, KIDNEY CANCER
Most common cause of hemorrhagic metastasis
LUNG CANCER
Most common among hematologic malignancies ti metastasize to the subarachnoid space
ACUTE LEUKEMIA
3 Solid tumors that most frequently cause leptomeningeal metastases
BREAST, LUNG, MELANOMA
Definitive method and often considered the gold standard to diagnose leptomeningeal metastases
DEMONSTRATION OF TUMOR CELLS IN CSF
CSF cytologic examination is most useful in what malignancies
HEMATOLOGIC MALIGNANCIES
Part of the spine affected most commonly in epidural metastasis
THORACIC SPIN > LUMBAR > CERVICAL
Presenting symptom of epidural metastasis in virtually all patients
BACK PAIN
Best test for epidural metastasis
MRI OF THE COMPLETE SPINE
Surgical procedure of choice for epidural metastasis
COMPLETE REMOVAL OF THE MASS, TYPICALLY ANTERIOR TO THE SPINAL CANAL
Standard treatment for brain metastases
WHOLE-BRAIN RADIOTHERAPY
Most serious toxicity from radiotherapy as they are often irreversible
LATE DELAYED TOXICITY
Complication seen most commonly after whole-brain radiotherapy
LEUKOENCEPHALOPATHY
Second only to myelosuppression as dose-limiting toxicity of chemotherapeutic agents
NEUROTOXICITY
Most common form of suppurative CNS infection
BACTERIAL MENINGITIS
Most common cause of meningitis in adults > 20 years
S.PNEUMONIAE
Important clue to diagnosis of meningococcal infection
PETECHIAL OR PURPURIC SKIN LESIONS
Most disastrous complication of increased ICP
CEREBRAL HERNIATION
2 most common etiologic organisms of community-acquired bacterial meningitis
S. PNEUMONIASE AND N. MENINGITIDES
Most common symptom of brain abscess
HEADACHE
Most common cause of peripheral neuropathy in developed countries
DIABETES MELLITUS
Most common diabetic mononeuropathies
MEDIAN NEUROPATHY AT THE WRIST AND ULNAR NEUROPATHY AT THE ELBOW
Most common cranial mononeuropathies in DM
CNVII > III > VI > IV
Most common cranial mononeuropathies in scleroderma
TRIGEMINAL NERVE
Most common cranial nerve involved in sarcoidosis
VII
Most common mononeuropathies in uremia
CARPAL TUNNEL SYNDROME
Most common form of peripheral neuropathy associated with HIV infection and usually seen in patients with AIDS
DISTAL SYMMETRIC POLYNEUROPATHY
Most common associated malignancy with neuropathies
LUNG CANCER
2 Most common causes of acute generalized weakness leading to admission to ICU
GBS AND MYASTHENIA GRAVIS
Manifests as a rapidly evolving areflexic motor paralysis with or without sensory disturbance, associated with Campylobacter jejuni found in undercooked chicken
GBS
Most common cause of familial parkinson’s disease
MUTATION OF THE LRRK2 GENE
Most common cause of secondary parkinsonism
DOPAMINE BLOCKING AGENTS
Mainstay of therapy of Parkinson Disease
LEVODOPA-CARBIDOPA
Major clinical effect of central-acting anticholinergic drugs
TREMORS
Most widely used antidyskinesia agent in patients with advanced PD and the only oral agent that has been demonstrated in controlled studies to reduce dyskinesia
AMANTADINE
Most common cause of nursing home placement in PD patients
DEMENTIA
Most common movement disorder
ESSENTIAL TREMOR
Major differentials for tremors
DYSTONIC TREMOR OR PD
Standard drug therapies for essential tremors
BETA BLOCKERS OR PRIMIDONE
Most common forms of dystonia
FOCAL DYSTONIAS
Most commonly seen with neuroleptic drugs or after chronic levodopa treatment in PD patients
DRUG-INDUCED DYSTONIA
Most common systemic disorder that causes chorea
SLE
Most common acute hyperkinetic drug reaction
DYSTONIA
Most common subacute drug reaction
AKATHISIA
Gold standard for diagnosis of Wilson’s disease
LIVER BIOPSY
Most common psychogenic movement disorder
TREMOR AFFECTING THE UPPER LIMBS
Date rape drug
FLUNITRAZEPAM
Non-sedating anti-anxiety
BUSPIRONE
Fomepizole inhibits what enzyme?
ALCOHOL DEHYDROGENASE
Disulfiram inhibits what enzyme?
ALDEHYDE DEHYDROGENASE