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Neurology Flashcards

1
Q

Seen in acute hypoxia/ischemia
Evident by 12-24 hours

Shrinkage of cell body, pyknosis of nucleus, nucleolar disappearance, eosinophilia

A

Acute neuronal injury

Red neurons

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2
Q

Hallmark of acute neuronal injury

12-24 hours

A

Loss of Nissl substance

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3
Q

Seen in chronic and progressive neurodegenerative disease

Cell loss, reactive gliosis

A

Subacute and chronic neuronal injury

Degeneration

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4
Q

Seen during regeneration

Increased protein synthesis with axonal sprouting

A

Axonal reaction

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5
Q

Seen in aging, viral infections and degenerative diseases

Intracytoplasmic accumulation

A

Neuronal inclusions

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6
Q

Site of protein synthesis of neurons

Granular bodies of RER

A

Nissl susbtance

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7
Q

HSV body

A

Cowdry type A in temporal lobe

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8
Q

Rabies body

A

Negri body in pyramida cells of hippocampus and purkinje cells of cerebellum

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9
Q

Alzheimer’s body

A

Neurofibrillary tangles of hyperphosphorylated tau proteins

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10
Q

Parkinson’s disease body

A

Lewy Body of alpha synuclein protein

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11
Q

Hypertrophy and hyperplasia of astrocytes

A

Gliosis

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12
Q

Astrocyte functions

A

Metabolic buffers/detoxifiers
Control flow of substances between BBB and CSF
Recycle glutamate

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13
Q

Eosinophilic structures that occur within ASTROCYTIC processes that are found in regions of long-standing gliosis and pilocytic astrocytoma

A

Rosenthal fibers

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14
Q

Basophilic and lamellated structures found in advancing age, representing a degenerative change in astrocytes

A

Corpora amylacea

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15
Q

Sites where corpora amylacea are found

A

Brain
Lung
Prostate

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16
Q

Sum of the components of the intracranial cavity is constant

Brain, Blood, CSF

A

Monroe Kelly Doctrine

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17
Q

Sequence of compensation

A

CSF -> Venous blood -> Arterial blood (ischemia) -> Brain (herniation)

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18
Q

Due to BBB disruption and increased vascular permeability

Increased fluid leakage

Seen in inflammation or neoplasms

A

Vasogenic edema

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19
Q

Due to CNS injury that prevents maintenance of membrane ionic gradient

Increased CSF secretion

Seen in hypoxic/ischemic injury

A

Cytotoxic edema

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20
Q

Only type of cerebral edema responsive to steroids

A

Vasogenic edema

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21
Q

Increase in ventricular CSF volume due to loss of brain parenchyma

A

Hydrocephalus ex vacuo

Alzheimer’s
Dementia

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22
Q

Most common cause of congenital hydrocephalus

A

Congenital Aqueductal Stenosis

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23
Q

Cushing’s triad

A

Widened pulse pressure
Hypertension
Irregular breathing
Bradycardia

due to pressure on vagus nerve

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24
Q

Asymptomatic bony defect or a severe malformation with a flattened, disorganized segment of spinal cord

A

Spina bifida

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25
Q

Extension of CNS tissue through a defect in the vertebral column

A

Myelomeningocoele

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26
Q

Diverticulum and malformed brain tissue extending through a defect in cranium

A

Encephalocoele

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27
Q

Malformation of the anterior end of the neural tube

A

Anencephaly

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28
Q

Completely open brain and spinal cord

A

Craniorachischisis

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29
Q

Occipital skull and spine defect with extreme retroflexion of the head

A

Iniencephaly

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30
Q

Deficiency of at least two vertebral arches

Covered with lipoma

A

Closed spinal dysraphism

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31
Q

Prescribed period of intake of folic acid in women desirious of pregnancy

A

1 month before and first 3 months of pregnancy

400 mcg
0.4 mg

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32
Q

Reduced number of gyri

A

Lissencephaly

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33
Q

Small and irregular formed convolutions

A

Polymicrogyria

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34
Q

Incomplete separation of cerebral hemispheres across the midline

A

Holoprosencephaly

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35
Q

Associated with mental retardation

A

Agenesis of corpus callosum

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36
Q

Tonsillar extension into vertebral canal

A

Arnold Chiari Type I

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37
Q

Small posterior fossa
Vermis extension into foramen magnum
Hydrocephalus
Myelomeningocoele

A

Arnold Chiari Type II

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38
Q

Enlarged posterior fossa
+/- vermis
Large midline cyst

A

Dandy Walker

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39
Q

Fluid filled cavity in central canal from tumors or trauma

Pain centers of ventral white commisure damaged loss of pain and temp sensation in UE

A

Syringomyelia

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40
Q

Placque jaune are most commonly found at sites of

Can cause epileptic foci

A

contrecoup injury

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41
Q

Occurs in deep white matter region, cerebral peduncles, superior colliculi, deep reticular formation and brachium conjunctivum

Characterized by widespread and asymmetric axonal swellings

Coma shortly after trauma

A

Diffuse Axonal Injury

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42
Q

Pterion is the union of the

A

Frontal
Parietal
Sphenoid
Temporal

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43
Q

Chronic traumatic encephalopathy due to repeated head trauma causing accumulation of tangles in frontal and temporal lobes

A

Dementia pugilistica

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44
Q

Single most common cause of CVD

A

Cardioembolic stroke

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45
Q

Most sensitive neurons to hypoxia

A

Pyramidal cell layer of hippocampus (area CA1)
Cerebellar purkinje cells
Pyramidal neurons in cerebral cortex

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46
Q

Areas of the brain with little collateral flow

A

Thalamus
Basal ganglia
Deep white matter

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47
Q

Most common site of cardiam thromboemboli lodging

A

MCA

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48
Q

Most commonly associated with atherosclerosis and plaque rupture

Especially at Carotid bifurcation, MCA, Basilar artery

A

Thrombotic

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49
Q

Cytotoxic and vasogenic edema

Loss of gray and white matter differentiation

A

First 12 hours CVD infarct

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50
Q

Neutrophils (weeks)

Macrophages (months to years)

A

12-48 h CVD infarct

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51
Q

Reactive astrocytes

May be cause of seizure

A

48h-1 week CVD infarct

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52
Q

Angiogenesis and gliosis

A

1 month onwards CVD infarct

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53
Q

Golden hour for rTPA therapy in CVD

A

3-4.5 hours

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54
Q 
Infarcts <15 mm
Most common in lenticular nucleus
Putamen
Thalamus
Internal capsule 
Deep white matter
Caudate
Pons
A

Lacunar infarct

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55
Q

Slit-like cavities secondary to resporption of hemorrhage

A

Slit hemorrhage

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56
Q

Cortical > subcortical

Dementia
Gait
Pseudobulbar signs +/- focal neurologic deficits

A

Vascular dementia

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57
Q

Affects Subcortical > cortical

Dementia (parasagittal)
Gait
Incontinence

A

Binswanger disease

58
Q

Most common cause of intraparenchymal hemorrhage

A

Ganglionic (basal ganglia and thalamus) - HTN Putamen

Lobar - cerebral amyloid angiopathy

59
Q

CHTN is associated with development of these microaneurysms in the basal ganglia (putamen)

A

Charcot bouchard

60
Q

Cerebral amyloid angiopathy most commonly in lobar hemorrhages are located in

A

Leptomeningeal (arachnoid and pia)

Cerebral cortical arterioles

61
Q

SAH is increased in

A

Autosomal dominant polycystic kidney disease
Ehlera Danlos
Marfan
NF Type I

62
Q

Pathognomonic finding of Waterhouse Friedrichsen Syndrome

A

Purpura fulminans

63
Q

Most common cause of aseptic or acute viral meningitis

A

Enterovirus

64
Q

Antibiotic approved for prevention of MAC

A

Azithromycin

65
Q

Neurosyphilis patterns of involvement

A

Meningovascular
Paretic
Tabes dorsalis

66
Q

Impaired joint position sense
Loss of pain sensation
Areflexia
Charcot joints (skin and joint)

A

Tabes Dorsalis

67
Q

HSV meningitis affected site

Inclusion body

A

Inferior and medial regions of temporal lobes
Orbitofrontal gyri

Cowdry Type A

68
Q

CMV Meningitis causes

A

Periventricular necrosis

Microcephaly and periventricular calcifications

Most common source of congenital infections

69
Q

Polio virus affects

A

Anterior horn motor neurons of spinal cord

70
Q

First symptom of rabies virus

A

Local paresthesia at site of bite

71
Q

Rabies virus binds using

And inhibits

A

Glycoproteins

Nicotinic receptor in brain

72
Q

Rabies body

A

Negri bodies

Pyramidal neurons of hippocampus and purkinje cells of cerebellum

73
Q

HIV infects the cell

A

Macroglia

Because it contains CD4 receptors

74
Q

HIV causes

A

IRIS (immune reconstitution inflammatory syndrome; paradoxical deterioration starting therapy)

Dementia due to inflammatory reactivation of microglia

75
Q

JC Polyoma virus infects the cell

A

Oligodendrocyte causing demyelination

Immunosuppresed

76
Q

JC Polyomavirus causes

A

Progressive multifocal leukoencephalopathy

77
Q

C neoformans preferentially affects

A

Basal meninges hydrocephalus

Soap bubble lesions

78
Q

Most common cause of brain abscess in HIV individuals

A

Cerebral toxoplasmosis

79
Q

Cerebral toxoplasmosis on MRI

A

Multiple ring-enhancing lesions

Central necrosis, organisms in the intermediate zone, tachyzoites and bradyzoites in periphery

80
Q

Triad of congenital toxoplasmosis

A

Hydrocephalus
Chorioretinitis
Calcification

81
Q

Naegleria from swimming in warm and still waters causes

A

Primary amebic encephalitis

82
Q

Acanthamoeba resulting in coma and death in weeks to months is usually associated with immunosupression causes

A

Granulomatous amebic meningoencephalitis

83
Q

Cerebral malaria is caused by

A

Plasmodium falciparum

vascular dysfunction and reduced blood flow

84
Q

Prion

A

CJD
Gerstmann-Straussler-Scheinker
Fatal familial insomnia
Kuru

85
Q

Spongiform change and rapid dementia

86
Q

Most common prion disease

characteristic of

A

Creutzfeld Jacob Disease

Startle myoclonus

87
Q

Autoimmune demyelinating disorder

Distinct episodes of neurologic deficits separated in tine, attributable to white matter lesions that are separated in space

Most common demyelinating disorder

Relapsing remitting

A

Multiple sclerosis

88
Q

Multiple sclerosis radiographic feature

A

Dawson’s fingers

89
Q

Mutliple sclerosis CSF analysis

A

+ oligoclonal IgG bands

90
Q

Multiple sclerosis frequent initial manifestation

A

Visual impairment

Internuclear opthalmoplegia

91
Q

Criteria for diagnosis of Multiple Sclerosis

A

McDonald’s Criteria

2 or more clinical attacks
2 or more lesions

92
Q

Syndrome with synchronous bilateral optic neuritis and spinal cord demyelination

“Asian MS”

A

Neuromyelitis optica

Devic’s disease

93
Q

Neuromyelitis optica antibody analysis

A

+ aquaporin 4

Tx plasmapharesis, anti-CD20

94
Q

2-6 days after rapid correction of hyponatremia

acute disorder characterized by loss of myelin in the BASIS PONTIS and portions of PONTINE TEGMENTUM

Rapidly evolving quadriplegia

A

Central Pontine Myelinosis

Locked-in

95
Q

Limit of correction for sodium

A

8-10 meqs/day

96
Q

Most common cause of dementia in older adults

Agnosia
Aphasia
Apraxia
Visuospatial disorientatiob
Executive dysfunction
A

Alzheimer’s disease

97
Q

Alzheimer’s treatment

A

Donepezil + Memantine

98
Q

Cholinesterase inhibitor that improves memory and attention

99
Q

NMDA antagonist acetylcholinesterase inhibitor for moderate to severe dementia

100
Q

Alzheimer Disease accumulation

A 
Plaque (beta amyloid)
Neurofibrillary tangle (hyperphosphorylated tau) correlates better with degree of dementia
101
Q

Most common terminal event in Alzheimer’s

102
Q

Prominent behavioral and personality changes
Language defixit
Memory loss

A

Frontotemporal dementia

103
Q

Frontotemporal dementia hallmark

A

Pick bodies - aggregates of tau

Atrophy of the frontal and temporal lobes

104
Q

Parkinson’s disease accumulation

A

Lewy body (alpha-synuclein)

105
Q

Parkinson’s anatomic changes

A

Pallor of substantia nigra
Basal nucleus of Meynert (cholinergic)
Dorsal motor nucleus of X

106
Q

Multiple System Atrophy neuroanatomical circuits affected

A

Striatonigral (leading to Parkinsonism)
Olivopontocerebellar (leading to ataxia)
Autonomic nervous system (autonomic dysfunction with OH)

107
Q

Parkinsonism
Ataxia
Autonomic dysfunction; OH

A

Multiple System Atrophy

108
Q

Multiple System Atrophy radiographic feature

A

Hot cross bun sign

Atrophy of pontocerebellar tract

109
Q

Autosomal dominant
Progressive movement disorders
Dementia

Degeneration of striatal neurons

Generalized jerky and hyperkinetic movements (choreoathetosis)

A

Huntington disease

110
Q

Huntington disease is characterized by

A

CAG repeat expansion

Huntingin gene

111
Q

Box car ventricle from atrophy of caudate nucleus

A

Huntington disease

112
Q

Fragile X Syndrome trinucleotide repeat expansion

113
Q

Myotonic dystrophy trinucleotide repeat

114
Q

ALS mutation

115
Q

ALS hallmark

A

Bunina bodies (remnants of autophagic vacuoles)

116
Q

ALS anatomical changes

A

thin anterior roots of spinal cord

atrophy of precentral gyrus

117
Q

ALS tx

118
Q

Progressive muscular atrophy

119
Q

Primary lateral sclerosis

120
Q

Progressive bulbar palsy

A

Cranial motor nuclei

121
Q

Marked loss of lower motor neurons resulting in progressive weakness

A

Spinal Muscular Atrophy

122
Q

Most severe form of SMA

A

Type I Werdnig Hoffman disease

123
Q

Acute onset of psychotic symptoms
Opthalmoplegia

Reversible

Hemorrhage and necrosis in the mamillary bodies and walls of 3rd and 4th ventricle

A

Wernicke’s encephalopathy

124
Q

Short term memory loss and confabulation

Irreversible

Lesions in the dorsomedial nucleus of the thalamus

A

Korsakoff syndrome

125
Q

Alcohol causes impaired absorption of

126
Q

Causes degeneration of ascending and descending tracts due to defect of myelin formation

A

B12 deficiency

127
Q

Hypoglycemia Type II DM

128
Q

Hypoglycemia w/o T2DM

129
Q 
Confusion 
Deliriun
Headache
Dizziness
Mood and personality changes
Paresthesia
Seizures
Blurred vision
A

Neuroglycopenic

130
Q

Most common manifesfation of hepatic encephalopathy

A

Inverted sleep wake pattern
Asterixis
Seizure

131
Q

Carbob monoxide causes selective injury of

A

Bilateral globus pallidus
Cerebral cortex
Hippocampus
Cerebellum

132
Q

Ethanol causes atrophy of

A

anterior vermis

133
Q

Drunk level

A

0.08 % blood alcohol

134
Q

Radiation causes

A

Marked tissue edema

135
Q

Most common CNS tumor

A

Glioma

Astrocytoma

136
Q

Fever, rash, sore throat, cervical and axillary LN
Hepatosplenomegaly
Young adult

A

Infectious Mononucleosis

137
Q

Psammoma bodies

A

Papillary Thyroid carcinoma
Meningioma
Ovarian cystoadenocarcinoma

138
Q

Most common primary site of originating metastases

139
Q

Paraneoplastic syndrome

Antibodies against voltage-gated calcium channels in the presynaptic terminal of NMJ

A

Lambert-Eaton Myasthenic Syndrome

140
Q

Small cell lung cancer

Paraneoplastic Syndromes

A

ACTH
SIADH
LEMS

Pathology (24 decks)

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