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Step 2 CK: UWorld Questions > Neurology U WORLD Questions > Flashcards

Neurology U WORLD Questions Flashcards

1
Q

Incidence =

Prevalence =

A

New case/total-people w/ disease

Diseased/total

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2
Q

Drug for Partial and Grand Mal seizures, SJS or TEN risk, GI symptoms common

A

Lamotrigine, Na+ channels

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3
Q

Visual pathways

A

First Aid Page 486

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4
Q 
Recurrent lapses into sleep
strong emotion
brief tone loss
decress CSF hypocretin 1
Short Rem
A

Narcolepsy

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5
Q

White pupillary reflex in young =

Inc risk of?

Gene?

A

Retinoblastoma

Osteosarcoma

RB

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6
Q

retarded, asocial, macroorchidism, long face =?

Gene?

A

Fragile X

FMR1, CGG repeat, X linked, hypermethlyated

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7
Q

Early Alz

AV septal Defect

HIrshsprung

duodenal atresia

T1DM

Hypothyroid

Leukemia

A

Down Syndrome

Chrom 21 x3, APP gene multipled (NOT ApoE gene = late Alz)

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8
Q

Neisseria Meningitis recurrent attacks, why? (2)

A

MAC dysfxn

OR

too much IgA (disseminated infxn

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9
Q

GABA-A MOA

A

hyperpolarize: Cl- in

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10
Q

Left face, right body loss of pain, temp, ipsilateral ataxia

A

Wallenberg (Lateral Medullary Syndrome)

CN5 nucleus, Spinothalamic Tract, inferior peduncle

PICA fed by Vertebral (lateral formina of Cervical spine)

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11
Q

Farmer, inc ACh symptoms (SLUDGE)

A

organophosphate poisoning (covalent bonded)

treat w/ atropine, pralidoxime

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12
Q

Alcoholic presents with confusion, vision loss, unsteady gait

A

Wernicke-Korsakoff: mamillary body affected

Dec thiamine = dec erythroctye transketolase

give thiamine WITH glucose

Wernicke = reversible
Wernicke Korsakoff = irreversible

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13
Q

Diplopia, no adduction of eye, no corneal reflex =? (nerves)

exit they travel through?

A

CN3, CN6, CN5, superior ophthalmic vein

Superior orbital fissure

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14
Q

Most important aspect in diagnosing Tetanus

A

H&P

no ABs, cultures, or toxin tests

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15
Q

G+ intracellular motile rod
narrow hemolysis, tumbling
high and low temp multiply

virulence factor

Agar

immunity

most at risk?

A

Listeria monocytogenes

listeriolysin O

Blood

Cell mediated

neonates and Hodgkins lymphoma

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16
Q

Stiff neck, fever, altered mentation =

treat?

A

Bacterial meningitis

empiric Abx, LP, CSF analysis

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17
Q

Neisseria CNS pathway

Staph Aureus

Strep Pneumo

H Infl

A

MC adults: pharynx, blood, choroid, meninges

Wound

Ear

Lymph

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18
Q

Adrenergics

Alpha 1

Beta 1

Beta 2

A

dilate eye, contract PBS, contract bladder (Ep, NE, phenylephrine, methoxamine)

Inc heart rate (Ep, DA, dobutamine, isopretenol)

dilate PBS, dilate bronchi, relax uterus (Dobutamine, isopretenol, terbutaline, ritodrine)

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19
Q

unpredicatable on/off parkinson’s symptoms

A

on/off phenom: long term Parkinson’s treatment

inc nigrostriatal degen, dec therapeutic window

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20
Q

SNS to eccrine sweat glands and adrenals

PNS pre gang and post gang

Somatic

SNS to Renal vessels

SNS to Heart and Vessels

SNS to other sweat glands and vessels

A

NACh

NACh - MACh

NACh

NACh - D1

NACh - NE

NACh - MACh

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21
Q

Wernickes: alpha ketoglutarate

A

amino group of alanine tansferred to alpha ketoglutarate

then converted to glucose

thiamine is co factor

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22
Q

Short term non-addictive sleep help

A

Zolpidem: Zs for Zs

same mechanism as benzos (inc freq Cl- channel firing at GABA-A)

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23
Q

GABApentin MOA

A

voltage gated Ca channels in presynaptic neuron

block fusion and NT vesicle release

also enhances GABA activity

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24
Q

increased AFP and AChE on amniocentesis

A

failure of fusion of neural plate edges

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25
Q

neonate, MacConkey agar, pink colonies, G- rod=

Antigen?

A

E coli meningitis

K1 capsule

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26
Q

Rifampin, Carbamezapine, phenobarbitol, phenytoin do what to P450 and serum of drugs metabolized by P450

Fluconazole, cimetidine, omprazole, do what to P450 and serum of drugs metabolized by 450

A

inc P450, so dec serum level of drugs

block P450, inc serum level of drugs

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27
Q

brachial plexus block affects diaphragm by?

phrenic nerve roots pass through?

A

ipsilateral diaphragm paralysis

phrenic nerve roots C3-5 pass thru scalenes

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28
Q

No abduction past horizontal, shoulder droop

location of nerve

A

CN 11 effected

Post Triangle of neck

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29
Q

Ptosis, down and out, fixed and dilated, loss of accomodation =

A

CN3 lesion

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30
Q

Do secondary messengers play a role in presynaptic release?

A

no, Ca+ channels

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31
Q

left dysdiadochokinesia?

A

left cerebellar mass

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32
Q

Parkinson’s drugs that worsen anxiety and agitation

A

Carbidopa and levodopa

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33
Q

weak wrist flex, add, 4th and 5th digits, claw

place nerve gets compressed

Spinal Levels of nerve?

A

Ulnar nerve (ulnar claw)

Guyon’s canal

C8-T1

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34
Q

Right nasal hemianopia

A

Right internal carotid artery, perichiasmal lesion

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35
Q

Migraines

Symptom treatment

abortive therapy

Prophylaxis

A

Sumatriptan 5HT

B blockers, anticonvulsants

SNRIs

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36
Q

young boy/man, ataxia, muscle weakness, kyphoscoliosis, pes cavus, frequent falls

associated disorder?

Inheritance

A

Friedreich’s Ataxia

HCM

AR: frataxin gene, GAA tri nuke repeat, chrom 9 (mitochondrial fxn)

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37
Q

Lipid stained macrophages, how long since stroke?

A

microglia, 3-5 days post stroke

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38
Q

Loss of CNS myelination =

common sign of MS

A

MS or multifocal encephalopathy: oligodendrocyte depletion

Oligoclonal IgG bands

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39
Q

asc. bilateral muscle weakness

MC bacteria associated

A

GBS, immune mediated

Campylobacter Jejuni

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40
Q

Foramen spinosum

Foramen Rotundum

Foramen Ovale

A

V1 ophthalmic branch, MMA and V

V2 maxillary branch

V3 mandibular branch

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41
Q

Ataxia, recurrent pulmonary infections, telangeictasia =

Gene?

A

ataxia telangectasia

ATM: AR: DNA break repair

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42
Q

BPDII mother, child born with neural tube defect

A

folic acid and valproate: 4 weeks gestation

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43
Q

Ventrolateral nuclei

Ventromedial nuclei

anterior nuclei

posterior Nuclei

arcuate nuclei hormones

Paraventricular nuclei hormones

supra optic nuclei hormones

suprachiasmatic nuclei hormones

A

hunger: destruction = anorexia
satiety: destruction = hyperphagia

Destory = hypertherm

Destroy = hypotherm

DA, GHRH, GnRH

AD, CRH, oxy, TRH

ADH, Oxy secrete

Circadian and pineal fxn

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44
Q

extensor muscle palsy =

A

crutch palsy, saturday night palsay, radial nerve palsy

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45
Q

worry about everything

A

GAD

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46
Q

B blockers help with?

exacerbate

A

angina (B1 dec HR and BP)

Asthma/COPD B2 bronchoconstriction

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47
Q

Resting membrane permeable =

Ligand gated

voltage gated

A

K

Na

Cl

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48
Q

Dementia + HIV

whats affected

pathology

A

HIV associated dementia

subcortical (deep) gray

inflammatory microglial nodules

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49
Q

CN3 palsy ispilateral temporal lobe mass

A

uncal herniation, downward displacement

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50
Q

Oral thrush + musltiple ring enhancing lesions

A

HIV, toxoplasmosis

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51
Q

Amitryptilin: type of drug?

side effects?

A

TCA

insomnia, anti ACh (no sludge) urinary retention, confusion, constipation

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52
Q

treatment for toxoplasmosis ring enhancing lesions

A

pyrimethamine and sulfadiazine (clindamycin if allergy), follinic acid

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53
Q

Mass lesions with HIV and EBV

A

primary CNS lymphoma, B cells

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54
Q

CN5 neuralgia treatment

MOA

adverse

A

Carbamezapine

Na channels

bone marrow suppress and SIADH

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55
Q

Restless leg syndrome treatment

MOA

A

DA agonist, pramipexole

Fe+ deficient or idiopathic

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56
Q

Cavitary lesion, HTN, deep, hemiparesis

if atherosclerosis

A

HTN, small lacunar infarct, internal capsule

history of, big stroke

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57
Q

Serotonin syndrome (hyperthermia, tremor, clonus, hyperreflexia)

A

SSRI OD in depression

tryptophan

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58
Q

Cyproheptadine MOA

A

block Histamine and serotonin: antipsychotic

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59
Q

DIC w/ adrenal destruction post infection

A

N. meningitidis, Waterhouse Freidrichson

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60
Q

Hip drop contralateral on Trendelenburg test =

A

weak Glute Med, lean ipsilateral, superior gluteal nerve injury on standing leg

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61
Q

Gardener w/ mydriasis (dry and dilated eyes)

A

plant that blocks AChM: atropine poisoning

need physostigmine (AChEI that crosses BBB)

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62
Q

HSV (shingles) CN5 tract: anterior or retrograde?

kinesin or dynein

latent or active phase

A

anteriorgrage, kinesin, active

retrograde, dynein, latent

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63
Q

dec CO2 =? on ICP

use to treat>

A

vasoconstrict, = inc vascular resistance = dec in CBF = dec. in

cerebral edema

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64
Q

CN9, 10, 11 ipsilateral syndrome

A

Venet syndrome, jugular foramen mass

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65
Q

Low 5HT w/ neurodeterioration (retard) =?

due to deficient in ?

treat with ?

A

Phenyketouria

BH4 (tetrahydropiopterin) or pheynl-hydroxylase, inc phenylalanine

low phenyl diet and BH4

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66
Q

TMD

Mandibular division of CN5 (V3) does?

Maxillary (V2) does?

A

all mastication muscles and tensor tympani middle ear

sensory

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67
Q

Viral LP shows?

A

normal glucose, inc protein, 90% leukocytes

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68
Q

Treatment for tonic/clonic + absence seizure

Absence alone?

A

Valproate

Ethosuximide

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69
Q

papilledema is due to?

A

impaired axoplasmic flow in optic nerve

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70
Q

unilateral facial paralysis, dec tearing, hyperacusis, loss of ant. 2/3 taste

A

Bells palsy

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71
Q

L-R disorientation, agraphia, acalcula, agnosia

A

Gerstmann syndrome

angular gyrus of dominant parietal lobe

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72
Q

loss of fxn of mammilary body (alcoholic)

A

short term memory loss

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73
Q

Familial Parkinson’s pathological feature

due to

A

alpha synuclein lewy bodies

Ubiquitiation problem

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74
Q

Down and out eye, artery involved

muscles active

A

Posterior communicating artery

lateral rectus, superior oblique

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75
Q

Lateral forearm sensory?

elbow flexion and 6 shooter?

A

lateral cutaneous nerve

MSK cutaneous nerve

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76
Q

Epidural hematoma (looks like, due to)?

subdural hematoma (looks like, due to)?

A

lens, MMA rupture

crescent, cortical bridging veins

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77
Q

Hemangioblastoma, kidney liver, pancrease

Hamartomas and cutaneous angiofibromas

PNS tumor, neurofibromas, optic gliomas, caf a luit, iris nodules

Bilateral CN8 Schwannomas and meningiomas

cutaneous facial angiomas, leptomeningial angiomas, retard, seizure, hemipegia, tram track skull

Telangectasias

A

VHL syndrome AD

TS

Von Recklinghuasens (NF1)

NF2 AD

Sturg Weber

Osler Weber

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78
Q

Symmetrical ventricle enlargement, tuberculosis infxn can cause?

due to?

A

communicating hydrocephalus

arachnoid granulation problem

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79
Q

Neuronal shrinkage, cytoplasmic eosinophila?

A

glial hyperplasia

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80
Q

kid, parkinsons, inc transaminases, dec ceruplasmin

gene

treat

A

Wilson’s

AR ATP73

D Penicillamine

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81
Q

BBB: made of

can cross freely?

areas w/ no BBB

A

Tight jxns, end feet of astrocytes, BM

Nonpolar/lipid soluble

area postrema (vomit), post pituitary (ADH release), organ of lamina terminalis (blood osmolality)

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82
Q

Narcolepsy area of the brain

lab values

A

lateral hypothalamus: promotes wakefulness and REM

Dec hypocretin 1, 2, orexins A and B

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83
Q

contralateral homonymous hemianopia

A

occipital cortex

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84
Q

neonate hydrocephalus, IC calcifications, chorioretinitis (yellow) = ?

due to ?

A

congenital toxo

in utero cat feces

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85
Q

absence seizures treatment

MOA

A

ethosuximide

dec Ca++ channel current in thalamic nuclei

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86
Q

Adult polycystic kidney disease associated w/?

treat w/, MOA

A

SAH

Nimodipine (dec. Ca++ current) prevent vasospasm and neurodeficits

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87
Q

decrease accomodation, cant read, drugs used?

MOA

A

1st gen antihistamines (chlorpheniramine, diphenhydramine)

block histamine and ACh at ciliary muscle

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88
Q

central scotomas

A

lesions of macula

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89
Q

sudden arm up jerking lesion where?

spinal levels

associated

A

lower trunk brachial plexus, Klumpkes claw hand, intrinsic hand muscles

C8-T1

Horners

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90
Q

finger and thumb Extension weakness, repetitive pronation, supination, trauma = ?

A

radius subluxation, radial nerve, supinator canal

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91
Q

Right sided pure hemisensory loss

posterior lateral

posterior medial

A

thalamic stroke contralateral

body

face

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92
Q

dementia, ataxia, urinary incontenence in older individual

spinal levels

A

Normal pressure hydrocephalus

S2-S4

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93
Q

Traumatic event then neuromptoms

A

Conversion disorder

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94
Q

CN5, mandible, maxilla, zygoma, incus, malleus, masstication muscles come from?

CN7, stapez, styloid, lesser horn hyoid, facial muscles come from?

neonate missing any of these

A

1st arch

2nd arch

treacher collins syndrome

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95
Q

Kids w/ stroke like neuro deficits

A

mitochondrial diseases, heteroplasmy, inc, lactate variability of presentation: MELAS

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96
Q

self mutilation (biting), hyperuricemia, decrease HGPRT, increase PRPP =

MOA

A

Lesch Nylon

inc blood uric acid, kids w/ developmental delays

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97
Q

acute painless monocular vision loss

A

central retinal artery occulsion: cherry red macula

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98
Q

progressive weakness

A

MG, AChR Abs, thymoma

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99
Q

esosinophilic staining red neurons

A

ischemic stroke 12-24hrs ago

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100
Q

parkinsons treatment

MOA

A

pramipexole

direct DA receptor stimulus

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101
Q

pregnant w/ monolike illness

infant at greatest risk for

A

CMV

chorioretinitis

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102
Q

brady cardia after inferior MI due to?

treatment?

can cause?

A

dec Sa and AV node conductance

atropine

closed angle glaucoma

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103
Q

kinesin antero or retrograde

affect if missing

A

antero

dec synaptic vesicles

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104
Q

anxiety treatment

assoicated NT

brain location where NT is produced

A

SSRI fluoxeteine

5HT

Raphe nuclei

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105
Q

ANterior pituitary is produced from?

A

surface ectoderm

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106
Q

Multiple sclerosis low or hgih neuronal length constant

A

low

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107
Q

Late Alzhemiers associated w/? (3)

A

ApoE4, E4

APP chrom 21

Presenlin 1 (chrom 14), and 2 (chrom 1)

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108
Q

Rapid recovery from propafol anesthesia due to

A

tissue redistribution of drug

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109
Q

neonate, acidosis, inc anion gap, ketosis, hypoglycemia, inc propionic acid due to

A

methylmalonyl coa deficit, cant metabolize Val, isoleu, metho, threonine

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110
Q

puffere fish toxin?

MOA

A

tetrodotoxin

Na+ channels, carrdiac and nerve tissue

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111
Q

how to prevent MPTP damage to DA neurons?

A

MAO-B blocker: selegiline

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112
Q

premie, large anterior fontanels, <1500g, hypotonia, prominent scalp veins

A

intraventricular hemorrhage

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113
Q

thymoma on CT, large mass

A

MG, autoantibodies to AChR

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114
Q

Parkinsons treatment

A

Levodopa (crosses BBB)

Carbidopa (blocks decaroxylase)

Entacapones (blocks COMT

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115
Q

pupil constrict, hypotension, vasodilate, which receptor stimulated

A

M3 ACh

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116
Q

alpha heli to beta pleated sheet

A

H bond rearrangement

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117
Q

Focal Seizures:

Simple

Complex

Treatment

A

Partial hemisphere

motor symptoms only (arm jerk)

Motor + absence seizure

carbamazepine, gababpentin, pehnobarbitol, phenytoin

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118
Q

Generalized Seizures

Tonic/clonic

Myoclonic

ABsence

Treatment

A

both hemispheres

LOC and jerking

brief jerk

LOC

Lamotrigine, levetiracetam, topiramate, valproate, ethosuximide

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119
Q

lymphoma, dec immunity, india ink stain and suocraud agar = ?

Treatment

A

Cryptococcal meningitis

Amphotericin B and Flucytosine

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120
Q

recurrent seizures more than 5min

treatment

A

status epilepticus

IV lorazepam (GABA)

IV phenytoin (Na+)

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121
Q

flushing, diaphoresis, nausea after drug taken?

used for?

A

cholinomimetic

atonic bladder

122
Q

volatile anesthetics inc?

A

CBF = ICP

123
Q

Chronic loss of peripheral vision

drugs target

A

open angle glaucoma = inc IOP and cup/disk ratio

ciliary epithelium

124
Q

Vomiting and vertigo

A

vestibular system inner ear

125
Q

surgery, drug that precipitates opiod withdrawal symptom

A

Buprenorpohine, only a partial u agonist

126
Q

antipsychotics with acute dystonic rxn due to

A

D2 antagonism in nigrostriatal pathway

127
Q

no vertical gaze, upper lip numb, cheeck, gingiva number

A

orbital floor fracture: maxilla, infraorbital nerve (V2)

inferior rectus trapped

128
Q

5 year old, gait problems, posterior fossa mass, primitive cells

rosenthal fibers, low grade

small round, blue cells, high grade

A

medulloblastoma

pilocytic astrocytoma

meduloblastoma

129
Q

Tetanus, spams: anterior or retrograde

affects WHich NTs

A

REtro

GABA and Glycine in cord

130
Q

contralateral motor/sensory deficits in LE and urinary incontinence

A

ACA occlusion

131
Q

Startle epilepsy, blotchy red ragged muscle fibers on Gomori trichome stain

A

maternal inherited mitochondrial disease

132
Q

N meningitidis vaccine

A

capuslar protein, anticapsular antibodies

133
Q

low cerebellar tonsils

adolscent, or adult =

neonate, severe, aqueductal stenosis, myelomeningocele, syrinx

A

Arnold Chiari malformation

Type I

TYpe II

134
Q

Saddle anesthesia and no anal reflex

A

S2-4 dermatome

135
Q

all extensors motor, sensory posterior UE, wrist drop, axilla or mid humerus

FLexion, finger abduction, thumb add

flexion thumb opposition

A

Radial nerve C5-T1

Ulnar Nerve

Median Nerve

136
Q

Achilles reflex

A

S1

137
Q

extracellular neuritic plaques medial temporal lobe, amyloid beta (APP)

Neurofibrillary tangles cytoplasm

A

ALzheimers, APP

Tau

138
Q

Hemiballism

modulateds

A

lacunar stroke damage to subthalamic nucleus

BG output

139
Q

icepick, unilateral, recurring HA, tearing and runny nose

A

cluster HA

140
Q

cystic degeneration of putamen

A

WIlson’s disease

141
Q

hypotonia, hepatomegaly, seizure, infant death, VLCFA

A

peroxisomes defect

142
Q

South, infxn, rash, stroke symptoms, encepthalitis w/ flaccid paralysis

A

WNV: flavivirus RNA

insect bite

143
Q

aggressive, flat, jerky

MOA

Inheritence

Treatment

A

Huntingtons

loss of GABA, atrophy of caudate

Tri repeat HD gene Chrom 4, AD

resperidine, tetrabenzine, haloperidol, benzos

144
Q

diabetic neuropathy due to?

A

nonenzymatic glycosylation and endoneural arteriolar hylanziation

145
Q

HIV, HA, mass, EBV =

A

PCNS lymphoma, CD20 or 79a cells, high grade

146
Q

papilledema, HA, vomit

no up gaze, light neer dissection, bilateral eye retraction

lesion

location

A

Parnaurd syndrome

Germinoma, pineal gland mass

dorsal midbrain

147
Q

dot or flame retinal hemorrhages

A

HTN

148
Q

origin of seizure deficits

A

contralateral pirmary somatosensory coretex (post central gyrus)

149
Q

elderly, recurrent lobar hemorrhage in occipital and parietal lobes

A

cerebral amyloid angiopathy

150
Q

coagulase neg, extracell polysac biofilm virulence

A

Staph epiderm

151
Q

loss of prop, stabbing and stumbles, VDRL+ spinal fluid, Argyll pupill

affects?

A

Neurosyphilis

Dorsal columns

152
Q

+Romberg, prop, fatigue, sensory deficits

A

B12 deficit

153
Q

MOA of huntingtons

A

histone deacetylation = gain of fxn, silence neuronal sruvival genes

treat w/ histone deacetylase inhibitors

154
Q

lancet G+ cocci pairs

A

Strep pneumo, most common isolated meningitis

155
Q

acute hepatitis and centrolobar necrosis can be caused by

A

halogenated inhaled anesthetics (Flurones): P450

156
Q

Numbness and tingling after TB treatment w/ isoniazid

A

competes w/ B6 pyridoxine

157
Q

Long term pyridostigmine exacerbate

improves w/ endrophonium test (tensilon)

A

myasthenic or cholinergic crisis

myasthenic, not cholinergic

158
Q

ANS modulated by

NACh modulated by

A

cAMP, IP3, or Ions

Na+

159
Q

white around fundoscopic vessels

treat?

A

CMV retinitis

Gancicyclovir

160
Q

labor, fecal/urinary incontinence =

A

pudendal nerve stretch injury

161
Q

sporadic neurolgic symptoms, woman 20-30 yo, IgG, HL

Treat

A

MS, Autoimmune

INF beta

162
Q

ISchemic injury in brain

ischemic injury not in brain

irreversible

A

liquifactive necrosis

coagulative necrosis

yes

163
Q

antipsychotics, missed periods, nipple discharge: pathway

A

tuberoinfundibular path, prolactin

164
Q

K+ on nerve graph

A

down stroke not peak or resting: most K+ permeable

165
Q

Decerebrate extesnor posture after brain injury/hemorrhage

decorticate flexor posture

A

transtentorial/uncal hernation = pons injury, mid brain injury, at or below red nucleus

cerebral hemis or internal capusle, at or above red nucleus

166
Q

post cardiac arrest lack of pupillary light reflex

A

upper midbrain axonal injury

167
Q

meningiomas occur most commonly at

A

midline falx or tentorium cerebeli

168
Q

contralateral hemineglect

A

meningioma in parietal lobe

169
Q

kid, flaccid paralysis, degen ant horn cells

A

spinal muscular atrophy, SnRNP spliceosomes, SMN1

170
Q

hyperacusis in facial nerve palsy

A

stapedius nerve and stapedius mscle paralysis

171
Q

liqufactive necrosis due to

A

lysosomal digeston of tissue

172
Q

as you move down in spinal cord cord white matter

A

increase, thicker space in ventral horn

173
Q

enkaphalenins, dynorphins, endorphins, opiates, ACTH

A

POMC regions and MSH

174
Q

<1yo, regression motor skills, macrocepthaly, bright red fovea, w/ white macula

inc GM ganglioside

inc B glucocerebroside

inc sphingomyelin and HSM

A

lysosomal storage disease

Tay Sachs: AR, no B hexoasminidase A

Gaucher

Miemann Pick

175
Q

most common viral meningitis 3

A

Enterovirus

aborvirus

HSV2

176
Q

Agitation, disorientation, pharyngospasm, photophobia, salivation

virus type
receptor type

A

Rabies

ssRNA Rhabdovirus bullet shaped
NAChR

177
Q

Carbamazepine, barbituates, phenytoin, rifampin, griseofulvin, St Johns wart, modofinil, cyclophosphamide

A

CYP450 Inducers: dec drug concn

178
Q

Amiodarone, Cimetidine, Fluoroquinolones, clarithromycin, azoles, GF juice, Isoniazid, Ritonavir

A

CYP450 Inhibitors, inc drug concen

179
Q

opiate induced analgesia

A

mu recetpor, inc K+ open, hyperpol post synaptic

dec Ca+ influx presynaptic

180
Q

treatment for essential tremor

A

propanlol B blocker

181
Q

ADPKD

A

SAH berry aneurysms

182
Q

berry aneurysms w/ down and out eye

A

near ICA branch point, compress CN3 at PcommA

183
Q

spontaneous deep intracerebral hemorrhage due to?

location

A

HTN

lenticulostraite arteries

184
Q

1st 3 finger sensory deficits: nerve?

wheres it trapped?

between which muscles

A

Median

Flexor retinaculum

FD superficialis and profundus

185
Q

Nonsense speech: wordy Wernieckes

A

MCA (does Brcas)

186
Q

hearing loss tinnitus, NF2, neuroma location

A

pontomedullary jxn or CPA

187
Q

contralateral hemiplegia of fuace and UE and aphasia if dominant

A

MCA occlusions

188
Q

hgih blood - gas partition =

low soluble =

A

slower equilibration w/ brain than NO

rapid onset

189
Q

PTSD diagnosed after

A

1month of symptoms

190
Q

round cells, peripheral nuclei, granular nissl substance =

A

axonal rxn post wallerian degen

191
Q

1st 3 digits, tinels + at flexor retinaculum

A

Carpal tunnel, median nerve compresion

192
Q

unstable, fatigue, pallor of nails, hands

A

b12 deficit, serum methylmalonic acid

193
Q

dysarthria and contralateral ataxic hemiparesis

A

CN5 lateral aspect mid pons

194
Q

temporal bone injury, LOC

A

MMA, epidural hematoma, skull and dura

195
Q

veicular tender rash on dermatome

latent in?

Abs?

A

VZV shingles reactivation

dorsal root ganglion

IgG

196
Q

HIV meningitis, budding yeast, latex agglutination, pneumocystic

A

Cryptococcus neoformans

197
Q

LUng tumor, cerebellar degen, dizzy, limb ataxia, dysarthria, visual problems, get better w/ stimulation

A

autoimmune Lambert Eaton

Anti yo, P/q, Hu

purkinje neurons

198
Q

succinylcholine for surgery, fever muscle rigitidty, malignant hyperthermia due to?

treat?

A

increase ca++ release

dantrolene

199
Q

+ babinski, hyperreflexia =

A

UMN lesion

200
Q

topical for open angle glaucoma

A

latonoprost PGE2 inc outflow aq humor uveoscleral

201
Q

INO disordered conjugate horizontal gaze

A

MLF lesion ipislateral dorsal pons

202
Q

Neuro Malignant syndrom =

caused by

treat w/

A

looks like serotonin syndrome

antipsychotics

dantrolene and stop drug

203
Q

gait and truncal ataxia

A

acute cerebellar lesion vermis

204
Q

well differentiated neoplasm, juvenile , hair glial cells, cerebellum, rosenthal fibers, granular eosinophilic bodies

A

pilocytic astrocytomas

205
Q

smoker + horners (ptosis, miosis, anhidrosis)

ANS?

SOmatic

A

pancost tumor atapex of lung

ciliary ganglia C8-T2

brachial plexus shoulder pain

206
Q

caudate nucleus: Location and disease

A

lateral ventricle, Huntingtons

207
Q

Femoral nerve block =

A

lidocaine into femoral crease, not ring

208
Q

appendectomy, loss of sensation over ipsilateral suprapubic area

GenFem nerve?

A

iliohypogastric n

cremasteric reflex

209
Q

Benzos MOA

TCA MOA

Barbs MOA

A

inc freq CL- channel open

block NE and 5HT reuptake

Inc duration CL- goben GABA-A

210
Q

Adductors innervation

A

Obturator nerve, L2-4

211
Q

NE made in

A

Locus ceruleus, posterior rostral pons: near lateral floor 4th ventricle

RAS arousal

212
Q

dense glial scar due to?

process

A

myelin debris persists for years

Wallerian degen

213
Q

HA, vomit, papilledema, dry skin, HSM< weird diet

A

Vit A tox

214
Q

Peripheral facial palsy

A

Parotid gland mass

215
Q

shrunken nuclei, no nissl, eosinophilic cytoplasm =

time since injury

A

irreversible cell injury

red neuron, 12-24 hours

216
Q

2 years progressive headaches w/ acute onset neuro symptoms = ?

Pathology

A

Meningioma

Whorled psammoma bodies

217
Q

young, visin change, HA, calcified mass, choelsterol =

from?

A

craniopharyngioma

ant. pituitary, rathke pouch remnant

218
Q

rapid neuro symptoms, decline and death with dementia w/in months =

path

A

Creutzfeldt-jakob

vacuolated areas, prion PrP, no treatment

219
Q

young, reatrd, seizures, pallor of SN, locus ceruleus, vagal nucleus =

pathophys?

A

PKU

dec phenylalanine hydroxylase

220
Q

loss of sense of tonsillar lining but no hoarseness = ?

A

CN9 deficits (not 10, 10 is hoarse)

221
Q

gingival hyperplasia =

A

phenytoin

222
Q

deep brain stimulation to globus pallidus or subthalamic nuclei in parkinsons used to

A

promote thalamo cortical disinhibition

223
Q

cataracts, gonadal atrophy, frontal baldnes, inability to loose grib, gait disturbance =

gene

A

myotonic dystrophy

CTG tri nuke repeat

224
Q

GBS path

A

endoneural inflammation infiltrate

225
Q

capsaicin depletes?

results in?

A

substance P

pain relief but hurts first

226
Q

rapid hypo Na+ correction =

A

osmotic demyelinating syndrome

227
Q

Neisseria meningitidis vaccine against

A

pili, no adherence to nasopharynx

228
Q

S100+, biphasic dense-nondense (Anteri A + B), acoustic neuroma

embyro deriv?

also S100+

A

Schwannoma, NF2

neural crest

melanoma

229
Q

decrease in motor end plate potential repeated contractions

A

MG

230
Q

Excessive cholinergic stimuation of gut (SLUDGE) due to AChEI treatment

A

Scopolamine (ANTI M)

231
Q

myoclonic/tonic clonic seizures treatment

A

braod spectrum anticonvuslants = valproate

232
Q

child, febrile seizure best treatment

A

supportive care (aceto or Ibpu for comfort: block PGE2

233
Q

after bronchoscopy (atropine) restless, dilated, disoreinte

A

use physostigmine (BBB), not neostigmine or edrophonium (do not cross BBB)

234
Q

miosis, bradycardia, dec RR, hypotension, dec mentalfxn and dec bowel sounds =

A

opiate intox

235
Q

vomiting chemo trigger zone

A

front of 4th ventricle = area postrema

236
Q

foot slap, no eversion, numb dorsal foot, lateral shin =

A

common peroneal n injury

237
Q

dec choline acetylatransferase in nucleus basalis and hioppocampus, yellow or green under polarized light after congo red

Substantia nigra =

caudate nucleus =

A

Alzhemiers

Parkinsons

Huntingtons

238
Q

hearing loss, ipsilateral facial numbness, dec corneal reflex =?

A

CPA and acoustic schwannoma

239
Q

big 3rd and lateral ventricles, normal sized 4th

A

cerebral aqueduct stenosis

240
Q

butterfly mass, very quick onsset and growth, located in cerebral hemispheres

A

Glioblastoma

241
Q

wide based gait, nonreactive but accomodating reflex, dec DTR Knee/ankle, + romberg

type of bug

accentuated by

A

Neurosyphilis, tabes dorsalis

Spirochete

HIV

242
Q

helderly w/apparently enlarged ventricles (due to cortical loss)

A

hydrocephalus ex vacuo

243
Q

NMDA role in Huntingtons

A

cell death, chorea, aggressive, memory problems

244
Q

Tongue Sensory:

General Ant 2/3

General Post 1/3

Gustatory Ant 2/3

Gustatory Post 1/3

Root bud

A

V3

CN9

CN7

CN9

CN10

245
Q

spongiform transformation of gray matter

A

CJD PrP prion

246
Q

opsoclonus, myoclonus, hypotonia, abd. mass, inc catechols

gene amp?

A

Neuroblastoma adrenal medulla

N-Myc

247
Q

deep intracerebral hemorrhage due to HTN =

A

Charcot Bouchard aneurysm (not saccular SAH)

248
Q

seizures, intracerebral bleeding

A

cavernous hemangioma

249
Q

cant walk down stair can walk up, tuck chin and tilt head away from one side

A

CN4 lesion (SOM

250
Q

superior/anterior to cerebellum

A

hippocampus

251
Q

NF2 protein and chrom

NF1 protein and chrom

A

merlin, 22

neurofibromin 17

252
Q

slit lamp test +

A

Wilsons (ring on eyes)

253
Q

Old brain infarct =

A

glial scar (astrocytic processes) on periphery

254
Q

ipsilateral CN3 palsy, hemiparesis

A

transtentorial/uncal herniation

255
Q

days old SAH presenting w/ new neuro symptoms due to?

prevention?

A

vasospasm

Nimodipine (Ca channel blocker)

256
Q

HA, acute blindness one eye, previous fever, shoulder and pelvic pain = ?

Ortho symtoms caused by?

A

large vessel arteritis (temporal or Multinuclear giant cell arteritis)

polymyalgia rheumatica

257
Q

clasp knife spasticity (initial resistance then release) due to lesion in

where is lesion if it is in contralateral arm, leg , lower face

A

UMN, any point in pyramydal motor system

Internal capsule

258
Q

subdural hematoma and retinal hemorrhages in baby

A

shaken baby

259
Q

ataxia, myoclonus, subacute sclerosing panencephalitis due to

type of virus

vaccine is

A

mealses (rubeola)

ss enveloped RNA hemagglutinin

live atten virus

260
Q

lesion to CST =

presents as?

A

UMN

spastic hyperreflex

261
Q

Synaptophysin is a marker for ?

GFAP is a marker for?

A

neurons

gliomas

262
Q

LP needle placed at?

anatomical landmark

spinal cord ends at

A

L3-4, or L4-5

Iliac crest

L1

263
Q

DM, CN3 down and out, normal reactive pupil, ptosis =

A

ischemia injury

264
Q

young, loss of bilateral upper and lower pain and temp sensory loss =

associated w/

A

syringomyelia

scoliosis, Arnold Chiari

265
Q

diaphragmatic nerves

A

C3-5 phrenic nerve

266
Q

baby, lethargy, vomit, tachypnea, inc ammonia, inc propionic acid, acidosis =?

missing enzyme?

A

congenital methylmalonic acidemia

dec methylmalolyl COA mutase

267
Q

nausea, dry mouth, ptosis, difficulty swallowing

blocks?

A

botulinium

blocks ACh release presynapse

268
Q

HIV, lung infxn, then brain, spherical yeast, india ink, thick capsule

A

Cryptococus neoformans

269
Q

many people, close quarters, meningitis

endotoxin?

A

N. meningitids

outer lipooligosacch

270
Q

UMN and LMN motor only symptoms

locations?

treatment

A

ALS

precentral gyrus, LCST, anterior horn

Riluzole (dec glutamate release)

271
Q

potency of inhaled anesthetic =

A

min alveolar concentration, the lower the more potent

272
Q

drug rxn, facial edema, rash, LAD, eosinophilia 2-8 weeks post drug

A

phenytoin

273
Q

sinus infxn followed by CN3,4,5,6 symptoms =

most common bug

A

cavernous sinus thrombus

S aureus

274
Q

Pupillary light reflex not present

A

no optic nerve input

275
Q

biceps // brachioradialis reflex

A

C5-C6

276
Q

1st brain area damaged in cardiac arrest

due to

A

hippocampus

global cerebral ischemia and hypoperfusion

277
Q

sensory lateral shoulder, motor deltoid, abduction, C5-6

A

Axillary nerve

278
Q

hypoxia w/ bilateral wedge shapes in ACA, MCA, PCA watershed encephalopathy orientation

A

parallel to cerebral convexity

279
Q

ulcer, fatigue =

spinal areas affected

A

B12 deficit

DC, Spinocerebellar tract, LCST

280
Q

reciting months of year backwards tests

A

attention and concentration

281
Q

syringomelia affects

A

ant white commissure

282
Q

older paitents with insomnia treatment

A

rameltion (Melatonin receptor)

283
Q

PC and LCST affected in women

A

B12 def

284
Q

torticolis, subterminal spore formation

A

CLostridium botulinum

285
Q

HTN, left temporal himretina

A

L lateral geniculate body

286
Q

treatment for MS spasticity

A

Baclofen (GABA-B), tizanidine (alpha 2)

287
Q

Broca’s, right hemipareisis, comprehension good, nonfluent, area affected?

A

inferior frontal gyrus (Brodman 44-45)

288
Q

home canned food, diplopia (NACh) and dry mouth (MACh)

A

Botulinum

289
Q

Rheumatoid arthritis, intubated, then quadriparesis

A

cervical sublux

290
Q

contralalteral hemianopia

+ paresthesis and numbness

A

PCA infarct

Lateral thalamus

291
Q

MS autoimmune response

A

T cell mediated

292
Q

drugs to avoid w/ benzos

A

sedatives (diphen and chlorphen)

293
Q

loss of motor fxn 1 side, sense on other side

A

Brown Sequard (hemisection of spinal cord)

294
Q

wet age related macular degen due to

treat

dry vs wet

subretinal hemoorrahge and drusen

A

inc VEGF

Randibizumab, bevacizumab, smoking cessation

gradual, acute

symptoms

295
Q

inappropriate behavior

A

Picks/Frontotemporal dementia

296
Q

Large AV concentration of anesthetic =

A

inc tissue solubility = slow onset axn

297
Q

fibular fracture, foot drop no toe extension, eversion intact =

no eversion =

A

deep pereoneal nerve

superficial

298
Q

Vit E def looks like?

spine areas affected

A

Freidrichs ataxia

spinocerebellar tracts, DC, dec DTRs

299
Q

dilated capillaries in cavernous sinus

A

hemangioma, shows w/ seizures

300
Q

contralateral homo hemianopia

A

optic track lesion

301
Q

kyphoscoliosis, high plantar arch, heart failure, gait ataxia

inheritance

pathophys

tracts affected

A

Freidreich ataxia

AR, FXN, GAA tri nuke repeat

iron sulfur enzymes

spinocerebellar

Step 2 CK: UWorld Questions (20 decks)

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