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1
Q

ependymoma - histology

A
  1. perivascular rosettes

2. rob-shaped blepharoblasts (basal ciliary bodies) found near nucleus

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2
Q

Migraine treatment

A

acute: NSAID, triptan, ergot
prophylaxis: topiramate, verapamil, life style, propranolol, amitriptuline, valproate

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3
Q

Multple scleoris - CSF

A

increased IgG + myelin basic protein

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4
Q

Limbic system - structures

A
  1. hippocampus
  2. amygdala
  3. formix
  4. mammilary bodies
  5. cingulate gyris
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5
Q

extra-ocular movements during REM are due to

A

Paramedian pontine reticular formation/conjugate gaze center

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6
Q

Cerebellum deep nuclei

A

lateral to medial

Dentate, emboliform, globuse, fastigial

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7
Q

cns watershed zone damage –>

A
  1. upper leg/upper arm weakness

2. defect in higher order visual process

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8
Q

causes of anencephaly

A
  1. low follate

2. DM1

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9
Q

Freidreich ataxia - mode of inheritance

A

AR (GAA on frataxin / ch 9)

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10
Q

penis dermotome

A

S3

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11
Q

local anesthesia - order sensation loss

A
  1. Pain
  2. Q
  3. Touch
  4. pressure
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12
Q

cyclobenzaprine - mechanism of action

A

centrally acting skeletal relaxant (related to TCA)

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13
Q

MERRE syndrome - meaning and manifestations

A

myoclonic epilepsy, ragged red fibers

  • -> progressive myocl epilepsy
  • -> short stature
  • -> lactic acidosis
  • -> hearing loss
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14
Q

pseudorosetes rosetes are aka

A

Horner Wright

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15
Q

Collier sign

A

parinaud syndrome –> bilateral eyelid retraction –> sclera visible aboce the superior corneal limbs

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16
Q

hydrocephalus caused by increased CSF production is due to

A

papillomas of the choroid plexus

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17
Q

Vernet syndrome

A

lesion of jugular foramen synftome –> dusfunction of CN IX, X, XI

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18
Q

chemoreceptor zone - location

A

in the area postrema of the dorsal medulla near the 4th ventricle

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19
Q

horizontal gaze center - location / aka

A

aka: doll’s reflex

midbrain

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20
Q

MC location of sacculat aneurysm

A

anterior commun + ACA

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21
Q

Nucleus basalis of Meynert - location

A

neocortex

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22
Q

anterior 2/3 of the tongue is separated by 1/3 by

A

ternimal sulcus (and foramen cecum in the middle)

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23
Q

the spinal accessory nerve is vulnerable to injury at

A

the posterior triangle of the neck

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24
Q

bilateal ACA occlusion

A
  1. behavioral problems (abulia)
  2. urinary incontinence
  3. primitive reflexes
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25
Q

intraventricular hemorrhage in preterm infants originates from the

A

germinal matrix, a highly cellular + vascularized layer in the subventricular zone from which neurons + glial cells migrates out during bran development

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26
Q

posterior limb of of the internal capsule carries

A

anterior 2/3 –> motor fibers
posterior 1/3 sensory fibers
most lesions result in pure motor or combines (rare pure sensor)

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27
Q

visual cortex lesion - macula sparing - why

A

because macula receive collateral blood flow from MCA

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28
Q

Cavenous sinus thromobisis - due to

A

mc is due to contiguous spread of an infection from medial 1/3 of the face, sinuses (ethmoidal, sphenoidal), or teeth –> infection goes retrograde (valveless facial venous systme) via superior + inferior opthalmic veins
MC: s. aureus

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29
Q

CNS - histamine is produced at … / role

A

posterior hypthalamus –> play important role in arousal + weakness

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30
Q

corpus collosum blood supply

A

anterior 4/5 –> ACA

splenium –> PCA

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31
Q

permeability barrier in nervous system

A

perineurium

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32
Q

lateral cerebellar hemisphere is aka

A

neocerebellum or cerebrocelebellum

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33
Q

prosopoagnosia - area of lesion

A

right inferior temporal lobe (vascular teritorry of the the MCA

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34
Q

endotracheal intubation in a patient with chronic RA –>

A

sublxation (vertebral malalignment) the atlantoaxial joint –> acute compression of the spinal cord / vert arteries –> spinal shock (paralyisis, decreased reflex below the level of compression), hypotension (due to loss of sympathetic tone, sudden death

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35
Q

glossopharyngeal nerve - parasympathetics

A

inferior salivatory nulcleus –> CN 9 –> otic ganglion –> travels allong auticulotemporal nerve (V) parotid gland secretion

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36
Q

arcuate nuclei of hypothalamus

A

secretion of dopamine (inhibits prolactin), GHRH, GnRH

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37
Q

thoracic outlet syndrome is due to compression of ….. in the

A

lower trunk of plexus + subclavian vessels in the scalene triangle (between anterior + mimiddle scalene muscles + the 1st rib)

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38
Q

interscalene nerve blcok –> side effects

A

transient ipsilateral dipragmativ paralysis due to involvment of phrenic nerve roots as they pass thorought the interscalene sheath
(should be avoided in COPD or contralateral phrenic nerve lesion)

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39
Q
  1. CN 9. 10, 11 exit the brainstem through
  2. CN 12 exits the brainstem through
  3. CN 3 exits the brainstem through
A
  1. postolivary sulcus (posterior to olive)
  2. sulcus between olive + pyramide
  3. interpendicular space
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40
Q

patients with temporomandibular disorder due to V3 can have –>

A

boh jaw + otologic symptoms

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41
Q

infraorbital nerve is the continuation of the

A

maxillary nerve (V2)

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42
Q

binocular visual field - in degrees

A

bnocular field - 120
monocular field - 40 in each eye
all: 200

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43
Q

orbital floor damage –>

A
  • sensation of upper cheek, upper lip, upper gingiva numbness + paresthesia (infraorbital nerve)
  • exopthallmos (etrapment of the inferior rectus muscle) –> impaired vertical gaze
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44
Q

optic track lesions - Marcus Gunn pupil

A

optic tract lesions can also cause relative afferent pupillary defect in the pupil contralateral to the tract lesion, as the nasal portion of the retina contributes more inputo to pretectal nucleus than the temporal lesions

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45
Q

trapezius paralysis –>

A
  1. drooping of shoulder
  2. impaired abduction above horizontal
  3. winging scapula
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46
Q

general features that aid in localizing a transverse spinal cord section

A
  1. moving rostrally –> increased amount of white matter, decreased gray, more oval
  2. lower cervical + limbosacral regions have large ventral horns
  3. thoracic + early lumbar have intermediolateral cel columns
  4. gracile + uneate fasciculi are present above T7 spinal levels, hhere only gracili fasciculis below this level
47
Q

CN 7 exits the skull through …. and ….

A

stylomastoid foramen –> course within parotid gland –> terminal 5 branches:

  1. temporal
  2. zygomatic
  3. buccal
  4. mandibular
  5. cervical
48
Q

cerebellum area that control balance + eye movemets

A

flocculonodular

49
Q

radial nerve enter forearm anterior to lateral epicondyle - after?

A

divides into
superficial–> somatic sensory innervation to the radial half of the dorsal hand
deep –> innervates the extensor muscles of forerm

50
Q

radial nerve trauma in the supinator trauma

A

due to repetitive pronation/sunipation of forearm (screwdriver), dirct, dislocation of radius –> finger drop, not wrist drop, and not sensory symptoms
(between superficial + deep parts of supinator muscle

51
Q

locus ceruleus

A

paired of PIGMENTED brainstem nucleus –> located in the posterior rostral pons near the lateral floor of the 4th ventricle + functions as the principal site for norepinephrine syntheisis –> projects to all parts of CNS –> control mood, arousal (reticular activating system), sleep-wake states, cognition, autonomic function
implicated in the pathogenesis of anxiety disorders

52
Q

the CN 3 arises (level)

A

rostral midbrain at the level of superior colliculis + red nucleus, exits at the interpenducular fossa

53
Q

the CN 4 arises (level)

A

caudal midbrain + exits the dorsal midbrain just below the inferior colliculis) –> decussates

54
Q

facial nucleus is located

A

in the dorsalateral aspect of the caudal pon and extis at the ventrolateral pontomedullary junction (below the middle cerebellar peduncles

55
Q

primary visual cortex is aka … / divided to

A

striate cortex. Divided to:

  1. cuneus gyrus –> upper retina/lower field
  2. lingual gyrus –> lower retina/upper visual field
56
Q

Optic tract fibers project mainly to the

A
  1. lateral geniculate nucleus
  2. superior colliculus (reflex gaze)
  3. pretectal area (light reflex)
  4. surachiasmatic nucleus (cyrcadian rhythms)
57
Q

causes of CN 7 trauma

A

fractures of temporal bone after lateral head trauma or zygomatic orbit fractures

58
Q

2 mc symptoms of PCA stroke

A
  1. contralateral hemianopia with macular sparing

2. paresthesia + numbness on face, trank + limbs (lateral thalamu)

59
Q

anterior choroidal artery

A

last branch of internal carotid –> posterior limb of internal capsule, optic tract, lateral geniculate body, choroid plexus, uncus, hippocampus, amygdala

60
Q

artery of Percheron

A

branches off either the right or left PCA and supplies the bilateral thalami + dorsal midbrain
it is a rare normal variant and consider in patients bilateral thalami or dorsal midbrain strokes

61
Q

muscle spindle system vs Golgi tendon system

A

spindle –> monitors + maintains muscle length (intrafusal muscle fibers connected in paraller)
Golgi –> monitors + maintains muscle force (in series arrangement) –> ib sensory axons from here contact inhibitory interneurons

62
Q

from carotid sinus to medullary center

A

CN 9 –> Hering nerve (a branch of CN 9)

63
Q

direct vs inderect sympathomimetics according to CNS

A

indirect enter more readily

64
Q

blood solubility of an anesthetic is indicated by

A

its blood/gas partition coefficient:
higher blood solubility –> larger coefficient –> dissolve more easily in the blood –> larger amounts must be absorbed before becomes saturated –> slower induction
–> if lower coefficient (eg. N20) –> rapidly saturated

65
Q

Caspaicin?

A

used topical –> loss of membrane potential in noniceptive fibers + depletion of Sub P –> initial application results in burning + stinging sensation –> chronic exposure leads to reduced pain + transmission
(FOUND IN CHILLI PEPPER FAMILY)

66
Q

Drugs for neuropathic pain

A
  1. tricyclic antidepressants
  2. Anticonvulsants
  3. opioids
  4. Caspaicin
  5. Lidocaine
67
Q

side effects of levodopa that persist after carvidopa administration

A

behavioral symptoms (eg. anxiety + agitation) –> more with carvedipa –> decrease the dose –> if not possibl, add atypical antipsychotics (such as clozapine)

68
Q

fever above 42.2 –>

A

oxidative phosphorylation ceases –> ATP depleted -> end-organ damage

69
Q

Heat stroke - everything

A

caused by environmental exposure (eg. children left in hot cars –> requires treatment with active cooling

70
Q

febrile seizures - active cooling?

A

have not been shown to reduce the risk of seizres and may induce seizures by shivering + a transient rise in core body Q

71
Q

phenytoin causes gingival hyperplasia - mechanism

A

phenytoin –> increased PDGF –> macrophages activation –> stimulate proliferation of gingival cells

72
Q

juvenile myoclonic epilepsy?

A

a form of idiopathic generilized epilepsy that may be familial –> both arms are typically affected (both cerebra hemispheres are involved) –> sympotms espc by sleep deprivation + 1st h after awaking
treatment: broad spectrum anticonvulsant (like valproic)

73
Q

Ramelteon?

A

Ramelteon?melatonin agonists –> safe + effective in reducing time to sleep onset in elderly (benzodiaz, antihistamines, sedating antidepressants should be avoided in elderly)

74
Q

halothane mediated hepatitis - biopsy

A

centrilobular hepatic necrosis

75
Q

CN V neuralgia - location / treatment

A

particulary V2/3

carbamazepine is 1st choice (2nd: baclofen + valproic)

76
Q

opiodis induces euphoria / mood alternations - mechanism

A

involve dopaminergic pathways in the nucleus accumbens

77
Q

antiemetic drugs

A
  1. antimuscarinics (scopolamine) –> motion sickness
  2. antihistamines –> motion sickness
  3. Dopamine antagonists (metoclopraminde, prochloroperazine –> chemo
  4. 5-HT3 inhibitors –> chemo
  5. Neurokinin receptor antagnosits –> inhibits Substance P (Aprepitant, fosaprepitant) –> chemo
78
Q

train-of-4 stimulation

A

used during anesthesia to assess the degree of paralysis induced by NMJ agents –> peripheral nerve is stimulated 4 times in quick succession and the muscular response is recorded:

  1. nondepolarizing blocker –> progressive reduction of each of the 4 responses (fading pattern) as a result of less ach being releasd in each subsequent impulse due to the additional effect of presynaptic ach receptor blockage)
  2. depolarizing blocker –> initially equal reduction of all 4 twitches. Persisten exposure (phase 2) like nondepolarizing
79
Q

bupropion is preferred compare other antidepressants because

A
  1. no sexual dysfunction

2. less weight gain

80
Q
  1. smoking cessation drug that reduce craving + attenuate rewarding effect of nicotine
  2. alcohol cessation drug that reduce craving + attenuate rewarding effect of nicotine
A
  1. varenicline

2. naltrexone

81
Q

1st generation antipsychoticis: low vs high portency according to side effect

A

low (chlorpromazine, tioridazone) –> anti-hist, chol, a1

high potenecy –> neurologic (eg. extrapyramidal)

82
Q

paradox antipsychotics mediated akathisia

A

frequently misdiagnosed becaue misinterpreted as worsening psychotic symptom –> increased dose rather than decrease –> exacerbation of akathesia

83
Q

Neonatal abstinence syndrome

A

Withrawal from transplacental OPIATES due to maternal use –> neurologic, GI, autonomic symptoms

84
Q

opioid receptors - effects

A

Mu: Physical dependence, Euphoria, Resp + cardiac depress, reduced GI motility, sedation, analgesia
Kappa: Miosis, dysphoria, sedation, analgesia
Delta: antidepressants analgesia
(ALL at MU except miosis (k) and antidepressant (delta))
ALL ARE ANALGESIC

85
Q

CNS lymphomas - chemotherapy

A

poor respond

86
Q

carvenous hemangioma –> increased risk for

A
  1. intracarebral hemorrhage

2. seizure

87
Q

another clue for VHL

A

congenital cysts and/pr neoplasms in the kidney, liver, pancreas

88
Q

Guillain-Barre syndrome - cranial nerves?

A

Bell palsy

89
Q

Micturation reflex (urination) is regulated by the following ceters

A
  1. Sacral micturation center (S2-4): bladder contraction (parasympath)
  2. Pontine mictiration center: ponitne reticular foramtion –> coordinated relaxation of ecternal urethral sphincter
  3. cerebral cortex - inhibits sacral micturation center
90
Q

Amyloid precursors protein - function

A

transmembrane protein (found throughout the body)

91
Q

acute cerebellitis

A

post-viral cerebellar ataxia –> in children –> 2-3 weeks aftere varicella, measles or RBV infection -> resolve in 3 weeks

92
Q

the special charactersitic of C1 spinal nerve

A

the only spinal nerve carries only motor fibers

93
Q

Lissencephaly?

A

aka: agyria –> congnital absence of gyri –> severe mental retardation + seizures

94
Q

decerebrate vs decorticate

A

decerebrate –> damage to brainstem at or BELOW red nucleus (midpbrain tegmentum, pons) –> extensor posturing due to loss of descending excitation of the UPPER flexors
decorticate –> damage above red nucleus (hemisph, internal capsule) –> flexor due to loss of descending inhibition of the red nucleus –> hyperactivity of upper flexors

95
Q

neurons are highly sensitive to iscemia - mechanism

A

they do not store glycogen

96
Q

Prgressive supranuclear palsy

A

form of parkinsonisn resulting from neurodegeneration of the midbrain and frontal subcortical white matter –> rapidly progressive gait dysfunction and falls, exetutive function loss, and vertical gaze palsy
biopsy: deposition of phosphorylated tau proteins

97
Q

MS - hot shower

A

exacerbate fatigue due to decreased axonal transmission associated with increased heat

98
Q

tetanus toxin - detection

A

there is no available assay to detect it.

THE DIAGNOSIS OF TETANUS IS CLINICAL

99
Q

osmotic demyelination - manifestation

A
  1. quadriplegia due to demyelination of corticospinal tracts
  2. pseudobulbar palsy due to demyelination of the corticobulbar tracts of CN 9, 10, 11
100
Q

vascular vs Alzheimer dementia according to manifestation

A

vascular is more acute

101
Q

Red nucleus - location / function

A

located at anterior midbrain. Participate in motor coordination of the upper extremities

102
Q

raphe nucleus - location and function

A

located in the brainstem

role in sleep-wake cycle, anxiety, mood, psychosis, sexuality, eating behavior, impulsivity

103
Q

hypocretin functiuon

A

promote wakefulness + inhibit REM sleep-related phenomena

104
Q

Stages of grief - terminal illness

A
  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance
105
Q

adolescents are less less able to wiegh the risks and benefits of their decisions or anticipate that negative consequences may occur - mechanism

A

prefrontal cortex (center of executive function ) does not fully develop until 3rd decade of life

106
Q

first symptom of alcohol withdrawal

A

tremulousness

107
Q

Medical conditions linked to premature ejaculation

A
  1. prostatits

2. thyroid disease

108
Q

frontal lobe lesions

A

executive dysfunction + personality changes 2ry to impairment of the organisational, restrain + motivational systems:
left side –> apathy + depression
right side –> disinhibition

109
Q

Dmage to corpus callosum

A

split brain damage –> lack of interhemispheric transfer of informations (eg. unable to retrieve by one hand an object palpated with the other)

110
Q

dominant temporal lobe lesion

A

dominant: verbal memory (world recognition)
nondominant: nonvebral memory, including musical ability

111
Q

methadone adverse effect

A
  1. long QT

2. Resp depression

112
Q

Schwannoma histology

A
  • Antoni A: spindle cells + palisading nuclei surrounding pink areas (+verocey bodies: interspersing nuclear free zones)
  • Antoni B: looser stroma, fewer cells, and myxoid change
  • S100
113
Q

cricothryrotomy - passes through

A

skin –> superficial cervical facia (including fat + platyasma) –> investing and pretracheal layers of the deep cervical fascia –> cricothyroid membrane
(the 3rd layer of deep cerical fascia, the prevertebral, is not penetrated)

neurology FA (31 decks)

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