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uworld > Set 13 (Neurology) > Flashcards

Set 13 (Neurology) Flashcards

1
Q

Intestinal atresia DISTAL to duodenum

A

Vascular accidents in utero

ex: SMA obstructed –> “apple-peel” atresia

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2
Q

Toxic megacolon: imaging studies

A

Plain x-ray will do!
(Barium enema and colonoscopy = CONTRAindicated)
(US not useful)

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3
Q

hCG tx in infertility triggers?

A

LH surge

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4
Q

Menotropin + Large dose of hCG

A

Menotropin: act like FSH –> dominant ovarian follicle forms
hCG: act like LH –> LH surge –> ovulation

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5
Q

Lipids are digested in? absorbed in?

A

Digested in DUODENUM

Absorbed in JEJUNUM

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6
Q

Distended macrophages in intestinal LP

A

Whipple disease

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7
Q

Iron absorption

A

Duodenum

Proximal jejunum

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8
Q

Primary adrenal insufficiency: labs

A

HYPOnatremia, HYPERkalemia
HYPERchloremia
NON-AGAP metabolic acidosis

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9
Q

Standard deviation from the mean

A

1 std: 68%
2 std: 95%
3 std: 99.7%

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10
Q

Lactose

A

Glucose + Galactose

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11
Q

Viral gastroenteritis

Abdominal distention, flatulence, diarrhea after lactose ingestion

A

SECONDARY lactase deficiency

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12
Q

Glucokinase

A

Pancreatic beta cell

HIGH Vmax, HIGH Km

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13
Q

Gestational diabetes w/ family history

A

Glucokinase mutation

major glucose sensor in pancreatic cell

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14
Q

Gallstone ileus: stone stuck at?

A

Ileocecal valve

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15
Q

Gas seen in GB and biliary tree due to presence of fistula

A

Gallstone ileus

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16
Q

Tx of Congenital Adrenal Hyperplasia

A

Low doses of exogenous CORTICOSTEROIDS to suppress excessive ACTH secretion

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17
Q

Carcinoid tumor in the liver

A

Carcinoid SYNDROME! (secretory products NOT metabolized by liver):

Vasomotor instability (flushing, dizziness)
GI sx (diarrhea, abdominal pain)
Bronchoconstriction (dyspnea w/ wheezing)
Right-sided valvular heart disease
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18
Q

Insulin tx for DKA

A

Regular insulin PREFERRED

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19
Q

Peudomonas aeruginosa virulence factor exotoxin A is similar to?

A

Diptheria toxin

inhibit EF-2

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20
Q

Shiga-like toxin

A

EHEC

inhibit 60s ribosomal subunit in human –> block protein synthesis and preventing tRNA binding

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21
Q

Amiodarone: tests to monitor

A

LFT
PFT
TFT
(liver, pulmonary, thyroid)

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22
Q

Amiodarone: A/E

A

Hepatitis, Pulmonary fibrosis, Thyroid dysfunction
Corneal micro-deposits
Blue-gray skin discoloration

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23
Q

Pituitary apoplexy

A

Bleeding into PRE-existing pituitary adenoma

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24
Q

DOC of HYPERthyroidism in pregnancy

A

PTU

methimazole is teratogenic

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25
Q

Major A/E of HYPERthyroid drugs

A

Agranulocytosis

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26
Q

Ulcer in duodenum

A/w severe trauma or burns

A

CURling ulcers

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27
Q

Ulcer in esophagus, stomach or duodenum

A/w increased ICP

A

CUSHing ulcer

particular prone to perforation

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28
Q

Chronic gastritis w/ antral sparing

A

AI gastritis

–> pernicious anemia

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29
Q

3 main causes of HIV-associated esophagitis

A

Candida
CMV
Herpes virus

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30
Q

Runs along lesser curvature of stomach

where great majority of GASTRIC ulcer occurs

A

L and R Gastric arteries

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31
Q

Strongyloidiasis: stool

A

Rhabditiform larvae

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32
Q

Tx of strongyloidiasis

A

Ivermectin

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33
Q

Detection of parasite EGG in stool

A

Schistosomiasis

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34
Q

Triple test (pregancy)

A

AFP
hCG
Estriol

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35
Q

Increased AFP

A

NT defect
Anterior abdominal wall defect (omphalocele, gastroschisis)
Multiple gestation

and: most commonly: dating error.

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36
Q

Decreased AFP

A

Down syndrome

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37
Q

Cytokines that are chemotactic for neutrophils?

A

Leukotriene B4
C5a
IL-8

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38
Q

Bilious vomiting WITHOUT abdominal distention

1st day of life

A

HALLMARK of duodenal atresia

a/w Down syndrome

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39
Q

Lithium during early pregnancy

A

Ebstein’s anomaly

atrialized RV due to downward displacement of tricuspid valve

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40
Q

Valproate in pregnancy

A 
NT defect
(Valproic acid inhibit folate acid absorption)
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41
Q

Pramidone

A

Antiepileptic
Metabolized to phenobarbital and PEMA (also anticonvulsants)
LETHARGY!

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42
Q

Restlessness, Agitation
Dysphagia
Coma
Following exposure to cave BATS

A

Rabies encephalitis

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43
Q

Rabies virus: shape

A

(-)ssRNA

RNA dependent RNA polymerase

44
Q

Rabies: prophylaxis

A

Rhabdovirus strains grown in tissue cell culture and then INACTIVATED to produce:
KILLED virus vaccines.

45
Q

tRNA: site of binding of amino acid

A

3’ end

46
Q

Lithium: check labs for

A 
TSH (can cause HYPOthyroidism)
Lithium levels (narrow therapeutic window)
Renal fxn (nephrogenic diabetes insipidus)
47
Q

Pufferfish poisoning

A

Tetrodotoxin

binds to VG-Na+ channel in nerve and cardiac tissue, preventing sodium influx and depolarization

48
Q

Pica is a/w?

A

IDA

Common in pregnancy

49
Q

Tumbling motility @22C
Very narrow zone of B-hemolysis
Multiply at really low temperature (4C)

A 
Listeria monocytogenes
(gram+ facultative intracellular)
50
Q

Weak wrist extension

Sensation of arm intact

A

Radial head subluxation (“nursemaid’s elbow).
(sudden outward pulling on extended and pronated arm)

Deep branch: carries ONLY motor, no sensory.

51
Q

EXCELLENT alternative to SSRI for tx of depression (NO sexual dysfunction)

A

Bupropion!!!

also effective in tx of nicotine dependence

52
Q

Works on D4 receptors (vs. D2 of most antipsychotics)

A

Clozapine

A/E: agranulocytosis, check CBC

53
Q

Migraine: abortive therapy

A

Triptans (serotonin 5HT-1B or 1D agonist)

54
Q

Buproprion

A

Dopamine and NE reuptake INHIBITOR

depression, smoking cessation

55
Q

Venlafaxine

A

Serotonin-Norepinephrine reuptake inhibitor

56
Q

Fluoxetine
Sertraline
Paroxetine

A

SSRI

57
Q

Rate limiting step in heme synthesis

A

ALA synthase

require B6

58
Q

Acute Intermittent Porphyria: tx

A

Glucose loading

IV heme preparations

59
Q

Holoprosencephaly a/w?

A 
Trisomy 13 (Patau)
Trisomy 18 (Edward)
Fetal alcohol syndrome
60
Q

Malformation

A

PRIMARY defect in cell/tissues that form an organ

61
Q

Deformation

A

Anomalies due to EXTRINSIC mechanical force

62
Q

Deficient HGPRT

A

Lesch-Nyhan syndrome

XLR, failure of purine SALVAGE

63
Q

First committed step of de novo PURINE synthesis

A

PRPP amidotransferase

64
Q

Defect in alpha-keto acid dehydrogenase

A

MSUD

dystonia, poor feeding, inability to degrade BRANCHED chain a.a.

65
Q

Classic homocystinuria: diet

A

Methionine RESTRICTION

Cysteine SUPPLEMENTATION

66
Q

Benzodiazepine that treat insomnia but minimizes undesirable DAYTIME a/e

A

Triazolam

67
Q

Serotonin vs. Neuroleptic malignant syndrome

A

NMS: absence of myoclonus, precence of rigidity

68
Q

Neurofibromas in NF-1: embryology

A

Neural crest

since they are schwann cells

69
Q

Rapid recovery from thiopental is from?

A

REDISTRIBUTION

NOT metabolism

70
Q

HIGH blood/gas partition coefficient

A

MORE soluble in blood
SLOWER equilibration w/ brain
LONGER onset time

71
Q

Best way to prevent tetanus in neonate

A

Maternal vaccination!

transfer of IgG anti-toxin across placenta

72
Q

Which adrenergic receptor is on uterus?

A

B2 (stimulation –> RELAX uterus)

73
Q

Triad of:
Hydrocephalus
Intracranial calcification
Chorioretinitis

A

Congenital toxoplasmosis

74
Q

A/E of bupropion

A

Seizure

75
Q

Medication that can CAUSE seizures

A 
Buropion
Clozapine
Isoniazid (if given w/o B6)
Ciprofloxacin
Imipenem
76
Q

Trochlear nerve palsy

A

Vertical diplopia

77
Q

Impaired transport of ornithine from cytosol to mito

A

Disorder of UREA cycle

Limit protein intake!

78
Q

Calcified cystic tumor in brain

Cholesterol crystals

A

Craniopharyngioma

Rathke’s pouch remnant

79
Q

Organophosphate poisoning caused by?

A

Cholinergic excess due to:

CHOLINESTERASE inhibition

80
Q

Cryptococcal meningitis: tx

A

Amphotericin B + flucytosine

Maintenance via: fluconazole

81
Q

DOC for heroin addiction and abuse

A

Methadone

long acting opiod w/ good oral bioavailability

82
Q

Express concern INDEPENDENT of understanding

A

Support

83
Q

Total sensory loss on CONTRAlateral side of body

A

Thalamic syndrome

84
Q

What causes lacunar infarct?

A

Small vessel lipohyalinosis and atherosclerosis

85
Q

Oligodendrocyte apoptosis

Pink patches in white matter tract

A

Multiple sclerosis

86
Q

Lancet-shaped Gram-positive cocci in pairs

A

Strep pneumo

THE m/c/c of bacterial meningitis in ADULTS of ALL ages

87
Q

Bean-shaped Gram negative cocci in pairs

A

Neisseria meningitidis

88
Q

Cafe-au-lait spots
Neurofibromas
Lisch nodules
Pseudoarthrosis

A

NF-1

89
Q

Carbachol and pilocarpine: used to tx?

A

Glaucoma

90
Q

Substance abuse: violent behavior (MOST likely a/w?)

A

PCP abuse

91
Q

Violent behavior, trauma
Nystagmus
Acute brain syndrome

A

PCP abuse

92
Q

Artery responsible for SA and AV node perfusion

A

RCA

93
Q

Ketamine

A

NMDA receptor antagonist

94
Q

Benzodiazepine intoxication and overdose: tx

A

Flumazenil

GABA receptor angatonist

95
Q

Suppression vs. Repression

A

Suppression is GOOD (mature and conscious)

Repression is IMmature and UNconscious

96
Q

Inactivated by lead

A

Delta-aminolevulinate dehydratase

Ferrochelatase

97
Q

Rate limiting step of heme synthesis

A

Delta-aminolevulinate SYNTHASE

require B6

98
Q

Acute intermittent porphyria: defect

A

Uroporphyrinogen I synthase

99
Q

NO photosensitivity

Urine darken upon exposure to light

A

Acute intermittent porphyria

uroporphyrinogen I synthase defect

100
Q

Cystic tumor in cerebellum of child

A

Pilocytic astrocytoma

101
Q

Spindle cells
Hair-like glial processes a/w microcysts
Rosenthal fibers
Granular eosinophilic bodies

A

Pilocytic astrocytoma

102
Q

Posterior fossa tumor in children

homer-Wright rosettes

A

Medulloblastoma (PNET)

103
Q

Pseudorosettes w/ GFAP + processes tapering twd blood vessels

A

Ependymomas

104
Q

Elevated HVA, VMA
N-myc
Neuropil
NSE, chromogranin, synaptophysin, S100+

A

Neuroblastoma

105
Q

Lateral vs. ventral spinothalamic tract

A

Lateral: pain and temperature
Ventral: touch and pressure (minor role)

106
Q

Bilateral disproportionate loss of pain and temperature sensation (disassociated anesthesia) involving arms and hands

A

Syringomyelia

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