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BSCE GOER > SGU Term 5 BSCE Book 3 > Flashcards

SGU Term 5 BSCE Book 3 Flashcards

1
Q

migraine

A

more common in women
on one side
lasts around 2 hours

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2
Q

tension headache

A

evenly distributed among men and women

starts in morning

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3
Q

cluster headache

A 
around eye, tearing, runny nose
more in males
max 20 min
last for several hours multiple times a day
starts at night
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4
Q

trigeminal neuralgia

A

mostly in men

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5
Q

ALS

A

glutamate overload kills motor neuron

death in 2-5 years

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6
Q

vit B12 def

A 
fatigue
mental fog
stored in liver
absorbed in terminal ileum complexed w intrinsic factor
megaloblastic anemia
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7
Q

myasthenia gravis: not enough meds

A

descending weakness
diplopia
ptosis
mask like facies

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8
Q

myasthenia gravis: too much meds

A

saliva and secretions

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9
Q

delirium

A

starts suddenly

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10
Q

mini mental status exam

A

27-30 normal

<27 abnormal

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11
Q

meningococcal meningitis

A

skin rash

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12
Q

guillan barre

A

ascending paralysis

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13
Q

pyramidal pattern weakness

A

FLEA = weakest

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14
Q

familial ALS

A

usually autosomal dominant
sometimes autosomal recessive
rare x-linked dominant

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15
Q

stroke

A

Face
Arms
Slurred Speech
Time is brain

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16
Q

vit B12 stored in

A

liver

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17
Q

increase risk of dementia

A

obesity
stress
high cortisol
sedentary

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18
Q

fontanel bulging in baby

A

meningitis

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19
Q

brain abscess diagnosis

A

high WCC, CRP, ESR

imaging

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20
Q

medulloblastoma

A

primary in children

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21
Q

craniopharyngioma

A

primary and benign near pituitary

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22
Q

secondary brain neoplasms

A 
breast
colon
lung
kidney
melanoma
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23
Q

power grading

A

0-5
5 is normal
0 is no movement

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24
Q

occam’s razor

A

localize lesion

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25
Q

LMN

A

cranial nerve nuclei
anterior horn cells
everything peripheral

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26
Q

ALS is usually

A

spontaneous

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27
Q

mutations in copper/zinc superoxide dismutase (SOD1) on chr 21

A

ALS

abnormal SOD1 causes toxic gain of function in protein, damaging motor neuron

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28
Q

pure motor symptoms, no sensory

A

ALS

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29
Q

bad prognosis in ALS

A

bulbar symptoms or respiratory symptoms

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30
Q

LMN at c5-t1 and UMN below

A

cervical myeloradiculopathy

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31
Q

primary lateral sclerosis

A

only UMN corticospinal tracts

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32
Q

dorsal columns affected only

A

B12 def

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33
Q

syringomyelia

A

LMN at level of cavity, UMN below

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34
Q

sometimes mimics ALS

A

Lyme disease

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35
Q

Definite ALS

A

signs in 3 spinal regions or

one bulbar and 2 spinal regions

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36
Q

probable ALS

A

signs in 2 regions or

UMN signs above/rostral to LMN

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37
Q

ALS meds

A

riluzole - inhibits glutamate release

edaravone - inhibits oxidative stress

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38
Q

death of ALS

A

respiratory infx, sepsis

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39
Q

myasthenia gravis clinical

A

proximal arms more affected than legs

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40
Q

meds that worsen MG

A 
aminoglycosides
D penicillamine
procainamide
quinidine
fluoroquinolones
macrolides
Ant-programmed death/checkpoint inhibitors (worsen pre existing and can cause first onset)
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41
Q

presynaptic NMJ dysfunction

Ab to P/Q voltage gated Ca channels

A

Lambert Eaton

can be paraneoplastic - small cell lung cancer

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42
Q

Botulism

A

presynaptic NMJ

toxin cleaves SNARE in terminal, preventing release of vesicles

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43
Q

imaging of chest in MG bc

A

associated w thymoma (thymectomy if under 65, Ab AchR +, <5 years disease)
thyroid dysfunction in MG

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44
Q

refractory MG

A

rituximab - anti CD 20 on B cells
eculizumab - complement inhibitor
cyclophosphamide
chronic IVIG or PLEx

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45
Q

Tx for myasthenic crisis

A

IVIG and PLEx

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46
Q

dystrophin gene

A

short arm of X chromosome (duchenne, becker)

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47
Q

labs in duchenne

A

high CK and transaminases

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48
Q

DMD treatment

A

glucocorticoids

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49
Q

DMD associated symptoms

A

scoliosis, lung development issues

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50
Q

cluster headache Tx

A

acute: oxygen, triptans
chronic: verapamil, corticosteroids

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51
Q

physical activity and headaches

A

makes migraines worse

no affect on tension

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52
Q

migraine Tx

A

triptans, NSAIDs, dihydroergotamine

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53
Q

migraine prevention

A

beta blockers, anti depressants, anticonvulsants, Ca channel blockers

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54
Q

migraine physiology

A

spreading wave of vasoconstriction (aura) followed by cortical dysfunction (migraine)

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55
Q

temporal arteritis/giant cell arteritis

A 
over 50
scalp tenderness, dull pain
malaise, night sweats, fever, weight loss
polymyalgia rheumatica
high ESR/CRP
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56
Q

temporal arteritis Tx

A

corticosteroids immediately when suspected - if not, pt goes blind

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57
Q

pseudotumor cerebri/idiopathic intracranial hypertension

A

female, over weight, child bearing age
tinnitus, headache, visual symptoms

caused by: hypervitaminosis A, isotretinoin, steroids/growth hormone, corticosteroid withdrawal, all cyclines

also addison, hypoparathyroidism, PCOS, obesity, pregnancy

CN VI palsy

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58
Q

pseudotumor cerebri Tx

A

acetazolamide, optic nerve fenestration, VP shunt if refractory

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59
Q

headache + high ICP

A

worst in the morning

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60
Q

striatum

A

caudate nuc + putamen

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61
Q

lentiform nuc

A

putamen + globus pallidus

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62
Q

below subthalamic nuc

A

substantia nigra

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63
Q

parkinson’s

A

substantia nigra problem
asymmetric problems at onset

sometimes after trauma OR exposure to Manganese

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64
Q

hemiballismus

A

subthalamic nucleus problem

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65
Q

parkinson’s pathophys

A

loss of pigmented dopamine producing cells in substantia nigra
alpha-synuclein and ubiquitin in cytoplasm called LEWY BODY in cortical neurons

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66
Q

parkinson’s Tx

A 
levodopa - precursor of dopamine (sinemet)
ropinirole, pramipexole
COMT inhibitors
anticholinergics
amantidine, selegiline (MAO B inhib)

deep brain stimulation, thalamotomy, unilateral pallidotomy

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67
Q

drugs that can cause parkinsonism

A 
neuroleptics
metoclopramide
reserpine
CCB - flunarizine
valproic acid
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68
Q

huntington’s genetics

A

Ch 4 , short arm
CAG on exon 1
huntington protein overexpressed - endocytosis, intracellular trafficking
anticipation

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69
Q

huntington’s pathophys

A 
NMDA excitotoxicity
defective mitochondrial energy metabolism
free radicals
aggregate protein triggers apoptosis
caudate and putamen mainly involved
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70
Q

huntington imaging

A

caudate atrophy

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71
Q

huntington meds

A

dopamine antagonists
atypical antipsychotics
tetrabenazine

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72
Q

hemiballismus

A

contralateral subthalamic nucleus lesion

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73
Q

tardive dyskinesia

A

pt with longterm dopamine antagonist meds (absent in sleep)
involuntary movement of tongue, face etc

dysfunction of dopamine transporter

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74
Q

dystonia Tx

A

trial of levodopa/carbidopa

hereditary may be sinemet responsive

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75
Q

cerebellum

A

cerebrocerebellum - planning, coordination
spinocerebellum - regulating, error correction, proprioception
vestibulocerebellum - balance, ocular reflexes

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76
Q

cerebellar lesion

A

hypotonia
pendular DTR
scanning dysarthria
nystagmus

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77
Q

freidrich’s ataxia

A

AR
GAA in Ch 9
decreased frataxin expression - FXN
less mitochondrial energy, more oxidative stress
degeneration of neural tracts and peripheral nerves

death from cardiac complications

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78
Q

FXN protein

A

mitochondrial protein for assembly of iron/sulphur enzymes

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79
Q

transverse myelitis

A

acute spinal cord syndrome in MS

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80
Q

MS associations

A 
multifactorial
dec sunlight exposure?
vit D def
eventual degeneration of white and grey matter
painful visual loss
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81
Q

lhermitte’s sign

A

electricity radiating down spine/arms when bent over

seen in MS

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82
Q

uhthoff phenomenon

A

worse symptoms at higher temp in MS

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83
Q

marcus gunn pupil

A

light swing to affected eye causes bilateral dilation
relative afferent pupillary defect

glaucoma, retinal disease, MS

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84
Q

internuclear ophthalmoplegia

A

can’t do lateral gaze bc MLF lesion

can cross eyes successfully

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85
Q

MS diagnosis

A

CSF test for oligoclonal bands and high igG

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86
Q

mood vs affect

A

mood - what pt says

affect - what physician observes

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87
Q

MDD

A

depression and anhedonia + 5/9 other symptoms for at least 2 weeks

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88
Q

postpartum blues

A

peaks 4-5 days postpartum

resolves in 2 weeks postpartum

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89
Q

MDD w peripartum onset

A

more than 2 weeks

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90
Q

persistent depressive disorder/dysthymia

A

depressed + at least 2 (appetite, conc, hopeless, energy, worthless, sleep change)
(no suicide, anhedonia, or psychomotor)

2 years

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91
Q

episodic MDD

A

2 months in btw

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92
Q

complicated grief

A

more than 6 mo

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93
Q

premenstrual dysphoric disorder

A

most cycles during past year + cause disability/disturbance

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94
Q

medial prefrontal limbic

A

serotonin

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95
Q

reward

A

dopamine

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96
Q

depression

A

inc - amygdala, medial prefrontal cortex (to neg)
dec - ventral striatum (to pos)

overall inc limbic, dec neocortical
dec delta (slow wave) sleep
dec REM latency
inc REM density
inc REM in first half of sleep (inc in second half in normal ppl)
dec BDNF (brain derived neurotrophic factor)

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97
Q

bipolar

A

I - manic
II - hypomanic and MDE
cyclothymic - 2 years, hypomanic and depressive that don’t meet criteria (less than 2 months between symptoms)

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98
Q

bipolar Tx

A 
lithium - first line
lamotrigine - second line
valproic acid - pt w renal dysfunction
carbamazepine
oxcarbazepine
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99
Q

suspected seizure

A

do electroencephalogram

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100
Q

aura

A

focal onset

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101
Q

channelopathies - generalized

A

benign neonatal convulsions
GABA or K
familial or sporadic

102
Q

channelopathies - focal

A

AD nocturnal frontal lobe epilepsy (ADNFLE) - affected gene is neuronal nAChR

103
Q

infx seizures

A

neurocysticercosis

HSV or other encephalitis

104
Q

metabolic seizures

A

hypoglycemia
hyponatremia

hypercalcemia

105
Q

immune seizures

A

NMDA encephalitis

106
Q

status epilepticus

A

seizure for over 30 min without regaining consciousness

start treatment at 5 min

107
Q

management of SE

A

lorazepam, midazolam, or diazepam IV
phenytoin loading dose IV
next level - phenobarbital or propofol

intubate
thiamine and glucose empirically

108
Q

delerium pathophys

A

dysfunction of reticular activating system - low ACh, anticholinergics make it worse

hyperdopaminergia - D2 blocking meds help control

GABA agonist withdrawal - high glutamate activates locus ceruleus -> norepinephrine release -> tachycardia etc, dopamine release in mesolimbic tract -> confusion etc.

109
Q

lewy body disease

A 
fluctuating cognition
hallucinations, delusions, depression
parkinsonism before cognitive decline
REM sleep disorder
severe neuroleptic sensitivity
repeated falls, syncope
orthostatic hypotension
urinary incontinence

alpha - synuclein
SPECT/PET - low striatal dopamine transporter uptake, low occipital activity
MIBG myocardial scintigraphy - low, sympathetic denervation
EEG - slow wave, temporal transient wave

no family history

110
Q

vascular disease

A

complex attention decline

personality changes, abulia

111
Q

vascular depression

A

late onset depression + psychomotor slowing +executive dysfunction = small vessel ischemic disease

112
Q

alzheimer’s

A

postmortem: cortical atrophy, amyloid plaques, tau neurofibrillary tangles

early onset - AD, mut of amyloid precursor protein presinilin 1, 2

ApoE4 inc risk
down syndrome

113
Q

illness or surgery -> acute delerium

A

prodrome of lewy body

114
Q

acute vs subacute

A

acute - bacterial meningitis

subacute - fungal meningitis

115
Q

TIA

116
Q

lacunar stroke

A 
lipohyalinosis
pure motor or sensory
ataxic hemiparesis
disarthria
clumsy hands
117
Q

hypoperfusion

A

watershed area - man in barrel

btw MCA and ACA - area of proximal arms

118
Q

carotid

A

unilateral

119
Q

neglect syndrome

A

lesion of non dominant hemisphere

120
Q

subcortical

A

no specific area affected more

121
Q

sensory stroke

A

ventral thalamus

122
Q

clumsy hand

A

ventral pons, genu of internal capsule

123
Q

ataxic hemiparesis

A

pons, internal capsule

124
Q

ischemic stroke management

A

thrombolytic (tPA) if w/in 4.5 hrs

>4.5 hr -> thrombectomy (neuro interventional)

125
Q

bacterial meningitis

A

broad spectrum antibiotics, and steroids

126
Q

prion disease

A

rapidly progressive and always fatal

127
Q

inherited prion disease

A

gerstmann straussler scheinker syndrome

fatal familial insomnia

128
Q

CJD

A

akinetic mutism
diagnosis: protease resistant PrP
EEG sharp waves
CSF - elevated 14-3-3, high tau, positive RT QuIC assay

use MRI FLAIR sequences
hockey stick, pulvinar sign

early sign on MRI: diffuse gyriform cortical signal change

129
Q

cluster C personality disorder

A

avoidant, Obsessive compulsive, dependent

130
Q

selective mutism

131
Q

phobia

132
Q

social anxiety disorder / social phobia

A

fear of negative evaluation

specifier: performance only

133
Q

separation anxiety

A

can present w abdominal pain

134
Q

agoraphobia

A

fears difficulty of escape

6 mo

135
Q

panic disorder

A

fear of dying
fear of loosing control, going crazy
derealization, depersonalization

136
Q

panic attack

A

4/13 possible symptoms

less than 4 would be limited symptom

137
Q

acute panic attack

A

alprazolam

138
Q

generalized anxiety disorder

A

3/6 symptoms

139
Q

OCD

A

orbitofrontal cortex, anterior cingulate cortex, striatum

140
Q

acute stress disorder

A

w/in a month

dissociation symptoms not in PTSD

141
Q

PTSD

A 
>1 mo
dissociative reaction (flashback)
decreased cortisol
inc corticotropin
underactive anterior cingulate cortex and hippocampus
142
Q

adjustment disorder

A

w/in 3 mo

resolves w/in 6 mo

143
Q

diabetes

A

distal axonopathies

144
Q

neuronopathies

A

toxic - cisplatin, B6

145
Q

wallerian degeneration

A

diabetic mononeuropathy
focal trauma
infarct
vasculitis

146
Q

segmental demyelination

A

AIDP/CIDP
diphtheric neuropathy
metachromatic leukodystrophy
charcot marie tooth disease

147
Q

axonal degeneration

A

metabolic

drugs/toxins

148
Q

small fiber peripheral neuropathies

A

sodium channel mutations

hypertriglyceridemia

149
Q

peroneal muscular atrophy

A

charcot marie tooth disease

150
Q

type 1A charcot marie tooth

A

duplication of PMP22 - short arm of Ch 17

151
Q

foot drop
high arch
hammer toes
onion bulb formations on nerve biopsy

A

charcot marie tooth

152
Q

meralgia paresthetica

A

lateral cutaneous nerve of thigh traped beneath inguinal ligament
entrapment/compression neuropathy

153
Q

peroneal palsy/fibular nerve palsy

A

fibular head
entrapment/compression neuropathy
foot drop

154
Q

carpal tunnel

A

median nerve compressed beneath flexor retinaculum

hypothyroidism
acromegaly
RA
pregnancy, diabetes, wrist trauma

manage: nocturnal splinting

155
Q

radial neuropathy

A

wrist drop

crutch palsy

156
Q

NF1

A 
von recklinghausen's disease
Ch 17
NF1 = tumor suppressor, neurofibromin
lische nodules
cafe au lait
sphenoid wing dysplasia
pseudoarthrosis
157
Q

NF2

A

Ch 22
merlin/schwannomin
benign tumors on both auditory nerves - vestibular schwannoma

158
Q

tuberous sclerosis

A

TSC1 - Ch 9 - Hamartin
TSC2 - Ch 16 - tuberin

both are tumor suppressor genes

facial angiofibromas around nose and chin
cortical tubers
giant cells
Ab to phosphorylated ribosomal S6

159
Q

sturge weber

A

encephalo trigeminal angiomatosis
port-wine stain birthmark
tram-track calcifications of brain on same side as birthmark - leptomeningeal vascular malformations

seizures, glaucoma, cognitive impairment

160
Q

ataxia telangiectasia

A

AR
ATM - Ch11 - cell division, DNA repair
low IgA - sinopulmonary infx
risk of lymphoma, leukemia

high alpha fetoprotein, CA125

161
Q

von hippel lindau

A

AD
VHL tumor suppressor - Ch 3
hemangioblastomas
endolymphatic sac tumor

162
Q

intellectual developmental disorder

A

intellectual, adaptive, onset during developmental period

163
Q

pervasive developmental disroder

A

PDD/NOS
autism

too many neurons in amygdala then loose them, normal ppl gain neurons

164
Q

ADHD

A

6 for 6 mo

165
Q

monro-kellie hypothesis

A

volume in cranium is fixed, if one part inc, another dec

166
Q

uncal herniation

A 
down and out
contralateral weakness (cerebral peduncle)
contralateral visual field deficit (ipsi PCA stroke)
167
Q

subdural hematoma

A

crosses suture lines

168
Q

epidural hematoma

A

lenticular, biconvex

restricted by suture lines

169
Q

subarachnoid hemmhorage

A

nuchal rigidity
thunderclap headache
normal CT
congophilic angiopathy

berry aneurysm

LP: bloody, xanthochromia
kernig’s - dec straight leg raise
3rd nerve palsy
depressed LOC

Tx: CCB - nimodipine
christmas tree bleed

170
Q

vasospasm after SAH

A

hypertension
hypervolemia
hemodilution

171
Q

acute COMA

A

Dextrose - 25 mg IV
Oxygen
Naloxone - 1 mg IV (opiate OD)
Thiamine 500 mg IV (wernicke’s)

172
Q

GCS

A

eye 4, verbal 5, motor 6
3 - no response to any
7,8 - intubate

173
Q

pos/neg symptoms

A

pos - dopamine

neg - muscarinic

174
Q

bizarre delusions

A

thought withdrawal, insertion

delusions of control - body being controlled etc

175
Q

sleep

A

hypnagogic - falling asleep

hypnapompic - waking up

176
Q

brief psychotic disorder

A

at least a day, < 1 mo

no neg symptoms

177
Q

schizophreniform

A

at least a month, <6 mo

178
Q

schizophrenia

A

6 mo
cerebro ventricular enlargement
dec brain volume

inc dopamine and serotonin
amphetamines worsen it
dec NMDA receptor function

first line Tx - second gen antipsychotics

179
Q

personality disorders

A

A - odd - paranoid, schizoid, schizotypal
B - dramatic - antisocial, borderline, histrionic, narcissistic
C - anxious, fearful - avoidant, dependent, obcessive compulsive

180
Q

bulimia and binge eating

A

at least once a week for 3 mo

181
Q

bulimia

A

at least 18.5 (normal or overweight)
use of ipecac - cardiac and skeletal myopathies
rectal prolapse

182
Q

GI drugs causing sexual dysfunction

A

cimetidine, methanteline bromide

183
Q

anticonvulsants

184
Q

opiates

A

orgasmic dysfunction

185
Q

screening Q’s for dysfunction

A

avoid why questions

186
Q

pedophilia minimum age

187
Q

fetish

A

prior to adolescence

188
Q

mets to brain

A

lung, breast, melanoma

189
Q

most primary brain tumors are

190
Q

risk for brain tumor

A

high dose ionizing radiation

191
Q

meningioma

A

arachnoid cap cells

192
Q

medulloblastoma

A 
primitive neuroectodermal tumor
spread via CSF
ch 17
small blue round tumor cells
homer wright rosette
little boys
193
Q

oligodendroglioma

A

headache, personality change, seizure
1p, 19q deletion
fried egg
chicken wire

194
Q

ependymoma

A 
intracranial - kids
spinal - adults
NF2
obstructive hydrocephalus
localized, low grade, slow growing

perivascular pseudorosettes
ependymal rosettes

195
Q

glioblastoma multiforme

A

grade 4
necrosis
endovascular proliferation

196
Q

GBS

A

ascending paralysis
low back pain
loss of DTR
autonomic arrhythmia, constipation

197
Q

GBS diagnosis

A

high protein, normal cells = albumino cytologic dissociation
high WBC -> lyme, sarcoid, HIV, lymphoma

give IVig and PLex, no corticosteroids

198
Q

high dose decadron

A

compressive myelopathies

199
Q

brown sequard

A

contralateral - loose pain and temp

ipsilateral - loss of motor etc

200
Q

anterior spinal

A

bilateral loss of motor function

201
Q

central cord syndrome

A

upper extremity loss of motor and sensation, incomplete loss below

cervical spondylosis, neck hyperextension

202
Q

somatic symptom disorder

A

thoughts, anxiety, time and energy

mild if 1, moderate if 2
severe if 2 and more than one somatic complaint

persistent - over 6 mo

203
Q

illness anxiety disorder

A

no symptoms or mild

6 mo

204
Q

conversion disorder

A

la belle indifference

dissociative

205
Q

malingering

A

for secondary gain like to get off work

206
Q

factitious

A

intentional symptom falsification

207
Q

substance use

A

mild - 2,3
mod - 4,5
severe - 6 or more

dopamine in VTA ventral tegmental area, project thru medial forbrain to nucleus accumbens and frontal cortex

12 mo, 2 manifestations

208
Q

PCP

A

NMDA antagonist

209
Q

LSD

A

serotonin agonist

210
Q

inhalants

A

encephalopathy and arrhythmias

cell membrane disruption

211
Q

glutamate

A

maintenance of addictive behavior

212
Q

exertional chest pain

A

angina pectoris

213
Q

mini mental for alzheimer’s bc

A

focuses on memory

214
Q

inflammatory synovial fluid

A

2000

ESR, CRP, anemia of chronic disease

215
Q

arthralgia and myofascial

A

no swelling or erythema

216
Q

bursitis or tendonitis

A

active more painful than passive

217
Q

myo fascial

A

full range of motion

218
Q

septic arthritis

A

gram pos: staph aureus, gonorrhea
monoarticular
knee
papulo pustular skin lesions

219
Q

pseudogout

A

high parathyroidism
low thyroidism
hemochromatosis, diabetes, wilson

asymmetric oligoarticular

distinguish from gout w synovial fluid

220
Q

chronic inflammatory arthropathy

A

ESR, CRP
rheumatoid factor
anti CCP

221
Q

RA spares the

A

DIP joints

222
Q

RA

A 
deforming
ulnar deviation
swan neck
extensor tenosynovitis
MCP and PIP swelling
223
Q

extra articular RA

A

splinter hemorrhage
elbow nodules
nodule on heart valve - murmur
renal (penicillamine, NSAIDs) and eye probs

224
Q

SLE

A 
non deforming
fetal loss in 2nd trimester
livedo reticularis - antiphospholipid Ab
anti Ro Ab - neonatal lupus
raynaud
225
Q

polymyositis, dermatomyositis

A 
DM - periorbital edema
lung disease, diaphragmatic weakness
gottron's papules
regged cuticles
muscle inflammation, necrosis of fibrils
226
Q

spondyloarthropathies

A

chronic inflamm - spine and sacroiliac
asymmetric oligoarticular
HLA-B27
seronegative

erythema nodosum
pyoderma gangrenosum
psoriatic plaques
oncholysis

enthesitis
dactylitis - daylight sign
aortic regurgitation
conjunctivitis

227
Q

OA

A

asymmetric
DIP - heberden’s node
PIP - bouchard’s node

228
Q

allergic contact dermatitis

A

nickel, poison ivy/oak, rubber gloves
type 4 HS
cutaneous lymphocyte associated antigen

229
Q

atopic dermatitis

A

chronic itch
starts in infancy, remits spontaneously
atopic triad - asthma, allergic rhinitis/hay fever
xerosis, lichenification
igE
filaggrin FLG gene mut - dec barrier function

acute is type 1 HS, chronic is type 4

230
Q

cutaneous leukocytoclastic vasculitis

A

hypersensitivity vasculitis - small vessels
immune complex formation -> C5a -> neutrophils
lower extremities 10 days after Ag exposure
spots dont blanch

type 3 HS

231
Q

urticaria

A 
blanching
wheal - central pallor, erythematous flare
angioedema
transient and migratory
dermographism - pop up bc light scratch
acute up to 6 wk

colon, lung, rectum CA
SLE, sjogren, RA vasculitis - collagen vasc diseases

hyperthyroidism, prego, menopause

type 1 HS, igE (if ige independent, opiates or nsaids)

232
Q

erythema multiforme

A 
HSV, mycoplasma pneumonia
skin homing CD8+ attack basal mucosa and epithelium
target/iris/bullous lesion
minor - skin
major - skin + mucous
7 days
keratinocyte necrosis
233
Q

steven johnson

A

toxic epidermal necrolysis

234
Q

bullous pemphigoid

A

subepidermal, autoimmune
Ab against hemidesmosomal Ag (BPAg 1,2)
pruritic, tense bullae
no mucosal involvement

type 2 HS
furosemide can cause it or Abx

235
Q

pemphigus

A

intraepidermal blister and acantholysis
skin and mucus
flaccid bullae
Ab to desmosomal Ag (Dsg1,3) on keratinocytes

type 2 HS

causes: non hodgkin lymphoma, CLL, penicillamine, captopril
rare: myasthenia gravis

intercellular IgG and C3

236
Q

PV

A

Dsg3 - btw basal and spinous

die w/out Tx

237
Q

PF

A

Dsg1 - btw granular and corneum

survive

238
Q

telangiectasia

A

blanches

purpura doesnt blanch

239
Q

roseola

A 
high fever
infants appear well
HHV 6,7
dsDNA
spread: oropharyngeal secretions
lymphotropic for CD4+
recurrence - salivary glands

neuro - HHV6 in endothelial cells of vessels in frontal lobe

240
Q

rubeola/measles

A

paramyxovirus, ssRNA
subacute sclerosing panencephalitis
koplik spots/enanthem
cephalocaudal exanthem

241
Q

rubella/german measles

A

togaviridae, ssRNA
rash fades in 3 days
lymphadenopathy
nasopharynx

congenital - first trimester infx, blueberry muffin skin

242
Q

molluscum contagiosum

A 
poxvirus
STD in adults
skin to skin, fomites
painless umbilicated papules
not on palms and soles

intracytoplasmic basophilic inclusions - molluscum/henderson patterson bodies

243
Q

verruca vulgaris/warts

A

HPV
naked dsDNA
direct contact w ppl,surfaces
microabrasions allow entry

1,2 - warts
6,11 - anogenital warts
16,18 - anogenital, high risk for cancer - squamous cell and cervical CA

E6 and E7 inhibit p53 and pRb

condyloma accuminata, internal extension possible

244
Q

warts

A

church spire and koilocytes

245
Q

VZV

A

lesions at various stages

infective until all lesions are crusted

246
Q

varicella

A

reye syndrome and encephalitis

247
Q

zoster

A

ramsay hunt - ipsilateral facial nerve paralysis w loss of taste in anterior 2/3 of tongue

248
Q

group A strep

A

sinusitis
otitis media
pneumonia

249
Q

lymphangitis

A

s pyogenes

250
Q

strep bovis

251
Q

strep pneumo

A

capsule - virulence

252
Q

staph A spread

A

hyaluronidase

BSCE GOER (3 decks)

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