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Jenna's Shit List > Shit list 2 - Neuro > Flashcards

Shit list 2 - Neuro Flashcards

1
Q

Pilocytic Astrocytoma

A

Kids MCC.
Benign.
Posterior fossa i.e. cerebellum, but can be supratentorial.
GFAP +.
Rosenthal fibres (eosinophilic, corkscrew), spindle cells.
Cystic and solid.

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2
Q

Medulloblastoma

A

Kids, 2nd MCC.
Highly malignant.
Type of PNET.
Compress 4th ventricle –> hydrocephalus and drop mets.
Always cerebellum, MC = vermis.
Homer-Wright rosettes.
Solid, small blue cells, high mitotic index.

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3
Q

Ependymoma

A

Kids.
4th ventricle ependymal cells, so can cause hydrcephalus.
[adults MC is spine].
Perivascular pseudo-rosettes.
Rod-shaped blepharoplasts (basal ciliary bodies) near nucleus

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4
Q

Craniopharyngeoma

A

Kids.
Benign.
Supra-tentorial.
Confused with pituitary adenoma as both cause bitemporal hemianopsia.
From rathke’s pouch derivatives, so can calcify.

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5
Q

Pleiomorphic xanthoastrocytoma

A

Kids/teens.
Sudden onset seizures.
Leptomeningeal, reticulin deposits, chronic inflammatory cells.

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6
Q

CYP 450 Inducers

A 
Chronic alcoholism.
St. John's Wort.
Phenytoin.
Phenobarbital.
Carbamazapine.
Nevirapine (NNRTI).
Rifampin.
Greisofulvin.
Benzopyrines.
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7
Q

CYP450 Inhibitors

A 
Acute alcohol abuse.
Ritonavir (protease).
Amiodarone (III).
Cimetidine.
Ketoconazole.
Isoniazid (INH).
Grapefruit juice.
Quinidine (Ia).
Macrolides (not A, esp E)
Omeprazole
Ciprofloxacin
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8
Q

Common CYP 450 substrates

A

Warfarin.
Anti-epileptics.
Theophylline.
OCP.

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9
Q

Lithium: use, AE, toxicities

A

Use: bipolar and SIADH
AE: tremor, nephrogenic DI, hypothyroidism, Ebstein anomalie
Toxicity: via thiazides

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10
Q

Atypical Antipsychotics: names, use, general AE. specific AE

A

Names: Quetiapine, olanzapine, risperidone, aripooprazole, ziprasidone, clozapine
Use: schizophrenia, bipolar, OCD, anxiety disorders, depression, mania, tourette’s
AE: QT prolongation
Spec AE:
- O/C = weight gain
- C = agranulocytosis (weekly WBC) and seizures (and weight gain)
- R = prolactin

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11
Q

DOC trigeminal neuralgia

A

Carbamazapine

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12
Q

Myotonic dystrophy: inheritance, s/s

A

AD.
CTG repeat.
Type I fibre destruction.
S/S: myotonia (can’t release door knobs), muscle wasting, frontal baldness, arrhythmia, testicular atrophy, cataracts

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13
Q

Glioblastoma Multiforme

A

Adult.
MC malignant (1yr).
Can cross corpus callous to other hemisphere.
GFAP +.
Pseudopallisading, pleiomorphic, central necrosis and hemorrhage

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14
Q

Meningioma

A 
Adult.
Benign.
Convexities and parasaggital; extra-axial and may have tail.
From arachnoid cells.
Seizures of focal neurological signs.
Whorrled spindle-cells, psammoma bodies.
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15
Q

Hemangioblastoma

A 
Adult.
Cerebellar.
VHL when also have retinal.
Thin-walled capillaries.
Can make EPO.
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16
Q

Schwannoma

A 
Adult.
@ cerebello-pontine angle MC.
S-100+.
common on VIII - tinnitus, vertigo, sensory hearing loss - CONSTANT (ddx = mennieres = episodic).
Bilateral VII = NF-2
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17
Q

Oligodendroglioma

A 
Adult.
Frontal lobe white matter.
Chicken wire capillaries.
Fried eggs
Often calcify
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18
Q

uveitis: causes

A

Systemic inflammatory diseases: B-27, sarcoidosis, RA, juvenile idiopathic arthritis

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19
Q

Retinal detachment

A

Separation of photo-R layer from RPE –> photoreceptors degenerate –> vision loss.

Secondary to retinal breaks, diabetic traction, inflammatory effusions.

splaying and paucity of retinal vessels.

Flashed and floaters, then curtain drawn down on vision. Emergency

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20
Q

Central retinal artery occlusion

A 
Acute.
Painless monocular vision loss.
Cloudy/pale retina.
Attenuated vessels.
*Cherry red fovea*
MCC is ICA embolism --> opthalamic a. --> retinal a.
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21
Q

Retinitis pigmentosa

A

Inherited retinal degeneration.
Starts with night blindness.
Bony spicule shaped deposits.

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22
Q

Retinitis

A

Retinal edema and necrosis.
Via infection - HSV, VZV, CMV.
Also associated with immunosuppression.

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23
Q

pupillary light reflex

A 
4 neurons.
CN II (n1) --> pretectal nucleus (midbrain) --> bilateral n2 -->EW nucleus --> n3 --> ciliary ganglion --> short ciliary (n4) --> pupillary spincter muscles

N4 cell body degeneration = Adie’s pupil (mono argyll-robertsons)

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24
Q

Mydriasis pathway

A

3 neurons:
HYpothalamus –> n1 –> ciliospinal centre of bulge (C8-T2) –> n2 –> exit at T1 into superior cervical ganglion –> n3 travels up ICA, through cavernous sinus, enters orbit as named “long-ciliary nerves” to pupil dilators [also tarsal and sweat glands of head and face]

25
Q

Pie in the sky

A

Meyer’s loop (temporal radiation)

26
Q

Pie on the floor

A

Dorsal optic radiation (parietal lobe)

27
Q

INO: disease, convergence, directional term

A

MS, usually bilateral.
Convergence in tact.
Right INO = right MLF lesion = right eye paralyzed

28
Q 
Demetia diseases and key feature:
Alz:
Pick's:
Lewy body:
CJD:
A

Alz: A-beta amyloid and NF tangles, low Ach
Pick’s: personality - disinhibition; WITH parkinsonian
Lewy: dementia BEFORE parkinsonian; visual hallucinations, lewy bodies (alpha-synneuclein)
CJD: w-m dementia with startle myoclonus, no inflammation

29
Q

Uthoff’s phenomenon

A

Heat sensitivity in MS - worse s/s

30
Q

Acute disseminates post-infectious encephalomyelitis

A

multifocal paraventricular inflammation and demyelination.

After VZV or measles, or rabies/smallpox vaccines

31
Q

Charcot-marie tooth disease

A

AD.
Motor and sensory.
Abnormal proteins or peripheral nerves or the myelin sheath.
Scoliosis, foot deformities i.e. pes cavus, common perineal = plantar-flexed
DDX = Friedrichs

32
Q

Krabbe
vs.
Metachromatic leukodystrophy

A

BOTH: Lysosomal storage disease, destroy myelin sheath, peripheral neuropathy

Krabbe:
Galactocerebroside ad psychosine buildup
S/S = peripheral neuropathy, dev. delay, optic atrophy, GLOBOID CELLS

MCLD:
Arylsulfatase A defic.
sulfatides buildup.
peripheral neuropathy, ataxia, dementia

33
Q

PML: cause, exacerbated by

A

Cause: JC in AIDS, destruction of oligodendrocytes

Exacerbated by: natalizumab, rituximab

34
Q

adrenoleukodystrophy

A

X-linked
VLCFA
buildup in nervous system, testes, adrenals
Coma/death, adrenal crisis

35
Q

Prevent/treat brain vasospasms

A

nifedipine

36
Q

steppage gait: nerve injured

A

Common peroneal

37
Q

H1-gen1’s:

A

Hzdroxyzine
Promethazine
Chlorpheniramine
Diphenhydramine

38
Q

ARMD:

2 types, findings, and Rx

A

Dry = dursen = yellowish material; rx = multivitamin, antioxidants, zinc, stop smoking

Wet = neovascularization from hypoxia via drusen; grey/green retina with fluid/bleed; Rx = anti-VEGF, later, Zn, smoking cessation

39
Q

Absence Seizures: other names

A
  • petit mal

- 3Hz spike wave complexes

40
Q

Alzheimers drugs: mechanism and names

A 
AchE inhibitors
Names:
- donepezil
- galantamine
- rivastigmine
- tacrine
41
Q

Pineal germinoma s/s

A

1) Precocious puberty via hCG
2) aqueductal compression causing non-communicating hydrocephalus
3) Tectum compression leading to impaired conjugate vertical gaze and convergence

42
Q

superior vs inferior colliculi

A

Superior = vision (conjugate vertical gaze, convergence

Inferior = auditory (sound localization)

43
Q

Brainstem lesion shortcuts

A

Medial lesion = pure motor + CSTr (motor)

Lateral lesion = mixed + Horners and ALS

44
Q

Relevant DA pathways

A

Mesolimbic-mesocortical - schizophrenia
Nigrostriatal - parkinsons
Tubuloinfundibular - inhibition of prolactin

45
Q

Thiopental

A

IV barbiturate for anesthesia; redistributed into fat and muscle

46
Q

Drug-induced parkinsonism

A

Typical antipsychotics > atypical antipsychotics

Anti-emetic/gastric motility: prochlorperazine, metochlopromide

47
Q

Rx of drug-induced parkinsons

A

ACH ANTAGONIST!
Benztropine, trihexyphenidyl
*but don’t use in old people with BPH or closed angle glaucoma etc…

48
Q

Hyperacusis via:

A

VII damage impairing stapedius muscle contraction to dampen sounds

[tensor tympany is the other muscle, innervated by motor V3]

49
Q

Middle meningeal artery - where did it come from

A

MMA

50
Q

Pteryon =

A

joining of frontal, temporal, parietal, and sphenoid bones

51
Q

Clozapine AE

A

agranulocytosis, seizures, weight gain (olanzapine)

52
Q

Myasthenia crisis vs cholinergic crisis

A

myasthenia crisis = not enough anti-AchE drug; improves with tensilon administration

cholinergic crisis = too much anti-AChE drug causing depolarization blockade; no improvement with tensilon

53
Q

SOD-1 mutations

A

ALS

54
Q

Nerves that can be affected in vestibular schwannomas

A

VIII (obviously; @ CPA) - hearing loss, tinnitus, vertigo
VII - facial paralysis, taste, hyperacusis (stapedius), lacrimation/salivation
V - loss of facial sensation, mastication, and corneal reflex sensory

Bilat = NF-2

55
Q

Mixed agonist-antagonist opioids

A

Pentazocine
Nalbuphine

K agonist - spinal analgesia
mu antagonist

56
Q

Narcolepsy rx

A 
Daytime = stimulants: amphetamines, modafinil
Nighttime = sodium oxybate (GHB)
57
Q

GFAP+

A

Astrocytes
oligodendrocytes
Ependymal

58
Q

1st area damaged in global cerebral ischemia

A

Hippocampus (pyramidal neurons) [then also cerebellar pyramidal neurons]

Jenna's Shit List (23 decks)

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