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Smart book CNS & psych Flashcards

1
Q

Where craniopharyngioma come from?

what embryonal layer

A

Rathke’s pouch - anterior pituitary

surface ectoderm

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2
Q

What drug class is used to treat Alzhiemers

which drug specifically?

A

AchE inhibitors

Donepezil, galantamine, rivastigmine

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3
Q

Which toxin is contained in mushrooms (when you eat them) that can cause bad effects like throwing up?

A

Muscarine which is a muscarinic agonist

incr. parasympathetic

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4
Q

Activation of _______ promotes synthesis of nitric oxide

A

M3 receptors

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5
Q

A collection of snRNPs and other pre mRNA proteins are called ______

whats its function?

A

Spliceosomes

remove introns by cleaving

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6
Q

What is incidence?

A

The number of NEW cases of a illness each year

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7
Q

whats the triad for meningitis?

A

Fever, neck stiffness, altered mental status

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8
Q

what type of speech is involved in Broca? what other finding would you see?

A

nonfluent speech and right hemiparesis

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9
Q

Whats the function of the cerebellar hemispheres

what are the three signs of a lesion here?

A

Motor Planning and coordination of ipsilateral extremeties

-dysdiadochokinesia (impaired rapidly alternating movements)

-limb dysmetria, intention tremor

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10
Q

cognitive tests

A
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11
Q

whats the triad for Wernickes encephalopathy

what part of the brain is involved?

A

Confusion Ataxia Neurologic symptoms

Opthtalmoplegia

Mamillary bodies

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12
Q

What is anterograde (from axon to skin) axonal transport mediated by?

A

Kinesin

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13
Q

whats Akathisia

A

extrapyramidal side effect of antipsychotics

restlessness inability to sit still

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14
Q

what are the side effects of antipsychotics

A
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15
Q

when a patient is on isoniazid what should you give along with it?

A

b6-pyridoxine to prevent isoniazid neuropathy

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16
Q

patients with major depressive episodes should be screened for what before starting antidepressents?

A

SHould be screened for manic episodes

this is to rule out/differentiate between MDD and bipolar disorder

starting antidepressants in bipolar do can induce mania

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17
Q

what are the symptoms of PKU

A

due to decr. phenylalanine hydroxylase or tetrahydrobipterin

-mental retardation, seizures, growth retardation, fair skin, musty odor

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18
Q

whats the function of the obturator nerve

A

Adduction of thigh

cutaneous innervation of medial thigh

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19
Q

What are the symptoms of west nile virus

A

Encephalitis, meningitis, flaccid paralysis

(+) ssRNA flavi virus

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20
Q

what are the prenatal tests to check for Neural tube defects?

A

Incr. AFP & AchE

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21
Q

Whats the deficient in each nerve injury

Obturator

Femoral

Common peroneal

Tibial

Superior gluteal

A

obturator- leg Adduction/medial cutaneous

Femoral - leg extension/thigh flexion

C. peroneal - foot drop

Tibial - cant curl toes/ foot everted

S. gluteal- pelvis tilts

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22
Q

what is fragile X caused by?

A

Trinucleotide CGG repeat on FXMR1 (fragile X mental retardation) gene

Hypermethylation and inactivation of gene

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23
Q

what does rabies bind to in that leads to infection?

A

Ach receptors

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24
Q

what are the serum findings in wilson dz

how do you treat it?

A

Low Ceruloplasmin

high Copper

-D-penicillamine

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25
what all bio reactions is **thiamine** involved in?
**ATP** **A-**ketoglutarate, **T**ransketolase, **P**yruvate dehydrogenase
26
How would **B12** deficiency present?
**Megaloblastic anemia** (impaired DNA synthesis) and nuerologic deficits *Subacute combined degeneration* of **dorsal column/lateral corticospinal**
27
What symptom is permanent even after treatment in Wernicke encephalopathy?
Memory impairment
28
whats the first line drug for **status epilipticus**
**Benzos!!!!**
29
How does Fragile X syndrome present?
FMR1 gene mutation (Methylation --\> inactivation) CGG repeat Fragile **X** has e**X**tra large **jaws, ears, testes**
30
whats the physical presentation of **downsyndrome**?
Low ears, short neck, epicanthic folds
31
whats the physical presentation of **Marfans syndrome**
Arachnodactyl (long skinny fingers), scoliosis, lens dislocation
32
Whats the physical presentation of **Fetal alcohol syndrome**
Thin vermillion border( thin upper lip), smooth philtrum (dip on upper lip) microencephaly,
33
What happens with an **Internal capsule** lesion in the brain?
**"clasp-knife" spasticity:** initial resistance then flaccid extension.
34
what is deficient in **Narcolepsy**
**Hypocretin1** aka **Orexin**
35
guy falls from a tree and grabs a branch. and now he cant really use his hand. what is it? and what nerves are messed up?
**Klumpke palsy** -tear of **Lower trunk** of brachial plexus
36
where are the serotonin releasing nuerons located in the brainT
The **Raphe** nucleus
37
Bilateral infarcts of the brain should lead you to think \_\_\_\_\_\_\_
water shed areas - hypoxic ischemic stroke as opposed to emoblism which would have infarcts everywhere in different locations
38
What all do you know about wilsons dz young guy with ataxia and liver problems (incr. transaminase)
excessive copper deposition in liver, basal ganglia, cornea
39
what are the muscles and bones associated with the pharyngeal pouches 1,2,3,4&6
1- muscles: mastication / bones: maxilla, mandible, incus mallus 2 - muscles: Facial expression muscles / bones: stapes, stylohyoid, lesser bone of hyoid 3 - muscles: stylopharyngeaus / bone: greater horn of hyoid 4&6- muscles: laryngeal/pharyngeal / bone: Cricord and thyroid cartilage
40
Ubiquination
plays an important role in: antigen processing, muscle wasting, Dna repair, **disposal of misfolded proteins**
41
2 year old with abdominal mass dancing eyes dancing feet
Neuroblastoma Neural crest cells - Nmyc overexpression
42
Stroke of the ACA presents as why? MCA
Contralateral paraylsis/sensory loss of **LOWER** the ACA does the frontal lobe and sagital sulcus (hommunculus) which at the sulcus starts with feet -mca would be more upper limb and face problems
43
what happens after neuronal damage to a section of brain (how does it get repaired)
Glial cells like AStrocytes go through hyperplasia to repair ## Footnote **Gliosis**
44
whats parinaud? what causes it?
diminished vertical gaze due to lesion of *superior caliculi* -stroke, hydroceph, pinealoma
45
where would you give a femoral nerve block?
Iliac crease
46
a person comes in with Subarachnoid hemorhage. wwhat do you give to prevent Cerebral vasospasm
CCB
47
got an old person suddenly going crazy waxing and waning. how do you treat?
Delirium haloperidol
48
how long does adjustment disorder last?
6 months
49
whats the route to the meninges for Nisseara meningitis
infected by respiratory droplets pharynx-\> blood -\> **Choroid plexus** -\> meninges
50
whats freidrich ataxia? where is the lesion in the spinal cord. most common cause od death?
Ataxia, with diabetes, hypertrophic heart, kyphoscoliosis -lateral spinocerebellar/dorsal column degeneration
51
what nerve innervates the forearm **flexors** and what about sensory innervation
**Musculocutaneous** lateral forearm
52
why do you get GB (ascending paralysis) after camp or influenza. what kind of response?
Antibodies against the infectious agent also attack myelin of peripheral nerves -**endoneural inflam infiltrate**
53
recurrant **unilateral** headaches Lacrimation and rhinorhea. perioribtal pain tx?
Cluster headaches acute: Sumatriptan prophylaxis: verapamil
54
where are the muscarinic and nicotinic receptors?
M1: Nerves and CNS : G**q** receptor(ip3dag) M2: Heart, atria SA AV node : G**i** (camp) M3: Glands and smooth muscle : G**q** ip3-dag \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Nicotinic: Skeletal muscle (motor end plate) and Adrenals
55
Shoulder drop and cant lift pass the horizontal position. what muscle is fucked?
**Trapezius**
56
Most common **Viral** causes of meningitis
Enterovirus, Arbovirus, HSV 2
57
difference between **normal pressure** and **obstructive** (non communicating) **hydrocephalus**
Obstructive is due to aqueduct stenosis or tumor that leads to incr. ICP that causes **headache N/V**
58
Guy comes in with muscle weakness and paresthesias after eating fish at a japanese resturaunt. what is the cause and MOA
Puffer fish - **Tetrodotoxin** - Blocks **Na** channels
59
What nerve is messed up in bells palsy and what does it innvervate
Facial nerve CN 7 -face muscles, anterior 2/3 taste, hearing, **salivary and lacrimal glands**
60
what can occur after Subarachnoid hemmorage? how do you treat it?
Vasospams causing CCB
61
What are the target organs for Alpha, Beta1, & Beta2 receptors
_Stimulation_ Alpha-vasoconstriction, urinary retntion, and mydriasis Beta 1- Heart (incr. rate, contractility, conductance) Beta2- Bronchodilation, uterus relaxation
62
**Decerebrate** vs **Decortate** posturing
**Decerebrate**: extension of extremities due to a lesion below the *Red nucleus* (pons, midbrain,) **Decortate:** flexion of arms due to a lesion above the red nucleus which disinhibits it. **\*red nucleus** causes flexing. so above or below will tell you
63
Whats the bond types between **primary** and **secondary** protein structures?
Primary - **Peptide bonds** Secondary - **Hydrogen bonds**
64
What should you know about glioblastoma?
Its an astrocytoma, common primary malignant **Buttergly Glioma**, resides in **Cerebral hemisphere** GFAP **necrosis and hemorrhage**
65
What innervates dorsum of foot and if fucked can cause **foot drop**
Common Peroneal
66
Whats the function of Radial nerve
Extensors, skin sensory to posterior arm and forearm
67
whats the inheritance of Neurofibromatosis
Autosomal dominant
68
Spontaneous deep intercerebral stroke due to hypertension
Basal ganglia / lenticulostriate muscles
69
Route of Rabies
Wound- motor neurons -salivary glands
70
Difference between **Oppositional Defiant disorder** and **Conduct disorder**
**OPP** is argumentative, defiant behavior, with deliberate teasing and blaming others **Conduct** is cruelty to others with no regards
71
what is acute stress disorder and its timeframe
hyperarousal and avoidance symptoms as a result of life threatening or traumatic event 3 days to 1 months
72
**Social anxiety** do vs **panic**
**Panic**: recurrant episodes of stress and worrying about when the next one will come **Social anxiety**: worried more about the criticism of others and not the stress itself
73
when you see **ornithine** you should think
UREA CYLCE
74
Whats a romberg test
Asking a patient who has ataxia to stand up and balance with eyes closed.' Positve test: once they close their eyes they stumble (meaning that they were relying on other senes to balance which means the **dorsal column** is fucked) Negative test: means that the ataxia is a cerebellar problem and not the spinal cord
75
whats diabetic retinopathy caused by?
poorly controlled diabetes leading to **ischemia** of the nerve
76
Which brain tumor has S100 +
Schwannoma CN VIII Cerebellar pontain angle
77
What part of the brain is first effected by ischemia
pyramidal cells of the **​Hippocampus** **purkinje cells** of **cerrebellum**
78
how would dandy walker syndrome present
Absence of vermis enlargment of 4th ventricle, noncommunicating hydrocephalus, **large head**, spina bifida
79
difference between **Tourrettes** and **Chronic tic syndrome**
**Tourettes:** both motor and vocal(phonic tic) \_\_\_\_\_\_\_\_ **Chronic tic syndrome** : one or the other for greater than a year
80
What do you tell a pt going through on off phenomenom of parkinsons treatment?
Its **unpredictable** thought to be due to closing therapuetic window
81
Upper vs Lower motor neuron problem
Upper: Babinski sign, hyper reflexia Lower: fasiculations atrophy

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