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Brain Gainz > Smart book CNS & psych > Flashcards

Smart book CNS & psych Flashcards

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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
Q

what all bio reactions is thiamine involved in?

A

ATP

A-ketoglutarate, Transketolase, Pyruvate dehydrogenase

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26
Q

How would B12 deficiency present?

A

Megaloblastic anemia (impaired DNA synthesis) and

nuerologic deficits

Subacute combined degeneration of dorsal column/lateral corticospinal

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27
Q

What symptom is permanent even after treatment in Wernicke encephalopathy?

A

Memory impairment

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28
Q

whats the first line drug for status epilipticus

A

Benzos!!!!

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29
Q

How does Fragile X syndrome present?

A

FMR1 gene mutation (Methylation –> inactivation)

CGG repeat

Fragile X has eXtra large jaws, ears, testes

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30
Q

whats the physical presentation of downsyndrome?

A

Low ears, short neck, epicanthic folds

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31
Q

whats the physical presentation of Marfans syndrome

A

Arachnodactyl (long skinny fingers), scoliosis, lens dislocation

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32
Q

Whats the physical presentation of Fetal alcohol syndrome

A

Thin vermillion border( thin upper lip), smooth philtrum (dip on upper lip) microencephaly,

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33
Q

What happens with an Internal capsule lesion in the brain?

A

“clasp-knife” spasticity: initial resistance then flaccid extension.

34
Q

what is deficient in Narcolepsy

A

Hypocretin1 aka Orexin

35
Q

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?

A

Klumpke palsy

-tear of Lower trunk of brachial plexus

36
Q

where are the serotonin releasing nuerons located in the brainT

A

The Raphe nucleus

37
Q

Bilateral infarcts of the brain should lead you to think _______

A

water shed areas - hypoxic ischemic stroke

as opposed to emoblism which would have infarcts everywhere in different locations

38
Q

What all do you know about wilsons dz

young guy with ataxia and liver problems (incr. transaminase)

A

excessive copper deposition in

liver, basal ganglia, cornea

39
Q

what are the muscles and bones associated with the pharyngeal pouches

1,2,3,4&6

A

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
Q

Ubiquination

A

plays an important role in: antigen processing, muscle wasting, Dna repair, disposal of misfolded proteins

41
Q

2 year old with abdominal mass

dancing eyes dancing feet

A

Neuroblastoma

Neural crest cells - Nmyc overexpression

42
Q

Stroke of the ACA presents as

why?

MCA

A

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
Q

what happens after neuronal damage to a section of brain (how does it get repaired)

A

Glial cells like AStrocytes go through hyperplasia to repair

Gliosis

44
Q

whats parinaud? what causes it?

A

diminished vertical gaze due to lesion of superior caliculi

-stroke, hydroceph, pinealoma

45
Q

where would you give a femoral nerve block?

A

Iliac crease

46
Q

a person comes in with Subarachnoid hemorhage. wwhat do you give to prevent Cerebral vasospasm

A

CCB

47
Q

got an old person suddenly going crazy

waxing and waning. how do you treat?

A

Delirium

haloperidol

48
Q

how long does adjustment disorder last?

A

6 months

49
Q

whats the route to the meninges for Nisseara meningitis

A

infected by respiratory droplets

pharynx-> blood -> Choroid plexus -> meninges

50
Q

whats freidrich ataxia? where is the lesion in the spinal cord. most common cause od death?

A

Ataxia, with diabetes, hypertrophic heart, kyphoscoliosis

-lateral spinocerebellar/dorsal column degeneration

51
Q

what nerve innervates the forearm flexors

and what about sensory innervation

A

Musculocutaneous

lateral forearm

52
Q

why do you get GB (ascending paralysis) after camp or influenza. what kind of response?

A

Antibodies against the infectious agent also attack myelin of peripheral nerves

-endoneural inflam infiltrate

53
Q

recurrant unilateral headaches

Lacrimation and rhinorhea. perioribtal pain

tx?

A

Cluster headaches

acute: Sumatriptan
prophylaxis: verapamil

54
Q

where are the muscarinic and nicotinic receptors?

A

M1: Nerves and CNS : Gq receptor(ip3dag)

M2: Heart, atria SA AV node : Gi (camp)

M3: Glands and smooth muscle : Gq ip3-dag

_______________

Nicotinic: Skeletal muscle (motor end plate) and Adrenals

55
Q

Shoulder drop and cant lift pass the horizontal position. what muscle is fucked?

A

Trapezius

56
Q

Most common Viral causes of meningitis

A

Enterovirus, Arbovirus, HSV 2

57
Q

difference between normal pressure and obstructive (non communicating) hydrocephalus

A

Obstructive is due to aqueduct stenosis or tumor that leads to incr. ICP that causes headache N/V

58
Q

Guy comes in with muscle weakness and paresthesias after eating fish at a japanese resturaunt. what is the cause and MOA

A

Puffer fish - Tetrodotoxin - Blocks Na channels

59
Q

What nerve is messed up in bells palsy and what does it innvervate

A

Facial nerve CN 7

-face muscles, anterior 2/3 taste, hearing, salivary and lacrimal glands

60
Q

what can occur after Subarachnoid hemmorage?

how do you treat it?

A

Vasospams causing

CCB

61
Q

What are the target organs for Alpha, Beta1, & Beta2 receptors

A

Stimulation

Alpha-vasoconstriction, urinary retntion, and mydriasis

Beta 1- Heart (incr. rate, contractility, conductance)

Beta2- Bronchodilation, uterus relaxation

62
Q

Decerebrate vs Decortate posturing

A

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
Q

Whats the bond types between primary and secondary protein structures?

A

Primary - Peptide bonds

Secondary - Hydrogen bonds

64
Q

What should you know about glioblastoma?

A

Its an astrocytoma, common primary malignant

Buttergly Glioma, resides in Cerebral hemisphere

GFAP

necrosis and hemorrhage

65
Q

What innervates dorsum of foot and if fucked can cause foot drop

A

Common Peroneal

66
Q

Whats the function of Radial nerve

A

Extensors, skin sensory to posterior arm and forearm

67
Q

whats the inheritance of Neurofibromatosis

A

Autosomal dominant

68
Q

Spontaneous deep intercerebral stroke due to hypertension

A

Basal ganglia / lenticulostriate muscles

69
Q

Route of Rabies

A

Wound- motor neurons -salivary glands

70
Q

Difference between Oppositional Defiant disorder and Conduct disorder

A

OPP is argumentative, defiant behavior, with deliberate teasing and blaming others

Conduct is cruelty to others with no regards

71
Q

what is acute stress disorder and its timeframe

A

hyperarousal and avoidance symptoms as a result of life threatening or traumatic event

3 days to 1 months

72
Q

Social anxiety do vs panic

A

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
Q

when you see ornithine you should think

A

UREA CYLCE

74
Q

Whats a romberg test

A

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
Q

whats diabetic retinopathy caused by?

A

poorly controlled diabetes leading to ischemia of the nerve

76
Q

Which brain tumor has S100 +

A

Schwannoma

CN VIII Cerebellar pontain angle

77
Q

What part of the brain is first effected by ischemia

A

pyramidal cells of the ​Hippocampus

purkinje cells of cerrebellum

78
Q

how would dandy walker syndrome present

A

Absence of vermis

enlargment of 4th ventricle, noncommunicating hydrocephalus, large head, spina bifida

79
Q

difference between Tourrettes and Chronic tic syndrome

A

Tourettes: both motor and vocal(phonic tic)

________

Chronic tic syndrome : one or the other for greater than a year

80
Q

What do you tell a pt going through on off phenomenom of parkinsons treatment?

A

Its unpredictable

thought to be due to closing therapuetic window

81
Q

Upper vs Lower motor neuron problem

A

Upper: Babinski sign, hyper reflexia

Lower: fasiculations atrophy

Brain Gainz (30 decks)

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