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SPIEGEL > TEST 2 > Flashcards

TEST 2 Flashcards

1
Q

inability to repeat certain phrases, word finding difficulty, multiple paraphasic errors; naming sometimes impaired, auditory comprehension intact

A

conduction aphasia (lesion to arcuate fasiculus b/w broac’s and wernicke’s)

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2
Q

rapidly correcting hyponatremia leading to central pontine myelinolisis leads to

A

locked in syndrome (dissection of pons)

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3
Q

advocacy group made up of families of mentally ill; can work locally or state wide or federal

A

National alliance for the mentally ill (NAMI)

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4
Q

time window for TPA

A

within 3-4.5 hours of stroke (not later)

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5
Q

ipsilateral Horner’s syndrome, ipsilateral loss of fine touch in face + contralateral loss pain/temp in body, cerebellar ataxia, vocal cord weakness; dx and localize lesion

A

lateral medullary syndrome (Wallenberg syndrome)

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6
Q

What does NE do to aggressioN?

A

inhibit (like serotonin)

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7
Q

metochromatic leukodystrophy (mode of inheritance, and what is deficient)

A

autosomal recessive, deficiency in arylsulfatase A (ASA)
causes accumulation of sulfatides -> demyelination -> gait disorder with hypotonia with lower limb areflexia

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8
Q

biopsy finindgs metachroatic leukodystrophy

A

metachromatic inclusions within Schwann cells/macrophages; abnormal ASA enzyme assay in luekyocytes and increased sulfatide excretion

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9
Q

which primitive reflex keeps going after 6 months sometimes?

A

parachute reflex (grasp rooting, Moro, tonic neck reflex all should be gone before 6 months)

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10
Q

most commo cause of visual deficits in AIDS pt

A

CMV

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11
Q

difficulty recognizing one’s emotions

A

alexithymia

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12
Q

risperidone affinity to D2 receptor

A

just as much as haldol = also has risk for EPS

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13
Q

treatment of choice for urinary retention

A

bethanecol

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14
Q

which mood stabilizer has the most general/broad coverage for multiple seizures (general tonic clonic, absence, myclonic, etc)

A

VPA

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15
Q

anticholinergic side effects

A

dry mouth, blurry vision, sweating, orthostatic hypotension, sedation, lethargy, agitation, slowed cardiac conduction

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16
Q

nerve for foot flexion/dorsiflexion

A

L5; lesion causes foot drop

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17
Q

foot extension nerve

A

S1

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18
Q

nerve for leg extension

A

L3/L4

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19
Q

hip flexion nerve

A

L1, L2, L3

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20
Q

nerve for achilles/ankle jerk motor reflex

A

S1

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21
Q

which antidepressant can be used to treat gastic ulcers and why?

A

amitriptyline; due to antihistaminic effect

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22
Q

brown sequard syndrome involves what findings (spinal cord hemisection)

A

IPSILATERAL loss of motor+posterior column (proprioception, fine touch, vibration) to and below level of lesion
CONTRALATERAL loss of pain and temp a few dermatomes below lesion

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23
Q

poor performance on cube drawing deficiency in what area

A

right parietal lobe, inferior temporal lobe (deficits in spatial perception and attention)

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24
Q

Alzheimer’s and LBD performance on clcok drawing and delayed recall

A

clocko drawing - LBD worse, Alz better
delayed recall - Alz worse

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25
Q

poor letter F fluency on MOCA, lesion?

A

frontal lobe

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26
Q

overall scores of initial MOCA for Alz comapred to LBD or FTD?

A

WORSE overall

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27
Q

MOCA < 26; what to brain

A

chronic reduction of cerebral blood flow

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28
Q

MOCA results in depression

A

global cognitive slowing; tend to be < 26 even with no dementia

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29
Q

MOCA deficits in brain mets?

A

defiits in delayed recall, language, visual/spatial executive function

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30
Q

pt speaks in nonsens sayin g”thar szing is phrumper zu stalking”; normal intonation but nobody can understand him;

A

wernicke’s aphasia/fluent aphasia

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31
Q

pt presents with inability to write, calculate, do arithmetic, inability to dstinguish fingers on hand; where is lesion

A

left parietal (gerstmann syndrome)

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32
Q

CSF findings in HSV

A

lymphcytic pleocytosis (increased WBCs)

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33
Q

up to down (order of brainstem)

A

midbrain
pons
medulla

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34
Q

fmidbrain lesions cause what kind of symptoms (CN 3-5)

A

“eyeballs”
abnormality in eye ovements and face sensation

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35
Q

lesions to pons cause what (CN 5-9)

A

“middle face”
abnormalities in facial movement, chewing, saliva, hearing/balance

36
Q

Damge to medulla causes what

A

“neck stuff” CN9-12
tongue movement, taste, swalloing, neck movement

37
Q

lesions to what part of brain stem can cause ataxia?

A

all of them! cerebellum has projections to all parts of brainstem

38
Q

pt presents with hiccups, left sided facenumbness, nystagmus, hoarseness,, deficits in pain temp on RIGHT side of body, ataxia, vertigo, nausea, vomiting; what blood vessel invovled?

A

lateral medullary syndrome/wallengerg
occlusion of POSTERIOR INFERIOR CEREBELLAR ARTERY

39
Q

treatment bell’s palsy

A

steroids OR antivirals if caused by HSV

40
Q

suspected cause of trigeminal neuralgia?

A

susuperior ceberallar artery compressiong CNV near connection to pons

41
Q

how to differentiate alcoholic cereballar degeneration from wernicke’s encephalopathy?

A

ACD doens’t cause eye movement issues or eye pain

42
Q

treatment for Huntington’s

A

symptomatic treatment
can also uses haldol or high potency antipsychotics

43
Q

activity of subthalamic nucleus and globus pallidus in parkinson’s

A

INCREASED (leads to DA inhibition and movement disorders like bradykinesia)

44
Q

what mood stabilizer can be helpful in pseudotumor cerebri?

A

topamax (inhibits carbonic anhydrase leading to decerased cSF production and lowers ICP)

45
Q

CSF MS

A

oligoclonal bands, elevated protein, nucleated cells

46
Q

what can trigger MS flares?

A

infections (common cold, URI), heat, pregnancy, emotional stress

47
Q

how to differentiate ALS from cervical spondylosis and transverse myelitis

A

ALS doesn’t present with SENSORY issues; only motor

48
Q

stocking glove sensory deifict

A

GBS

49
Q

most helpful test for ALS

A

EMG (w/ fibrilations)

50
Q

parkinson symptoms (gait issues, bradykinesia, rigidity) with difficulties with vertical gaze?

A

progressive supranuclear palsy

51
Q

pupils in botulism

A

DILATED (causes blurred vision)

52
Q

autoantibodies taret what in lambert eaton

A

PRESYNAPTIC CALCIUM (prevents release of Ach)

53
Q

pupils in MG

A

NORMAL, reactive

54
Q

antibodies target in MG

A

POST SYNAPTIC Ach receptors (so Ach production is normal just blocked)

55
Q

site of Ach production

A

nucleus basalis of Meynert

56
Q

introns or exons geneticall y active?

A

EXONS; introns are spliced out

57
Q

DNA methylation does what to transcription

A

represses (DNA Methylation Masks)

58
Q

Histone methylation vs histone acetylation

A

methylation - REPRESSES DNA transcription most of the time; “Methylation Mostly Mutes”
acetylation - relaexes chromatin coils and ACTIVATES transcription; “Acetylation ACTivates”

59
Q

single gene affecting multiple phenotypes

A

pleiotropy (PKU)

60
Q

Same genotype yielding varying phenotypes/clinical features/disease severity

A

variable expressivity (NF-1, MS)

61
Q

imprinting on chromosome 15

A

angelman - Paternal imprinting (lmom’s chromosome deleted/silent)
Prader Willi - maternal imprinting; (father’s chromosome 15 deleted)

62
Q

chromsomal translocation occuring on pairs of acrocentric chromosomes leading to long and short arms

A

robertsonian translocations (downs, Patau, miscarriage, stillbirth)

63
Q

transitional object; “good enough mother”

A

Winnicott

64
Q

“ego splitting”, infant/mother relationship; “depressive/paranoid/schizoid positions

A

Melanie Klein

65
Q

“mirroring”, narcissim

A

Kohut (Self psychology)

66
Q

who developed modern, short-term therapy by shortening sessions/decreasing frequency

A

Franz Alexander

67
Q

who developed/utilized interpersonal therapy

A

developed by Klerman, uutilized by Harry Stack Sullivan

68
Q

who developed therapy that reduces overt behaviors/symptoms of mental illness, uses conditioning and modeling

A

John Watson (developed behavioral therapy)

69
Q

counterconditioning to decrease maladaptive anxiety; decreases response to anxiety provoking stimuli

A

systematic desensitization; good for phobias

70
Q

what is like systematic desensitization but nore extreme and with no hierarchy

A

flooding (intead of slowly exposing someone to increasing heights, just tell them to go to tallest building and sit there until fear subsides)

71
Q

who designed biofeedback

A

Miller

72
Q

unearthing repressed emotoins and reliving them to increase insight

A

abreaction

73
Q

expression of an emotion in one member elicits expression of emotion in another

A

contagion

74
Q

idea that an individual is not alone with their problems

A

universalization

75
Q

what type of therapy involves neutraility, circular interaction between family/therapists, circular questions

A

Milan system; type of family therapy

76
Q

mechanism carbidopa-levodopa

A

carbidopa - inhibits DOPA decarboxylase and prevents metabolism of levodopa to dopa before it can cross BBB

77
Q

defense mechanism most often seen in psychosis and paranoid personality disorder

A

projection

78
Q

seizures, hemiparesis, facial cutaneous angioma (PORT WINE NEVUS), ID; toddler

A

Sturge Weber

79
Q

retinal+CNS hemangioblastomas, visercal cyssts, tumors; most often in cerebellum and kidneys

A

Von Hippel Landau

80
Q

early onset ataxia with small dilated bruising

A

ataxia telangectasia

81
Q

sweating/cool/blue skin after constant pain after injury/trauma

A

COOL SKIN AFTER PAIN?
reflex sympathetic dystrophy

82
Q

carbamazepine inducer at what?

A

2C19
3A4

83
Q

clozapine substrate of what

A

1A2

84
Q

if pt loses capacity and no surrogate decision maker can be found…what does the state do?

A

takes steps to make a decision that PRESERVES AND PROTECTS HUMAN LIFE

85
Q

tobacco smoking lowers levels of which meds?

A

CLOZAPINE
OLANZAPINE
HALDOL
AMITRIPTYLINE
IMIPRAMINE

SPIEGEL (3 decks)

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