Test 3 Review Deck Flashcards
What is the neurotransmitter used for inputs from the cortex to the striatum?
Glutamate
What are the five cardinal motor features of Parkinson’s?
TRAPS
Tremor (pill-rolling resting)
Rigidity (cogwheel)
Akinesia/bradykinesia
Postural instability
Shuffling gait
What occupational exposures and occupations are associated with increased risk of developing Parkinson’s?
Exposures: agent orange, paraquat, rotenone
Occupations: welders, farmers
Beating the shit out of your bed partner in your sleep is a possible predictor of developing which neurological disease 10-20 years later?
REM sleep behavior disorder –> Parkinson’s
What is the number one treatment for chorea as seen in Huntington’s disease?
Tetrabenazine
What is the trinucleotide sequence associated with Huntington’s? How many repeats are associated with 100% penetrance of the disease? How many repeats are normal?
CAG
40+ –> disease
29 or less is normal
What is your Dx?
Huntington’s (atrophy of the caudate)
What structure is affected by the ring-enhancing lesion seen in the photo? How would this manifest clinically?
That lesion is in the sub-thalamic nucleus, which normally suppresses movement.
This would present clinically as unilateral hemiballismus (huge jerky and sudden movements)
Self-medication with ________ may help reduce tremors in people with essential tremor.
alcohol
Name three drugs and one procedure that treats essential tremor.
- Propranolol
- Primidone
- Topiramate
Procedure: deep brain stimulation
Describe some presenting symptoms of optic neuritis and one clinical exam finding.
Blurry vision
Decreased acuity
Eye pain, worse with movement
Exam finding: afferent pupillary constriction defect
What is a Lhermitte sign and what disease is a positive sign associated with?
Chin-to-chest
Is positive, patient feels electric shocks running down spine
Positive in MS, meningitis
Relapsing-remitting MS may progress to what type of MS?
Secondary progressive MS
Audition of which frequencies are lost as people age?
Higher frequencies are lost with age
Normal intraocular pressure is less than _____ mmHg
22 mmHg
What are the risk factors for cataract development?
Increased age
Smoking
Diabetes
UV light exposure
Amblyopia is characterized as vision loss due to deprivation of the visual cortical areas during the critical developmental period, resulting in the lack of formation of the _______ _______ column.
ocular dominance column
Name four underlying causes of amblyopia.
Congenital cataracts
Anisometropia (unequal refractive power)
Strabismus
Ptosis
What is myopia?
Near-sightedness - you can only see shit when its up close
Either from your eye being too long or too much refractive lens power (image is formed in front of the retina)
What is hyperopia?
Far-sightedness - you can only see shit at far distances
Due to too little refractive lens power or the eye being too short (image is formed behind the retina)
Dry AMD is characterized by a build-up of ______. How is it treated?
drusen
Treat with anti-VEGF (intravitreal injections every 4-6 weeks)
What causes wet AMD?
Neovascularization of the choroid
What are the two forms of diabetic retinopathy? What is the treatment for each (other than blood sugar control)?
For macular edema: intravitreal anti-VEGF
For proliferative: pan-retinal coagulation and vitrectomy
Old person with jaw claudication, bouts of temporary blindness, and muscle aches. What is your Dx? What is the treatment?
Temporal (giant cell) arteritis. Treat w/ high dose steroids.
Which hypothalamic nuclei regulates circadian rhythms?
Suprachiasmatic
Which hypothalamic nuclei are responsible for increasing thermogenesis when you get cold?
Posterior nuclei and peroptic anterior (POA)
What does the paraventricular nucleus do?
Contains magnocellular neurons that make ADH, oxytocin (neurohypophysis) and parvocellular neurons that make all the hormones that act on the anterior pituitary (adenohypophysis)
What does the dorsomedial nucleus do?
Integrates shit, makes u hungry
What do the mammillary bodies do?
Memory (conversion of short to long-term)
What tract serves for sympathetic outflow from the hypothalamus? What about parasympathetic?
Sympathetic: hypothalamospinal tract
Parasympathetic: dorsal longitudinal fasciculus
What is the triad of Horner’s syndrome?
Ptosis, miosis, anhydrosis
What area in the brain is responsible for laying down new, declarative memories?
Hippocampus
The medial forebrain bundle connects the hypothalamus with the nucleus ________ in the striatum and is involved with…?
connects the hypothalamus with the nucleus accumbens in the striatum; involved in reward
What part of the brain looks like a cinnamon roll?
Hippocampus
How do you treat Wernicke-Korsakoff syndrome?
IV thiamine before giving any glucose
Name four major clinical features of narcolepsy. Name one lab test that is suggestive of the diagnosis of narcolepsy.
Sleepiness, hallucinations, cataplexy, sleep paralysis.
Test: CSF hypocretin/orexin will be low
What is the first line treatment for chronic insomnia?
Better sleep hygeine and cognitive behavioral disorder.
Name three secondary causes of restless leg syndrome and one lab test you should get for someone if their history suggests the diagnosis.
Iron deficiency, pregnancy, end-stage renal disease.
Check serum ferritin.
Regarding Broca’s aphasia, state whether or whether not a patient will have…
fluent speech
ability to repeat words
comprehension
Nonfluent, no repitition, comprehension is intact
Regarding Wernicke’s aphasia, state whether or whether not a patient will have…
fluent speech
ability to repeat words
comprehension
Fluent speech, no ability to repeat, comprehension NOT intact
Regarding conduction aphasia, state whether or whether not a patient will have…
fluent speech
ability to repeat words
comprehension
Speech is fluent, no ability to repeat, comprehension intact
Strokes involving the non-dominant hemisphere often affect one’s ________.
attentiveness (eg. hemineglect)
In a patient with hemineglect, is the side of neglect ipsilateral to, or contralateral to the lesion?
Contralateral
What is the diagnostic criteria for dementia?
2 or more impairments of different aspects of cognition that end up interfering with one’s ability to work/function.
- decline from previous ability
- not explained by delirium or other disorder
A patient presents with Parkinsonian-like motor problems, but also seems demented. They also complain of vivid hallucinations. What is your Dx?
Lewy body dementia
Name major clinical features of frontotemporal dementia.
Loss of inhibition (hyperphagia, doing lewd shit, being inappropriate), loss of empathy
Describe how cerebral palsy progresses.
It doesn’t!
Describe the gross motor classification system (GMCS) for CP patients aged 6-12.
Ambulatory:
I: one can barely notice a problem
II: can walk without aids
III: can walk with aids
Non-ambulatory:
IV: needs wheelchair most of time; can stand
V: needs power wheelchair all the time
What is a single-event multi level surgery for a CP patient?
When surgeons wait until several orthopedic issues (eg. tendon lengthening) may be operated on at once so the patient isn’t in the hospital all the fucking time.
