Test 69: Neurology Flashcards

1
Q

hypnagogic

A

going to sleep

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2
Q

hypnopompic

A

“pompous upon awakening”

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3
Q

Name 3 mutation sites that have been associated with early-onset familial Alzheimer disease

A
  1. amyloid precursor protein gene on chromosome 21
  2. Presenilin 1 gene on chromosome 14
  3. Presenilin 2 gene on chromosome 1
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4
Q

Name 1 mutation site associated with late-onset Alzheimer disease

A

Apoliporotien E4

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5
Q

Inhaled anesthetics with high tissue solubly have what arteriovenous concentration gradient

A
  • large

- slower onset of actions

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6
Q

What is length constant

A

measure of how far along an axon an electrical impulse can propagate

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7
Q

what does myelination do to neuron properties

A
  • increases constant length ( Direct impact)

- decreases constant time

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8
Q

Wilson’s disease damages what in the brain

A
  1. putamen

2. basal ganglia

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9
Q

What are 2 broad categories for seizures

A
  1. partial

2. Generalized

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10
Q

Name 2 partial seizures

A
  1. Simple

2. complex

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11
Q

Name 2 generalized seizures

A
  1. Tonic/clonic

2. Absonce seizure

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12
Q

Define partial simple seizures

A

no loss of conscious

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13
Q

define partial complex

A
  • partial loss of conscious

- autonomics: lip smaking, not responsive, not on floor

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14
Q

define generalized tonic clonic seizures

A

classic convulsions

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15
Q

define generalized absonce seizures

A

little kids, starring spells

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16
Q

What is the first line of drug for Absence seizure

A

Ehosuximide ( only treats absence seizure)

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17
Q

What is the best long term use for Absence seizure and tonic clonic seizure

A

Valporic acid

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18
Q

Lambert Eaton is associated with what cancer

A

small cell lung cancer

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19
Q

Injury to right temporal lobe hurts what part of the eye neurons

A

Meyer’s loop

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20
Q

Injury to Meyer’s loops in temporal lobe results in what visual defect

A
  • contralateral superior quadrantanopia
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21
Q

32 year old migrant worker is brought to the emergency room with painful paroxysmal involuntary muscle contractions involving mainly the jaw, neck and trunk. What is the causative agent

A

clostridium tetani

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22
Q

How does Clostridium tetani travel in the body

A

within motor neuron by retrograde transport into spinal cord
- inhibits inhibitory interneurons and unregulated firing of primary motor neurons

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23
Q

What is the second most common inherited muscle disorder

A

Myotonic dystrophy

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24
Q

Myotonia

A

abnormally slow relaxation of muscles

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25
Q

21 yr old caucasian male suffers from weakness and gait disturbance. He noticed that he had difficulty releasing the doorknob lately. Physical examination shows cataracts, frontal baldness, and gonadal atrophy. Biopsy shows muscle atrophy involving mostly type 1 fibers. The patient’s condition is best described as which of the following

A

Myotonic dystrophy

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26
Q

A cerebellar ( or retina) hemangioblastoma in association with congenital cysts of the kidneys, liver, and/or pancreas is highly suggestive of what

A

von Hippel-Lindau disease

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27
Q

inheritance pattern of von Hippel-Lindau disease

A

autosomal dominant

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28
Q

Another name for Von Recklinghausen’s disease

A

Neurofibromatosis type 1

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29
Q

What is von Ricklinghausen’s disease

A
  • inherited peripheral nervous system tumor syndrome
  • neurofibromas, optic nerve gliomas,
  • Lisch nodules and cafe au lait spots
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30
Q

Neurofibromatosis type 2

A

bilateral cranial nerve VIII schwannomas and multiple meningiomas

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31
Q

General sensation from anterior 2/3 of tongue is carried by what nerve

A

mandibular division of the trigeminal nerve

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32
Q

Gustatory ( taste) of the anterior 2/3 of the tongue is provided by what nerve

A

chorda tympani branch of the facial nerve

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33
Q

Foramen cecum

A

Normal remnant of thyroglossal duct

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34
Q

Patient has impaired balance, tremor, and difficulty speaking over last several months.Elevated transaminases. Cousin died at young age with progressive neurologic disease

A

Wilson’s disease

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35
Q

Slit lamp test

A

Eye exam can check for Kayser-Fleischer rings

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36
Q

Parinaud syndrome

A

paralysis of conjugate vertical gaze due to lesion in superior colliculi ( stroke, hydrocephalus, pinealoma)

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37
Q

Pinealoma can cause

A
  • Parinaud syndrome
  • Obstructive hydrocephalus
  • Precocious puberty in males
38
Q

What are clinical symptoms for obstructive hydrocephalus

A

papilledema, headache, and vomiting

39
Q

Clinical symptoms of Parinaud syndrome

A
  • Limitation of upward gaze with downward gaze preference,

- Bilateral eyelid retraction

40
Q

What are the urea cycle components

A

Ordinarily, Careless Crapper Are Also Frivolous About Urination

  • Ornithine
  • Carbamoyl phosphate
  • citrulline
  • Aspartate
  • Argininosuccinate
  • Fumararte
  • Arginine
  • urea
41
Q

What does arginine make in urea cycle via

A
  • urea and ornithine

- arginase

42
Q

Clinical symptoms for arginase deficiency

A
  • Progressive spastic diplegia
  • growth delay
  • abnormal movements
43
Q

What degrades serotonin

A

Monoamine oxidase

44
Q

When is orotic acid overproduced

A

excess carbamoyl phosphate in urea cycle

45
Q

Almost all volatile anesthetics increase what blood flow?

A

cerebral blood flow

  • other organ blood flow is decreased
46
Q

left leg weakness, mild headaches, Cutaneous neurofibromas, and cafe-au-lait spots

A

Neurofibromatosis 1

47
Q

what is the mutation in neurofibromatosis 1

A

NF1 on chromosome 17

AD

48
Q

What drug should be used to treat myoclonic seizures

A

Valproic acid

49
Q

MOA of fluphenazine and used for?

A

dopamine antagonist

- Tourette syndrome

50
Q

Stapedius muscle is innervated by what nerve

A

stapedius nerve ( branch of facial nerve)

51
Q

Paralysis of stapedius muscle results in what

A

hyperacusis

52
Q

What is interscalene nerve block used for

A

anesthetizes the brachial plexus as it passes through scalene triangle

53
Q

What muscle block must be taken into consideration for brachial plexus anesthetize

A

diaphragmatic paralysis

54
Q

Patient presents with upper extremity bilateral hand tremor and gets better with alcohol use? what am i?

A

essential tremor

55
Q

What is essential tremor get better or worse with movement

A

worse

56
Q

First line treatment for essential tremors

A

nonselective B-blocker such as propranolol

57
Q

What is opsoclonus-myoclonus

A

“dancing eyes-dancing feet”

58
Q

Opsoclonus-myoclonus is a paraneoplatic syndrome associated with what

A

neuroblastoma

59
Q

What is the most common tumor of adrenal medulla in children

A

neuroblasoma

60
Q

What is the genetic problem in neuroblastoma

A

overexertion of N-myc oncogene

61
Q

where is cryptococcus neoformans found in

A

soil and pigeon droppings

62
Q

How is cryptococcus neoformans transported

A

inhalation

63
Q

the resting potential of the neuronal membrane is close to equilibrium potential of what ion and why?

A

potassium ion

- resting membrane is most permeable to K

64
Q

Clostridium botulinum prevents the release of what

A

acetylcholine from presynaptic nerve terminals at neuromuscular junction
- preventing muscular contraction

65
Q

What do organophosphates block

A

acetylcholinesterase inhibitors

66
Q

Genome for Rhabdoviridae virus

A

single stranded RNA virus

- bullet shaped capsule

67
Q

receptor cytomegalovirus bind to

A

cellular integrins

68
Q

Receptor Epstein Barr binds to

A

CR2 ( CD21)

69
Q

What is the genetic genome for west nile? transmission? most common time of the year

A

positive-sense, single stranded flavivirus

  • transmitted by female mosquitoes
  • summer
70
Q

common perennial nerve is susceptible to injury where

A

lateral neck of fibula cause by compression

71
Q

clinical signs of common perennial nerve injury

A
  • weakness on foot dorsiflexion ( foot drop)
  • weakness in eversion and toe extension
  • sensory loss over lateral leg and dorsolateral foot
72
Q

Malignant tumors of parotid gland often compress and disrupt what nerve

A

facial nerve, causing ipsilateral facial droop

73
Q

cranial nerve VII exits the skull through what hole

A

stylomastoid foramen

74
Q

When taking Levodopa, why is carbidopa added? why is this also bad?

A
  • reduce most peripheral side effects of levodopa

- dopamine becomes more available to the brain

75
Q

Clasp-knife” spasticity is seen in what lesion

A

upper motor neuron lesions

76
Q

Stroke in internal capsule results in what

A

pure motor weakness in contralateral arm, leg, and lower face

77
Q

Does upper motor neurons travel through internal capsule

A

yes

78
Q

the head of the caudate nucleus is separated from globes plaids and putamen by what

A

internal capsule

79
Q

Gene of internal capsule carries

A

corticobulbar fibers

80
Q

anterior limb of internal capsule carries what

A

thalamocortical fibers

81
Q

What do muscarinic receptors do to arteries

A

vasodilate

82
Q

NO enter muscles cells and activate what

A
  • cyclic-GMP
  • activate myosin light chain phosphatase
  • smooth muscle relaxation
83
Q

absent tyrosinase activity is what

A

albinsm

84
Q

Anterior cerebral artery supplies what

A

medial portion of 2 hemispheres

85
Q

occlusion of anterior cerebral artery causes what

A
  • contralateral motor and sensory deficits in lower extremities, behavioral changes, and urinary incontinence
86
Q

Branches of internal carotid in circle of wilis

A
  1. anterior cerebral artery

2. middle cerebral artery

87
Q

What virulence factor is responsible for many toxic effects observed in meningitis and meningococcemia

A
  • Meningococcal lipooligosaccharide (LOS)
88
Q

lipooligosaccharide LOS is a virulence factor for what bacteria? what does it do

A

Neisseria Meningococci

- sepsis

89
Q

Role of Peroxisome

A

catabolism of

  1. very long chain fatty acids
  2. branched-chain fatty acids
  3. amino acids
  4. ethanol
90
Q

What neuron problems are seen in B12 deficiency

A
  1. degeneration of dorsal columns and lateral corticospinal tract
91
Q

what are serum elevations of Vitamine B12 deficiency

A

Methylmalonic and homocysteine elevated