Test 69: Neurology Flashcards
hypnagogic
going to sleep
hypnopompic
“pompous upon awakening”
Name 3 mutation sites that have been associated with early-onset familial Alzheimer disease
- amyloid precursor protein gene on chromosome 21
- Presenilin 1 gene on chromosome 14
- Presenilin 2 gene on chromosome 1
Name 1 mutation site associated with late-onset Alzheimer disease
Apoliporotien E4
Inhaled anesthetics with high tissue solubly have what arteriovenous concentration gradient
- large
- slower onset of actions
What is length constant
measure of how far along an axon an electrical impulse can propagate
what does myelination do to neuron properties
- increases constant length ( Direct impact)
- decreases constant time
Wilson’s disease damages what in the brain
- putamen
2. basal ganglia
What are 2 broad categories for seizures
- partial
2. Generalized
Name 2 partial seizures
- Simple
2. complex
Name 2 generalized seizures
- Tonic/clonic
2. Absonce seizure
Define partial simple seizures
no loss of conscious
define partial complex
- partial loss of conscious
- autonomics: lip smaking, not responsive, not on floor
define generalized tonic clonic seizures
classic convulsions
define generalized absonce seizures
little kids, starring spells
What is the first line of drug for Absence seizure
Ehosuximide ( only treats absence seizure)
What is the best long term use for Absence seizure and tonic clonic seizure
Valporic acid
Lambert Eaton is associated with what cancer
small cell lung cancer
Injury to right temporal lobe hurts what part of the eye neurons
Meyer’s loop
Injury to Meyer’s loops in temporal lobe results in what visual defect
- contralateral superior quadrantanopia
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
clostridium tetani
How does Clostridium tetani travel in the body
within motor neuron by retrograde transport into spinal cord
- inhibits inhibitory interneurons and unregulated firing of primary motor neurons
What is the second most common inherited muscle disorder
Myotonic dystrophy
Myotonia
abnormally slow relaxation of muscles
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
Myotonic dystrophy
A cerebellar ( or retina) hemangioblastoma in association with congenital cysts of the kidneys, liver, and/or pancreas is highly suggestive of what
von Hippel-Lindau disease
inheritance pattern of von Hippel-Lindau disease
autosomal dominant
Another name for Von Recklinghausen’s disease
Neurofibromatosis type 1
What is von Ricklinghausen’s disease
- inherited peripheral nervous system tumor syndrome
- neurofibromas, optic nerve gliomas,
- Lisch nodules and cafe au lait spots
Neurofibromatosis type 2
bilateral cranial nerve VIII schwannomas and multiple meningiomas
General sensation from anterior 2/3 of tongue is carried by what nerve
mandibular division of the trigeminal nerve
Gustatory ( taste) of the anterior 2/3 of the tongue is provided by what nerve
chorda tympani branch of the facial nerve
Foramen cecum
Normal remnant of thyroglossal duct
Patient has impaired balance, tremor, and difficulty speaking over last several months.Elevated transaminases. Cousin died at young age with progressive neurologic disease
Wilson’s disease
Slit lamp test
Eye exam can check for Kayser-Fleischer rings
Parinaud syndrome
paralysis of conjugate vertical gaze due to lesion in superior colliculi ( stroke, hydrocephalus, pinealoma)
Pinealoma can cause
- Parinaud syndrome
- Obstructive hydrocephalus
- Precocious puberty in males
What are clinical symptoms for obstructive hydrocephalus
papilledema, headache, and vomiting
Clinical symptoms of Parinaud syndrome
- Limitation of upward gaze with downward gaze preference,
- Bilateral eyelid retraction
What are the urea cycle components
Ordinarily, Careless Crapper Are Also Frivolous About Urination
- Ornithine
- Carbamoyl phosphate
- citrulline
- Aspartate
- Argininosuccinate
- Fumararte
- Arginine
- urea
What does arginine make in urea cycle via
- urea and ornithine
- arginase
Clinical symptoms for arginase deficiency
- Progressive spastic diplegia
- growth delay
- abnormal movements
What degrades serotonin
Monoamine oxidase
When is orotic acid overproduced
excess carbamoyl phosphate in urea cycle
Almost all volatile anesthetics increase what blood flow?
cerebral blood flow
- other organ blood flow is decreased
left leg weakness, mild headaches, Cutaneous neurofibromas, and cafe-au-lait spots
Neurofibromatosis 1
what is the mutation in neurofibromatosis 1
NF1 on chromosome 17
AD
What drug should be used to treat myoclonic seizures
Valproic acid
MOA of fluphenazine and used for?
dopamine antagonist
- Tourette syndrome
Stapedius muscle is innervated by what nerve
stapedius nerve ( branch of facial nerve)
Paralysis of stapedius muscle results in what
hyperacusis
What is interscalene nerve block used for
anesthetizes the brachial plexus as it passes through scalene triangle
What muscle block must be taken into consideration for brachial plexus anesthetize
diaphragmatic paralysis
Patient presents with upper extremity bilateral hand tremor and gets better with alcohol use? what am i?
essential tremor
What is essential tremor get better or worse with movement
worse
First line treatment for essential tremors
nonselective B-blocker such as propranolol
What is opsoclonus-myoclonus
“dancing eyes-dancing feet”
Opsoclonus-myoclonus is a paraneoplatic syndrome associated with what
neuroblastoma
What is the most common tumor of adrenal medulla in children
neuroblasoma
What is the genetic problem in neuroblastoma
overexertion of N-myc oncogene
where is cryptococcus neoformans found in
soil and pigeon droppings
How is cryptococcus neoformans transported
inhalation
the resting potential of the neuronal membrane is close to equilibrium potential of what ion and why?
potassium ion
- resting membrane is most permeable to K
Clostridium botulinum prevents the release of what
acetylcholine from presynaptic nerve terminals at neuromuscular junction
- preventing muscular contraction
What do organophosphates block
acetylcholinesterase inhibitors
Genome for Rhabdoviridae virus
single stranded RNA virus
- bullet shaped capsule
receptor cytomegalovirus bind to
cellular integrins
Receptor Epstein Barr binds to
CR2 ( CD21)
What is the genetic genome for west nile? transmission? most common time of the year
positive-sense, single stranded flavivirus
- transmitted by female mosquitoes
- summer
common perennial nerve is susceptible to injury where
lateral neck of fibula cause by compression
clinical signs of common perennial nerve injury
- weakness on foot dorsiflexion ( foot drop)
- weakness in eversion and toe extension
- sensory loss over lateral leg and dorsolateral foot
Malignant tumors of parotid gland often compress and disrupt what nerve
facial nerve, causing ipsilateral facial droop
cranial nerve VII exits the skull through what hole
stylomastoid foramen
When taking Levodopa, why is carbidopa added? why is this also bad?
- reduce most peripheral side effects of levodopa
- dopamine becomes more available to the brain
Clasp-knife” spasticity is seen in what lesion
upper motor neuron lesions
Stroke in internal capsule results in what
pure motor weakness in contralateral arm, leg, and lower face
Does upper motor neurons travel through internal capsule
yes
the head of the caudate nucleus is separated from globes plaids and putamen by what
internal capsule
Gene of internal capsule carries
corticobulbar fibers
anterior limb of internal capsule carries what
thalamocortical fibers
What do muscarinic receptors do to arteries
vasodilate
NO enter muscles cells and activate what
- cyclic-GMP
- activate myosin light chain phosphatase
- smooth muscle relaxation
absent tyrosinase activity is what
albinsm
Anterior cerebral artery supplies what
medial portion of 2 hemispheres
occlusion of anterior cerebral artery causes what
- contralateral motor and sensory deficits in lower extremities, behavioral changes, and urinary incontinence
Branches of internal carotid in circle of wilis
- anterior cerebral artery
2. middle cerebral artery
What virulence factor is responsible for many toxic effects observed in meningitis and meningococcemia
- Meningococcal lipooligosaccharide (LOS)
lipooligosaccharide LOS is a virulence factor for what bacteria? what does it do
Neisseria Meningococci
- sepsis
Role of Peroxisome
catabolism of
- very long chain fatty acids
- branched-chain fatty acids
- amino acids
- ethanol
What neuron problems are seen in B12 deficiency
- degeneration of dorsal columns and lateral corticospinal tract
what are serum elevations of Vitamine B12 deficiency
Methylmalonic and homocysteine elevated
