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Step 1 Smartbook > Week 1 > Flashcards

Week 1 Flashcards

1
Q

Pernicious anemia causes …

A 
B12 deficiency (antibodies against parietal cells or IF)
Atrophic gastritis leading to gastric carcinoma
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2
Q

Pernicious anemia labs will show

A

increased methylmalonic acid and homocysteine (Same as B12 deficiency)

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3
Q

Reye syndrome is caused by

A

mitochondrial dysfunction

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4
Q

Clindamycin may be used as

A

acne treatment

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5
Q

C Diff pathogenesis

A

exotoxins A and B attract granulocytes and are cytopathic

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6
Q

Pseudomembranous colitis presents as

A

diarrhea after starting antibiotics

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7
Q

Megaloblastic anemia is caused by

A

Impaired DNA synthesis due to limited precursors

=> B12 deficiency (most often due to pernicious anemia) or B9 (Folate) deficiency

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8
Q

Megaloblastic anemia causes

A 
neuro symptoms (demyelination), parasthesis, gait disturbances, glossitis, autoimmune gastritis (predisposing to gastric carcinoma)
Macrocytic RBC's and hypersegmented neutrophils
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9
Q

Plummer Vinson Syndrome causes

A

esophageal webs, dysphagia, and iron deficiency anemia

Increased risk for SCC in upper 2/3 of esophagus

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10
Q

Beta blockers are used in acute coronary syndrome because they

A

inhibit neurotransmitter/receptor interaction in synapses

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11
Q

In long term opioid therapy, buprenorphine can

A

precipitate withdrawal (partial agonist)

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12
Q

Most common cause of bilateral absence of Vas Deferens

A

Cystic Fibrosis

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13
Q

Myasthenia Gravis is autoantibodies against

A

nicotinic acetylcholine receptors on post synaptic membrane on the NMJ

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14
Q

Myasthenia Gravis autoantibodies cause

A

receptor degradation and membrane damage,

Leads to impaired action potentials and fluctuating weakness that worsens during the day

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15
Q

Often presents with ocular and bulbar (chewing) weakness that worsens throughout the day

A

Myasthenia gravis

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16
Q

Myasthenia gravis is treated with

A

acetylcholinesterase inhibitors to prevent breakdown of ACh in NMJ (Pyridostigmine)

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17
Q

Organophosphates (pesticides) are

A

irreversible acetylcholinesterase inhibitors

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18
Q

Organophosphates cause

A

Cholinergic excess (salvation lacrimation diaphoresis bradycardia bronchospasm)

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19
Q

Treat organophosphate poisoning with

A

Muscarinic antagonist such as atropine and pralidoxime

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20
Q

Neural tube defects can be detected with

A

Alpha fetoprotein and acetylcholine esterase

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21
Q

Abnormal accumulation of CSF in the brain due to overproduction or impaired drainage

A

Hydrocephalus

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22
Q

Hydrocephalus causes

A

Macrocephaly for feeding hypertonicity and Hyper reflexes

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23
Q

Acute onset neurological symptoms not compatible with any known disease and associated with stress

A

Conversion disorder

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24
Q

Excess anxiety and preoccupation with unexplained symptoms

A

Somatic symptom disorder

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25
Q

X-linked disorder presenting with long narrow face prominent chin and forehead and large testes

A

Fragile X syndrome

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26
Q

Fragile X syndrome may have findings that mimic

A

Anxiety, autism, and ADHD

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27
Q

Fragile X mental retardation is due to what Gene

A

Fmr1 Gene

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28
Q

Tay-Sachs disease is a deficiency of what leading to an accumulation of what

A

Beta hexosaminidase A leading to accumulation of gm2 ganglioside

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29
Q

Progressive neurologic deterioration in infants, with a cherry red macula and startle reflex

A

Tay-Sachs disease

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30
Q

Three to five days after a stroke

A

Microglia appear to phagocytize fragments of neurons myelin and necrotic debris

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31
Q

Number of new cases per year divided by total at-risk population

A

Incidence

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32
Q

Lamotrigine levetiracetam Topiramate valproic acid

A

Broad spectrum anticonvulsant used for most seizures focal or general

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33
Q

Carbamazepine, Gabapentin, phenobarbital, phenytoin

A

Narrow Spectrum anticonvulsant used for focal onset seizures

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34
Q

A stroke in the thalamus may damage the ventral posterior lateral nucleus and medial nucleus causing

A

Contralateral sensory loss,

proprioceptive defects including unsteady gait

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35
Q

Small vessel occlusion in the deep brain associated with uncontrolled hypertension and diabetes

A

Lacunar infarct

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36
Q

Deficiency in chronic alcoholism

A

Thiamine, B1 deficiency, leading to Wernicke encephalopathy and mammillary body destruction

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37
Q

When someone presents with chronic alcoholism and malnourishment what do you give them

A

Thiamine and then dextrose to prevent encephalopathy

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38
Q

12 to 24 hours after a stroke

A

Red neurons, eosinophils and loss of Nissl substance

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39
Q

24 to 72 hours after a stroke

A

Neutrophilic infiltrate

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40
Q

3 - 7 days after a stroke

A

Macrophages and microglia and phagocytosis

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41
Q

One to two weeks after a stroke

A

Reactive gliosis and Vascular proliferation around the necrosis

42
Q

Greater than two weeks and the month after stroke

A

A glial scar forms and cystic areas are surrounded by dense glial fibers

43
Q

Arginase deficiency causes

A

Progressive spastic diplegia, growth delay, and abnormal movements
Build-up of Arginine and depletion of ornithine in the urea cycle

44
Q

Depression, Progressive dementia, choreiform movements, caudate atrophy

A

Huntington’s disease

45
Q

CAG repeats at chromosome 4 that lead to anticipation

A

Huntington’s disease

46
Q

Mono amine profile of Huntington’s disease

A

Decreased Gaba, decreased acetylcholine, increase dopamine

47
Q

Defect in ATM Gene with a failure to repair DNA

A

Ataxia telangiectasia

48
Q

Ataxia telangiectasia presents with

A

Sensitivity to ionizing radiation, cerebellar Ataxia, spider angiomas, sinopulmonary infections

49
Q

Binds mu receptors to activate potassium channels and hyperpolarize neurons, terminating pain transmission

A

Morphine

50
Q

Mutations in NF1 tumor suppressor Gene cause

A

Neurofibromatosis type 1

51
Q

Neurofibromatosis type 1 presents with

A

Numerous cutaneous neurofibromas drive from Schwann cells (neural crest) and Cafe Au Lait spots

52
Q

Anterograde transport such as in HSV is mediated by

A

Kinesin

53
Q

Retrograde transport toward the nucleus is mediated by

A

Dynein

54
Q

Serotonin is released from

A

raphe nuclei

55
Q

A lesion to cranial nerve 7 does what to sound

A

causes hyperacusis by paralyzing the stapedius

56
Q

Present with intellectual disability, seizures, pallor of catecholamine nuclei, musty odor, and hypopigmentation

A

PKU - phenylketonuria

57
Q

phenylketonuria is the

A

Inability to convert phenylalanine to tyrosine vs phenylalanine hydroxylase

58
Q

PKU results from a deficiency of

A

Phenylalanine hydroxylase or tetrahydrobiopterin

59
Q

the axillary nerve supplies

A

the deltoid and teres minor and sensory for the skin over the shoulder

60
Q

injury to the axillary nerve causes

A

sensory loss and weak shoulder abduction, most often due to trauma

61
Q

the long thoracic nerve supplies

A

serratus anterior

62
Q

injury to the long thoracic nerve most often occurs during and results in

A

injury during node dissection resulting in winged scapula

63
Q

cryptococcus neoformans route of transmission

A

respiratory transmission, with the lungs the most common site of entry
Yeast often disseminates in the immunocompromised

64
Q

exit the pelvis through the obturator canal

A

obturator nerve

65
Q

obturator nerve injury

A

most often due to compression and causes weak thigh adduction and medial thigh sensory loss

66
Q

contralateral motor and sensory of the Upper Limb and face (may also cause speech and language deficits)

A

middle cerebral artery occlusion (MCA)

67
Q

anterior cerebral artery occlusion (ACA)

A

affects the lower limb motor and sensation contralateral

68
Q

posterior cerebral artery occlusion

A

effects vision causing hemianopia with macular sparing contralaterally

69
Q

Bonds holding proteins together

A

hydrogen bonds

70
Q

Intraventricular Hemorrhage in premature infants usually occurs in

A

the germinal Matrix with increased frequency in lower age and lower birth weight infants

71
Q

cavernous hemangiomas occur in

A

the brain parenchyma due to VHL disease (VHL gene mutation on Chr. 3)
Causing an increase risk for intracerebral Hemorrhage and seizures
Associated with pheochromocytoma and RCC

72
Q

red ragged muscle fibers

A

scene in mitochondrial diseases as the mitochondria accumulate under the sarcolemma
mitochondrial disease is strictly maternal inheritance

73
Q

sodium propagates action potential

A

down an axon

74
Q

Depolarizes The Junction to allow neurotransmitter release

A

Calcium

75
Q

provides sensation to the suprapubic and gluteal regions and motor to anterolateral abdominal wall

A

iliohypogastric nerve

76
Q

injury to the iliohypogastric nerve

A

occurs with appendectomy or other abdominal wall surgery

results in burning suprapubic pain

77
Q

Excessive daytime sleepiness, episodic loss of motor tone with emotion (cataplexy), and sleep paralysis

A

Narcolepsy

78
Q

narcolepsy with cataplexy is caused by

A

decrease hypocretin 1 and hypocretin 2 which is produced in the lateral hypothalamus

79
Q

Benign childhood brain tumors presenting as calcifications containing cholesterol crystals

A

craniopharyngiomas which arise from remnants of rathke’s pouch

80
Q

urea cycle defects cause what to accumulate

A

Ammonia

treat by decreasing ammonia with protein restriction

81
Q

looks like toxoplasmosis, but is Epstein-Barr virus positive and is a b-cell lymphoma

A

primary central nervous system lymphoma

82
Q

Presents with dystonia, choreoathetosis, self mutilation, and hyperuricemia during first few years of life

A

Lesch-Nyhan Syndrome

83
Q

Lesch-Nyhan syndrome is caused by

A

Deficiency of hypoxanthine-guanine phosphoribosyltransferase (HGPRT)
Results in failure of purine salvage pathway (degrading hypoxanthine and guanine)
Increases PRPP amidotransferase

84
Q

Trochlear nerve innervates what muscle

A

the superior oblique of the eye

allow the eye to look in and down

85
Q

injury to the trochlear nerve, trochlear nerve palsy, causes

A

the injured eye to stay upward, resulting in vertical diplopia
patients have a hard time reading up close and walking down stairs

86
Q

Neuroleptic Malignant Syndrome (NMS)

A

Caused by overdose of antipsychotics

Results in rigidity, fever, HTN, tachycardia, altered sensorium, and increased CK (rhabdo)

87
Q

Alanine transfers

A

Nitrogen to the liver for disposal

88
Q

Lowering pCO2 (a potent vasodilator) decreases intracranial pressure by

A

Causing vasoconstriction, increasing VR, and decreasing cerebral blood flow

89
Q

Lesions in the temporal lobe have what affect on vision

A

Disrupt meyer’s loop causing a contralateral upper quadrant anopia

90
Q

Phrenic nerve

A

Located at C3-C5 and innervates the ipsilateral hemidiaphragm (hiccups)
Affected by spreading lung cancer

91
Q

C5, C6 spinal nerve reflex

A

Biceps and brachioradialis

92
Q

C7, C8 spinal nerve reflex

A

Triceps reflex

93
Q

Concentration of leptin correlates with

A

Body fat

94
Q

Normally as leptin increases food intake

A

Decreases

Leptin decreases appetite stimulation and inhibits food intake

95
Q

Mutations in leptin cause

A

Hyperphagia and profound obesity

Unable to prevent appetite stimulation

96
Q

Irritability, dystonia, poor feeding, maple syrup or burnt sugar urine scent, increased muscle tone

A

Maple syrup urine disease

97
Q

Cause of treatment of maple syrup urine disease

A

Caused by BCKDC deficiency preventing the breakdown of leucine and valine
Restrict branched chain AA’s such as leucine and valine (found in breast milk)

98
Q

Children should know 50-200 words and use 2 word phrases by

A

Age 2

99
Q

Diabetic neuropathy is caused by

A

Increased glucose, leading to increased sorbitol, causing osmotic damage to the cells
Or by thickening of peripheral blood vessels, causing microangiopathy and ischemia to the nerves

100
Q

The middle of the cerebellum lesions

A

Lesions of the vermis, causing truncal ataxia

Step 1 Smartbook (2 decks)

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