Week 1 Flashcards
1
Q
Pernicious anemia causes …
A
B12 deficiency (antibodies against parietal cells or IF) Atrophic gastritis leading to gastric carcinoma
2
Q
Pernicious anemia labs will show
A
increased methylmalonic acid and homocysteine (Same as B12 deficiency)
3
Q
Reye syndrome is caused by
A
mitochondrial dysfunction
4
Q
Clindamycin may be used as
A
acne treatment
5
Q
C Diff pathogenesis
A
exotoxins A and B attract granulocytes and are cytopathic
6
Q
Pseudomembranous colitis presents as
A
diarrhea after starting antibiotics
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
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
9
Q
Plummer Vinson Syndrome causes
A
esophageal webs, dysphagia, and iron deficiency anemia
Increased risk for SCC in upper 2/3 of esophagus
10
Q
Beta blockers are used in acute coronary syndrome because they
A
inhibit neurotransmitter/receptor interaction in synapses
11
Q
In long term opioid therapy, buprenorphine can
A
precipitate withdrawal (partial agonist)
12
Q
Most common cause of bilateral absence of Vas Deferens
A
Cystic Fibrosis
13
Q
Myasthenia Gravis is autoantibodies against
A
nicotinic acetylcholine receptors on post synaptic membrane on the NMJ
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
15
Q
Often presents with ocular and bulbar (chewing) weakness that worsens throughout the day
A
Myasthenia gravis
16
Q
Myasthenia gravis is treated with
A
acetylcholinesterase inhibitors to prevent breakdown of ACh in NMJ (Pyridostigmine)
17
Q
Organophosphates (pesticides) are
A
irreversible acetylcholinesterase inhibitors
18
Q
Organophosphates cause
A
Cholinergic excess (salvation lacrimation diaphoresis bradycardia bronchospasm)
19
Q
Treat organophosphate poisoning with
A
Muscarinic antagonist such as atropine and pralidoxime
20
Q
Neural tube defects can be detected with
A
Alpha fetoprotein and acetylcholine esterase
21
Q
Abnormal accumulation of CSF in the brain due to overproduction or impaired drainage
A
Hydrocephalus
22
Q
Hydrocephalus causes
A
Macrocephaly for feeding hypertonicity and Hyper reflexes
23
Q
Acute onset neurological symptoms not compatible with any known disease and associated with stress
A
Conversion disorder
24
Q
Excess anxiety and preoccupation with unexplained symptoms
A
Somatic symptom disorder
25
X-linked disorder presenting with long narrow face prominent chin and forehead and large testes
Fragile X syndrome
26
Fragile X syndrome may have findings that mimic
Anxiety, autism, and ADHD
27
Fragile X mental retardation is due to what Gene
Fmr1 Gene
28
Tay-Sachs disease is a deficiency of what leading to an accumulation of what
Beta hexosaminidase A leading to accumulation of gm2 ganglioside
29
Progressive neurologic deterioration in infants, with a cherry red macula and startle reflex
Tay-Sachs disease
30
Three to five days after a stroke
Microglia appear to phagocytize fragments of neurons myelin and necrotic debris
31
Number of new cases per year divided by total at-risk population
Incidence
32
Lamotrigine levetiracetam Topiramate valproic acid
Broad spectrum anticonvulsant used for most seizures focal or general
33
Carbamazepine, Gabapentin, phenobarbital, phenytoin
Narrow Spectrum anticonvulsant used for focal onset seizures
34
A stroke in the thalamus may damage the ventral posterior lateral nucleus and medial nucleus causing
Contralateral sensory loss,
| proprioceptive defects including unsteady gait
35
Small vessel occlusion in the deep brain associated with uncontrolled hypertension and diabetes
Lacunar infarct
36
Deficiency in chronic alcoholism
Thiamine, B1 deficiency, leading to Wernicke encephalopathy and mammillary body destruction
37
When someone presents with chronic alcoholism and malnourishment what do you give them
Thiamine and then dextrose to prevent encephalopathy
38
12 to 24 hours after a stroke
Red neurons, eosinophils and loss of Nissl substance
39
24 to 72 hours after a stroke
Neutrophilic infiltrate
40
3 - 7 days after a stroke
Macrophages and microglia and phagocytosis
41
One to two weeks after a stroke
Reactive gliosis and Vascular proliferation around the necrosis
42
Greater than two weeks and the month after stroke
A glial scar forms and cystic areas are surrounded by dense glial fibers
43
Arginase deficiency causes
Progressive spastic diplegia, growth delay, and abnormal movements
Build-up of Arginine and depletion of ornithine in the urea cycle
44
Depression, Progressive dementia, choreiform movements, caudate atrophy
Huntington's disease
45
CAG repeats at chromosome 4 that lead to anticipation
Huntington's disease
46
Mono amine profile of Huntington's disease
Decreased Gaba, decreased acetylcholine, increase dopamine
47
Defect in ATM Gene with a failure to repair DNA
Ataxia telangiectasia
48
Ataxia telangiectasia presents with
Sensitivity to ionizing radiation, cerebellar Ataxia, spider angiomas, sinopulmonary infections
49
Binds mu receptors to activate potassium channels and hyperpolarize neurons, terminating pain transmission
Morphine
50
Mutations in NF1 tumor suppressor Gene cause
Neurofibromatosis type 1
51
Neurofibromatosis type 1 presents with
Numerous cutaneous neurofibromas drive from Schwann cells (neural crest) and Cafe Au Lait spots
52
Anterograde transport such as in HSV is mediated by
Kinesin
53
Retrograde transport toward the nucleus is mediated by
Dynein
54
Serotonin is released from
raphe nuclei
55
A lesion to cranial nerve 7 does what to sound
causes hyperacusis by paralyzing the stapedius
56
Present with intellectual disability, seizures, pallor of catecholamine nuclei, musty odor, and hypopigmentation
PKU - phenylketonuria
57
phenylketonuria is the
Inability to convert phenylalanine to tyrosine vs phenylalanine hydroxylase
58
PKU results from a deficiency of
Phenylalanine hydroxylase or tetrahydrobiopterin
59
the axillary nerve supplies
the deltoid and teres minor and sensory for the skin over the shoulder
60
injury to the axillary nerve causes
sensory loss and weak shoulder abduction, most often due to trauma
61
the long thoracic nerve supplies
serratus anterior
62
injury to the long thoracic nerve most often occurs during and results in
injury during node dissection resulting in winged scapula
63
cryptococcus neoformans route of transmission
respiratory transmission, with the lungs the most common site of entry
Yeast often disseminates in the immunocompromised
64
exit the pelvis through the obturator canal
obturator nerve
65
obturator nerve injury
most often due to compression and causes weak thigh adduction and medial thigh sensory loss
66
contralateral motor and sensory of the Upper Limb and face (may also cause speech and language deficits)
middle cerebral artery occlusion (MCA)
67
anterior cerebral artery occlusion (ACA)
affects the lower limb motor and sensation contralateral
68
posterior cerebral artery occlusion
effects vision causing hemianopia with macular sparing contralaterally
69
Bonds holding proteins together
hydrogen bonds
70
Intraventricular Hemorrhage in premature infants usually occurs in
the germinal Matrix with increased frequency in lower age and lower birth weight infants
71
cavernous hemangiomas occur in
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
red ragged muscle fibers
scene in mitochondrial diseases as the mitochondria accumulate under the sarcolemma
mitochondrial disease is strictly maternal inheritance
73
sodium propagates action potential
down an axon
74
Depolarizes The Junction to allow neurotransmitter release
Calcium
75
provides sensation to the suprapubic and gluteal regions and motor to anterolateral abdominal wall
iliohypogastric nerve
76
injury to the iliohypogastric nerve
occurs with appendectomy or other abdominal wall surgery
| results in burning suprapubic pain
77
Excessive daytime sleepiness, episodic loss of motor tone with emotion (cataplexy), and sleep paralysis
Narcolepsy
78
narcolepsy with cataplexy is caused by
decrease hypocretin 1 and hypocretin 2 which is produced in the lateral hypothalamus
79
Benign childhood brain tumors presenting as calcifications containing cholesterol crystals
craniopharyngiomas which arise from remnants of rathke's pouch
80
urea cycle defects cause what to accumulate
Ammonia
| treat by decreasing ammonia with protein restriction
81
looks like toxoplasmosis, but is Epstein-Barr virus positive and is a b-cell lymphoma
primary central nervous system lymphoma
82
Presents with dystonia, choreoathetosis, self mutilation, and hyperuricemia during first few years of life
Lesch-Nyhan Syndrome
83
Lesch-Nyhan syndrome is caused by
Deficiency of hypoxanthine-guanine phosphoribosyltransferase (HGPRT)
Results in failure of purine salvage pathway (degrading hypoxanthine and guanine)
Increases PRPP amidotransferase
84
Trochlear nerve innervates what muscle
the superior oblique of the eye
| allow the eye to look in and down
85
injury to the trochlear nerve, trochlear nerve palsy, causes
the injured eye to stay upward, resulting in vertical diplopia
patients have a hard time reading up close and walking down stairs
86
Neuroleptic Malignant Syndrome (NMS)
Caused by overdose of antipsychotics
| Results in rigidity, fever, HTN, tachycardia, altered sensorium, and increased CK (rhabdo)
87
Alanine transfers
Nitrogen to the liver for disposal
88
Lowering pCO2 (a potent vasodilator) decreases intracranial pressure by
Causing vasoconstriction, increasing VR, and decreasing cerebral blood flow
89
Lesions in the temporal lobe have what affect on vision
Disrupt meyer's loop causing a contralateral upper quadrant anopia
90
Phrenic nerve
Located at C3-C5 and innervates the ipsilateral hemidiaphragm (hiccups)
Affected by spreading lung cancer
91
C5, C6 spinal nerve reflex
Biceps and brachioradialis
92
C7, C8 spinal nerve reflex
Triceps reflex
93
Concentration of leptin correlates with
Body fat
94
Normally as leptin increases food intake
Decreases
| Leptin decreases appetite stimulation and inhibits food intake
95
Mutations in leptin cause
Hyperphagia and profound obesity
| Unable to prevent appetite stimulation
96
Irritability, dystonia, poor feeding, maple syrup or burnt sugar urine scent, increased muscle tone
Maple syrup urine disease
97
Cause of treatment of maple syrup urine disease
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
Children should know 50-200 words and use 2 word phrases by
Age 2
99
Diabetic neuropathy is caused by
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
The middle of the cerebellum lesions
Lesions of the vermis, causing truncal ataxia
