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Neuro > Week 2 > Flashcards

Week 2 Flashcards

1
Q

Mets to the brain most commonly originate from what primary sites?

A
  • melanoma
  • RCC
  • lungs
  • breast
  • GI (colon)
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2
Q

What is meningeal carcinomatosis?

A

a small cell carcinoma that has metastasized to the meninges of the brain and seeded the CSF

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3
Q

Diffuse gliomas are associated with a ___ mutation, while circumscribed ones are associated with a ___ mutation.

A
  • diffuse: IDH1 or IDH2

- circumscribed: BRAF

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4
Q

How do mets to the brain typically appear on imaging?

A
  • edematous
  • at the grey/white interface
  • well-circumscribed
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5
Q

What is the AMEN mnemonic?

A

a tool to recall the histologic features of grade II, III, and IV astrocytomas

  • atypia
  • mitoses
  • endothelial proliferation
  • necrosis
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6
Q

Which CNS tumor is associated with a p53 mutation?

A

diffuse astrocytoma

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7
Q

What is MGMT?

A
  • a gene that encodes a DNA repair enzyme

- if methylated, it is non-functional and suggests a diffuse astrocytoma will respond to chemo

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8
Q

Pseudopalisading necrosis is a feature of what CNS tumor?

A

glioblastoma

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9
Q

What are the features of pilocytic astrocytoma?

A
  • present in childhood
  • cystic-solid lesion
  • associated with NF-1
  • common in cerebellum, 3rd ventricle, optic nerve
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10
Q

Which CNS tumor is always superficially located near the surface of the brain?

A

pleomorphic xanthoastrocytoma

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11
Q

What are the features of pleomorphic xanthoastrocytoma?

A
  • adolescence
  • cystic-solid
  • located near surface
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12
Q

Which CNS tumor is characterized by calcifications, chicken wire vasculature, and perinuclear halos?

A

oligodendrocytomas

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13
Q

What is the clinical significance of 1p/19q?

A

codeletions suggest an oligodendrocytoma will be chemosensitive

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14
Q

Perivascular acellular regions called pseudorosettes are a feature of what CNS tumor?

A

ependymomas

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15
Q

Hyalnized vessels surrounded by mucin and then a layer of cells is characteristic histology for what CNS tumor?

A

myxopapillary ependymoma

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16
Q

Which CNS tumor is seen in adolescents with early onset epilepsy?

A

gangliomas

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17
Q

What are the features of gangliomas?

A
  • early onset epilepsy
  • calcifications
  • neuronal/astrocytic morphology
  • located in temporal lobe
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18
Q

Which CNS tumor stains for NeuN?

A

central neurocytoma

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19
Q

Which CNS tumor arises exclusively in the ventricle attached to the septum pallicidum near the foramen of monroe?

A

a central neurocytoma

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20
Q

Which tumor arises in the midline of the cerebellum?

A

medulloblastoma

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21
Q

What are the features of medulloblastoma?

A
  • always arise in cerebellum, typically near midline
  • neuroectodermal origin
  • lots of mitoses
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22
Q

What tumor arises in fossa of children under the age of 5?

A

atypical teratoid rhabdoid tumor

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23
Q

What is a rhambdoid?

A

a cell with the nucleus displaced by the cytoplasm

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24
Q

NF-2 is associated with which CNS tumor?

A

meningioma

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25
Q

NF-1 is associated with which CNS tumor?

A

pilocytic astrocytoma

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26
Q

Which CNS tumor is sometimes hormonally active?

A

meningiomas

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27
Q

Psammoma bodies are a feature of what CNS tumor?

A

meningiomas

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28
Q

Which CNS tumor is associated with VHL?

A

hemangioblastomas

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29
Q

Which CNS tumor is lipid-rich?

A

hemangioblastomas

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30
Q

Meningiomas have what origin?

A

arachnoid

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31
Q

Whorl cells are a feature of what CNS tumor?

A

meningiomas

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32
Q

What is Brown Sequard syndrome?

A

a syndrome that mimics a hemisection of the spinal cord

33
Q

Damage to the upper thoracic spinal cord will have what effect on the bladder?

A

it will often lead to spastic bladder

34
Q

What virus commonly infects ependymal cells?

A

CMV

35
Q

What are rosenthal fibers composed of?

A

heat shock proteins

36
Q

Rosenthal fibers are a feature of what three disease?

A
  • chronic gliosis
  • pilocytic astrocytomas
  • Alexander’s disease
37
Q

The JC virus infects what glial cell population?

A

oligodendrocytes

38
Q

Lewy bodies are a feature of what two disease?

A
  • lewy body dementia

- parkinson’s

39
Q

Granulovacuolar change is seen in what disease process?

A

Alzheimer’s

40
Q

What are alzheimer type II astrocytes?

A

an abnormal astrocyte that appears in those with hepatic or metabolic encephalopathy

41
Q

What are Hirano bodies composed of?

A

actin

42
Q

Bunina bodies are a feature of what disease?

A

ALS

43
Q

What is transsynaptic degeneration?

A

a type of Wallerian degeneration in which a nerve cell atrophies due to loss of afferent input

44
Q

Negri bodies are associated with what disease?

A

rabies

45
Q

What are corpora amylacea?

A

age-related degenerative change seen near the surface of the brain composed of ubiquitinated heat shock proteins

46
Q

Which glial cell lays down scar tissue in the CNS?

A

astrocytes

47
Q

What are gemistocytes?

A

expanded astrocytes

48
Q

What is considered an acute sensorimotor deficit? Subacute? Chronic?

A
  • acute: less than four weeks
  • subacute: four to eight weeks
  • chronic: more than eight weeks
49
Q

Diabetic peripheral neuropathy is associated with what pattern of numbness?

A

“stocking-glove” aka length dependent

50
Q

What peripheral neuropathy is often preceded by a flu-like illness?

A

Guillain-Barre

51
Q

What are the four primary causes of mononeuropathy multiplex?

A
  • leprosy
  • vasculitis
  • hereditary
  • lyme disease
52
Q

What are axonotmetic, neuropraxic, and neurotmetic injuries?

A
  • axonotmetic: axon transected but surrounding CT intact
  • neuropraxic: crush injury, ischemia, demyelination
  • neurotmetic: irrecoverable transection of axon and CT
53
Q

Inflammatory demyelinating polyneuropathies are typically characterized by what kind of weakness?

A

proximal

54
Q

What are the two most significant length-dependent neuropathies?

A

diabetes and CSPN

55
Q

What is the classic cold-dependent patterned neuropathy?

A

leprosy

56
Q

What is cryptogenic sensory polyneuropathy?

A

a length dependent neuropathy of unknown cause

57
Q

Chronic inflammatory demyelinating polyneuropathy is best treated with what?

A

corticosteroids

58
Q

Onion bulbing is a feature of what sort of peripheral neuropathy?

A

segmental demyelination

59
Q

The corneal reflex is mediated by what nerves?

A

CN V and VII

60
Q

The knee jerk reflex is mediated by what spinal nerve?

A

L4

61
Q

Motor units are recruited in what order?

A

smallest to largest

62
Q

How is the ventral horn organized?

A

lower motor neurons that innervate more distal muscles are located more laterally

63
Q

What muscles will demonstrate an inverse stretch reflex?

A

spastic or rigid muscles

64
Q

How does a spinal cord injury affect an individual’s flexion reflex?

A

the reflex becomes exaggerated and can even become paired with bladder or bowel evacuation

65
Q

Describe the circuitry of the inverse stretch reflex.

A
  • stretch of spastic/rigid muscle puts tension on the GTO
  • Ib afferents synapse onto an inhibitory interneuron
  • that interneuron inhibits the alpha motor neuron of the stretched muscle
66
Q

What reflex complements the flexion reflex?

A

the crossed extensor reflex

67
Q

What NT is present at the neuromuscular junction?

A

acetylcholine

68
Q

The femoral nerve mediates what deep tendon reflex?

A

the knee jerk

69
Q

The stretch reflex is mediated by the ___ sensory receptor while the inverse stretch reflex is mediated by the ___ sensory receptor.

A
  • stretch: muscle spindle

- inverse: GTO

70
Q

Where do muscle spindle Ia afferents project?

A
  • homonymous and heternymous alpha motor neurons
  • spinocerebellar neurons in Clarke’s column
  • the dorsal column
71
Q

What is muscle rigidity?

A
  • sustained contraction at rest
  • increased tonic stretch reflex
  • increased stiffness
72
Q

What is muscle spasticity?

A
  • no contract at rest
  • increased phasic stretch reflex
  • resistance to stretch proportion to velocity of stretch
73
Q

What is the cremasteric reflex?

A
  • stroke the medial upper thigh
  • scrotal elevation
  • L1/L2
74
Q

What is myasthenia gravis?

A

a disease in which Abs are directed against AChRs like those at the NMJ

75
Q

What is a Jendrassik maneuver?

A

a procedure used to heighten a person’s stretch reflex

76
Q

How do Ia muscle spindle afferents differe from type II?

A

Ia sense both length and velocity while II only sense length

77
Q

What is reciprocal innervation?

A

contraction of a muscle is accompanied by inhibition of its antagonist

78
Q

Clonus is a feature of what kind of muscle disorder?

A

spasticity

79
Q

In what order are motor units recruited by an external electrical stimulation?

A

larger units first

Neuro (7 decks)

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