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Neuro_Kaplan
| Question | Answer |
|---|---|
| What syndrome is due to thiamine deficiency? | Wernicke-Korsakoff syndrome |
| What mitochondrial enzyme catalyzes conversion of pyruvate to acetyl-coA? | Pyruvate Dehydrogenase |
| What cofactors and coenzymes are used by PDH? | thiamine pyrophosphate , lipoic acid, coenzyme A, FAD, and NADH |
| What is the treatment of GAD? | Lorazepam (Benzodiazepines) |
| What is the MOA of benzodiazepines? | increase frequency of GABA-A channel opening |
| What are catecholamines made from? | tyrosine |
| What is the treatment for OCD? | Clomipramine (TCA) |
| What inhibitory neurotransmitter increases Cl- conductance? | GABA-A |
| What is the MOA of TCAs? | blocks the reuptake of NE and serotonin |
| What phase are postmitotic cells in? | G1 or G0 |
| What is the chromosome number of postmitotic cells? | 2N |
| What phase of the cell cycle are cells undergoing mitosis in? | G2 |
| What is the chromosome number of cells undergoing mitosis? | 4N |
| What phase in the cell cycle are cells undergoing DNA synthesis? | S phase |
| How do you treat acute angle closure glaucoma? | Acetazolamide |
| Patient with intense pain in eye, pupil dilated, non-reactive to light appearing red and steamy. Diagnosis? | Acute angle closure glaucoma |
| Preterm infants are at risk of developing what b/c of oxygen therapy? | retinopathy of prematurity |
| What is the mechanism of retinopathy of prematurity? | accelerated neovascularization in inner layers of the retina |
| What is seen on the retinal exam in retinopathy of prematurity? | white pupillary reflex |
| Patient on exam of shining light in right eye experiences pupillary constriction of left eye. Diagnosis? | left oculomotor nerve palsy |
| How much does a nerve grow per day | 1 mm |
| What pathology is due to failure of closure of caudal (posterior) neuropore? | myelomeningocele |
| What is the MOA of antipsychotics (neuroleptics)? | all typical antipsychotics block dopamine D2 receptors |
| What does blocking D2 receptor do? | increases CAMP levels |
| What is the pathology in multiple sclerosis? | IFN-gamma activates macrophages which cause demyelination |
| What is the type of hypersensitivity in multiple sclerosis? | type 4 HS |
| What do you give for ischemic stroke? | tPA |
| What drug is given for increased ICP but the use is limited in ischemic stroke? | steroids |
| Patient with sudden-onset of fainting. What is this type of seizure? | Atonic |
| Patient experiences quick, repetitive jerks. What is this type of seizure? | Myotonic |
| What senses tension within intrafusal fibers to detect muscle length? | spindle afferents |
| What is a complication from overdosing on TCAs? | lethal arrhythmias |
| How do you treat the CV toxicity from TCAs? | NaHCO3 |
| What drug causes nystagmus, mydriasis, HTN, and tachycardia? | PCP |
| What drug causes miosis? | heroin |
| What is the MOA of methamphetamine? | induces dopamine release |
| What is the pathology of GBS? | demyelination of peripheral nerves |
| What is involved in Myasthenia Gravis? | NMJ and EOM |
| What is the MOA of Selegiline (MAO-B inhibitor)? | dopamine increased if MAO-B blocked b/c dopamine metabolized by MAO-B |
| What SE can Amitriptyline trigger? | narrow-angle glaucoma |
| How does Amitriptyline help in Parkinson's patients? | restores imbalance of dopamine and ACh by blocking effect of ACh |
| What is given to alcohol withdrawal patients? | Benzos (Chlordiazepoxide or Diazepam) |
| In alcohol withdrawal patients, how is the hyperadrenergic state corrected? | thiamine and clonidine/propranolol |
| What is the MOA of TCAs (Amitriptyline)? | inhibits biogenic amine reuptake at presynaptic neurons |
| What antimuscarinics are indicated for EPS? | benztropine and trihexyphenidyl |
| What neurotransmitter is absent if PNMT is absent? | Epinephrine |
| What are the TCA drugs? | Doc Amit, the Desi, took a north trip (Doxepin, Amitriptyline, Desipramine, Nortriptyline) - (Imipramine and Clomipramine) |
| What is the MOA of Sumatriptan? | serotonin 5HT1D/1B agonist - produces cerebral vascular VC |
| What is associated with Wernicke Korsakoff? | polyneuritis |
| How do you reverse Vecuronium (non depolarizing non blocking agent)? | Neostigmine (paralysis) |
| What do neuroepithelial cells give rise to? | glioblasts -> neuroglial cells include astrocytes and oligodendrocytes |
| What is the antidote of Benzos? | Flumazenil |
| Patient with neostriatal degeneration, choreoathetoid movements, and dementia. Diagnosis? Inheritance pattern? | Huntington's. AD inheritance. |
| What does the MLF connect? | abducens to contralateral oculomotor nucleus for conjugate gaze |
| What is the pathology in intranuclear ophthalmoplegia? | MLF demyelinated causing medial rectus palsy on attempting lateral conjugate gaze. |
| What is the diagnosis with MLF demyelination? | multiple sclerosis |
| How do you transect a pituitary adenoma? | transnasally through sphenoid sinus |
| What is the cerebellopontine angle? | cerebellum, upper medulla, and middle cerebellar peduncle |
| Which nerves emerge from the cerebellopontine angle? | facial nerve and vestibulocochlear nerve |
| What forms the lateral walls of the pituitary fossa? | cavernous sinuses |
| What nerve passes through the cavernous sinus along ICA? | abducens nerve |
| What happens with an abducens nerve lesion? | LR palsy |
| What is associated with hypercoagulable states with increasing frequency during pregnancy during the first few weeks postpartum? | sagittal sinus thrombosis |
| Where does the superior sagittal sinus run? | along attachment of falx cerebri |
| What is the abnormal reflex with damage to CST? | Babinski |
| Where do majority of CST decussate? | caudal medulla |
| What do Z-lines indicate? | NMJ |
| What neurotransmitter is used at the NMJ? | ACh |
| What are the layers of skin in a lumbar puncture? | skin -> superficial fascia -> deep fascia -> supraspinous ligament -> interspinous ligament -> interlaminar space (only in lumbar region) -> epidural space -> dura -> arachnoid -> subarachnoid space |
| Thrombus of which artery can produce "locked-in" syndrome? | basilar artery |
| Pain and/or sensory loss of posterior thigh, leg (except medially) and foot. Diagnosis? | sciatica |
| The sciatic nerve is formed by which nerves? | tibial nerve and common peroneal nerves traveling together in the gluteal region and thigh |
| What is the syndrome where PICA is occluded? | lateral medullary syndrome (Wallenberg syndrome) |
| What nerve produces weakness in the lower extremities? | sural nerve |
| What is the lobe for the primary sensory cortex? | postcentral gyrus of parietal lobe |
| Patient with right lower quadrantanopia has lesion where? | left parietal lobe lesion |
| Patient with right upper quadrantanopia has lesion where? | left temporal lobe lesion |
| Where does general sensation for the anterior 2/3 of the tongue come from? | mandibular division of trigeminal nerve (V3) |
| What is the nerve root for reflex to the ankle? | S1 nerve root |
| Patient with disruption of cerebral bridging vein has crescent shaped imaging. Diagnosis? | subdural hematoma |
| Patient with HTN and bradycardia. Diagnosis? | Cushing's reflex |
| What are the watershed areas in the brain? | ACA and MCA |
| What is a complication in preterm infants? | IVH - bleeding from germinal matrix |
| In IVH of preterm infants, which ventricles may blood accumulate? | lateral ventricles |
| Where may the obstruction occur in preterm infants with IVH? | foramen of Monro |
| What is a branch of the superior thyroid artery that enters the larynx by passing through thyrohyoid membrane? | superior laryngeal artery |
| Sensory innervation to laryngeal mucosa above vocal cords provided by which nerve? | superior laryngeal nerve |
| Which nerve provides sensory innvervation below the vocal cords? | recurrent laryngeal nerve |
| When there is no pupillary response when light is shined in the right eye, there is a defect where and carried by which nerve? | afferent pathway carried by optic nerve |
| Patient experiencing contralateral hemiparesis of the lower extremities and trunk due to CST involvement. Diagnosis? | Medial medullary syndrome |
| Medial medullary syndrome caused by occlusion of which artery? | anterior spinal artery |
| What ascends ipsilaterally in the dorsal columns and contains afferent fibers that mediate conscious proprioception, discriminative touch, and vibration sense? | DRG |
| What receives blood supply from lenticulostriate arteries which are prone to rupture in uncontrolled HTN? | internal capsule |
| What fibers are in the anterior limb of the internal capsule? | corticobulbar fibers |
| What fibers are in the posterior limb of the internal capsule? | corticospinal fibers to contralateral arm and leg |
| What happens in a hemorrhage of the left internal capsule? | right dense hemiplegia in paralysis of arm and leg and lower facial paralysis (UMN lesion) |
| What lobe is lesioned in a sensory neglect syndrome on the left side? | right parietal lobe |
| What is seen on PE with a meningioma of the parasagittal region and falx (medially located)? | leg paralysis |
| What is located above the piriformis through greater sciatic foramen? | superior gluteal artery, nerve and vein |
| What is located below the piriformis through greater sciatic foramen? | inferior gluteal artery, nerve, and vein |
| Where is the satiety center? | ventromedial nucleus |
| What is a central scotoma caused by? | lesion of the macula |
| La la la indicates which nerve? | CN 12 (hypoglossal) |
| What happens if the optic nerve is damaged in the right eye? | no pupillary constriction in either if shine in right b/c afferent limb of pupillary light reflex carried by CN2 (optic n) and efferent limb carried by CN3 (oculomotor n) |
| HSV1 is latent in which nerve and through which foramen? | CN V2 carried through foramen rotundum |
| Which nerve is affected in Charcot Marie Tooth ds? | deep peroneal nerve |
| What is seen on PE in Charcot Marie Tooth ds? | foot drop and pes cavus and wasting of anterior compartment of lower limb |
| What is the MC parasitic infection in the US? | T. gondii |
| Fungal infection of Missouri? What is the histology? | Cryptococcus meningitis - encapsulated budding yeasts |
| Patient with HIV has multiple ring enhancing lesions on MRI. Cause? | T. gondii from contaminated meat supply |
| AIDs patient with rapidly progressive demyelinating disorder. Diagnosis? Caused by which virus? | Progressive multifocal leukoencephalopathy. JC virus |
| Which cells does JC virus infect? | oligodendroglial cells - eosinophilic inclusions |
| AIDs patient with cryptococcus has what CSF labs? What is the histology? | dec glucose and mostly lymphocytes = monomorphic yeast |
| Newborn patient with meningitis. Diagnosis? Micro? | Strep agalactiae = gram positive coccus |
| What is the brain biopsy of HSV-1? | Cowdry type A inclusions |
| How does Strep pneumo meningitis attach to respiratory mucosa? | through production of IgA protease |
| Flaccid paralysis and respiratory failure in a newborn is due to what? | C. botulinum - ingestion of preformed toxin |
| Patient with black nasal discharge. Histology? | zygomycosis = patient with diabetes |
| Patient with group B strep has what test? | CAMP test positivity |
| Patient with late complication of rubeola infection at early age - patient at 1 yr infected and dies when 7 yrs. What is the cause? | SSPE |
| What is GBS similar to? | MS - autoimmune attack on myelin of peripheral nerves |
| Well-demarcated areas of demyelination of white matter (acquiring gray color similar to cortex) and remitting -relapsing clinical course describes what? | multiple sclerosis |
| MC eye tumor of childhood composed of neuroepithelial cells that form rosettes (Flexner-Wintersteiner rosettes)? | Retinoblastoma |
| What is the mutation in retinoblastoma? | tumor suppressor gene, Rb, on chromosome 13 |
| Retinal angiomas describe which disease? | von Hippel-Lindau disease |
| What is seen in the CNS (esp cerebellum) in von Hippel-Lindau ds? | hemangioblastomas |
| What is the defect in metachromatic leukodystrophy? | arylsulfatase A (cerebroside sulfatase) |
| Loss of pigmented dopamingergic neurons from substantia nigra and lewy bodies describes what disease? | Parkinson's |
| Intracytoplasmic eosinophilic inclusions describes what? | Parkinson's |
| What is the 2nd MC CNS lesion associated with EBV in AIDs patients? | NHL: B lymphocytes - CD4<50 |
| Patient has UMN and LMN degeneration. Diagnosis? | ALS - spinal cord and motor cortex affected |
| What is one of the earliest and most severely affected areas in Alzheimer's is what? | hippocampus |
| Where is the hippocampus located? | temporal lobe |
| What is the function of the hippocampus? | learning and memory |
| Patient with memory loss, Parkinsonism, and visual hallucinations has what disease? | diffuse lewy body disease |
| What is the histopath of diffuse lewy body disease? | lewy body (intracytoplasmic eosinophilic inclusion) containing ubiquitin |
| What is involved in diffuse lewy body disease? | limbic cortex, basal nucleus of Meynart and substantia nigra |
| Intracranial hemorrhage in an Alzheimer patient is due to what? | amyloid angiopathy |
| What is the afferent arc of the corneal reflex? | ipsilateral CN5 |
| What is the efferent arc of the corneal reflex? | bilateral CN7 |
| What is the nuclear factor that relates to neoplastic replicative activity? | Ki-67 |
| In Friedreich ataxia, the DRG degenerates causing what? | trans-synaptic degeneration in ipsilateral gracile and cuneate nuclei |
| Most frequent sites for massive intraparenchymal hemorrhage are? | internal capsule and basal ganglia |
| Craniopharyngiomas most likely cause what rather than galactorrhea? | pituitary dysfunction - DI |
| Patient in MVA and all scans normal. 3 weeks later patient becomes confused. Diagnosis? | Subdural hematoma |
| Patient with ophthalmoplegia, pseudobulbar palsy, axial dystonia, and bradykinesia has what pathology? | progressive supranuclear palsy |
| What is affected in tertiary syphilis? Diagnosis? | depigmentation of dorsal columns and dorsal roots. Tabes dorsalis. |
| What is the PE of tabes dorsalis? | impaired proprioception and locomotor ataxia |
| What is associated with tabes dorsalis? | Argyll-Robertson pupils |
| Pseudopaslisading necrosis describes what? | GBM |
| Intraneuronal aggregates of insoluble cytoskeletal elements composed mainly of abnormally phosphorylated tau protein forms what? | paired helical filaments - neurofibrillary tangles |
| How is pressure relieved in normal pressure hydrocephalus? | VP shunt |
| Patients with chronic hypertension are more prone to which type of hemorrhages? | internal capsule hemorrhages |
| What do tau proteins do? | stabilize microtubules |
| Which bacteria release IgA protease? | N. gonorrhea, S. pneumo, HiB |
| What disease is associated with JC virus? | progressive multifocal leukoencephalopathy (PML) |
| Patient with alternating stiffness and movement with an EEG of low-voltage, fast (10Hz) neuronal activity which gradually converts to slower, sharper, larger waves throughout both hemispheres has what? Treatment? | Tonic-clonic seizure. Phenytoin, valproate, carbamazepine |
| Treatment for status epilepticus and anxiety disorders? | diazepam |
| Treatment for Lennox-Gastaut syndrome (petit mal), akinetic, and myoclonic seizures also used in the management of panic and generalized anxiety disorder? | clonazepam |
| How do you calculate the probability a child inherits an autosomal dominant trait and expresses the phenotype? | penetrance x risk of acquiring trait |
| What is the probability that 2 heterozygotes will produce a child with Tay-Sachs? | 0.25 |
| What are prions insensitive to? | nucleases b/c possess no nucleic acids |
| What is the afferent and efferent limb of the gag reflex? | afferent: CN9; efferent: CN10 |
| Where do CN9 and CN10 exit the skull? | jugular foramen |
| Where does CN12 exit? | hypoglossal canal |
| What exits superior orbital fissure? | CN3,4,6, and ophthalmic arteries and veins |
| Middle meningeal artery exits where? | foramen spinosum |
| Mandibular nerve exits where? | foramen ovale |
| Maxillary nerve exits where? | foramen rotundum |
| Function of a1? | increase vascular sm ms contraction, inc pupillary dilator muscle contraction (mydriasis) |
| Function of a2? | decrease sympathetic outflow, decrease insulin release |
| Function of B1? | increase HR, contractility, renin release, lipolysis |
| Function of B2? | VD, BD, increase HR, contractility, lipolysis, glucagon release, decrease uterine tone, increase insulin secretion |
| What is narcolepsy? | sudden onset of REM sleep with accompanying paralysis |
| What hallucinations are associated with narcolepsy? | hypnagogic |
| What are the p450 inducers? | BAG for CpR QTS: barbiturates, alcohol, griseofulvin, carbamazepine, rifampin, quinidine, tetracyclines, spironolactones |
| What are the p450 inhibitors? | I'D SMACK Quin: INH, Dapsone, Sulfa drugs, Macrolides, Amiodarone, Cimetidine, Ketoconazole, Quinolones |
| What are p450 dependent? | WEPTeD: warfarin, estrogen, phenytoin, theophylline, digoxin |
| What are the X-linked enzyme deficiencies? | Fabry and Lesh go Hunting for Candy, Pie and Gum: G6PD, CGD (NADPH), Pyruvate DH, Fabry's, Hunter's Lesch-Nyhan |
| Drugs that induce SLE? | HIPPPE: hydralazine, INH, procainamide, penicillamine, phenytoin, ethosuximide |
| What causes myasthenia gravis? | autoantibodies to ACh receptors at NMJ |
| Where are metastases located? | gray-white junction |
Created by:
eandres1
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