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Neuro_Kaplan

QuestionAnswer
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