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USMLE
Neuro 1
| Question | Answer |
|---|---|
| what waveform is present when awake with eyes open? | beta |
| awake with eyes closed - what waveform? | alpha |
| stage 1/light sleep - what waveform? | theta |
| stage 2/deeper sleep - what waveform? | sleep spindles and K complexes |
| stage 3-4/deepest, non-REM sleep, sleepwalking, night terrors, bed-wetting (slow-wave) - what waveform? | delta - lowest frequency, highest amplitude |
| in what stage of sleep is there dreaming, loss of motor tone, possibly a memory processing function, erections, increased brain O2 use? | REM |
| what waveform is associated with REM sleep? | beta |
| serotonergic predominance of raphe nucleus is key to initiating what? | sleep |
| what neurotransmitter reduces REM sleep? | NE |
| what is responsible for the extraocular movements seen during REM sleep? | PPRF (paramedian pontine reticular formation/conjugate gaze center) |
| what drugs shorten stage 4 sleep? what are they therefore useful for? | benzodiazepines - night terrors and sleepwalking |
| why is imipramine used to treat enuresis? | because it decreases stage 4 sleep |
| what happens to pulse and BP during REM sleep? | increased and variable |
| how often does REM sleep occur? | every 90 minutes - duration increases throughout the night |
| what is the principal neurotransmitter involved in REM sleep? | ACh |
| where's the lesion: motor (nonfluent/expressive) aphasia with good comprehension | Broca's area |
| where's the lesion: sensory (fluent/receptive) aphasia with poor comprehension | Wernicke's area |
| where's the lesion: conduction aphasia; poor repetition with good comprehension, fluid speech | arcuate fasciculus |
| where's the lesion: Kluver-Bucy syndrome (hyperorality, hypersexuality, disinhibited behavior) | bilateral amygdala |
| where's the lesion: personality changes and deficits in concentration, orientation, and judgement; may have reemergence of primitive reflexes | frontal lobe |
| where's the lesion: spatial neglect syndrome (agnosia of the contralateral side of the world) | right parietal lobe |
| where's the lesion: coma | reticular activating system |
| where's the lesion: Wernicke-Korsakoff syndrome | bilateral mammilary bodies |
| where's the lesion: tremor at rest, chorea, or athetosis | basal ganglia |
| where's the lesion: intention tremor, limb ataxia | cerebellar hemisphere (laterally located, affect lateral limbs) |
| where's the lesion: truncal ataxia, dysarthria | cerebellar vermis (centrally located - affects central body) |
| where's the lesion: contralateral hemiballismus | subthalamic nucleus - loss of inhibition of thalamus through globus pallidus |
| what do you call slow, writhing movements, especially of fingers? what are these characteristic of? | athetosis; basal ganglia lesion |
| where is Broca's area? | inferior frontal gyrus |
| where is Wernicke's area? | superior temporal gyrus |
| familial form of AD (10%) is associated with genes on what chromosomes? | 1, 14, 19 - APOE4 allele 21 - pApp gene |
| intracellular, abnormally phosphorylated tau protein is associated with what? | neurofibrillary tangles in AD |
| dementia, aphasia, parkinsonian aspects & specificity for frontal and temporal lobes? | Pick's disease |
| intracellular, aggregated tau protein is associated with what? | Pick bodies |
| what disease is associated with Lewy bodies? | Parkinson's |
| what 2 degenerative diseases are associated with spinocerebellar atrophy? | olivopontocerebellar atrophy, Friedreich's ataxia |
| this disease is associated with degeneration of anterior horns | Werdnig-Hoffman disease |
| this disease presents at birth as a 'floppy baby'; tongue fasciculations are characteristic | Werdnig-Hoffman disease |
| how is Werdnig-Hoffman disease inherited; what is the median age of death? | AR, 7 months |
| polio is associated with degeneration of what? | anterior horns - LMN destruction |
| how is poliovirus transmitted? | fecal-oral |
| what are the CSF findings in poliomyelitis? | lymphocytic pleocytosis with slight elevation of protein |
| what is the classic triad associated with MS? | scanning speech, intention tremor, nystagmus (SIN) |
| what is the treatment for MS? | beta-interferon or immunosuppressant therapy |
| the prevalance of this disease increases with distance from equator | MS |
| what are periventricular plaques? | areas of oligodendrocyte loss and reactive gliosis seen in MS (preservation of axons) |
| patients with what disease can present with optic neuritis, MLF syndrome, hemiparesis, hemisensory symptoms, or bladder/bowel incontinence? | MS |
| what is progressive multifocal leukoencephalopathy associated with? | JC virus - seen in 2-4% of AIDS patients (reactivation of latent virus) |
| what is the treatment for Guillain Barre? | respiratory support until recovery; plasmapheresis, IVIg |
| symmetric ascending muscle weakness beginning in distal lower extremities is seen in what disease? | Guillain Barre |
| what are the CSF findings in Guillain Barre? | elevated CSF protein with normal cell count - albuminocytologic dissociation; elevated protein leads to papilledema |
| this disease is marked by inflammation and demyelination of peripheral nerves and motor fibers of ventral roots | Guillain Barre - sensory effect is less severe than motor |
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Asclepius
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