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Neurology

Rx Review Round 4

QuestionAnswer
Degeneration of Dopaminergic neurons in the Substantia nigra? Parkinson disease
Neurons involved in Parkinson's disease have are projected into which area of the CNS? Striatum
What two basal ganglia areas compose the Striatum? Putamen and Caudate
Which type of Dopamine receptor is labeled as Excitatory? D-1 receptor
WHich type of Dopamine receptor is labeled as Inhibitory? D-2 receptor
Stimulation of the D1 and D2-receptors in the Striatum cause ---> Facilitation of movement
Which nerve is commonly affected in Thyroid surgery? Recurrent Laryngeal branch of the Vagus nerve
What is the most significant presentation of recurrent Laryngeal branch of the vagus nerve damage after Thyroid surgery? Hoarseness
Which Pharyngeal arch gives rise to the Vagus nerve? 6th
Which Laryngeal muscles are innervated by CNX? All intrinsic laryngeal muscles except for the Cricothyroid
Which two type of populations are commonly affected by L. monocytogenes meningitis? Very young and the very old
What is the empiric treatment for Listeria monocytogenes meningitis? Ampicillin/amoxicillin
Gram-positive bacilli that grows in cold temperatures. Listeria monocytogenes
What are the two food types that most commonly cause acquisition of L. monocytogenes infection? Unpasteurized dairy products and Cold deli meats
What is the main function of the Cerebellum? Coordination of movement in the IPSILATERAL side of the body
Lesion to the Cerebellar Hemisphere is often presented with: Ataxia, instability, and DYSMETRIA on the ipsilateral side of the lesion
What condition is described by damaged neurons in the cerebellum? Cerebellar degeneration
What are clinical features of LATERAL lesions to the Cerebellum? Affection of voluntary movements of the arms and a propensity to fall to the affected side
What are medial structures of the Cerebellum? Vermis, fastigial nuclei, and flocculonodular lobe
What are the most significant clinical features of medial lesions to the Cerebellum? 1. Truncal ataxia (wide-based cerebellar gait) 2. Nystagmus 3. Head tilting
Griseofulvin is considered an CYP450 system _______________. Inducer
What is the normal range of INR in a patient on Warfarin? 2.5-3.5
Common use for Griseofulvin? Treatment of superficial fungal infections
Which Nervous system tracts are affected in Neurosyphilis? Dorsal columns and Dorsal nerve roots
Late presentation of untreated Syphilis infection? Neurosyphilis
What is the clinical presentation of Neurosyphilis? Decreased vibration and prioception, sensory ataxia, pupillary abnormalities, neurogenic bladder disturbance, and shooting pains.
What is the common or distinctive pupillary abnormality seen in Neurosyphilis? Argyll-Robertson pupil
Pupil that accommodates to light but does not react Argyll-Robertson pupil
HSV-1 is an: Circular, double-stranded DNA
What is a common neurological cause of HSV-1 infection? Temporal Lobe Encephalitis
How is HSV-1 Temporal lobe encephalitis presented? Hemiparesis of affected side, aphasia, ataxia, seizures, and increase intensity of affected area in MRI
What is the MCC of SAH? Rupture of arterial aneurysms
What time of day accounts for 1/3 of cases of SAH? During sleep at the middle of the night
What is often described as "worst headache of my life"? SAH
Damage/Occlusion of the Anterior Spinal artery causes? Medial Medullary syndrome
What are the main clinical features of Medial Medullary syndrome? 1. Weakness of Contralateral body 2. Ipsilateral tongue deviation 3. Contralateral loss of proprioception and vibratory sense below the face
Damage to which structure accounts for ipsilateral tongue deviation upon protrusion in a patient with Medial Medullary syndrome? Damage to Caudal medulla-- Hypoglossal nerve
Damage to the medial lemniscus in Medial Medullary Syndrome is manifested by: Loss of prioception and vibratory sense in the contralateral side, below the face
Which artery is occluded in Wallenberg syndrome? PICA
What is another term used for Wallenberg syndrome? Lateral Medullary syndrome
What are the key distinctions of Wallenberg syndrome? Dysphagia, Hoarseness, and decreased gag reflex
How is AICA occlusion distinctive to occlusion of PICA? AICA causes paralysis of face, decreased lacrimation , decreased salivation, and decrease taste in the anterior 2/3 of the tongue.
Occlusion of the PICA causes? Lateral Pontine syndrome
What is the equation for Infusion rate? = (Css) x (CL)
What is another term used for Plasma concentration? Css (steady-state concentration)
Md = (Plasma concentration ) x CL ---------------------------------- bioavailability
What is the most common organism that causes bacterial meningitis in College dorm students? Neisseria meningitis
What is the best option for treatment of N. meningitidis? 3rd generation Cephalosporin such as Ceftriaxone
What is the mode of action of Ceftriaxone? Bactericidal agent with B-lactam ring that inhibits cell wall synthesis via inhibition of Bacterial Transpeptidases
What are some key distinctions of N. meningitidis? Photophobia, phonophobia, and a rash (petechiae) in the abdomen and lower extremities.
What is the area affected in Wernicke aphasia? Superior Temporal Gyrus of the Left-temporal lobe
A patient with perfect wording, but no sense in what the patient is saying. Dx? Wernicke aphasia
Damage to the Arcuate Fasciculus causes? Conduction aphasia
Conduction aphasia? Presents with good comprehension and fluency, but poor repetition.
What are the gaps in myelination along the axon of adjacent Schwann cells? Nodes of Ranvier
What occurs in the nodes of Ranvier? Influx of Na+ current and efflux of K+ current
Which type of myelinating cells have Nodes of Ranvier? Schwann cells
Common MILD traumatic brain injury Concussion
How is a concussion produced? Due to acceleration and deceleration of the brain, which occurs after BLUNT trauma
What are symptoms seen in a concussion? Headache, confusion, and amnesia with or without loss of consciousness.
The disruption of axonal function cause the symptoms of _____________________. Concussion
What is the reason of the symptoms seen in a contusion? Shear tear and diffuse axonal injuries
Which is most severe, a concussion or contusion? Contusion
How is clinically characterized Hereditary Spastic Paraplegia? Progressive degeneration of the Lateral Corticospinal tract and subsequent lower extremity weakness and spasticity (stiffness)
What is contained in the Lateral Corticospinal tract? Motor neurons that control descending voluntary movements of contralateral limbs
What is the function of the anterior corticospinal tract? Control of proximal muscles (trunk)
What is produced in the Anterior Spinothalamic tract? Nerves corresponding to CRUDE TOUCH and Pressure
Which nervous tract contains the nerves responsible for pain and temperature sensations? Lateral Spinothalamic tract
What is contained or composed the Dorsal column? Fasciculus cuneatus and Fasciculus gracilis
What is the role or functions of the Dorsal Column? Each fasciculus contain sensory neurons involved in pressure, vibration , fine touch, and proprioception
What is the most common cause of metastases to the brain? Lung cancer
What is the typical presentation of brain metastases? Multiple masses in brain
Which area of the nerve is rich in Purkinje cells? Cerebellum
Cerebellar Purkinje cells use which inhibitory NT? GABA
What are two common excitatory neurotransmitter used by Cerebellar Purkinje cells? Acetylcholine and Glutamate
What are the main functions of Astrocytes? Physical support and repair of the CNS
What are secondary functions of Astrocytes? 1. Maintain the BBB 2. Metabolize Potassium
What is the function of Ependymal cells? Line ventricular system and make CSF
What is the embryological problem seen in Lissencephaly? Failed neuronal cell migration
How is Lissencephaly diagnosed? Ultrasound in 28-week of gestation, showing a smooth surface of the cerebral hemisphere
Lack of both gyri and sulci in the cortex of the developing brain of an embryo? Lissencephaly
Which radiculopathy reproduces weak dorsiflexion? L5
What are important S1-radiculopathy symptoms? 1. Diminished ankle jerk reflex 2. Weak plantar flexion of the foot 3. Back pain radiating to the corresponding leg, reproduced by the straight leg raise test
Which kind of infection in infancy can later develop Subacute Sclerosing Panencephalitis? Measles
Untreated Measles may develop _____________________________ later in life. Subacute Sclerosing Panencephalitis
What is the only CSF abnormality seen in SSP? CSF globulin
Chronological appearance of Neonatal Conjunctivitis Chemical --> Gonorrhea --> Chlamydia --> HSV
How many days after birth is Gonorrhea-induced conjunctivitis produced? 2-5 days
What is the MCC of conjunctivitis in a baby of 5-14 days old? Chlamydia
Which is the latest causative organism of neonatal conjunctivitis? HSV
The rupture of Bridging veins MCC --> Subdural Hematoma
What is the shaped of the bleeding in Subdural Hematoma? Crescent-shaped areas on CT scan
Exposure to extreme environmental heat with inappropriate dissipation of heat. Heat stroke
What are some characteristics seen with Heat stroke? CNS dysfunction (confusion), end-organ damage, ARDS, and rhabdomyolysis
What is the most common of Temporal encephalitis in AIDS patients? HSV-1 infection
What are the findings in lumbar puncture of HSV-1 Temporal Lobe encephalitis? Bloody CSF in LP
What is the treatment of HSV-1 temporal lobe encephalitis? IV acyclovir
What is the definition of a Supratentorial mass pushes the Medial Temporal lobe medially and inferiorly, compressing the ipsilateral oculomotor nerve and the contralateral crus cerebri? Uncal herniation
Uncal herniation that causes contralateral hemiparesis is due to? Contralateral crus cerebri against Kernohan's notch
Which notch is pushed in a Uncal herniation that causes IPSILATERAL hemiparesis? Crus cerebri against the Tentorial notch
How is the CN3 palsy seen in uncal herniation? Ipsilateral CN3 palsy
What are main symptoms seen in Alcoholic Cerebellar degeneration? 1. Gait impairment (ataxia) 2. Dysarthria, diplopia and intermittent blurred vision
What are the symptoms of PCP intoxication? Aggression, psychomotor agitation, increased temperature, tachycardia, HTN, and nystagmus.
How is the pupil size differ in cocaine and PCP intoxication? Mydriasis --- cocaine, Normal size --- PCP
Which are two common conditions that produce Horner syndrome? Pancoast tumor and PICA occlusion
Hoerner syndrome is seen with triad? 1. Ptosis 2. anhidrosis 3. miosis
What are some SAH complications? Rebleeding, vasospasms, seizures, hyponatremia, hydrocephalus, and increased ICP
What is the most common ischemic complication of SAH? Vasospasm leading to delayed cerebral ischemia
What symptoms indicate vasospasm after SAH? New-onset focal neurological deficits 4-12 days after initial event
What causes NPH? Reduced CSF absorption in the venous system
Which sinus is damaged in the MCC of NPH? Superior Sagittal sinus
What are the results of Cavernous sinus damage? Produces visual deficits and paralysis of CN 3, 4, V1, V2, and 6.
What is the cause of Open-angle glaucoma? Rise in INTRAOCULAR pressure due to increased production of aqueous humor
What treatment of Open-angle glaucoma causes mydriasis? Norepinephrine
What drugs are used in Open-angle glaucoma causes miosis and cycloplegia? Anti-cholinomimetic agents
Loss of accommodation Cycloplegia
Damage to Subthalamic nucleus causes ______________________ deficits. Contralateral
What is Hemiballismus? rare movement-disorder that results in wild, flailing movement of the limbs
What area of the brain is damaged in Hemiballismus? Subthalamic nucleus
What are common chemotherapeutic agents that may cause Cerebellar dysfunction? Cytarabine and Fluorouracil
Which causes Subthalamic nucleus activity? Directly excites the INTERNAL SEGMENT of the Globus pallidus, which then inhibits the Thalamus
Internal segment of the Globus Pallidus stimulation causes: Inhibition of the Thalamus
What kind of infarcts are more common to cause Basal ganglia? Lacunar
What is the value of the Resting membrane potential? -60mV
What ion current is in charge of Depolarization? Influx of Sodium ions into the cells
Efflux of K+ out of the cell in cell membrane, is involved in: Hyperpolarization and Repolarization
Which negatively charged ion current is not involved in production of an Action potential? Chloride
Which kind of cells use Calcium in the production of muscle AP? Cardiac myocyte and Skeletal muscle cell
What mutation causes Wilson's disease? ATP7B gene
What is the result of the mutation of the gene that causes Wilson disease? Decreases the secretion of Copper into the biliary system, which leads to accumulation of Copper i the brain, liver, and cornea.
What is the most common cause of viral meningitis in children? Enterovirus infection
What are the CSF abnormalities of Viral meningitis? 1. Elevated WBC (lymphocytes) 2. Elevated protein 3. Normal glucose
What is the genomic description of Enteroviruses? Naked, positive sense ssRNA virus
Essential tremor is more apparent in _________________ postures. Sustained
A patient sustained posture tremor is seen more evident in which kind of tremor disorder? Essential tremor
Essential tremor becomes worst during? Movement and anxious mood
CNS lymphoma in often seen in which kind of patients? Immunocompromised (AIDS)
CNS lymphoma is associated with which virus? EBV
Which cell receptors provide possible infection of cell by EBV? CD21+B cells
Mutated or damaged CD21 + receptors on B cells cause --> Unregulated B-cell proliferation ----> lymphomas
Created by: rakomi