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Neurology
New set 2023 UWORLD only
| Question | Answer |
|---|---|
| What is the anatomically characteristic of communicating hydrocephalus? | Symmetrical enlargement of the ventriculi |
| What is the MCC of a Communicating Hydrocephalus? | Dysfunction/obliteration of subarachnoid villi |
| What are common causes for dysfunctional subarachnoid villi? | Meningeal infection (TB), SAH, or intraventricular hemorrhage. |
| What are the 3 main subdivisions of the Ectoderm? | Surface ectoderm, Neural tube, and Neural crest |
| What are the derivatives of the SURFACE ectoderm? | 1. Anterior pituitary (Rathke pouch) 2. Lens & Cornea 3. Inner ear sensory organs 4. Olfactory epithelium 5. Nasal & oral epithelial linings 6. Salivary glands 7. Epidermis, sweat & mammary glands |
| What is common sensory distribution loss in Diabetic neuropathy? | Stocking-and-glove distribution |
| What causes Diabetic Peripheral neuropathy? | Hyalinization of ENDONEURIAL arteries and ischemic nerve damage |
| What neurotransmitter is produced in the Ralphe nucleus? | Serotonin |
| Which classes of medication are known to inhibit serotonin reuptake in neurons? | SSRI, SNRIs, and TCAs |
| What neurotransmitter is produced by the Nucleus basalis of Meynert? | Acetylcholine |
| What neurotransmitter is produced by the Locus coeruleus? | Norepinephrine |
| Serotonin is synthesized in the: | Raphe nuclei |
| Norepinephrine is synthesized in the: | Locus coeruleus |
| Acetylcholine is synthesized in the: | Nucleus basalis of Meynert |
| Wath is the sensory distribution of the hand by the Median nerve? | Palmar surface to the first 3 digits and radial half of the 4th digit. |
| Is median damage seen with Thenar or Hypothenar atrophy? | Thenar atrophy |
| Which nerve is commonly damaged in patients with weakness in thumb abduction/opposition? | Median nerve |
| What are signs indicting Median nerve damage? | Tinel sign and Phalen sign |
| What nerve is damaged in Carpal Tunnel syndrome? | Median nerve |
| At what level is the Median nerve compressed in order to cause Carpal Tunnel syndrome? | At the Transverse Carpal Ligament |
| What are the antibodies against Myasthenia gravis? | Post-synaptic Nicotinic ACh receptors |
| What condition is caused by antibodies against postsynaptic Nicotinic ACh receptors? | Myasthenia gravis |
| What are 2 common NON-depolarizing Neuromuscular blocking agents? | Vecuronium and Rocuronium |
| What is the MOA of non-depolarizing NM blocking agents? | Competitive antagonists of Nc receptors |
| Are MG patients susceptible to non-depolarizing NM blocking agents? | Extremely sensitive due to MG patients are depleted of Nc receptors |
| How is the clinical depiction or description of watershed area ischemic strokes? | Symmetric, Bilateral wedge-shaped strips of necrosis over the cerebral convexity, parallel and adjacent to the interhemispheric fissure |
| Which cranial nerves are part of the Cavernous sinus? | CNs: 3, 4, 6, and V1 and V2 |
| What is severe complication of Ethmoidal or Sphenoidal sinus infection? | Cavernous sinus thrombosis |
| Are cranial nerve deficits in Cavernous sinus thrombosis, ipsilateral or contralateral? | Ipsilateral |
| What is a key physical characteristic of a Cerebellar tremor? | ↑↑ tremor as action approaches the target |
| What is the approximate frequency of Cerebellar tremors? | < 5 Hz |
| What are common Cerebellar dysfunction signs? | Ataxia, dysmetria, and impaired rapidly alternating movements |
| Episodic, unilateral, throbbing headaches associated with N/V, and sensitivity to light. Dx? | Migraine |
| Pathogenesis of Migraines | Genetic predisposition of ↑ cerebral excitability ---> abnormal neuronal activation of TRIGEMINAL afferents and the release of Calcitonin gene-related peptide |
| What is the function/role of Calcitonin gene-related peptide? | Vasoactive neuropeptide involved in transmission of pain signals |
| What condition's pathogenesis is associated with the ↑ release of Calcitonin gene-related peptide and Trigeminal afferent fibers? | Migraine |
| What are abortive treatments for acute migraine? | Analgesics, triptans, antiemetics, ergotamine |
| What are Migraine preventive medication classes? | ß-blockers, TCAs, anticonvulsants [topiramate, valproate] |
| Wath is the earliest change underlying cytotoxic edema after a stroke? | Accumulation of intracellular Na+ and water due to failure the ATP-dependent ion transporter in hypoxic cells |
| What is pressure physical complication of ↑ ICP? | Brain herniation |
| Which part of the cells stops working in Ischemic stroke first? | ATP-dependent ion transport in hypoxic cells |
| What is dystonia? | Sustained, involuntary muscle contractions |
| What is present in muscle bx in patients with dystonia? | Muscle fiber hypertrophy with insignificant histologic changes |
| What is a common bone complication leading to Cervical radiculopathy? | Osteophytes that form due to degenerative changes --> narrowing the neural foramina --> nerve root compression |
| What is the DOC for Status Epilepticus? | Lorazepam |
| What kind of medication is Lorazepam? | Benzodiazepine |
| What is MOA of Benzodiazepines? | Enhance the effect of GABA at the GABA-A receptor -----> ↑ Chloride influx and suppression of AP firing |
| What is the MC Pineal gland tumor? | Germinoma |
| What are the key associations of a Germinoma? | Obstructive hydrocephalus and Parinaud syndrome |
| What brain neoplasm is known to cause Endocrine-pathologies due to pituitary/hypothalamic dysfunction? | Germinomas |
| The________ key region for homeostasis. | Hypothalamus |
| Which hypothalamic nucleus mediates satiety? | Ventro-medial nucleus |
| What is the clinical result of mutated or damaged Hypothalamic ventromedial nucleus (VMN)? | Hyperphagia and obesity |
| Which CNS degenerative disease is known to have ↓↓↓ ACh levels? | Alzheimer disease |
| What is the result of ↓↓ choline acetyltransferase activity in the brain? | ↓↓↓ ACh in Nucleus of Meynert and hippocampus |
| Which transport protein is associated with the reactivation of latent HSV? | Kinesin |
| What is the MC of a single brain abscess? | Direct spread of contagious infection |
| What pathogen is MC associated with Temporal abscess? | HSV |
| What structures make up the Limbic system? | Limbic cortex, amygdalae, hippocampus, hypothalamus, mamillary bodies, and anterior thalamic nuclei |
| What are the functions or roles of the Limbic system? | Homeostasis, olfaction, memory consolidation, and emotional responses |
| Which cranial nerve nuclei is affected in HZV-Opthalmics? | CN V1 |
| Common Alzheimer disease medications that cause Syncope? | Acetylcholinesterase inhibitors such as Donepezil and Rivastigmine |
| What are two common ACh-esterase inhibitors? | Donepezil and Rivastigmine |
| Common fibular (peroneal) nerve injury is seen with what motor deficits? | Weakness on foot DORSIFLEXION and Eversion |
| What are sensory losses in Common Fibular (peroneal) nerve injury? | ↓ sensation in lateral shin, dorsal foot, and btw 1st and 2nd toes |
| BH4 is essential in the synthesis of which neurotransmitter? | Serotonin and Dopamine |
| What is another name for Wallenberg syndrome? | Lateral Medullary infarct |
| How is the loss of pain and temperature distribution in Wallenberg syndrome? | Ipsilateral face (CN nucleus), and Contralateral body (spinothalamic tract) |
| Is Horner syndrome in Wallenberg syndrome, ipsilateral or contralateral? | Ipsilateral |
| What fibers are affected in Ipsilateral Horner syndrome, as seen in Wallenberg Sx? | Descending sympathetic NS fibers |
| Which artery if dissected can lead to lateral medullary syndrome (ischemia)? | Vertebral artery |
| What are common neuropathologic features of Alzheimer's disease? | 1. Amyloid plaques (extracellular accumulation of ß-amyloid) 2. Neurofibrillary tangles |
| What neurodegenerative disease is associated with Neurofibrillary tangles? | Alzheimer disease |
| How are neurofibrillary tangles composed? | Formed when TAU protein becomes HYPERPHOSPHORYLATED and dissociated from the microtubules to form paired helical filaments |
| Protein associated with neuronal microtubules | TAU-protein |
| What are 2 important associations of Dementia with Lewy bodies? | 1. α-synclein protein aggregation 2. Parkinson-like syndrome |
| Which neurodegenerative disorder is associated with α-synclein protein association? | Lewy-body dementia |
| What is the main histological clue for HIV-dementia? | Microglial nodules and multinucleated giant cells |
Created by:
rakomi
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