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Neurology Block
All sorts of neurology questions and buzz words from Neuro block
| Question | Answer |
|---|---|
| Loss of consciousness, longer duration of 1 to 2 minutes and the presence of automatisms usually signifies what type of seizure? | Complex Partial Seizure |
| What is the most common form of epilepsy in children? | Partial Seizures |
| What type of seizure begins in both hemispheres? | Generalized Seizures |
| Petit Mal, brief lapses of consciousness, disruption in speech or motor is what type of seizure? | Absence Seizure |
| What type of seizure shows a long myotonic period where the child usually ends up falling or dropping due to loss of muscle tone? | Atonic Seizures |
| MOst common convulsive disorder of childhood. | Febrile Seizures |
| Grand Mal | Tonic-clonic Seizure |
| Fifth Day Fits | Benign Idiopathic Neonatal Seizures |
| Mental Retardation with mixed seizure disorder, most common in patients with infantile spasms. | Lennow-Gastaut Syndrome |
| Juvenile Myoclonic Seizure Triad | Generalized, Myotonic, Absence |
| First line treatment for Juvenile Myoclonic Seizures? | Valproic Acid |
| Fixed, midsize pupils of 4 - 5 mmm signifies a problem where in the brain? | Midbrain |
| Pinpoint pupils signifies a problem where in the brain? | Pontine/ Pons |
| Unilateral, fixed and dilated pupil signifies a problem where? | Is most likely compression of CN III. |
| Cheyne-Stokes Respiration Pattern (crescendo -> decrescendo) | Hemisphere dysfunction |
| Central Neurogenic Hyperventilation (sustained deep breaths) | midbrain to upper pons |
| Kussmaul (deep slow breaths) | diabetic ketoacidosis |
| Apnea is a sign of what kind of problem? | medulla |
| How to respond to an unconscious patient… | STONED: Sugar, Thiamine, O2, Narcan, Evaluate, Differential Dx |
| Asymmetry in a coma patient, think… | structural |
| Likely cause of intracerebral hemorrhage | hypertension |
| Caused by occlusion of smaller, penetrating arteries, presence of fibrinoid | Lacunar Infarctions |
| Most common cause of cardioembolic stroke | atrial fibrillation |
| Beading of vessels within the brain is characteristic of what condition? | CNS Vasculitis |
| A core of forever-lost brain cells surrounded by damaged brain cells that could still be repaired | Penumbra |
| A resting tremor is associated with what condition? | Parkinson’s Disease |
| An intention tremor is assoc. with a problem where? | cerebellum |
| Drugs that help relieve the tremor of Parkinson’s Disease | Anticholinergic |
| Main side-effect of anticholinergics that could make them countraindicated in the elderly population | memory loss |
| 3 anticholinergic drugs used for Parkinson’s | Trihexiphenidyl, Benztropine mesylate, Diphenhydramine |
| What 2 NT can increase GABA to Globus Pallidus? | Ach and Glutamate |
| DOPA is converted to Dopamine via… | DOPA-decarboxylase |
| 2 components that can prolong DOPA in the synapse | Mono-oxidase B (MAO-B) inhibitors & Cartechol-ortho methyl transferase (COMT) inhibitors |
| MAO-B inhibitors for Parkinson’s | Selegeline and Rasagaline |
| COMT inhibitors for Parkinson’s | Entacapone and Tolcapone |
| NMDA receptor for what? | glutamate |
| What Parkison’s drug has a slight effect on NMDA receptors? | Amantadine ( weak NMDA antagonist) |
| An acquired persistent, confusional state | dementia |
| The clinical traid of confusion, gait disturbance and extra-ocular dysmotility point to which disease? | Wernicke’s Encephalopathy (usually assoc. with alcohol & thiamine deficiency) |
| Infarcts or hemorrhages within mamillary bodies of hypothalamus | Wernicke’s Encephalopathy |
| Extra-ocular dysfunction in Wernicke’s | Ophthalmoplegia |
| Water is white on this imaging and it is best for showing pathology | T2 Weighted MRI |
| Lacunar infarctions are due to what size vessels? | small vessels |
| Decreased glucose metabolism esp. in the posterior cerebrum on PET scan | Alzheimer’s Disease |
| On microscopic analysis, a patient is found to have neurofibrillary tangles and senile plaques. What is the most likely cause of these findings? | Alzheimer’s Disease |
| What material are senile plaques made of? | Amyloid (Amyloid Beta proteins or fragments of APP) |
| Anticholinesterase Inhibitors for Alzheimer’s Disease, they are … | Donepezil, Galantamine, Rivastigmine |
| NMDA receptors control what substance? | Calcium entry |
| Pick’s Bodies | Pick’s Disease |
| There is atrophy of what two lobes with Pick’s Diease? | Frontal and Temporal |
| A dementia with visual hallucinations | Dementia with Lewy Bodies |
| Lewy Bodies in cerebral cortex | Dementia with Lewy Bodies |
| Intention tremors are assoc. with which dementia? | Dementia with Lewy Bodies |
| A resting tremor is assoc. with which dementia? | Parkinson’s Disease |
| A CAG repeat on Chromosome 4, autosomal dominant | Huntington’s Disease |
| A fatal dementia involving rigidity, clumsiness and myclonic jerks | Creutz-feldt Jakob Disease (prion disease) |
| Positive 14-3-3 analysis of CSF | CJD (Creutz-feldt Jakob Disease) |
| Spongiform encephalopathy involving microscopic vacuoles | CJD |
| The clinical triad of gait disturbance (magnetic), urinary incontinence and cognitive disturbance are characteristic of what disease? | Normal Pressure Hydrocephalus |
| Treatment of Normal Pressure Hydrocephalus | shunt |
| Speaking a heard word pathway | Primary auditory area -> Wernicke’s Area -> Arcuate Fasciculus -> Broca’s Area -> Primary Motor Cortex |
| Speaking a written word pathway | Primary Visual Area -> Angular Gyrus -> Wernicke’s Area -> Broca’s Area -> Primary Motor Cortex |
| Left Hemisphere tasks | language and calculation |
| Right Hemisphere tasks | drawing |
| Huntington’s Chorea is a clinical triad of … | dominant inheritance, choreoathetosis, and dementia (usually results in death in 10 -> 20 years) |
| What structure is responsible for the coordination of movements during the action? | cerebellum |
| What structure/s are responsible for planning movements? | Basal Ganglia |
| A key sign of a cerebellar dysfunction | Dystonia (uncontrollable muscle contractions) |
| Cells in the ventral horn at the edge of gray matter that monitor UMN and LMN interaction | border cells |
| What is the function of the vermis? | To fine tune motor control of axial musculature |
| What is the function of the paravermis (intermediate hemisphere)? | lower extremity fine motor control |
| Portion of the cerebellum that control complex movement and is a part of the cerebrocerebellum tract | lateral hemisphere |
| Tract found in the floccularnodual lobe | vestibulocerebellum tract |
| The main afferent (input) pathway to the dentate nucleus to begin the trisynaptic circuit | Perforant Pathway |
| The main efferent (output) pathway (CA1 & subiculum -> mamillary bodies -> ANT -> subcallosal cortex -> assoc. area of neocortex | Fornix |
| Can’t make new memories | Anterograde Amnesia |
| Can’t recall past memories | Retrograde Amnesia |
| Removal of this organ results in an inability to transfer memory from short term to long term | Hippocampus |
| What type of memories is the hippocampus responsible for? | Explicit Memories |
| An event that after a presynaptic neuron is overactive, when the presynaptic neuron goes back to normal firing, the post synaptic neuron continues to fire at an increased rate | Lone Term Potentiation |
| LTP (Long Term Potentiation) is linked with what function? | Spatial Learning |
| This structure is responsible for emotional learning, fear, reward and implicit facial recognition | Amygdala |
| What part of the brain is responsible for fear triggered sympathetic discharge? | Lateral Hypothalamus |
| Amygdala to Parabrachial Nucleus | increased respiration |
| Amygdala to Cingulate gyrus and locus coreuleus | increased HR, NE, BP and fear |
| Amygdala to Periaquaductal Grey | defensive behavior |
| Hypoemotionality, loss of fear, psychic blindness, hypersexuality and hyperorality are symptoms of what? | Kluver-Bucy Syndrome (Bilateral temporolimbic lesions) |
| A direct receptor in the post-synaptic cell membrane is the… | Ionotropic Receptor |
| An indirect receptor in the post-synaptic cell membrane is the… | Metabotropic Receptor |
| What are the main 2 determinants of the degree of differential blockade of local anesthetics? | pKa and lipid solubility |
| A low pKa with local anesthetics shifts equilibrium to the ionized form and leads to…. | a slower/ delayed onset of action |
| Muscle spindle is sensitive to changes in? | length |
| Golgi Tendon Organ is sensitive ti changes in? | tension |
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