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QBank Qs > Neuro 1 > Flashcards

Neuro 1 Flashcards

1
Q

How are anesthetics with high tissue solubility characterized by arteriovenous concentration gradients and onset of action?

A

large arteriovenous concentration and slower onset of action

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2
Q

What are the Sx associated with syringomyelia?

A

The syrinx damages the ventral white commisure, leading to bilateral loss of pain and temp sensation limited to the affected levels (arms and hands). Destruction of motor neurons causes flaccid paralysis and atrophy of intrinsic hand muscles.

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3
Q

What is an antidote to atropine OD and why is it effective?

A

Physostigmine - it is a tertiary amine that can inhibit acetylcholinesterase peripherally and centrally
(Neostigmine and edophonium have quaternary ammonium structures that limit CNS penetration)

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4
Q

What are the 5 enzymes that branched-chain alpha-ketoacid dehydrogenase (as well as pyruvate and alpha-ketoglutarate dehydrogenase) require?

A 
Thiamien pyrophosphate
Lipoate
Coenzyme A
FAD
NAD
(Tender Loving Care For Nancy)
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5
Q

What vitamin is involved in the transamination and decarboxylation steps in amino acid metabolism as well as heme and nuerotransmitter synthesis?

A

Pyridoxine (vitamin B6)

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6
Q

Whate are the side effects of B6 deficiency?

A

sideroplastic anemia and hyperhomocysteinemia

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7
Q

What has 5; to 3; exonuclease activity in addition to 5’ to 3’ polymerase and 3’ to 5’ exonuclease activity?

A

DNA polymerase I - removes RNA primer and damaged DNA

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8
Q

What does DNA polymerase III do?

A

initiates DNA replication

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9
Q

What enzymes in the heme biosynthetic pathway are inactivated by lead?

A

delta-aminolevulinate and ferrochelatase

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10
Q

What compounds accumulate in lead poisoning?

A

delta-ALA and protoporphyrin IX

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11
Q

What are Sx of orotic aciduria and what supplementation can improve Sx?

A

orotic aciduria: hypochromic megaloblastic anemia, neurologic abnormalities, growth retardation, and excretion of orotic acid in urine
-uridine supplementation improves Sx by inhibiting carbamoyl phosphate synthetase II

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12
Q

What is the treatment of choice for LIsteria meningitis in infants?

A

Ampicllin (it is not sensitive to cephalosporins)

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13
Q

What pharmological therapy can be used to assist in the prevention of cerebral vascular spasm following SAH?

A

CCBs - especialy amlodipine

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14
Q

What is the first line Tx for essential HTN in the outpt setting?

A

thiazide diuretics

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15
Q

What is used as a part of the Tx for increased ICP?

A

osmotic diuretics such as mannitol

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16
Q

What is an single-gene autosomal-dominant disorder d/t the mutation of the NF1 gene located on chromosome 17?

A

Neurofibromatosis type 1

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17
Q

What causes cystic degeneration of the putamen as well as damage to basal ganglia structures?

A

Wilson disease

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18
Q

What structure is located medial to the insula and lateral to the globus pallidus on coronal sections?

A

putamen

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19
Q

What structure is immediately medial to the putamen? What structure separates this from the putamen?

A

globus pallidus; internal capsule

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20
Q

What is a mixed DA and NE reuptake inhibitor used to treat depression and smoking addiction?

A

Bupropion

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21
Q

What is the mainstay therapy of acute mania?

A

mood stabilizing agent (i.e. lithium, valporate, or carbamazepine) + atypical antipsychotic (i.e. olanezapine)

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22
Q

What is a microtuble-associated, ATP-powered motor protein that facilitates the anterograde transport of NT-containing secretory vesicles down axons to the synaptic terminals?

A

Kinesin

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23
Q

What syndrome is d/t hypersensitivity of skeletal muscles to inhalation anesthetics (especially halothane) and muscle relaxant succinylcholine?

A

malignant hyperthermia

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24
Q

How does malignant hyperthermia present clinically?

A

fever and muscle rigidity after surgery under general anesthesia along with tachycardia, hypertension, hyperkalemia, and myoglobinemia

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25
Q

What is the MOA of dantrolene?

A

it is a muscle relaxant that acts on ryanodine receptors and prevents further release of Ca2+ inot the cytoplasm of muscle fibers in malignant hyperthermia

26
Q

What is the difference between nondepolarizing and depolarizing neuromuscular blockers?

A

nondepolarizing neuromuscular blockers prevent acetylcholine binding to the receptor, while depolarizing blockers causes a constant stimulation of the receptor

27
Q

What are 3 traditional high potency typical antipsychotics?

A

haloperidol, fluphenazine, pimozide

28
Q

What are 2 traditional low potency typical antipsychotics?

A

chlorpromazine and thioridazine

29
Q

What are 4 atypical antipsychotics?

A

clozapine, risperidone, olanzapine, and quetiapine

30
Q

What can atypical antipsychotics cover that typicals cannot?

A

positive and negative Sx of schizophrenia

31
Q

What is first line therapy for both generalized anxiety disorder and panic disorder?

A

selective reuptake inhibitor (SSRI) such as paroxetine

32
Q

What is a short acting BZ?

A

triazolam - good for pts employed in mission-critical positions

33
Q

What is an intermediate acting BZ?

A

lorazepam

34
Q

What are 3 long acting BZs?

A

diazepam flurazepm and chlordiazepoxide

35
Q

A temporary course of what drug can be used during the SSRI initiation period if there is significant increase in anxiety related Sx?

A

BZs

36
Q

Why is the myelopathy associated wtih vitamin B12 deficiency known as subacte combined degeneration?

A

it refers to the degeneration of both ascending (dorsal columns) and descending (corticospinal tract) pathways

37
Q

Where is the lesion in Wernicke aphasia?

A

superior temporal gyrus in the dominant (left) temporal lobe

38
Q

What is oligohydramnios associated with?

A

renal agenesis

39
Q

What is polyhydramnios associated wtih?

A

gastrointestinal obstruction (duodenal, esophageal, or intestinal atresia) and anencephaly

40
Q

What two things is valproic acid indicated for?

A

mood stabilizer and anticonvulsant - it decreases the propagataion of abnormal APs by enhancing the inhibitory action of GABA in the CNS
-it is the DOC for myoclonic seizures and 2nd line for absence

41
Q

What is the MOA of lithium?

A

it acts by inhibiting the cellular concentration of IP3 and is used in preventing both manic and depressive bipolar disorder

42
Q

What originates from the lateral aspect of the mid-pons at the level of the middle cerebellar peduncles?

A

trigeminal nerve

43
Q

what arises from the dorsolateral aspect of the caudal pons at the pontomedullary junction (below middle cerebellar peduncles)?

A

facial n.

44
Q

what arises from the preolivary sulcus at the level of the rostral medulla?

A

hypoglossal n.

45
Q

What Sx are present with infarct to anterior portion of medial pons?

A

dysarthria and ataxic hemiparesis

46
Q

What structure is most frequently affected in pts with Wernicke encephalopathy?

A

mam,illary body

47
Q

What is a a short-acting hypnotic med used for insomnia unrelated to BZs that has the same MOA of binding GABAa, but a much lower risk of tolerance and dependence?

A

Zolpidem

48
Q

What are benign and slow-growing tumors arising from the arachnoid villi associated wtih psamomma bodies?

A

Meningiomas

49
Q

Where are meningiomas most commonly found?

A

parasagittal region or adjacent to the lateral convexity of the hemisphere in the region of the sphenoid wing and olfactory nerve

50
Q

Where do BZs exhibit their effects?

A

BZs bind GABAa channels to increase Cl- influx and frequency

51
Q

What can cardiac arrest d/t acute MI lead to in the brain?

A

global cerebral ischemia

52
Q

What is the first area damaged during global cerebral ischemia?

A

hippocampus

53
Q

What areas are most volunerable to cerebral ischemia?

A
  • pyramidal cells of hippocampus and neocortex

- Purkinje cells of cerebellum

54
Q

What X-linked recessive trait is characterized by macroorchidism, large jaws, and ears?

A

Fragile X syndrome

55
Q

What is the genetic defect of Fragile X syndrome?

A

increased number of trinucleotide repeats (CGG) in the FMR-1 gene located on the long arm of the X-chromosome

56
Q

How does ALS present clinically?

A

loss of neurons in the anterior horns of the spinal cord (LMN lesion) cause muscle weakness and atrophy; demyelination of lateral corticospinal tract (UMN) leads to spasticity and hyperreflexia

57
Q

What presents with an abundance of lipids seen in the cytoplasm after ischemic infarct ~3-5 day after onset?

A

microglia d/t extensive phagocytosis of myelin breakdown products

58
Q

What is scotoma?

A

any visual defect surrounded by a relatively unimpaired field of vision

59
Q

What is most likely seen on visual field examination with macular degeneration?

A

central scotomas

60
Q

What visual defect can occur d/t calcified carotid arteries?

A

binasal hemianopsia - pressure to the lateral areas of optic chiasm

QBank Qs (15 decks)

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