Neuro 4

Question 1

Which pharyngeal arch is associated with formation of the mandible, maxilla, malleus, incus, zygoma, vomer, palate, and temporal bone?

Answer 1

first arch neural crest derivatives

Question 2

What nerve is the first arch associated with?

Answer 2

trigeminal n.

Question 3

Which pharyngeal arch is associated with the styloid process, lesser horn of the hyoid, and the stapes?

Answer 3

second arch neural crest derivatives

Question 4

What nerve is the second arch associated with?

Answer 4

facial n.

Question 5

What muscles does the first arch gives rise to?

Answer 5

all the muscles of mastication, anterior belly of the digastric, mylohyoid, tensor tympani, and tensor veli palatin

Question 6

Which muscles does the second arch give rise to?

Answer 6

muscles of facial expression, the stylohyoid, stapedius, and the posterior belly of the digastri

Question 7

Which arches make up cartilaginous structures of the larynx?

Answer 7

fourth and sixth arches

Question 8

What fetal abnormality does leakage of AFP and acetylcholinesterase indicate?

Answer 8

NTDs - fusion defect

Question 9

What is an essential activator of carbamoyl phosphate synthase I for the urea cycle from the precursors acetyl-CoA and glutamate?

Answer 9

N-acetylglutamate

Question 10

What are 4 indications for the long-acting BZ diazepam?

Answer 10

1. anxiolytic: anxiety and panic
2. sedative-hypnotic: short term Tx of insomnia
3. anticonvulsant: status epilepticus, 1st line for alcohol seizure withdrawal
4. muscle relaxant: UMN spasticity and tetanus

Question 11

Which class of drugs should pts on diazepam avoid and why?

Answer 11

1st generation antihistamine antagonists: chlorpheniramine and diphenydramine
- 1st generation antihistamines blocks peripheral and central H1 receptors and can be very sedating because they easily penetrate the BBB and accumulate in the CNS

Question 12

Which type of schizophrenia is characterized by prominent delusions and auditory hallucinations?

Answer 12

paranoid schizophrenia

Question 13

Which type of schizophrenia is characterized by significant disturbance of motor function?

Answer 13

catatonic schizophrenia

Question 14

Which type of schizophrenia is characterized by emotional blunting, eccentric behavior, and loose associations between episodes of active schizophrenia?

Answer 14

residual schizophrenia - they lack hallucinations, delusions, disorganized speech, or catatonia

Question 15

Which type of schizophrenia describes a pt who is clearly schizophrenic but does not fit a specific category?

Answer 15

undifferentiated schizophrenia

Question 16

Which type of schizophrenia is characterized by disorganized speech and behavior and a flat or inappropriate affect?

Answer 16

disorganized schizophrenia

Question 17

A 3yo male is hospitalized with progressive spastic paresis of his lower extremities and choreoathetoid movements. Comprehensive lab testing reveals very high arginine levels in both the child’s plasma and CSF. What enzyme is deficient and what is it normally involved in the production of?

Answer 17

Arginase - involved in the production of urea and ornithine

Question 18

What is the Dx of a pt with chronic loss of upper extremity pain and temperature sensation, UE weakness and hyporeflexia, LE weakness and hyperreflexia, and kyphoscoliosis?

Answer 18

Syringomyelia

Question 19

What Sx do you see first wiith syringomyelia, and what Sx appear later?

Answer 19

first: bilateral loss of pain and temp d/t damage of ventral white commissure and anterior horns
later: expresion of syrnix within cervical cord can produce LE weakness and hyperreflexia by affecting the lateral corticospinal tract

Question 20

Does ALS cause sensory loss?

Answer 20

NO.

Question 21

What drug is an antiepileptic that is metabolized to phenobarbital and phenylethylmalonamide (PEMA)?

Answer 21

Primidone

Question 22

Name the conditions associated with Down syndrome.

Answer 22

1. Neurologic disease: Alzheimer
2. Acute leukemias: AML and ALL
3. Congenital heart disease: endocardial cushion defects, VSD, ASD
4. GI defects: duodenal atresia and Hirschprung disease

Question 23

What are negri bodies and where are they commonly found in pts with a rabies infection?

Answer 23

They are round, eosinophilic inclusions seen in the cytoplasm of pyramidal neurons of the hippocampus and cerebellar Purkinje cells

Question 24

What portion of the tRNA binds amino acids?

Answer 24

3’ end

Question 25

Which anticonvulsant drug causes gingival hyperplasia and what is the MOA?

Answer 25

Phenytoin - it causes an increased expression of PDGF which stimulates proliferation of gingival cells and alveolar bone

Question 26

What are SE or lithium?

Answer 26

neuromuscular excitability, nephrogenic diabetes insipidus, hypothyroidism, and cardiac conduction defects

Question 27

What are the SE of methimazole?

Answer 27

edema, rash, and agranulocytosis

Question 28

What kind of aneurysms are small in size (

Answer 28

Charcot-Bouchard aneurysms

Question 29

What are clinical findings of atrophy of nasal mucosa and partial destruction of the nasal septum pathognomonic for in the setting of agitation, chest pain, dilated pupils that are responsive to light, high BP, and tachycardia?

Answer 29

Cocaine abuse

Question 30

What is the MOA of cocaine abuse?

Answer 30

Cocaine inhibits the presynaptic reuptake of NE, DA, and 5-HT

Question 31

What can rapid correction of chronic hyponatremia lead to?

Answer 31

central pontine myelinosis: osmoetic demyelination of the axons in the central part of the pons

Question 32

What are the Sx of central pontine myelinosis?

Answer 32

qudriplegia d/t demyelination of the CST and pseudobulbar palsy d/t demyelination of the corticobulbar tracts of CN IX, X, and XI

Question 33

Which atypical antipsychotic is most likely to cause EPS?

Answer 33

Risperidone

Question 34

What syndrome associated with small cell lung carcinoma can cause headache, facial and UE edema, and dilated veins of teh upper torso?

Answer 34

SVC syndrome

Question 35

Anterior horn cells of a severed axon demonstrate cell body rounding, peripheral displacemtn of the nuclei and dispersion of Nissl substance to the periphery of the cells. These findings most likely describe:

Answer 35

axonal reaction

Question 36

Other than MS, where else is oligodendrocyte depletion seen?

Answer 36

progressive multifocal leukoencephalopathy