Neurology # 2 Flashcards
Donepezil: what type of drug and application
AChE inhibitor and upregulates acetycholine activity for patients with AD
Amyotrophic lateral sclerosis (ALS) characteristics
combined UMN and LMN deficits with no sensory or oculomotor deficits; both UMN and LMN signs. Can be caused by defect in superoxide dismutase 1. presents with fasciulations with eventual atrophy and weakness of hands; fatal
Broca (expressive) aphasia: mnemonic
Broken Boca. Nonfluent aphasia with intact comprehesion and impaired repetition. inferior frontal gyrus of frontal lobe
C. tetani toxin: mechanism and what it cuases
Tetanospasmin which causes tetanus. cleaves SNARE proteins for neurotransmitters. Blocks release of inhibitory neurotransmitters, GABA and glycine from Renshaw cells in spinal cord.
Causes spastic paralysis, trismus (lockjaw), risus sardonicus (raised eyebrows and open grin)
parkinson’s disease is characterized by degeneration of what in where and where to these project to?
degeneration of dopaminergic neurons of the substantia nigra. These neurons project to the striatum (putamen and caudate) to facilitate movement
why are diabetics more susceptible to mucormycosis? why is this worrisome?
high gluose content in nasal secretions is associated with increased vulnerability. concern of possible introduction of the microorganism into the meninges
Rabies mechanism and incubation and symptoms
travels to the CNS by migrating in a retrograde fashion up nerve axons. long incubation period (weeks to months). Symptoms: fever, malaise –> agitation, photophobia, hydrophobia –> paralysis, coma –> death
Syringomyelia denition and symptoms
cystic cavity (syrinx) within the spinal cord (if central canal –> hydromyelia). Crossing anterior spinal commissural fibers are typically damaged first. Results in a “cape-like”, bilateral loss of pain temperature and sensation in upper extremeties (fine touch preserved)
MAO drugs (mnemonic) and mechanism
MAO Takes Pride In Shanghai (Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline). Nonselective MAO inhibition increased levels of amine neurotransmitters (NE, 5-HT, dopamine)
Wernicke-Korsakoff syndrome
caused by thiamine deficiency. Triad of confusion, opthalmoplegia and ataxia (wernicke encepalopathy). May progress to irreversible memory loss, confabulation, personality change. associated with periventricular hemorrhage/ necrosis of mammilary bodies.
MS findings
increased protein (IgG) in CSF. Oligoclonal bands are diagnostic. MRI is gold standard. Periventricular plaques (areas of oligodendrocyte loss and reactive gliosis) with destruction of axons.
MS treatment
Beta-interferon, immunosuppresion, natalizumab.
Valproic acid side effects
GI, distress, rare but fatal hepatoxicity (measure LFts). Neural tube defects in fetu (spina bifida), tremor, weight gain, contraindicated in pregnancy
Side effects of phenytoin
nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, eripheral neuropathy, megloblastic anemia, teratogenesis (fetal hydantoin syndrome) SLE-like syndrome, induction of cytochrome P450, Stevens-Johnson syndrome, osteopenia
what is delirium tremens and how does it present?
life-threatening syndrome resulting from alcohol withdrawal that is manifested by agitation, disorientation, hallucination and autonomic instability peaking 2-5 days after a patient’s last drink
