Block 3 Neuro

Question 1

3 genes associated with ALS

Answer 1

SODI, UBQLN2, and C9ORF72

Question 2

Riluzole-

Answer 2

decreases glutamate response to prolong life in ALS

Question 3

Patient presents with early falls, axial rigidity, supranuclear gaze palsy (vertical more than horizontal) and hummingbird’s sign. What do they have?

Answer 3

Progressive Supranuclear Palsy

Question 4

assymetric parkinsonism associated with tau protein deposition =

Answer 4

Corticobasal Ganglionic Degeneration

Question 5

most common genetic mutation in parkinsons =

Answer 5

LRRK2

Question 6

Rasagiline-

Answer 6

selective MAO-B inhibitor

Question 7

MAO-B degrades _________

Answer 7

dopamine

Question 8

MAO-A degrades ________

Answer 8

serotonin and NE

Question 9

MS usually first presents with

Answer 9

optic neuritis

Question 10

Dawson’s fingers-

Answer 10

lesions lining up perpendicular to ventricles; suggestive of demyelination rather than vascular lesion. indicative of MS

Question 11

Causes of MS-

Answer 11

T cells, genetics, Vitamin D deficiency, and Epstein Barr Virus

Question 12

Which T cells are responsible for MS

Answer 12

Th1 (pro-inflammatory)

Question 13

How do Interferon B and glatiramer acetate treat MS?

Answer 13

increase Th2 count

Question 14

how does Fingolimod treat MS?

Answer 14

sequester T cells to lymph nodes

Question 15

Tysabri, the strongest MS drug, works how?

Answer 15

prevents T cells from crossing the BBB

Question 16

RAS is mediated by what NTs?

Answer 16

acetylcholine, serotonin, dopamine, NE, and histamine

Question 17

pathway for ipGRC’s

Answer 17

SCN-PVN-thoracic spinal cord-IMLCC-sympathetic chain-superior cervical ganglion-pineal gland

Question 18

locus coeruleus/lateral tegmental group-

Answer 18

NE neurons located in pons

Question 19

pedunculopontine/laterodorsal tegmental (PPT/LDT)-

Answer 19

cholinergic neurons, project to thalamus

Question 20

dorsal/medial raphe and raphe pontis nucleus-

Answer 20

serotoninergic neurons in midbrain

Question 21

ventral periaqueductal gray matter/VTA/subs nigra-

Answer 21

dopaminergic

Question 22

tuberomamillary nucleus-

Answer 22

histaminergic

Question 23

orexin comes from?

Answer 23

lateral hypothalamic area

Question 24

when melatonin feeds back into the SCN, the SCN can either cause wakefulness by signaling the _______, or sleep, by signaling __________

Answer 24

lateral hypothalamic area

ventrolateral preoptic nucleus

Question 25

what stimulates RAS?

Answer 25

Lateral hypothalamic area

Question 26

the sensory thalamus is sensitized by activation of its:

Answer 26

nicotinic receptors

Question 27

the reticular thalamus is inhibited by the activation of its:

Answer 27

muscarinic receptors

Question 28

waves associated with awake state

Answer 28

alpha and beta

Question 29

Stage 1 sleep waves

Answer 29

theta

Question 30

stage 2 sleep waves

Answer 30

sleep spindles/ K complexes

Question 31

stage 3 and 4 sleep waves

Answer 31

delta

Question 32

slow wave sleep is initiated in the ________ nucleus via inhibition

Answer 32

ventrolateral preoptic nucleus (VLPO)

Question 33

VLPO releases _______ to inhibit RAS and the Thalamus

Answer 33

GABA

Question 34

GABAergic neurons of the PRF and thalamus inhibit _____ systems and activate _____ system

Answer 34

NE, 5HT | Ach

Question 35

how do we achieve muscle atonia during REM sleep?

Answer 35

GABA from PRF inhibits NE and 5-HT systems, which where inhibiting acetylcholine neurons. The disinhibition causes ACh--> glutaminergic neuron--> glycinergic neuron--> alpha motor neuron--> muscle atonia

Question 36

How do we achieve cortical activity during REM sleep?

Answer 36

GABA from PRF inhibits NE and 5-HT systems, which where inhibiting acetylcholine neurons. The disinhibition causes ACh neurons--> GABA neurons in thalamus--> inhibit input from eyes (leads to REM)

Question 37

____ neurons generate rapid eye movements

Answer 37

PRF

Question 38

GABA neurons of PRF inhibit input from dorsal column nuclei during REM, which causes

Answer 38

decreased sensory response

Question 39

Tetrad of narcolepsy:

Answer 39

excessive sleepiness, sudden weakness, hallucinations, and muscle paralysis

Question 40

narcolepsy is associated with a mutation of

Answer 40

hypocretin/orexin receptor

Question 41

are there sensory symptoms in myopathies?

Answer 41

no

Question 42

most common inherited myopathy

Answer 42

myotonic dystrophy

Question 43

myotonic dystrophy due to

Answer 43

defect in protein kinase myotonin gene. CTG repeat

Question 44

a sign of myotonic dystrophy is early ______

Answer 44

cataracts

Question 45

Tensilon test-

Answer 45

acetylcholinesterase inhibitor. must perform in ER because it causes bradycardia.

Question 46

Treatment of Myasthenia gravis

Answer 46

acetylcholinesterase inhibitors

Question 47

symptoms of botulism-

Answer 47

difficulty swallowing, dry mouth, paralysis, fatigue...

Question 48

what symptoms are absent with botulism?

Answer 48

no fever, no elevated BP, no confusion

Question 49

radiculopathy-

Answer 49

involvement of one specific dermatome

Question 50

mononeuropathy multiplex-

Answer 50

multiple single nerve lesions

Question 51

Key finding with polyneuropathies-

Answer 51

sensory complaints greater than weakness

Question 52

Charcot Marie Tooth Disease-

Answer 52

inherited demyelinating neuropathy

Question 53

signs of Charcot Marie Tooth disease-

Answer 53

hammer toes and high arches. Also Stork Legs

Question 54

Rubral Tremor-

Answer 54

slow course tremor with combined features of other tremors

Question 55

Cerebellum is concerned with these non-motor functions

Answer 55

sensory disc., attention, memory, verbal learning, speech. Through connections to cortical areas

Question 56

4 brainstem nuclei that contain preganglionic parasympathetics

Answer 56

edinger westphal, superior salivatory, inferior salivatory, dorsal motor nucleus of vagus

Question 57

which nerve is not part of cervical plexus, even though it is usually grouped with it?

Answer 57

suboccipital nerve

Question 58

4 nerves of cervical plexus

Answer 58

lesser occipital, greater auricular, transverse cervical, and supraclavicular

Question 59

name the 3 trunks of brachial plexus

Answer 59

superior, middle, inferior

Question 60

name the divisions of the brachial plexus

Answer 60

each trunk has anterior and posterior division

Question 61

name the cords of the brachial plexus

Answer 61

lateral, medial, and posterior cord

Question 62

ulnar nerve innervates all intrinsic muscles of the hand except:

Answer 62

1/2 LOAF. 2 lumbricals, opponens pollicis, abductor pollicis brevis, and flexor pollicis brevis

Question 63

Klumpke's paralysis-

Answer 63

ape and claw hand. lesion of C8 and T1

Question 64

weakness of pronation indicative of

Answer 64

anterior interosseous nerve lesion

Question 65

claw hand indicative of

Answer 65

ulnar nerve lesion

Question 66

which ventral rami make the lumbar plexus?

Answer 66

T12-L4

Question 67

which ventral rami make the lumbosacral plexus?

Answer 67

L4-S3

Question 68

tibial nerve is derived from what nerve?

Answer 68

the sciatic nerve

Question 69

which cells form parallel fibers in the cerebellar cortex?

Answer 69

granule cells

Question 70

the only excitatory cell in the cerebellar cortex

Answer 70

granule cell

Question 71

inhibitory interneurons of the cerebellar cortex

Answer 71

golgi cells

Question 72

pontocerebellar fibers originate from

Answer 72

contralateral pons

Question 73

olivocerebellar fibers originate in

Answer 73

contralateral inferior olive

Question 74

the only source of climbing fibers-

Answer 74

inferior olivary nuclei

Question 75

how many climbing fibers innervate each purkinje cell?

Answer 75

only 1

Question 76

are climbing fibers excitatory or inhibitory?

Answer 76

excitatory