General neuro 0424Q Flashcards

1
Q

obstruction of brachiocephalic vein

A

sx similar to SVC syndrome but on ONE side of body - ex: face and arm swelling, engorgement of subcutaneous veins of neck.

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2
Q

DNA pol I

A

remove RNA primer via 5’-3’ exonuclease activity. also fills in gaps by 5’-3’ DNA replacement.

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3
Q

primase

A

forms RNA primer (free 3’-OH)

aka DNA dependent RNA polymerase.

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4
Q

benzodiazepines

A

increase freq of opening of CNS GABA receptor chloride channels. hyperpolarized membrane = less excitable.

effects: anxiolytic, anticonvulsant, muscle relaxant, sedative-hypnotic

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5
Q

tx of serotonin syndrome

A

cyproheptadine - antihistamine with anti-serotonergic properties

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6
Q

serotonin syndrome

A

altered mental status: confusion, agitation.

neuromusc dysfunction: tremor, clonus, hyperreflexia, rigidity, myoclonus.

autonomic instability: tachycardia, HTN, hyperthermia, diaphoresis, vomiting, diarrhea.

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7
Q

prevention of neonatal tetanus (rigidity, spasms)

A

maternal immunization with tetanus toxoid - allow transfer of protective IgG antitoxin Abs across placenta to fetus

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8
Q

most common cause of retinitis in HIV pt

A

CMV - esp with CD4+ count < 50.

treat with ganciclovir.

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9
Q

drugs that induce serotonin syndrome

A

any that increase serotonin levels - combo SSRI + MAO-I; high dose SSRI

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10
Q

precursor of serotonin

A

tryptophan

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11
Q

tetanospasmin

A

neurotoxin released by C.tetani.
inhibition of inhibitory interneurons in SC that regulate firing of primary motor neurons. neurotoxin blocks release of GABA and glycine used by interneurons.

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12
Q

Alzheimer NT

A

decreased ACh in nucleus basalis of Meynert and hippocampus - due to decreased activity of CHAT

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13
Q

essential AA when PKU develops

A

tyrosine (can no longer be synthesized from phenylalanine)

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14
Q

enzymes affected in PKU

A

phenylalanine hydroxylase is DEFICIENT - can’t convert Phe to Tyr. responsible for disease.

tyrosinase is INHIBITED by excess phenylalanine - can’t synthesize melanin from Tyr. fair pigmentation results.

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15
Q

propionic acidemia

A

propionyl CoA is derived from AA (Val, Ile, Met, Thr), odd number fatty acid, chol side chains. deficiency of propionyl CoA carboxylase (prop CoA to methylmalonyl CoA) leads to development of acidemia.
methylmalonyl CoA is supposed to form succinyl CoA for TCA cycle.

sx: poor feeding, vomit, hypotonia, lethargy, dehydration, anion gap acidosis.

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16
Q

genetic reassortment

A

in viruses with segmented genomes.
exchange of entire genome segments.
results in GENETIC SHIFT.

ex: orthomyxovirus, rotavirus.

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17
Q

influenza surface glycoprotein

A

hemagglutinin - undergoes genetic reassortment.

*anti-hemagluttinin Abs help prevent re-infection (circulating IgG; mucosal IgA in nasopharynx)

18
Q

genetic DRIFT

A

occurs via point mutations.
occurs in any virus.
much slower and less drastic change.

19
Q

distinguishing feature of Edwards syndrome

A

trisomy 18.
clenched hands with overlapping fingers.

other features: small jaw, small eyes, low ears. rocker bottom feet (also seen in Patau)

20
Q

lesion of macula

A

central scotoma

21
Q

CSF findings in cryptococcal meningitis

A

low glucose
increased protein
increased cell count (lymphocytes)

*dx by INDIA INK staining of CSF

22
Q

tx of cryptococcal meningitis

A

amphotericin B

initial period: flucytosine
long-term maintenance: fluconazole

23
Q

incidence of disease

A

new cases per yr / total pop at risk

24
Q

axonal transport

A

anterograde: away from nucleus, down axon toward nerve terminal - KINESIN
retrograde: toward nucleus - DYNEIN

25
Q

EBV mononucleosis

A

fever, pharyngitis, lymphadenopathy, hepatosplenomegaly, atypical lymphocytosis, positive monospot.

26
Q

mitochondrial disease

A

maternal inheritance ONLY.
affect male and female offspring equally (100%).
variable severity due to random distribution of normal and mutated mito between daughter cells during mitosis - HETEROPLASMY.

27
Q

Leber hereditary optic neuropathy

A

mito dz.

bilateral vision loss.

28
Q

myoclonic epilepsy with ragged red fibers

A

mito dz.

myoclonic seizures and myopathy w/exercise. irregular muscle fibers on bx.

29
Q

mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS)

A

mito dz.

as described by name.

30
Q

morphine

A

binds to G-protein linked MU receptor - increased potassium efflux causes hyperpolarization of postsynaptic neurons to block pain transmission

31
Q

maple syrup urine disease (MSUD)

A

defect in alpha-keto acid dehydrogenase.

inability to degrade branched chain AAs (valine, leucine, isoleucine)

32
Q

triad of Wernicke syndrome

A
  1. ophthalmoplegia
  2. ataxia
  3. confusion

reversible with THIAMINE.

33
Q

Korsakoff syndrome

A

complication of Wernicke.
PERMANENT memory loss and confabulation.

damage of medial dorsal nucleus of thalamus.

34
Q

exacerbation of thiamine deficiency

A

glucose infusion - bc thiamine is used in metabolism of simple sugars

35
Q

what causes subarachnoid hemorrhage?

A

rupture of saccular (berry) aneurysm or AV malformation.

36
Q

which drug causes sexual dysfunction: SSRI or bupropion?

A

SSRI

37
Q

which has a better side effect profile: SSRI or TCA?

A

SSRI

TCA effects: urinary retention. cardiac arrhythmias (OD). seizure. orthostatic hypotension. sedation.

38
Q

what accumulates in B12 deficiency and why?

A

methylmalonic acid - B12 is cofactor for methylmalonyl CoA mutase that converts methylmalonyl CoA into succinyl CoA

39
Q

what worsens MS sx?

A

heat exposure

40
Q

alzheimer-specific therapies

A
  1. enhanced cholinergic effect
  2. neuroprotection w/antioxidants
  3. NMDA receptor antagonism
41
Q

MAO inhibitor-tyramine crisis

A

hypertensive crisis after consuming WINE and CHEESE and SAUSAGE.

MAO-I blocks degradation pathway for amine NTs - including tyramine (sympathomimetic) in food.