Gustafson

Question 1

GPCR

Answer 1

• use 2nd messengers

- in the CNS they are from RHODOPSIN family

Question 2

GABAa

Answer 2

-IONOTROPIC -> FAST transmission

Question 3

GABAb

Answer 3

-METABOTROPIC -> SLOW transmission

Question 4

stroke

Answer 4

• CLINICAL event
• SUDDEN onset of neuro deficits
• TIA not a stroke
• don’t need complete loss of blood flow to get infarction

Question 5

penumbra

Answer 5

• blood flow 10-17 ml/min -> reversible damage w/ recirculation
• blood flow <7.7-14 -> irreversible damage

Question 6

most sensitive neurons to ischemia

Answer 6

• pyramidal cell layer of hippocampus
• cerebellar Purkinje cells
• pyramidal neurons in cerebral cortex (neocortex)

Question 7

focal ischemia due to hypo perfusion

Answer 7

• causes watershed infarcts

- border b/w ACA and MCA highest risk***

Question 8

most common cause of embolic thrombi

Answer 8

• CARDIOGENIC: A-fib***, calcified heart valves, mural thrombus after MI, paradoxical emboli due to ASD, coronary artery bypass
• need to anticoagulate

Question 9

epidural hematoma

Answer 9

• cause: traumatic skull fracture -> middle meningeal arteries
• younger ptx
• NOT cross suture lines

Question 10

subdural hematoma

Answer 10

• cause: blunt trauma -> bridging veins
• elderly
• CAN cross suture lines

Question 11

subarachnoid hemorrhage

Answer 11

-cause: trauma or rupture of aneurysm (saccular/berry)

Question 12

basal ganglia hemorrhage

Answer 12

-cause: HTN -> rupture of Charcot-Bouchard aneurysms (lenticulostriate arteries)

Question 13

lobar hemorrhage

Answer 13

-cause: OLD AGE or cerebral amyloid angiopathy (CAA)

Question 14

main symptoms of meningitis

Answer 14

• HEADACHE
• NUCHAL RIGIDITY
• FEVER
• +Brudzinskis and +Kernigs

Question 15

SUPPURATIVE meningitis

Answer 15

• ACUTE inflammation -> granulocytes
• hyperacute, rapid worsening, SEPSIS
• DEADLY and FAST progression

Question 16

ASEPTIC meningitis

Answer 16

• CHRONIC inflammation -> lymphocytes

- rapid onset but slower than suppurative

Question 17

is a CT or MRI better at looking for meningitis?

Answer 17

T2 MRI -> leptomeningeal enhancement

-T2 MRI also better for encephalitis

Question 18

CSF meningitis

Answer 18

• pleocytosis (> 5 WBCs per hpf***) 4=normal
• ELEVATED OP (>250mmH2O)
• NO RBCs

Question 19

CSF encephalitis

Answer 19

• pleocytosis
• NORMAL OP (<240mmH2O)
• ELEVATED RBCs

Question 20

main symptoms of encephalitis

Answer 20

• DELIRIUM
• SEIZURES
• FEVER

Question 21

which lobe is affected when HSV causes encephalitis

Answer 21

-temporal lobe

Question 22

cerebral abscess

Answer 22

• clinical: mass effect, FOCAL deficit, fever, SEIZURES
• SLOW onset
• surrounding capsule w/ edema
• image w/ T1 MRI

Question 23

subdural empyema

Answer 23

• PUS under the dura -> deadly

- emergency surgery

Question 24

edema surrounding cerebral abscess

Answer 24

-TREATABLE

Question 25

edema from ischemia

Answer 25

-cytotoxic (NON-TREATABLE)

Question 26

Multiple Sclerosis (MS)

Answer 26

- MULTIPLE lesions and >1 episode - REPEATED ATTACKS - lose myelin but PRESERVE axons - damage OPTIC nerves - lymphocytes attack myelin basic protein and myelin associated glycotprotein -> PERIVENOUS inflammation - CSF: high IgG, OLIGOCLONAL BANDS - image: PERIVENTRICULAR PLAQUES

Question 27

Neuromyelitis Optica (NMO)

Answer 27

- longer lesions than MS - Anti-Aquaporin 4 Ab*** - NECROSIS - affect eyes (optic neuritis) and spinal cord - Tx: Rituximab

Question 28

Acute Disseminated Encephalomyelitis (ADEM)

Answer 28

- MONOPHASIC (single attack) - NO relapsing or progressive course - affects brain and spinal cord - Tx: steroids

Question 29

Acute Transverse Myelitis (ATM)

Answer 29

- MONOPHASIC (single attack) - NO relapsing or progressive course - affects spinal cord only - Tx: steroids...more likely for chronic deficit

Question 30

Parkinson's disease

Answer 30

- loss of SN dopaminergic neurons - histo: alpha-synuclein Lewy bodies - idiopathic -> ABNORMAL dopamine SPECT - iatrogenic -> NORMAL dopamine SPECT

Question 31

Huntington's Chorea

Answer 31

- autosomal DOMINANT - CAG repeats - atrophy of Caudate nucleus and Putamen

Question 32

Friedrich Ataxia

Answer 32

- aut. recessive | - ataxia, spastic, weak, sensory neuropathy, Cardiomyopathy

Question 33

Ataxia-Telangiectasia

Answer 33

- aut. recessive | - ataxia-dyskinetic syndrome + telangiectasias + IMMUNODEFICIENCY

Question 34

ALS

Answer 34

- UMN/LMN loss - sporadic - bulbar WORSE prognosis than manual - RESPIRATORY FAILURE

Question 35

Progressive Muscular Atrophy

Answer 35

- subtype of ALS | - lose LMN

Question 36

Primary Lateral Sclerosis

Answer 36

- subtype of ALS | - lose UMN

Question 37

Spinal Muscular Atrophy (SMA)

Answer 37

-lose LMN in spinal cord

Question 38

SMA type 1

Answer 38

Werdnig-Hoffman - fatal in neonate - "floppy baby" - tongue fasciculations

Question 39

SMA type 3

Answer 39

Kugelber-Welander - child/adolescent

Question 40

SMA type 4

Answer 40

adult

Question 41

what shows a seizure on a EEG?

Answer 41

SUDDEN change | -inter-ictal spike

Question 42

epilepsy

Answer 42

syndrome of REPEATED seizures

Question 43

can normal brains have seizures?

Answer 43

YES | -most common cause are single, unprovoked seizures

Question 44

what can a diseased brain cause

Answer 44

-BOTH seizures and cognitive impairment

Question 45

what creates the electrical amplitude recorded on EEG?

Answer 45

MANY neurons firing SYNCHRONOUSLY together

Question 46

symptoms of seizures

Answer 46

- clonus -> fast contraction, slow relaxation (oscillating) - myoclonus -> irregular, sudden jerks (no rhythm) - tonic -> sustained contraction

Question 47

simple partial seizures

Answer 47

-RETAIN consciousness

Question 48

complex partial seizures

Answer 48

-LOSE consciousness

Question 49

secondary generalized focal seizures

Answer 49

-more common than primary generalized seizures