neuro 3 Flashcards
1
Q
3 most cmmon metastaes to brain
A
lung, breast, kidney
2
Q
MCC tumor of astrocytes in children
A
pilocytic astrocytoma
benign
3
Q
malignant high tumor of astrocytes, MCC seen in adults , high grade
A
glioblastoma multiforme
4
Q
distribution of glioblastoma
A
CAN CROSS CORPUS CALOSUM
5
Q
histologic hallmark glio
A
edge of necrosis “psudopallisaiding” peomorphic tumors
ENDOTHELIAL CELL PRLIFERATION
6
Q
intermdediate filament present in glioblastoma
A
GFAP
7
Q
adult arachnoid cell atumor
A
meningioma
more often in females
8
Q
round mass attached to dura assocaied with seizures
A
meningioma
9
Q
whirled appearance of cells and psamomma bodies
A
meningioma
10
Q
schwannoma
A
benign tumor of schwanna cells
11
Q
MCC cranial nerve and location of schwanomma
A
CN 8 at cerebellopontine angle
12
Q
loss of hearing tinnitus
A
schwanomma
13
Q
bilateral vestibular schwanomma found in what disease
A
NF2
14
Q
what marker is positive in schwanomma
A
S100
15
Q
fried egg appearance (round nuclei with clear cytoplasm()
A
oligodendroglioma
16
Q
calcified tumor white matter usually involving frontal lobe and presents with seizures
A
oligodendroglioma
17
Q
most common CNS tumor in children
A
pilocytic astrocytoma
18
Q
cystic lesion with nodule growing on wall
A
pilocytic
“PILOCYSTIC” astrocytoma
19
Q
key finding in pilocytic astrocytoma
A
rosenthal fibers (eosinophilic corkscrew fibers) GFAP positive
20
Q
most common MALIGNANT tumor in children
A
medullobastoma
21
Q
small round blue cells, homer wright rosettes…origin of tumor
A
medulloblastoma
NEUROECTODERM
22
Q
feared complication of medulloblastoma
A
compress 4th venticle causing noncommunicating hydrocephalus and can send “DROP METASTASES” into spinal cord
23
Q
“drop metastaes” in spinal cord
A
medulloblastoma
24
Q
not medulloblastoma but presents with hydrocephalus
A
ependyomoma
25
key finding in ependymoma
perivascular pseudorosettes
| typically in 4th ventricle
26
bitemporal hemianopsia in CHILD
craniopharyngioma
27
origin of craniopharyngioma
rathke's pouch (same as adrenals)
typically assocaited with califications and CHOLESTEROL CRYSTALS
28
vertigal gaze palsy, obstructive hydrocephalus, PRECOCIOUS PUBERTY in males
pineal gland tumor (pinealoma)
29
consequences of cerebellar tonsillar hernation into foramen magnum
coma and death due to brain stem compression
30
consequences of uncal hernation
uncus = medial temporal lobe
compresses ipsilateral CNII (blown pupil, down and out gaze)
as well as ipsilateral PCA homonymous hemianopia with macular sparing
31
consequence of transtentorial (central downward hernation)
paramedian basilar artery branch rupture DURECT hemorrhages
32
cingulate (herniation under falx cerebri) hernation consequence
compresses anterior cerebral artery
33
tumor assocaited with VHL
hemangioblastoma
| usually found with retinal angiomas
34
epo producing tumor tumor
hemangioma
35
brain tumor assocaited with bHCG production
pinealoma
36
LP shows increased CSF protein with norlmal to low WBC (albuminocytologic dissociatoin)
guillan barre
37
how does campylobacter cause autoimmune attack of peripherla mylen
molecular mimicry
38
what will cause osmotic demyelination and what will cause cerebral edema/herniation
correcting hyponatremia - osmotic demyelination
| correcting hypernatremia - cerebral eema
39
kinesin responsible for whta process in cells
MICROTUBULE assocaited TP power motor protein that facilitates ANTERIOGRADE (down axon) transport of NT containting secretory vesicles
40
fuction of nerve that exits pelivs through obdurator foramen
```
obdurater nerve (L2 L4)
adducts thigh and sensory to distal medial thigh
```
41
nerve that provides motor function to aterolateral abdominal wall muscles and provies sensation of suprapubic region
iliiohypogastric nerve (L1 nerve root)
42
differencein eye defecit between PCA and MCA stroke
PCA - damages occipital cortex, results in contralateral homonymous hemianopia with MACULAR SPARING
MCA - homonymous hemianopia WITH macular INVOLVEMENT, usually presents with contralateral motor and sonsory loss
43
nipple dermatome
T4
44
what nerve roots responsible for erection and sensation of penil and anal zones
s2 s3 s4
| s2 3 4 keeps dick off floor
45
muscarinic effecton detrusor msucle of bladder
detosor CONTRACTION
| causes peeing
46
one week after stroke what will be prominent in cell ischemic tissue
MICROGLIA (1 week granulataion tissue phase)
47
MCC cause of spontaanoues lobar hemorrhage in elderly
cerebral amyloid angiopathy (usually affects occipital and parietal lobes)
48
non rhythmic conjugate eye movements and myoclonus in child with abdominal mass
neuroblastoma
djet o increased number of N-myc gene
most common extra cranial neoplasm in children
neural crest origin
49
microscopic findings neuroblastoma
solid sheets small cells dark nuclei and scant cytoplasm
50
CNX lesion where does uvula deviate
away from lesion (weak side collapses and points uvula away)
51
how does left CN XI lesion present
weakness in left shoulder (trapezius) and weakness turning head to RIGHT
ipsilateral shoulder weakness in contralateral turn
(left SCM helps turn head to right)
52
cn v motor lesion
jaw deviates TOWARDS lesion due to uonopposed force form opposite pterygoid muscle
53
UMN lesion what happens to forehead
spared (due to bilatral forehead UMN innervation
54
LMN lesion in face forehead
not spared (desttuction of CN 7 anywhere leads to ipsilateral paralysis of upper andlower muscles, hyperacusis, loss of taste to anterior tongue
55
tuberous clerosis mutation
TSC1/TSC2 mutation on chromosome 16 AD
56
cardiac rahbdomyoma, mental retardation, angiomyoplipoma, angiofibromas, mitra regurg
tuberous sclerosis
57
hamartomas CNS and skin, ashleaf spots, shagreen patches
tuberous sclerosis
58
somatic mosaicims for actiating mutaiton in one copy of GNAQ gene
sturge weber (encephalotrigeminal angiomatosis)
59
port wine stain, tram track calcificaiotns, glaucoma
sturge webber
60
birth mark in CN V1,V2 disribution
neus flammeus port wine stain seen in sturge webber
61
NF1 mutation in what type of gene
tummor suppressor gene on chrom17
62
besides bilateral acoustic schwanommas what other findings in NF2
juvenile cataracs, meningiomas, ependymomas (2 ears, 2 eyes, 2 parts of brain)
63
bilateral renal cell carcinoma, pheochromocytomas
VHL
64
mutated gene von hippel lindau
VHL gene DELETION
65
hemangioblastomas with angiomatosis (cavernous hemangiomas in skin
VHL
66
where are low frequency sounds heard
apex near helicotema (wide and felxible)
67
where are high frequency hsounds hear
base of chochlea (thin and rigid)
| these usually go first in presbyacusis
68
choleastoma is conductive hearing loss due to overgrowth of what in middle ear space
desquamated karatin (erodes ossicles and mastoid air cells)
69
very painful red eye, sudden visoin loss, halos around lotes, frontal headache, fixed and mid dilated pupil
ACUTE CLOSURE glaucoam
emergency
do not give epinephirine because it casues mydriasis
70
accumulation pus anterior chamber, conjucivitis
uveitis
| associated with HLAb27 conditions
71
deposition of yellowish extracellular material in retinal pigment epitheliam on pigment exam
age related dry macular degeneration
72
wet vs dry macular degen
dry - non exudative, has those yellow drussen deposits,
| wet - exudative has rapid loss of vision due to choroidal NEOVASCULARISATION treat with anti VEGF
73
f=what to look for in DM retinopatyh
look for damaged capillaries on fundoscopic, black hemorhagges (dark spots)plus macular edema
74
dilated retinal artery plus compression
retinal vein occlusion
75
crinkling retinal tissue
retinal detachment
76
flashes floaters, curtai drawin down in one eye
retinal detachment
77
which nerve mediates miosis and nucles
CN III via edinger westphal nucleus
| parasympathetic
78
marcus gunn pupil
APD (optic nerve damage or retinal injuyr
| decreased constriction when light is shined on affected eye compared to unaffced eye
79
Horner syndrome assocaied with what psinal location
anything above T1
80
eyes move upwad particularly with contralateral gaze, toruble moving down stairs, needs to tilt head opposite direction
cn iv damage trochlear nerve
81
ptosis down and out gaze
cn III motor injyr (usually form vascular dises)
82
blown pupil down and out gaze, absent pupillar light reflex
cn III parasympathetic lesion from compression or aneurysm, PCOM, uncal hernation
83
rihgt tempora lesion or MCA results in what
left upper quadrantanopia
84
right parietal lesion, MCA results in
left lower qudrantinopia
85
how to differentiate between temporal and parietal lesion
tempora - upper
| paraietal - lower qudrantanipa
86
central scotoma
macular degneration
87
hemanopia with macular SPARING
PCA infarct
88
decreased maxillary sensaiton, variable ophtalmoplegia, decreased corneal sensation, horner syndrome,
cavernous sinus snydomre
secondary to pituatary tumor mass effect or cavernous sinus thrombois
CN VI most suspectibel to injury
89
sturcute injured in INO
medial longitudinal fasiculas
| happens in MS
90
treatment for absence seizures
ethosuximide
| SUX TO HAVE SILENT SEIZURES
91
sie effects ethosux
```
EFGHIJ
Ethosux causes
Fatigue
GI edisress
Headache
Itching
and stevenJohnson syndrome
```
92
sensory impairment in palmar surface of first 3 digits and radial half of 3 digits often bilateral
nerve compression Carpal tunnel syndrome of median nerve
93
HIV patient with CD4 count 158 presents with weakness, visual chagnes, and speech difficulties which has been getting worse over past few weeks
MRI shows multiple NONenhancing lesions in brain
JC virus (polyoma)
94
renal transplant patient presents with gross hematuria nd fever
hemorrhagic cystiitis from BK virus (polyoma)
95
what to adminster with levodopa
cabidopa (inhibits DOPA decarboxylase
| this incraesse bioavailability of L-dopa and limit peripheral side ffects
96
MOA capsaicin
release and DEPLETION o fubsstance P...defunctionalization o f nociceptive nerve fibers
97
surgery patient develops acute hepatitis in post op period (days- weeks after) due to what med
halogentaed inhaled anesthetics (halothane, enflurane, isoflurane, desflurane
ANE drugs
98
patient coems in with organophosphate toxicity and given atropine...why must you also give pralidoxime
atropine is a muscarinic blocker only at MUSCARINIC affects but doesn't block NICITONIC effects like MUSCLE PARALYSIS....pralidoxime hasmuscarinic and nicotinic effects
99
MOA barbituates (thiopental) vs benzos
barbituates increase DURATION of CL channels opening, longer acting
benzos - increase FREQUENCY of opening of GABA chloride channels....more short acting
100
TB med that causes optic neuropathy
ethambutol
101
TB med that cauess red orange pee discoloration
rifampin
102
why is tazobactam added to pipercillin
decrease destruction by beta lactamase enzyme of bacteria
103
MOA acyclovir valacyclor famciciclovir
nucleoside analog which is incoporated into virus DNA by thymidine kinase which competes for viral DNA polymerase...
