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1

Age-related macular degeneration types and therapies

Dry = sub retinal drusen deposits or pigment changes. Wet = abnormal blood vessels w/ sub retinal fluid/hemorrhage, gray subretinal membrane, or neovascularization (acute over days to weeks). Tx of acute = anti-VEGF inhibitors (prevent neovascular membrane formation), laser, photo

2

1st line drug for partial seizures

Carbamazepine; regardless of simple or complex

3

1st line drug for tonic-clonic sz

Phenytoin, carbamazepine, valproate

4

1st line drug for myoclonic sz

Valproic acid

5

1st line drug for absence sz

Ethosuximide, blocks T-type Ca2+ channels that trigger and sustain pulsed discharges in thalamic neurons. (2nd = valproate)

6

Gene defect in Friedreich's ataxia?

Frataxin gene - mitochondrial protein for respiratory f(x) and Fe homeo. GAA repeat.

7

Drug after SAH to prevent vascular spasm?

Nimodipine

8

Viral CSF pattern?

Lymphocytic pleocytosis, normal glucose, elevated protein.

9

Bacterial CSF pattern?

Neutrophilic predominance, low glucose, high protein.

10

Early-onset familial Alzheimer's associated w/ what mutations?

APP (21- Down's!), presenilin 1 (14), and presenilin 2 (1). Apo E4 w/ late.

11

Path associated with lacunar infarcts?

Small vessel lipohyalinosis and atherosclerosis ->fluid-filled cavities

12

Alzheimer's path

Decreased ACh lvl (deficient choline acetyltransferase) found in basal nucleus. Hippocampus. Neurofibrillary tangles, senile plaques, amyloid angiopathy.

13

Myasthenia gravis

Circulating Ab's against post-synaptic Ach receptors -> complement-mediated destruction -> weakness (late in day). Associated with thymoma or thymic hyperplasia.

14

Two types of dopamine agonists

Ergot compounds (bromocriptine and pergolide) and nonergot compounds (pramipexole and ropinirole).

15

Phenytoin mech

Blocks Na+ channels and prolongs their rate of recovery. Inhibits high-frequency firing. Tonic-clonic and status.

16

Triptan mechanism

Serotonin 5-HT1b/5-HT1d AGONISTS that counter release of vasoactive peptides

17

Migraine mech

Pain due to activation of trigeminal afferents that innervate meninges -> release of vasoactive neuropeptides (substance P and calcitonin gene-related peptide) -> neurogenic inflammation due to vasodilation and plasma protein extravasation. Neuronal sensitization

18

How does ketamine block morphine tolerance?

NMDA receptor antagonist to block actions of glutamate.

19

Subfalcine herniation

Cingulate gyrus herniates under falx cerebri --> ACA compression

20

Uncal herniation

Ipsi oculomotor, ipsi PCA -> contralateral homonymous hemianopsia w/ macular sparing, compression of contra cerebral peduncle -> ipsilateral hemipareses. brainstem hemorrhages

21

Dmg to putamen vs. globus pallidus

Putamen initiates movt so lesions --> tremor, bradykinesia, and rigidity. GP external dmg = less movt. Internal dmg = excessive motion/movt. Think of damage to globus as the normal pathways through them b/c they are inhibited in their pathways.

22

Nucleus ceruleus?

NE-secreting neurons for flight or fight. Dorsal pons.

23

Raphe nuclei?

Serotonergic neurons. Sleep-wake, lvl of arousal. Lesion -> insomnia and depression. Sir Raphe the sleepy.

24

Nucleus basalis of Meynert?

Cholingergic cells. Decreased amounts in Alzheimer's disease. Cholling Mr. Meynert?

25

Red nucleus?

In anterior midbrain. Important for motor coordination of upper extremities.

26

Monocular scotoma?

A partial lesion in the retina, optic disk, or optic nerve. etio - macular degeneration and optic neuritis

27

Homonymous superior quadrantanopia?

Lesion or stroke involving temporal lobe (Meyer's loop)

28

Homonymous inferior quadrantanopia

Lesion or stroke involving PARIETAL lobe (DORSAL optic radiation)

29

Korsakaoff syndrome damages what particular nuclei?

Anterior and dorsomedial thalamic nuclei -> confabulation. Anterograde amnesia (usu. permanent).

30

Role of the notochord?

Induces overlying ectoderm to form the neural plate, which gives rise to the neural tube and neural crest cells (dy 18). Notochord becomes the nucleus puposus of the intervertebral discs.