Neuro 5 Flashcards
(73 cards)
What fetal abnormality can be seen in infants of mothers who take lithium during early pregnancy?
Ebstein’s anomaly: atrialized RV d/t downward displacement of tricuspid valve
What congenital anomaly is most likely to occur in pregnant pts who take valproate and why?
NTDs b/c valproate inhibits intestinal folic acid absorption
What 3 products are derived from POMC and what does this indicate?
B-endorphins, ACTH, and MSH - suggests there may be a close physiological relationship between stress axis and opioid system
What are 3 classic symptoms of pineal germinomas?
- precocious puberty: increased B-hDG
- obstructive hydrocephalus d/t compression of cerebral aqueduct
- Parinaud syndrome d/t compression of tectal area of the midbrain
Which hallucinogen presents with Sx of agitation, dissociation, hallucinations, violent behavior, and memory loss and PE findings of nystagmus and ataxia?
Phencyclidine
Which stimulant presents with Sx of euphoria, increased arousal, agitation, chest pain, headaches, and seizures and PE findings of tachycardia, hypertension, and mydriasis?
Cocaine
Which stimulant presents with Sx of agitation, psychosis, diaphoresis, and violent behavior with PE findings of tooth decay, HTN, tachycardia, and choreiform movements?
Methamphetamine
Which hallucinogen presents with Sx of visual hallucinations, depersonalization, euphoria, occasional dysphoria and panic and PE findings of mild tachycardia, milk HTN, and pt alert and oriented?
LSD
Which psychoactive drug presents with Sx of increased appetite, euphoria, slowed reflexes, and impaired time perception and PE findings of dry mouth, conjunctival injection, and mild tachycardia?
Marijuana
Which opioid analgesic presents wiht Sx of mild euphoria or lethargy to coma and PE findings of miosis, decreased respiratory rate, and decreased bowel sounds?
Heroin
What is the MOA of PCP?
hallucinogen that works as an NMDA antagonist leading ot excess release of excitatory NTs
Which vitamin deficiency leads to degeneration of spinocerebellar tracts, dorsal column of spinal cord, and peripheral nerves?
Vitamin E
Which vitamin deficiency presents with the triad of ataxia, confusion, and ophthalmoplegia?
Thiamine
What blood disorder causes acute abdominal pain, peripheral neuropathy, and hyponatremia?
acute intermittent porphyria
What disorder does severe vitamin E deficiency resemble?
Friedreich ataxia
What is the most common medical cause of excessive daytime sleepiness in the US?
obstructive sleep apnea
What are risk factors for obstructive sleep apnea?
obestiy, tonsillar hypertrophy, and hypothyroidism
What are Sx and PE findings of obstructive sleep apnea?
Sx: poor orophyrngeal tone leading to daytime sleepiness, morning headaches, and depression
PE: obesity and increased soft tissue in oropharynx
Which barbituate-like IV anesthetic agent is often used in surgery?
Thiopental
What is the cause of the short half life and rapid plasma decay of thipoental?
REDISTRIBUTION to other tissues throughout the body, such as skeletal muscle and adipose tissue
What is the course of CN III?
It exits the midbrain and courses between the PCA and superior cerebellar arteries
Aneurysm of which arteries can lead to a non-pupil sparing CN III palsy?
PCA or superior cerebellar a.
What type of injuries are GVE and GSE fibers of CN III susceptible to, respectively?
GVE: injury from compression (i.e. aneurysm and tumor) bc on outside of CN III
GSE: injury from ischemia (i.e. diabetes) bc on inside of CN III
A 34 yo swimmer presents with ear infection. While inspecting the pt, you insert a speculum into the external auditory meatus in close contact with its posterior wall. The pt faints during the procedure. Irritation of which of the following nerves was most likely induced?
CN IX - it does cutaneous innervation to the posterior part of the external auditory canal via small auricular branch and pt fainted d/t vasovagal syncope
