Neuro

Question 1

Most common cause of meningitis in older adults? What is its most important virulence factor?

Answer 1

S. Pneumoniae

Virulence factor: polysaccharide capsule which protects it from phagocytosis

Question 2

Buproprion drug class

Answer 2

Norepinephrine and dopamine Reuptake inhibitor
Increased risk of seizures in bulimics and anorexics
Tachycardia, insomnia, weight loss
Also used for smoking cessation; no sexual side effects

Question 3

Locked in syndrome results from infarcts of the ______. Since eye movements and eyelid elevation are controlled in the rostral midbrain, these functions remain preserved

Answer 3

Ventral pons

Question 4

Causes of locked in syndrome

Answer 4

Stroke of basilar artery
Tumor
Encephalitis
MS
Central pontine myelinolysis (demyelination of pons)

Question 5

The upper retina receives information from the lower visual field and travels in the _____ lobe. The lower retina receives information from the upper visual field and travels in the ____ field

Answer 5

Parietal lobe
Temporal lobe (loop of Meyer)

Question 6

Presentation for epidural hematoma

Answer 6

Initial concussion causes unconsciousness followed by regaining consciousness and appears lucid (Lucent interval); as Uncus herniates, it compresses midbrain around oculomotor nerve resulting in a DILATED PUPIL and loss of consciousness (uncal herniation)

Question 7

Does an epidural hematoma spread past a suture line?

Answer 7

No because the dura is attached to the skull at the suture lines so epidural hematoma results in baconvex accumulation of blood

Question 8

1. Paralysis of the entire side of face indicates what lesion?
2. Paralysis limited to lower half of face indicates what lesion?

Answer 8

1. Ipsilateral LMN lesion

2. Contralateral UMN lesion

Question 9

Werdnig Hoffman disease (spinal muscle atrophy type I) is a disease of ______ cells. In infants it also involves what tract?

Answer 9

Ventral horn cells

Corticobulbar involvement can cause poor feeding and respiratory failure in infants

Question 10

Temporal lobe abcess causative organisms

Answer 10

Staph
Strep (both aerobic and anaerobic)
Bacteriodes

Question 11

What is selegiline used to treat and how does it work?

Answer 11

Used to treat Parkinson’s
It is an MAO-B inhibitor. Dopamine is preferentially metabolized by MAO-B so dopamine levels will rise if MAO-B is inhibited

Question 12

Wernicke’s-Korsakoff syndrome is caused by a _____ deficiency secondary to _____. Which symptoms are reversible and which are irreversible? Which structure is this associated with?

Answer 12

Thiamine deficiency secondary to alcohol abuse

Wernicke’s encephalopathy (confusion, ataxia ocular palsies) is reversible. Korsakoff’s syndrome (anterograde and retrograde amnesia and confabulations) is irreversible.
Associated with Mamillary body