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Neuro Flashcards

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1
Q

Conversion disorder vs. somatic symptom disorder

A

Conversion has neurological involvement and often associated with acute stress

SSD: excessive anxiety around 1 or more symptoms

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2
Q

Schizophrenia vs. schizoaffective vs. schizophreniform

A

Schizophrenia: >2 symptoms for >6months
Brief psychotic d/o: <1month
Schizophreniform d/o: 1-6 months
Schizoaffective d/o: schizo + depression

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3
Q

Glaucoma drugs

A 
Sympathetic drugs (a ag, b antag) decrease Synthesis
chOlinomimetics increase Outflow

BimatoprOst, latanoprOst increase Outflow (iris darkening)

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4
Q

Vent treatment of increased ICP especially with trauma or acute

A

Hyperventilation -> decreased CO2 -> CNS vasoconstriction

CO2 is potent CNS vasodilator

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5
Q

Nissl substance

A

RER in neurons
Basophilic granules
Loss of nissl = apoptosis

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6
Q

Patterns of neural injury and findings:
Acute damage
Axonal loss
Neuronal atrophy

A

Acute: red dead, shrunken body/nuc, loss of Nissl, eos cyto
Axonal loss: big body, big nuc/nucleo, Nissl dispersion
Atrophy: loss of fxnal groups, reactive gliosis

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7
Q

POMC derivatives

A

ACTH
MSH
ß-endorphin (opioid)

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8
Q

Myotonic muscular dystrophy

A

AD - CTG repeat, anticipation
Abnormally slow relaxation of fibers
Can’t let go of doorknob, can’t let go of handshake

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9
Q

Buspirone

A

Non-benzo benzo
Slow onset
Good for GAD, bad for Panic Disorder/actue stuff

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10
Q

Mu, delta, and kappa opioid receptors are coupled to?

A

Inhibitory G protein

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11
Q

Effects of opioid analgesics on 1st and 2nd order neurons

A

1st (peripheral neuron): binds pre-terminal and inhibits voltage gated calcium
2nd (spinal cord neuron): binds post-terminal and stimulates K+ efflux out of cell

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12
Q

Cavernous malformation

A

Vascular malformation
Clusters of dilated, thin walled capillaries
Tend to bleed -> intracerebral hemorrhage
Hyperdense, bright mass on CT

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13
Q

Elevated 14-3-3 protein in CSF

A

Creutzfeldt-Jakob

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14
Q

Elevated hypocretin-1 in CSF

A

Narcolepsy

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15
Q 
Functional anatomy of cerebellum:
Lateral hemisphere
Intermediate hemisphere
Vermis
Flocculonodular lobe
A

Lateral hemisphere = motor planning
Intermediate hemisphere = motor execution via lateral descending systems
Vermis = motor execution via midial descending systems
FL = balance and eye movements

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16
Q

Headache followed by sudden unilateral blindness with a PMH of shoulder/hip pain?

A

Temporal arteritis
(with polymyalgia rheumatica)
Another sign = jaw claudication

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17
Q

Bilateral spastic paresis with elevated arginine

A

Arginase deficiency (produce urea, ornithine)
Urea cycle defect
Little to no hyperammonimia
Tx: low protein diet

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18
Q

First area of the brain that is damaged during global cerebral ischemia?

A

Hippocampus

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19
Q

Opsoclonus-myoclonus syndrome in a kiddo with an abdominal mass

A 
Neuroblastoma (vs. Wilms)
Can cross midline
Eye stuff = not wilms
N-myc
Catecholamine metabolites in urine
<4 years old
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20
Q

Dandy walker

A

Vermis agenesis. 4th ventricle dilation.
Fourth Fills Fossa
Non-communicating hydrocephalus

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21
Q

Chiari II (Arnold-Chiari)

A

Vermal herniation
Hydrocephalus (aqueductal stenosis)
Meningomyelocele

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22
Q

Chiari I

A

Tonsillar herniation

Associated with syrinx

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23
Q

Syringomyelia

A

Cape-like sensory loss (fine touch preserved)

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24
Q

Normal pressure hydrocephalus

Study These Flashcards
A

Wet wobbly and wacky:

Urinary incontinence
Magnetic gait/ataxia
Cognitive dysfxn

Affects elderly, dilated ventricles, episodic

25
Communicating hydrocephalus
Decreased CSF absorption by arachnoid granulations | Ex. scarring post-meningitis
26
Non-communicating hydrocephalus
= obstructive
27
Friedreich ataxia
AR -> (GAA)n frataxin gene Loss of DTR's, vib, prop Staggering gait, falling, nystag, pes, DM, HCM, scoli Staggering FRAT brother with a BIG, SWEET HEART Kinda looks like vitamin E deficency
28
Three elements of aphasia
Speech Fluidity Comprehension Repetition
29
Aphasia basics
Arcuate fasciculus connects Broca's and Wernicke's Any problem with AF = impaired repetition Transcortical occur AROUND Broca's (motor) and Wernicke's (seonsory) therefore AF is fine
30
SIG E CAPS
``` Sleep disturbance Interest (anhedonia) Guilt, feeling worthless Energy loss Concentration problems Appetite Psychomotor retardation Suicidal ideation ```
31
DIG FAST
``` Distractibility Irresponsibility Grandiosity Flight of ideas Activity/agitation no Sleep Talkativeness ```
32
Adult primary brain tumors
``` Glioblastoma Meningioma Hemangioblastoma Schwannoma ODG pituitary Adenoma ``` Old MEN Go Home After School
33
Childhood primary brain tumors + one in the abdomen
``` Pilocytic astrocytoma Medulloblastoma Ependymoma Craniopharyngioma Pinealoma ``` Also: Neuroblastoma - but not 1˚ brain (abdomen) MEDium Pinetrees Excite People's Christmas
34
Structure affected with hemiballism
Hemiballism = wild, involuntary, unilateral movements Damage to the subthalamic nucleus (lacunar stroke) which modulates BG output
35
Lambert-Eaton Syndrome
Myasthenic syndrome Antibodies against presyn Ca channels Associated with lung cancer Increase in muscle response with repetitive stim
36
Extensor vs. flexor posturing
At or below red nucleus = extensor (midbrain, pons) | Above red nucleus = flexor (hemispheres, int. cap)
37
Herniation syndromes
Subfalcine (ACA damage) Central (basilar artery rupture, Duret hemorrhage) Uncal (Blown pupil, down and out) Tonsillar (Brain stem compression) Speeding Colorado To Utah
38
Brain findings post MI and v-fib death
Watershed zones = wedge shaped necrosis caused by hypoperfusion Hypoxic-ischemic encephalopathy ACA/MCA MCA/PCA
39
Frontal lobe syndromes
Changes to executive fxn/personality Left side = more apathy and depression (Left=Lame) Right side = disinhibited behavior (Right=Risky)
40
Tetrodotoxin binds to?
Na channels preventing depolarization
41
Group B personality disorder
Historically, Bad Ass Narcisstists (Wild) Histrionic (attention seeking) Borderline (unstable, suicide, splitting) Antisocial (>18 -> <18=conduct d/o) Narcissistic
42
Personality disorders
Weird (paranoid, schizoid [d=distant], schizotypal [t=magical thinking] Wild (histrionic, borderline, antisocial, narcissitic) Worried (avoidant, OC, dependent)
43
Globus sensation
Functional disorder "feels like something stuck in throat" Intermittent/persistent Nothing on eval
44
Craniopharnyomas arise in who? From what? Cause what classic symptom?
In kids From Rathke's pouch (calcified on exam) Bitemporal hemianopsia
45
Difference between acute and post-traumatic stress disorder?
Acute <1 month | PTSD >1 month
46
Causes of Lhermitte's sign
MS | Cobalamin deficiency
47
Broca's vs. Wernicke's aphasia
``` Broca = broken boca (mouth), comprehension okay Wernickes = word salad, impaired comprehension ```
48
Unmyelinated axons
Group C fibers Autonomic postganglionic fibers Heat sensation Burning/dull visceral pain
49
Normal pressure hydrocephalus | Triad
``` Expansion of ventricles, elderly Wet, wobbly, wacky Urinary incontinence Ataxia Cognitive dysfunction ```
50
Many many lobar hemorrhages?
Amyloid angiopathy
51
ALS treatment?
Riluzole
52
HIV dementia path findings
Microglial nodules | May fuse to form giant cells
53
First sign of uncal herniation
Ipsilateral down and out eye
54
Hypertensive brain bleeds at initial presentation: Clean CT Hyperdense area on CT
Both involve lenticulostiate vessels Clean CT = arteriosclerosis, small rupture, will be present on CT later Immediate CT changes = CB rupture, intraparenchymal hemorrhage
55
Cerebellar lesions/bleeds
``` Lateral = limbs Medial/vermal = truncal ataxia (wide based gait) ```
56
Hydrocephalus due to cortical loss?
Not increased CSF, but cortical atrophy Hydrocephalus ex-vacuo
57
Alz dz: Neurotransmitter changes (where) Atrophied regions
Decreased Ach in the nuclus basalis | Atrophied cortical and hippocampal areas
58
Crutzfield Jakob
Prion dz Rapidly progressive Grey matter changes Spongiform encephalopathy
59
Cerebellar degeneration with extra-CNS cancer
Autoimmune attack Classic: Small cell lung Also: Breast/ovarian/uterine Anti-Yo, anti-P/Q, anti-Hu

STEP 1 (11 decks)

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