Neuro

Question 1

order of sleep stages and waveforms

Answer 1

awake- beta
awake (eyes closed)- alpha
non-rem:
  N1- theta
  N2- sleep spindles, K complexes
  N3- delta (sleep walking, night terrors, bed wet)
REM- beta

Question 2

decreased mesocortical dopaminergic pathway

Answer 2

negative symptoms

Question 3

increased mesolimbic dopaminergic pathway

Answer 3

positive symptoms

Question 4

decreased nigrostriatal dopaminergic pathway

Answer 4

extrapyrimadal symptoms

Question 5

decreased tuberoinfundibular dopaminergic pathway

Answer 5

increased prolactin–> gynecomastia, galactorrhea, sex dysfunction, decreased libido

Question 6

deep nuclei of cerebellum

Answer 6

(lateral to medial)
dentate, emboliform, globose fastigial

dont eat greasy food

Question 7

input to cerebellum

Answer 7

• contralateral cortex via middle cerebellar pedunce

- ipsilateral proprioceptive via inferior cerebellar peduncle

Question 8

outputs from cerebellum

Answer 8

purkinje cells –> deep nuclei –> superior cerebellar peduncele –> contralateral cortex

Question 9

stroke of middle cerebral artery

Answer 9

face and upper limb: contralateral paralysis and sensory loss

if dominant: aphasia
if nondominant: hemineglect

Question 10

stroke of anterior cerebral artery

Answer 10

lower limb: contralateral paralysis and sensory loss

Question 11

lacunar infarct of lenticulostriate artery

Answer 11

face and body: contralateral paralysis and sensory loss

Question 12

stroke of anterior spinal artery

Answer 12

Medial medullary syndrome

• contralateral paralysis
• contralateral decreased proprioception
• ipsilateral hypoglossal dys.

Question 13

stroke of PICA

Answer 13

lateral medullary syndrome (Wallenberg)

• vomit, vertigo, nystagumus
• decreased pain/temp (ipsilateral face, contralateral body)
• dysphagia, hoarse
• decreased gag reflex
• ipsilateral horners
• ataxia, dysmetria

Question 14

stroke of AICA

Answer 14

lateral pontine syndrome

• vomit, vertigo, nystagmus
• paralysis of face- decreased lacrimation, salivation, taste from anterior
• decreased pain temp (ipsilateral face, contralateral body)
• ataxia, dysmetria

Question 15

stroke of basilar artery

Answer 15

locked in syndrome- conscious and can blink

Question 16

stroke of posterior cerebral artery

Answer 16

contralateral hemianopia with macular sparing

Question 17

charcot-bouchard aneurysm

Answer 17

small vessels

from chronic hypertension

Question 18

most common spot of berry aneurysm

Answer 18

junction of anterior cerebral artery and anterior communicating artery

Question 19

effects of anterior communicating artery rupture from aneurysm

Answer 19

SAH

bitemporal hemianopsia, visual acuity deficits

iscemia in ACA–> contralateral hemiparesis and sensory loss in lower limb

Question 20

effects of posterior communicating artery rupture from aneurysm

Answer 20

SAH

ipsilateral CN III palsy–> mydriasis, ptosis

Question 21

central post-stroke pain syndrome

Answer 21

initial paresthesias

then- allodynia (pain from painless stimuli), dysesthesia (unpleasant touch)

Question 22

causes of subdural hematomas

Answer 22

• acute trauma
• chronic cerebral atrophy- elderly, alcoholism
• shaken babies

Question 23

causes of intraparenchymal hemorrhages

Answer 23

• systemic hypertension
• amyloid angiopathy
• vasculitis
• neoplasm
• reperfusion injury

Question 24

what enzyme can be defected in ALS?

Answer 24

superoxide dismutase

Question 25

parinaud syndrome

Answer 25

lesion in superior colliculi (stroke, hydrocephalus, pinealoma) paralysis of conjugate vertical gaze

Question 26

afferent and efferent of gag reflex

Answer 26

a- 9 | e- 10

Question 27

afferent and efferent of lacrimation reflex

Answer 27

a- V1 | e- 7

Question 28

uvula deviates which way in CN X lesion

Answer 28

away from lesion

Question 29

jaw deviates which way in CN V lesion

Answer 29

towards lesion

Question 30

CN XI lesion

Answer 30

contralateral SCN | ipsilateral trapezius

Question 31

tongue deviates which way in CN XII lesion

Answer 31

towards lesion (ipsilateral lesion)

Question 32

cavernous sinus syndrome

Answer 32

opthalmoplegia (CN VI most susceptible to injury) decreased corneal sensation Horner syndrome causes: tumor mass effect, fistula, thrombosis

Question 33

where in cochlea is low frequency and where is high freq?

Answer 33

low: apex near helicotrema (wide and flexible) high: base of cochlea (thin and rigid)

Question 34

DOC for trigeminal neuralgia and its MOA

Answer 34

carbamazepine- reduces ability of Na channels to recover from inactivation

Question 35

NF-1 what type of inheritance

Answer 35

aut dom

Question 36

optimal site for femoral nerve blockade

Answer 36

inguinal crease

Question 37

fracture of orbital floor

Answer 37

parasthesia of upper lip, upper cheek, upper gingiva (damage to infraorbital nerve) inferior rectus trapped- limits vertical gaze

Question 38

drugs to treat restless leg syndrome

Answer 38

dopamine agonists (ropinarole, pramipexole)

Question 39

MS diagnosis

Answer 39

high IgG with myelin basic protein in CSF oligoclonal bands MRI- gold standard- periventricular plaques multiple white matter lesions separated in space and time

Question 40

acute inflammatory demyelinating polyradiculopathy

Answer 40

Guillain-Barre syndrome- destroy schwann cells ascending paralysis autonomic dysregulation

Question 41

charcot-marie-tooth

Answer 41

hereditary motor and sensory neuropathy collection of diseases- aut dom- defective protein in peripheral nerves/myelin foot deformities, lower extremity weakness

Question 42

metachromatic leukodystrophy

Answer 42

aut rec LSD arylsulfatase A deficiency cant degrade myelin -->accumulates in lysosomes --> ataxia dementia

Question 43

pinealomas can cause...

Answer 43

- parinaud - obstructive hydrocephalus - precocious puberty (bHCG)

Question 44

cingulate (subfalcine) herniation

Answer 44

under falx cerebri compress anterior cerebral artery

Question 45

uncal herniation

Answer 45

compress ipsilateral CN III ipsilateral PCA (contralateral homonymous hemianopsia with macular sparing) contralateral crus cerebri at Kernohan notch

Question 46

cerebellar tonsil herniation through foramen magnum

Answer 46

cardiopulm arrest in brain stem--> coma, death

Question 47

Sturge-Weber syndrome

Answer 47

``` Sproadic port wine stain of face Tram track calcifications Unilateral Retardation Glaucoma GNAQ mutation Epilepsy ``` (STURGE) anomaly of neural crest derivatives

Question 48

Tuberous sclerosis

Answer 48

``` Hamartomas in CNS Angiofibromas Mitral regurg Ash leaf spots Rhabdomyoma TUberous sclerosis aut dOm Mental retardation renal Angiomylipoma Seizure Shagreen patches ``` (HAMARTOMAS)