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Uworld Jornal > Neuro > Flashcards

Neuro Flashcards

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1
Q

Radial Nerve function

A

Extension of wrist arm and finger joints below shoulder! Forearm supination, thumb abduction.

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2
Q

Injury or Radial N

A

At passage through supinator canal (due to repetitive pronation/supination, direct trauma, or sublexation of radius)

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3
Q

Features or Fragile X

A

Neurobehavioral problem

Prominent forehead and chin

large ears

long, narrow face

Large testis

hyperlaxity of joints in hand

Cytogenic: small gap near tip of log arm of X chr

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4
Q

Fragile X Syndrome

A

X linked mutation of FMR1 gene

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5
Q

Huntington Disease

A

CAG trinucleotide repeats of huntington gene

Leads to gain of function mutation which is responsible for transcription repression via histone deacetylation

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6
Q

Cause of acute hypertensive intracerebral hemorrhage

A

Charcot-Bouchard aneurysm (chronic hypertension leads to progressive arteriolar hyalinization and fibrinoid necrosis)

Often involves deep structures (basal ganglia, thalamus, pons)

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7
Q

AVM

A

Most common cause of intracranial hemorrhage in children

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8
Q

Phenytoin

A

Seizure medication (blocks voltage gated sodium channels in neurons)

Side effects:

  1. gingival hyperplasia
  2. ataxia and nystagmus
  3. disruption of folic acid metabolism (megaloblastic anemia)
  4. p450 inducer
  5. coarse facial features, hirsutism
  6. fetal hydantoin syndrome
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9
Q

Locus Ceruleus

A

Located at posterior rostral pons near lateral floor of 4th ventricle

Responsible for producing almost all NE in brain

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10
Q

Ataxia-Telangiectasia

A

cerebellar ataxia
telangiectasia
sinopulmonary infections

mutation of ATM gene (AR) responsible for DNA Break Repair

cerebellar atrophy

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11
Q

Pink MacConkey agar

A

organisms that ferment lactose (e.coli, Klebsiella, Enterobacter)

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12
Q

Narcolepsy

A

Cataplexy (loss of muscle tone, abnormal facial movements)
Hypocretin-1 deficiency in CSF
REM sleep latency <15 min

Recurrent lapses into sleep multiple times within the same day at least 3*/week for 3 months

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13
Q

Cluster Headache

A

Behind one eye

15-90 minutes

Nasal congestion and lacrimation

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14
Q

Tension Headache

A

stress, band-like pattern (b/l), bull tight, persistent

Muscle tenderness

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15
Q

Femoral Nerve Block

A

At inguinal creases, anesthetizes skin and muscles of anterior thigh, femur, and knee

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16
Q

Gerstmann syndrome

A
  1. Agraphia (inability to write)
  2. Acalculia (inability to do math)
  3. finger agnosia
  4. left-right disorientation

Stroke of angular gyrus of dominant parietal lobe

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17
Q

s-100 positive tumors

A

Schwannoma and melanoma (derived from neural crest)

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18
Q

Wilson Disease

A

AR mut in ATP7B, hinders hepatocellular copper transport

Reduced secretion of ceruloplasmin and decreased secretion of copper

Copper, a pro-oxidant, causes hepatocellular injury

Neuro involvement includes movement abnl and psych symptoms

Rings around iris

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19
Q

HIV-associated dementia

A
  1. subcortical dementia (attention/memory problems, executive dysfunction)
  2. due to inflammatory activation of microglial cells
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20
Q

Intranuclear acidophilic inclusions

A

HSV

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21
Q

Intranuclear basophilic inclusion

A

CMV

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22
Q

Vitamin E Def neuro symptoms

A

Mimics Friedreich Ataxia

Loss of position and vibration sense
Loss of DTR
Ataxia

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23
Q

Friedreich Ataxia

A

AR degenerative dz
Loss of proprioception and vibration sense (damage to dorsal columns)

Ataxia (loss of spinocerebella tract)

Spastic weakness (loss of lateral corticospinal tract)

Hypertrophic cardiomyopathy

Kyphoscoliosis

high arched feet

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24
Q

Vitamin A Toxicity

A

Acute: nausea, vomiting, vertigo, double vision

Chronic: alopecia, dry skin, lyperlipidemia, hepatotoxicity, hepatosplenomegaly, visual difficulties pailledema

Teratogenic: microcephaly, cardiac anomalies, fetal death

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25
Niacin deficiency
Pellagra (3 D's) 1. Dementia 2. Dermatitis 3. Diarrhea
26
Wernicke Encephalopathy
Chronic Thiamine deficiency (alcoholics) 1. Opthalmoplegia 2. Ataxia 3. Confusion Hemorrhage and necrosis of mammillary bodies Baseline erythrocyte transketolase activity low tx: thiamine supplementation with glucose infusion
27
Axonal Reaction
Change seen in neuronal body after axon is severed 1. cellular edema 2. nucleus displaced to periphery 3. Nissl substance fine, granular, and dispersed throughout cytoplasm
28
Most common side effect of levodopa/carbidopa
Anxiety and agitation
29
N. meningitidis virulence factor that underlies disease severity
Lipooligosaccharide | endotoxin
30
Length and time constant
1. Length constant: measure of how far along an axon electrical impulses can propogate without requiring active regeneration by ion channels 2. Time constant: measure of time it takes for membrane potential to respond to membrane permeability demyelination decreases length constant and increases time constant
31
Nerve responsible for sensation at suprapubic and gluteal region
Iliohypogastric nerve (L1 root) Often injured during appendectomy
32
Common Peroneal Nerve
responsible for ankle dorsiflexion, eversion and toe extension Sensory to lateral leg and dorsal foot Damage (compression or fracture of lateral neck of fibula) leads to foot drop
33
Diabetic mononeuropathy
CNIII central ischemia Ptosis, down and out gaze, normal light and accomodation
34
Berry aneurysm of COW
Often seen in ADPKD Rupture causes subarachnoid hemorrhage
35
Epidural hematoma from
fracture of temporal bone and tear of middle meningeal artery
36
Medulloblastom
sheets of primitive cells and many mitotic figures Located in cerebellum (vermis)
37
MLF
In pons Lesion: impaired adduction of ipsilateral eye during conjugate horizontal gaze
38
Subarachnoid Hemorrhage
Most commonly due to berry aneurysms
39
Baclofen
Agonist at GABA-B receptor for spasticity (Spinal cord dz, MS)
40
Tizanidine
alpha 2 agonist used for spasticity in spinal cord disease
41
NF1
AD mutation of NF1 TS gene 1. cafe au lait 2. CNS neoplasms 3. cutanous neurofibromas (from schwann cells/neural crest origin)
42
Conversion disorder (functional neurologic symptom disorder)
Neurologic symptom incompatible with any known neurologic disease (often associated with stress)
43
Spinal Muscle Atrophy
mutation in SMN1 (assembly of snRNPs) Impaired spliceosome function leads to degradation of anterior horn cell sin spinal cord with flaccid paralysis
44
Lobar hemorrhage
Cerebral amyloid angiopathy (beta amyloid deposition in vessel walls) often occipital and parietal lobes
45
Marcus Gun Pupil
afferent pupillary defect often due to optic tract lesion
46
Optic tract lesion
contralateral homonymous hemianopia and marcus gun pupil
47
C. Botulinum toxin
Inhibits ACH release from presynaptic terminals at NMJ and decreases CMAP (electric response of muscles) 3 Ds: diplopia, dysphagia, dysphonia
48
Pineal gland mass
1. obstructive hydrocephalus (papilledema, h/a worse while lying, vomiting) 2. Parinaud syndrome (limited upward gaze, b/ eyelid retraction, light-near dissociation) Most commonly: germinoma
49
Orbital floor fracture
damage to infraorbital nerve numbness to upper cheek, upper lip, upper gingiva
50
Battle sign
bruising over mastoid process basilar skull fractures
51
Guillain-Barre
Ascending symmetric weakness following febrile illness demyelination due to molecular mimicry inflammatory infiltrate within endomesium and lipid laden macrophages
52
Thalamic stroke
contralateral pure hemisensory loss VPL (spinothalamic and DCML input) VPM (trigeminal)
53
PCA infarct
contralateral hemianopia contralateral paresthesia and numbness (involvement of thalamus)
54
Middle cerebral artery stroke
mostly likely ischemic contralateral motor and sensory deficits to upper > lower extremities and face
55
Uhthoff phenomenon
MS symptoms worsen with increasing body temperature (exercise, hot shower)
56
Risk factors of MS
HLA-DRB1 Location Low vit D Smoking
57
Most common cause of sporadic encephalitis in adults
HSV type 1
58
Temporal lobe edema
HSV type 1 encephaopathy
59
VHL disease
AD capillary hemangioblastomas in the retina and/or cerebellum, congenital cysts in kidney, liver and pancreas increased risk for renal cell carcinoma (b/l)
60
Sturge-Weber Syndrome
cutaneous facial angiomas (overlyng V1 and V2 regions) leptomeningeal angiomas mental retardation seizures hemiplegia skull radiopacities (tram-track calcifications)
61
Jugular foramen contents
``` Jugular vein CN IX (taste post 1/3 tongue) CN X (dysphagia/hoarseness, soft palate drop and deviation of uvula toward normal side) CN XI (SCM and trapz paralysis) ``` Gag reflex (IX, X)
62
Obturator nerve
Thigh adduction and sensation over distal, medial thigh (passes through obturator canal)
63
Restless leg syndrome
due to iron deficiency, uremia, diabetes or idiopathic Tx: Dopamine agonist (pramipexole)
64
Tay Sachs
beta-hexosaminidase A deficiency Accumulation of GM2 ganglioside in lysosomes
65
Lesch Nyhan
deficient HGPRT (hypoxanthine-guanin phosphoribosyltransferase) .of purine salvage pathway
66
Thiamine deficiency
Wernicke encephalopathy (ataxia, nystagmus, ophthalmoplegia, anterrograde amnesia) Worsened with dextrose administration Necrosis of mammillary body
67
Hemiballism
Movement disorder with wild, involuntary, large amplitude flinging movements of proximal limbs due to basal ganglia lesion (subthalamic nucleus) often due to lacunar stroke of htn or dm
68
Pancoast tumor
non-small cell lung cancers Involvement of brachial plexus (ipsilat shoulder pain, upper limb parasthesia, areflexic arm weakness) involvement of cervical sympathetic ganglia (ipsilateral ptosis, miosis, anhydrosis)
69
Chemotherapy n/v
area postrema at dorsal surface of medulla and cauda end of 4th ventricle
70
WNV neuro symptoms
Asymmetric flaccid paralysis parkinsonian features (rigidity, bradykinesia, tremor, postural instability)
71
Wilson Disease
AR mut of APT7B hepatic copper accumuation, leak from damaged hepatocytes, deposits in other tissues Clinical findings (hepatitis, cirrhosis, parkinsonism, gait disturbances, depression, personality changes) Diagnosis: Low ceruloplasmin, high copper urinary excretion Kayser fleischer rings Tx: Chelators (D-penicillamine, trientine) zinc (interferes wit copper absorption)
72
Ventricles
``` Lateral ventricle foramen of monro third ventricle cerebral aqueduct fourth ventricle Magendie and luschka ```
73
3 mutations associated with early onset alzheimers
APP gene (chr 21) Prenselin 1 gene (chr 14) Presenilin 2 gene (chr 1)
74
Atrophy of alzheimers
Most pronounced in temporoparietal lobes and hippocampus
75
Treacher Collins Syndrome
Abnl development of 1st and 2nd pharyngeal arches | craniofacial abnl airway compromise, feeding difficulties, abnl ossicles
76
Peroxisome function
Oxidation of VLCFA H2O2 degradation
77
Proteasome function
degradation of ubiquinated proteins
78
Zellweger sydrome
defected peroxisomal biogenesis | craniofacial abnl, hepatomegaly, neuro defects, elevated VLCFA and phytanic acid
79
X-linked adrenoeukodystrophy
Defective transport of VLCFA into peroxisomes Present later with neuro deterioration, adrenal insufficiency
80
Normal pressure hydrocephalus
Wacky (dementia) Wobbly (gait disturbances) Wet (urinary incontinence due to stretching of descending cortical fibers))
81
Huntington disease
Acute onset personality changes (agression, flat affect, decreased memoriy and concentration) Movement disorder (jerky movmeent of extremities) B/l atrophy of caudate and putatmen and loss of GABA neurons in brain
82
Triptans
Serotonin agonists used for migraine tx
83
Foot Drop
common peroneal nerve damage
84
Parotid gland
CN VII courses through it Motor innervation to muscles of facial expression (damage leads to facial droop)
85
Vertical diplopia
Double vision when looking down (reading, walking down stairs) Seen with trochlear nerve palsy (SO innervation)
86
Neuroblastoma
px at 2 years with abdominal mass, ptosis, myoclonus, etc. elevvated catecholamine metabolites (neural crest origin) small round blue cells and homer wright rosettes
87
Biochemical change seen in alzheimers
Decreased ACh levels in hippocampus and nucleus basalis of meynert
88
Endogenous opioid peptides
Enkephalins, endorphins, dynorphins
89
Derivatives of POMC
1. beta-endorphins (endogenous opioid) 2. ACTH 3. MSH
90
Chiari type 1
crebellar tonsils herniate through foramen magnum px in adulthood with paroxysmal occipital headaches and cerebellar dysfunction (dizziness, ataxia)
91
Chiari type 2
downward displacement of cerebellum (vermis and tonsils) thorugh formen mangum px in infants with aqueductal stenosis, dysphagia, stridor, lumbar myeomeningocele
92
Dandy Walker malformation
hypoplasia/absense of cerebella vermis with cystic dilation of 4th ventricles and enlarged posterior fossa

Uworld Jornal (5 decks)

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