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Neuro Cards 1 Flashcards

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1
Q

Maternal Diabetes leads to what birth defect?

A

Anencephaly, Dextrocardia, Transposition GV Colobamina. Increased risk for nearly all cardiac and neural defects

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2
Q

Causes of polyhydramnios in utero

A

Anencephaly, TE fistula, Duodenal Atresia

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3
Q

Oxytocin is made in what hypothalamic structure

A

Paraventricular

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4
Q

ADH is made in what hypothalmic structure

A

Suprachiasmatic

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5
Q

Most common S/E with TCA related to what actions

A

Anticholinergic. Most common cause of death is arrythmias

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6
Q

Pt has damage to thalamus, BG, and Cortical Ribbon. EEG shows bursts of high voltage slow waves. What is the diagnosis

A

-Crutzfeld-Jacob disease. Progression over 6 months. BG, Thalamus, and cortical ribbon are Gray matter, which is preferentially targeted. EEG bursts are indicative of myoclonus.

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7
Q

Pt comes in with hyperphagia, hyperexuality, and docility. What is the diagnosis

A

-Kluver Bucy. Damage to amygdala. Most commonly with HSV. Commonly seen in AIDS pts.

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8
Q

What is the mechanism behind visual disturbances and anosmia

A

-Foster Kenedy: Increased ICP leads to damage to optic nerve and olfactory tracts.

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9
Q

Anterior Cerebellar outputs vs Posterior Cerebellar Outputs

A
  • Anterior is to descending tracts (rubrospinal, reticulospinal) balance (alcohol stumbling gait)
  • Posterior is to cerebral cortex and coordination (dysdiadechkinesis)
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10
Q

Cause of neuronal cell death in huntingtons. Levels of NT

A
  • Glutamate excitotoxicity.

- Reduced GABA and Ach

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11
Q

Sensation innvervation of Oropharynx

A

V3- Anterior tongue general sensation. Taste via lingual nerve and chorda tympani (VII)
XI- posterior tongue and superior pharynx including eustachian tube
X- Inferior pharynx and larynx

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12
Q

Most Common tumor of pineal gland

A

-Germinoma: Can lead to precocious puberty in childhood. Also will see paralysis of upward gaze.

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13
Q

Newborn with Rhinorrhea, Diahrrea, Tremors, Siezures

A

-Neonatal opiate withdrawl. Treat with small dose of opium and wean off

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14
Q

Pramipexole, Ropimerole

A

-D2 agonists used to treat parkinsons. Non Ergot. Ergot agonists like bromocriptine and pergolide also exist

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15
Q

Use of ampicillin in meningitis emperical treatment

A

-Covers Listeria Monocytogenes. Used in infants and immunocompromised

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16
Q

Physiologic adaptaions to alcohol

A
  • Decrease GABAa R, Increase, Increase excitatory NT

- Can treat withdrawls with BZ and centrally acting alpha2 agonists

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17
Q

Sequence of alcohol withdrawl

A

Initially tachycardia, tremors, HTN

Progress to hallucinations, siezures, hypersomnolence

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18
Q

RAS

A

-Located in midbrain, has cholinergic and adrergic projections, one to intralaminar nuclei.

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19
Q

Damage to hippocampus symptoms

A

Anterograde amnesia (rich in NMDAR)

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20
Q

Internal Capsule Structures

A

Anterior-Relay between Cerebellum, BG, Cortex

  • Genu: Corticobulbar
  • Posterior: Motor
  • Occlusion of lenticulostriate arteries and lacunar infarcts
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21
Q

Spinal 5 damage

A

PICA, AICA. Pain and Temp to face

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22
Q

Inferior Cerebellar peduncle

A

PICA, AICA (Horners in both)

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23
Q

Distinguish PICA from AICA

A

PICA- Gag (9,10)

-AICA (Facial and Cochlear)

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24
Q

PCA Paramedian Branches

A
  • 3,4, UMN 7

- Occular palsy (eye will be abducted, also loss of contralateral face)

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25
Abducens damage
-Anyerusism of Superior Cerebellar or PCA, also from medial pontine (Basilar)
26
Anteiror Communicating Anyeurism Symptoms prior to rupture
-Compress chiasm. Bitemporal Hemianopia
27
Posterior Communicating Anyeurism Symptoms prior to rupture
-Compress CN3
28
Subarachnoid Hematoma and complications
- Berry Anyeurism (AVM) | - 2-3 days post bleed can cause vasospasm and rebleed (Tx with nimodipine (ca channel blockers).
29
Risk Factors for intraparenchymal hemorrhage
- HTN, Diabetes, Vasculitis, Neoplasia | - Amyloid angiopathy
30
Bright on noncontrast CT
-Areas of hemorrhage. tPA is contraindicated
31
Symptoms in NPH caused by
-Stretching of the corona radiata (continuation of internal capsule)
32
Organization of Spinothalamic Tract anc Corticospinal
Legs are lateral arms are medial | -DCML (gracilus is medial (Legs) and cuneatus is lateral (arms)
33
Divisions of the spinothalamic tract
-Anterior is pressure, crude touch, Lateral is pain/temp
34
Riluzole
ALS, Na channels and decrease glutamate release
35
Tract involved in subacute combined degenerations
Corticospinal, Spinocerebellar, Dorsal Columns | -Ataxia and parethesias, usually no pain
36
Tabes Dorsalis Symptoms
- Loss of DTR, Charcot joint, Shooting pain, - Sensory Ataxia with positive rhomberg - Dorsal columns and dorsal roots
37
Newborn with tongue fasiculations and hypotonia
-Werdnig Hoffman (SMA). Death of LMN in anterior horn.
38
Freidrichs ataxia
- Trinucleotide repeat in frataxin (Fe-S mitochondria) - Pez cavus, kyphoscoliosis, ataxia - Die of hypertrophic cardiomyopathy - Degeneration of cerebellum and spinocerebellar tracts.
39
Cause of symptoms in pinealoma
- Compression of superior colliculus causes upward gaze palsy. - Most common is germinoma which can secrete hormones and cause precocious puberty.
40
PPRF Lesion
Deviation away from side | -Medial pons
41
Frontal Eye fields
-Deviation towards lesion
42
Causes of Cranial Nerve 3 Palsy
- Infarction of paramedian PCA that supplies the midbrain - Transtentorial (uncal herniation) mass occupying lesion including epidural hematoma - Anyeurism of posterior communicating and carotid in cavernous sinus. - Compression between superior cerebellar and posterior cerebral arteries
43
CN IV Pathology
- Arises from the dorsal aspect and crosses over | - Vulnerable to head trauma
44
CNV injury
- Towards lesion (lateral pterygoid) - Tensor tympani paralysis leads to hyperascusis - Spinal trigeminal with pain will cross over, contralateral in AICA and PICA lesions
45
CN VI injury
- Long course leaves it vulnerable to many insults (meningitis, trauma, syphilis) most common - Horizontal diplopia and medial strbismus
46
Hereditery Stroke
-CADASIL, Notch 3 mutation. Seen in young people
47
Fixed Dilated pupil
Cavernous Sinus
48
Causes of Retinitis
CMV, HSV, HZV, Toxo
49
Central Retinal artery occlusion
-Painless, cherry red spot
50
Vision changes in open angle glaucoma
-Slowly and progressive. Loss of peripheral vision before central
51
Risk Factors for glaucoma
-African American, Steroid use
52
Cataract Risk factors
- Trisomies | - Congenital infections
53
Pathways of pupillary dilation and constriction
- Constriction: Ed west to ciliary ganglion to short ciliary | - Dilation: Post hypothalamus to IML (Center budge), To superior cervical ganglion, then on IC to long cilliary
54
Pupillary light reflex pathway
- CN2 to pretectal nuclei to bilateral Ed West. | - Defect (retinal detachment or damage) there will not be consensual
55
Cause of damage to CN3 motor neurons
Diabetes (sorbitol pathway)
56
Retinal Detachment
- More common in myopia, detachment of retina from pigment epithelium. Curtain drawn down. - increase risk with diabetes and myopia
57
Location of Drusen
Below pigment epithelium
58
Measure of Alzhiemers severity
- Neurofibrillary Tangles | - Tx: Donepazil
59
How to detect Tau and NF tangles
Silver Stain
60
Lewy Body
- Hallucinations - Personality before parkinson effects - Lewy Bodies (a synuclein in cortex)
61
Picks Dementia
- Frontotemporal - Early change in personality progressing to aphasia and other dementia signs - Spherical tau aggregates (not NF tangles) balooned neurons - Effects layers 2,4 not 3,5,6
62
CSF Findings in guillan bare
-Increased protein without cells (albuniocytologic dissociation)
63
Treatment of Guillan Bare
- IVIG and Plasmaphoresis if severe and indicated | - Generally treatment is supportive
64
Adrenoleukodystrophy
-Defect in peroxisome formation, leads to accumulation of long chain FA and leukodystrophy
65
Charcot Marie Tooth (hereditery sensory and motor)
- Defect in myelin protein leads to demylination - Effects motor neurons and posterior colums (proprioception) - Pez Cavus and foot drop.
66
Acute Demhyelinating Encephalopathy
- Scattered demylination following viral illness | - Idiopathic
67
Metachormatic Leukodystrophy
- AR defect in arylsulfatase A leads to accumulation of sulfatides. - sulfatides cause breakdown of myelin sheath
68
Krabbes
-Defect in galactocerebrosidase, leukodystrophy
69
Position Testing in vertigo
- Central Vertigo will show immediate, strong, and variable direction nystagmus - Peripheral vertigo will be delayed and unidireectional
70
Port Wine Stain following CNV1
- Sturge Webber: De novo sporadic mutation allowing for proliferation of capillaries - Occurs in brain and eyes causing mass effect. - Can lead to siezures, glaucoma.
71
Lack of melanin in spots on face and mitral regurgitation
- Tuberous Sclerosis - AD hamartomas throughout body and lack of melanin on face (Ash leaf spots) - Focal neurological findings (siezures)
72
Bilateral Renal Cell Carcinoma
- VHL. AD mutation in TSG leads to cavernous hemangioma formation - Focal neurologic signs and polycythemia (HIF 1a metabolism)
73
Cafe Au Lait Spots, Lisch Nodules
- AD defect in RAS associated gene | - cutaneous neurofibromas (100% penetrant with variable expressivity)
74
Estrogen R positive brain tumor (more common in women)
-Meningioma
75
Calcified intraparenchymal tumor in adults
-Oligodendroglioma
76
Cystic and Solid Brain Tumor in kids
-Pilocytic astrocytoma
77
Drop Metastasis
Medulloblastoma | -May also compress 4th ventricle and cause hydrocephalus (less common than ependymoma, but possible)
78
Highly vascularized foamy cells in brain tumor
- Hemangioblastoma - Most commonly associated with VHL. Polycythemia common in these cases. - More common in kids
79
Oily mass with tooth enamel
Craniopharyngoma Rathkes pouch Bitemporal hemianopia
80
Trauma causes herniation of cerebellum through foramen magnum
-Death due to compromise of respiratory and cardiac centers
81
Anorexia and failure to thrive (hypothalamus)
Lateral Area (normally inhibited by leptin)
82
Hyperphagia and aggresion
Ventromedial (activated by leptin)

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