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Flashcards in Neuro from codebook 2 Deck (26):
1

other psych finding in LBD

paranoia

2

MS initiation pathophys

T in pimp hat + row of topless sorority girls on wall across from bed/initiated by CD4+ TH1 lymphocytes that react against self myelin antigens and secrete cytokines such as interferon-gamma to activate macrophages.

3

optho findings in MS

1) central scotomas
2) optic neuritis

4

neuron damage in MS

1) Characterized by loss of oligodendrocytes and myelin but with relative preservation of axons.
2) Sequence of demyelination acute plaques show dense lymphistiocytic infiltration older plaques show hyperplasia + hypertrophy of astrocytes + gliosis.

5

Tropical spastic paraparesis

Coded character: Dorian tolis: he’s being scalped by an Indian (demyelinating disease code)/demyelinating disease of spine and white matter and periventricular regions of the brain. /gradual unremitting course. He’s in a stretcher + lower extremities covered in darts/presentation = lower extremity weakness + back pain + urinary incontinence + eventual spastic paraplegia.
Location: Beach in front of house in Turks and Caicos

6

• Lennox-Gastaut syndrome (LGS)

Code: Lenny on porch sitting next to Forrest Gump + Spikes in ground + wave painted on house behind them/presentation = multiple seizure types (commonly atopic seizures) + mental retardation + spike and wave EEG pattern.
Location: On front porch in front of entryway

7

Myoclonic, Juvenile myoclonic epilepsy (JME)

♣ Code: Andrew Shellgren: /presents during adolescence. Both hemispheres of a brain sitting in driveway/idiopathic generalized (involves both hemispheres at first) epilepsy. He’s flailing both his arms around/presentation = brief, involuntary jerking movements involving both upper extremities with preservation of consciousness. Super hot val girl dancing around a stripper pole + lambs roaming around + levi daigle laughing at + /treatment = broad-spectrum anticonvulsants (valproic acid + lamotrigine + levetiracetam + topiramate). Huge stack of blue jeans (polygenic code)/polygenic. /myoclonic seizure = no loss of consciousness + brief jerking movements. Massive spice rack lining right side of road/some forms of beta-thalassemia caused by splice-site mutations.
♣ Location: Mike O’Connell’s driveway

8

Acute disseminated (postinfectious) encephalomyelitis

o Coded character: Jeff from neuro research: roman aqueduct lining room with inflammation statues on top/multifocal periventricular inflammation + demyelination after infection. Molly is skinning him + David Freeman in left corner covered in chickenpox/commonly measles or VZV. Dead negri with pharmacist on top in far right corner + peter freeman stuck in needle in left corner/or certain vaccinations (rabies, smallpox).
o Location: TMS lab

9

ortho finding in CMT

scoliosis + stork-like appearance of legs.

10

CMT genetics

Snop dogg dressed as pimp covered in colorful tacs in right corner/most common cause is a duplication of a large region on short arm of chromosome 17 that includes the PMP22 gene.

11

PML

o Coded character: JZ/associated with reactivation of JC virus in AIDS patients. He’s getting skinned by an indian + has a tube around him/demyelination of CNS due to destruction of oligodendrocytes. Tape around his mouth + sitting on a taxi + eyes carved out + left side of body covered in darts + eye on the back of his head (cortical blindness code)/presentation = rapidly progressive focal neurologic deficits without signs of increased ICP. Ataxia + aphasia + cranial nerve deficits + conjugate gaze abnormalities + hemiparesis + cortical blindness. /rapidly progressive, fatal. Patches of his head are glowing bright like holy light/imaging = MRI multiple nonenhancing T2-hyperintense lesions, areas of demyelination. JZ has a slinkey wrapped around his neck/JC virus is a polyoma virus, structure = circular DS. Tim doing lines off taxi to his right in a chicken suit/T cell count

12

Meniere’s disease

o Coded character: Brad from Duncan & Son’s: he’s sawing his ear off (tinnitus code) + vertigo + blaring noise + arrow in one ear/classic triad = UNILATERAL sensorineural hearing loss + vertigo + tinnitus. /episodes of vertigo that last for hours. Dad is beating a big Chinese drum on the side wall/patients often have difficulty hearing that often progresses to permanent, *low-frequency* sensorineural hearing loss. He’s in a sac and the place is flooded with water/endolymph up to his chest/pathophys= Result of an increase in the volume of the endolymphatic system (hydrops), which can result from either increased production or decreased excretion of endolymph. Malfunction of endolymphatic sac (responsible for filtration and excretion of endolymph) is one mechanism.
o Location: Mess hall at AK camp

13

VHL tumor suppressor gene

ubiquitin ligase component.

14

Neonatal intraventricular hemorrhage

• Coded character: Cambo Ferrante (premie)/increases in frequency with decreasing age and birth weight. Common complication of prematurity. Roman aqueduct running around room filled with blood/bleeding into ventricles. Neo is fighting germs + matrix scene is going on/usually occurs in the germinal matrix. /can lead to long term neurodevelopmental impairment.
• Location: Cambo’s room

15

Pilocytic (low-grade) astrocytoma

o Code: Huge bell hanging from ceiling/cerebellar. Huge pilons all around the room + glow-in-the dark stars on the ceiling/pilocytic astrocytoma. Nate is on kitchen table and his head is covered in cysts + metal balls/(Kicker) have both cystic and solid components, as opposed to medulloblastomas, which are always solid. Ian Rosenthal weaving in a big spindle next to the table + twisted eoss goddesses on top of all the pilons/microscopically = Rosenthal fibers corkscrew/twisted-shaped + intensely eosinophilic structures. Frodo in corner with bugs bunny in a suit on his shoulder/associated with TGFA proto-oncogene. Page massaging his head with Frodo on her shoulders/associated with SIS protooncogene. Fire hydrant coming out of nate’s head/increased ICP and hydrocephalus + . WHO rock band all with top hats on on far wall/WHO grade I. ted gill in a vat of acid on left/positive staining for glial fibrillary acidic protein (GFAP). Middle table is a taxi + pope blessing him + nail through his head + antlers on/presentation = ataxia + papilledema + severe headache + nystagmus.
o Location: Kitchen

16

argyll robertson pupil

(prostitute’s pupil (near-far accommodation but don’t react to light. Accomodates but doesn’t react).

17

pinealoma

o Code:Nate/strong male predominance. Big pile of germs on the coffee table/germinoma. Big pine tree in corner (pineal gland code) /tumor of the pineal gland. He’s covered in hair + has 3 dicks + placenta hanging from ceiling + fire hydrant coming out of his head + eyes paralyzed and looking down at floor/presentation = Parinaud syndrome (dorsal midbrain syndrome (paralysis of upward gaze and of convergence), due to mass effect) + precocious puberty (facial hair growth, enlarged genitalia -- due to Beta-hCG production) + obstructive hydrocephalus. Prostitute with Argyll sweatershirt on sucking his dick/(prostitute’s pupil (near-far accommodation but don’t react to light. Accomodates but doesn’t react). Devil sitting next to him/malignant. Floor covered in fried eggs/histo = similar to testicular seminomas (large cells in lobules with watery cytoplasm and fried egg appearance). Girl with three breasts to his right/precocious puberty when in girls.
o Location: Living room/TV area

18

medulloblastoma

o Code: Erik/predominately a pediatric tumor (40% diagnosed before age of 5). huge bell hanging from ceiling + worm wrapped around it/cerebellar vermis tumor (infra-tentorial location). Will dressed as a caveman to the left of the bed/form of primitive neuroectodermal tumor. Geiser of water coming out of his head + huge nail through his head/presentation = hydrocephalus (due to compression of 4th ventricle) + severe headaches. Met’s player at end of bed with CNS statute on back/can send “drop metastases” to spinal cord. He’s wearing a Native American headdress + sheets of blue balls all around bed/histo = Horner-Wright rosettes + sheets of small blue cells with hyperchromatic nuclei and scant cytoplasm. Big devil in right corner/most common maliginant childhood brain tumor. Stacks of ted gill to the left of the bed + stacks of neurons/characterized by both neuronal and glial proliferation. Ted gill in a vat of acid to the right of CNS statue/may have spindle cells, which stain for glial marker glial fibrillary acidic protein (GFAP).
o Location: Nate’s bedroom

19

Craniopharyngioma

o Code: Henry Nichols: Jesus standing on desk/rare, slow-growing, benign. He’s sitting on top of a saddle (suprasellar code)/typically located in the suprasellar region. /cystic with solid areas. He’s seating at the desk with his head covered in brown and yellow cysts + room flooded with yellow, viscuous fluid with yellow eggs floating in it and steak/cysts usually filled with a brownish-yellow, viscuous fluid resembling machine oil due to presence of protein and cholesterol crystals. Calcium balls hanging from the ceiling/calcification of cysts is highly characteristic. Massive almond dug into the right wall with Daniel Radcliffe/harry potter sitting on top/derived from remnants of Rathke’s pouch/anterior pituitary. Nests filled with wet carrots lining left wall + palisading fences surrounding carrots + Indians in the middle/on light microscopy, cysts are lined by cords/nests of stratified squamous epithelium with peripheral palisading and internal areas of lamellar “wet” keratin. Eyes on the side of his head/bitemporal hemianopsia. He has huge teeth/similar to tooth-like tissue because of origin from remnants of Rathke’s ouch.
o Location: Nate’s office

20

Other drug you can use for PD...

amitryptilline (decrease ACh)

21

Restless leg syndrome treatment

pramipexole or ropinirole

22

entacapone and tolcapone block PERIPHERAL breakdown

okay

23

Amantadine MOA for flu prophylaxis

She’s naked but just has a winter coat on/MOA for flu prophylaxis = binds to the M2 protein, thus preventing viral uncoating.

24

Amantadine MOA in PD

Michelle johns on her shoulder/MOA in parkinson’s = inhibits degradation of dopamine by monoamine oxidase type B.

25

other drug like benztropine?

Trihexyphenidyl

26

treatment of choice for drug-induced parkinsonism?

benztropine or trixhexyphenidyl