Neuro Misc. Flashcards
1
Q
What is Nissl substance
A
Rough endoplasmic reticulum
2
Q
What are the two types of Golgi axons and what is the difference between them
A
Golgi type 1 - long axons
Golgi type 2 - short axons
3
Q
Which cells produce myelin in the CNS and PSN respectively
A
CNS - oligodendrocytes
PNS - Schwann cells
4
Q
What is the ratio of oligodendrocytes to axons they produce myelin for
A
1 oligodendrocyte covers many neurons
5
Q
What is the ratio of Schwann cells to axons they produce myelin for
A
Many Schwann cells cover 1 neuron
6
Q
The influx of which two ions cause depolarisation
A
Na+
Ca2+
7
Q
The influx of which ion causes hyperpolarisation
A
Cl-
8
Q
The efflux of which ion causes hyperpolarisation
A
K+
9
Q
What do hyperpolarisation and depolarisation cause with regards to excitation and inhibition
A
Depolarisation –> excitation
Hyperpolarisation –> inhibition
10
Q
Name the main excitatory neurotransmitter
A
Glutamate
11
Q
Name the two main inhibitory neurotransmitters
A
GABA, Glycine
12
Q
What is the distribution of GABA and Glycine neurons in the brain
A
GABA is widespread
Glycine mostly in brainstem and spinal cord
13
Q
Name the 4 main types of sensory neuron
A
Aα
Aβ
Aδ
C
14
Q
Which of the types of sensory neuron has the most myelination
A
Aα
15
Q
A higher degree of myelination correlates to what speed of conduction
A
Fast conduction
16
Q
What do Aα neurons perceive
A
Proprioception of skeletal muscle
17
Q
What do Aβ neurons perceive
A
Skin mechanoreceptor information
18
Q
What do Aδ neurons perceive
A
Pain and temperature
19
Q
What do C neurons perceive
A
Pain, temperature and itch
20
Q
Which corpuscle has a higher two-point discrimination value, Meissner’s or Pacinian
A
Meissner’s
21
Q
Where do the DCML, Corticospinal and Spinothalamic tracts decussate
A
DCML at Medial Lemniscus
Spinothalamic at a segmental spinal level
Corticospinal - 85% at Medullary pyramids, 15% segmentally
22
Q
What are the 4 Brodmann areas
A
1, 2, 3a, 3b
23
Q
Define a “motor neurone pool”
A
All the alpha motor neurones which innervate a single muscle
24
Q
Explain reciprocal inhibition using the hamstrings and quadriceps as an example
A
1a fibre supplying alpha motor neurone of quadriceps inhibits the alpha motor neurone of the hamstrings via inhibitory interneurons
25
What is the difference between ionotropic and metabotropic receptors
Ionotropic - direct, rapid response
| Metabotropic - indirect, slow response via a signalling molecule
26
Out of GABAa and GABAb, which is ionotropic
GabaA
27
What are allodynia and hyperalgesia
Allodynia - Pain from a stimulus which is not normally painful
Hyperalgesia - Pain beyond expected from a normally painful stimulus
28
What is the Meningismus triad of symptoms
A headache, Neck stiffness, photophobia
29
What is the empirical treatment for Bacterial Meningitis
IV Ceftriaxone 2g Bd (+ IV ampicillin if suspected Listeria)
Chloramphenicol + Vancomycin if allergy
30
Which gene is implicated in Parkinson's
LRRK2 gene
31
Parkinson's triad
Pill rolling resting tremor
Brady/Akinesia
RIgidity (cog-wheel or lead pipe)
32
What can Levodopa be given with for treatment of Parkinsons's
Carbidopa
| Prevents the breakdown of levodopa in the bloodstream so more levodopa can enter the brain
33
Which cells undergo reactive gliosis and what does this involve
Astrocytes
Hypertrophy + Hyperplasia
1-2 weeks post-trauma
34
Which reaction do neurons undergo in response to hypoxia/ischemia and how long does this take
Red Neuron reaction
| 12-24 hours
35
What are Lewy Bodies made of
Alpha-synuclein
36
What are the two histopathological hallmarks of Alzheimer's
Neurofibrillary tangles
| Plaques
37
What are the tangles and plaques made up of in Alzheimer's disease
Neurofibrillary *Tangles --> hyperphosphorylated *Tau protein
Plaques --> Beta-amyloid protein
38
Name 2 drugs that can be given for Alzheimer's and how they work
Rivastigmine --> Cholinesterase inhibitor
| Memantine --> Voltage-dependant NMDA receptor antagonist
39
What are Pick's Cells and Pick's bodies and which disease are they seen in
Pick's cells --> Swollen Neurons
Pick's bodies --> Filamentous inclusions
Both seen in Frontotemporal dementia
40
What is the normal range of intracranial pressure
9-11 mmHg
41
What occurs during a sub-falcine herniation
Cingulate gyrus herniates under the flax cerebri
42
What occurs during a Transtentorial herniation
Medial temporal lobe herniates under tentorium cerbelli
43
What occurs during a tonsillar herniation
Cerebellar tonsils herniate through the foramen magnum
44
What is Cushing's triad and what does it suggest
Increase in Systolic Bp, Decrease in heart rate and Abnormal breathing
suggests tonsillar herniation
45
Which disease will cause oligoclonal bands on electrophoresis of CSF
Multiple Sclerosis
46
What are the Uhthoff phenomenon and L'hermitte sign and which disease can they be seen in
Uhthoff phenomenon --> Worsening of vision symptoms following a rise in body temperature
L'hermitte sign --> Upper limb paraesthesia on neck flexion
47
How does curare affect the neuromuscular junction
Blocks Ach receptor at NMJ
48
Curare is only harmful if administered via which routes
IM or IV
49
How does botox affect the neuromuscular junction
Cleaves proteins involved in Ach vesicle formation
50
Antibodies to which structures are created in Lambert Eaton syndrome
Pre-synaptic Ca channels
51
Antibodies to which structures are created in Myasthenia gravis
Post-synaptic Ach Receptor
52
What is the commonest muscular dystrophy
Myotonic Dystrophy
53
The levels of which neuropeptide will be low in CSF in Narcolepsy
Hypocretin
54
Which tracts carry 'fast' and 'slow' pain respectively
Fast pain --> Spinothalamic tract
| Slow pain --> Spinoreticular tract
55
Which sensory neuron types carry 'fast' and 'slow' pain respectively (think about the degree of myelination)
Aδ --> fast pain
| C --> slow pain
56
Which 3 brainstem regions are important in pain modulation
Peri-aqueductal gray
Locus coeruleus
Nucleus raphe magnus
57
Which brainstem region provides profound analgesia when excited
Peri-Aqueductal Gray (PAG)
58
Which brainstem region produces endogenous opioids and what are they called
Enkephalins --> produced by Nucleus Raphe Magnus
59
What are the 3 kinds of opioid receptors and which ones do opioid analgesics mostly work on
Mu --> most analgesic action of opioids work on these
Delta
Kappa
60
Name the basal ganglia
```
Putamen
Globius palladius
Subthalmic nucleus
Caudate nucleus
Substantia nigra
```
61
A hot-cross bun sign on MRI suggests which disease
Multi-system atrophy
62
What are the classical symptoms of multi-system atrophy
Parkinsonism
Autonomic dysfunction
Cerebellar dysfunction
63
How is Cerebral Perfusion Pressure calculated
Mean Arterial Pressure - Intra Cranial pressure
64
What is Split Hand syndrome and which disease can it be seen in
Preferential wasting of thenar muscles
| seen in ALS
65
What type of dementia is ALS associated with
Frontotemporal dementia
66
How could you differentiate between ALS and PLS
ALS has upper motor neurone signs in the legs and lower motor neurone signs in the arms
PLS has no lower motor neurone features
67
What is the only drug available for Motor Neurone Disease
Riluzole
68
Which type of dementia is suggested if a patient presents before the age of 65
Frontotemporal dementia
69
What is Hoffman's sign
holding the middle finger at the joint closest to the fingernail
"flicking" the nail of the person's middle finger, using their other hand.
If there is no movement in the index finger or thumb after this motion, the person has a negative Hoffman's sign. If the index finger and thumb move, the person has a positive Hoffman's sign
70
If a patient presents within 7days of a suspected TIA, what should you do
300mg Aspirin and specialist review in 24hours
71
Anti-psychotics should be avoided in patients with which disease
Parkinson's
72
If someone is seizuring in the community for longer than 5 minutes, what should be administered
Rectal Diazepam 10mg
73
Which cause of status epilepticus should be ruled out first
Hypoxia
74
Which epilepsy drug causes inhibition of the P450 system
Sodium Valproate
75
Aphasia as a symptom suggests a stroke in which artery
Dominant hemisphere middle cerebral artery
| Usually left
76
Name 5 sinister signs of a headache
```
Vomiting >1
Neuro deficit
Decreased GCS
A progressive headache plus fever
Positional/ Valsalva headache
```
77
What is the gold standard test for diagnosing Degenerative Cervical Myelopathy
MRI
78
```
What does a triad of
Ataxia
Dementia
Urinary incontinence
suggest?
```
Normal pressure hydrocephalus
79
What is the recommended treatment for Bell's Palsy and is it an upper or lower motor neurone disease
Prednisolone and lubricating eye drops
| Lower Motor Neurone
80
What is Todd's Paresis and which disease is it seen in
Post-Ictal weakness seen in focal seizures
81
What is Hereditary Sensori-Motor Neuropathy also known as and how many types are there
```
Charcot-Marie-Tooth Disease
2 type (type 1 - Autosomal Dominant)
```
82
What does sinusitis + fever + focal neurology suggest
Cerebral Abscess
83
What is Saturday Night Palsy
Compression of radial nerve against humeral shaft causing wrist drop
84
Which neurological condition are tetracycline antibiotics associated with
Idiopathic Intracranial Hypertension
85
What are 3 treatments for Idiopathic Intracranial Hypertension
Weight loss
Acetazolamide
Topiramate
86
Name the 4 ipsilateral and 1 contralateral symptom involved in lateral medullary syndrome
Ataxia
Nystagmus
Dysphagia
Cranial nerve palsy
Contralateral hemisensory loss
87
Autonomic dysreflexia can only occur above which vertebral level
T6
88
What sort of symptoms occur in autonomic dysreflexia
Extreme hypertension, sweating & flushing above the level of the cord lesion
89
What are Shagreen patches and which disease are they seen in
Rough patches of skin over the lumbar spine
| seen in Tuberous Sclerosis
90
What is hyposmia and which neurology condition could it be an early sign of
it is a reduced ability to smell and to detect odors
| Can be a sign of Parkinson's
91
What should you give for suspected Listeria Meningitis if the patient is allergic to penicillin
Co-trimoxazole alone
92
Which symptom of Normal Pressure Hydrocephalus precedes all the others
Ataxia
93
In Normal Pressure Hydrocephalus Ataxia, do people tend to fall backwards or forwards
backwards
94
Hyperhidrosis is an early feature of which neuro condition and why does it happen
A feature of early-stage syringomyelia
| Indicates hyperactivity in pre-ganglionic neurons
95
What is the treatment for cerebral venous thrombosis
Heparin/Warfarin for 6 months
| lifelong if already prothrombotic
