Neuro/Psych 4 Flashcards Preview

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Flashcards in Neuro/Psych 4 Deck (36):
1

Simple seizures

Focal (1 hemisphere)

- No LOC/postictal state
- Motor, sensory, autonomic, or psychic sx

Tx: narrow spectrum

2

Complex seizures

Focal (1 hemisphere)

- LOC and postictal state
- May have automatisms (e.g. lip smacking)

Tx: narrow spectrum

3

Tonic-clonic

Generalized (both hemis)

- LOC and Postictal state
- Diffuse muscle contraction (tonic) --- then rhythmic jerking (clonic)

Tx: Broad spectrum

4

Myoclonic seizures

Generalized

- No LOC or postictal state
- Brief jerking movements

Tx: broad spectrum

5

Absence seizures

Generalized

- Brief LOC (blank stare)
- May have automatisms (e.g. lip smacking)
- Usually no postictal state

Tx: ethosuximide

6

What are narrow spectrum tx for seizures?

Carbamazepine

Gabapentin

Phenobarbital

Phenytoin

7

What are broad spectrum tx for seizures?

Lamotrigine

Levetiracetam

Topiramate

Valproic acid

8

Tx for bulimia nervosa

- SSRIs
- Nutritional rehab
- CBT

9

Why is buproprion contraindicated in someone with bulimia?

Elevated risk of seizures

10

MOA of carbamazepine

Blocks VG-Na channels in cortical neurons

Stabilizes these channels in an inactivated state => fewer Na channels

11

Adverse effects of carbamazepine?

- Bone marrow suppression => anemia, agranulocytosis, thrombocytopenia
- Hepatoxic
- SIADH

Get LFTs and CBC periodically

12

Which tx are used in AD?

- Cholinesterase inhibitors (Donepezil)
- Antioxidants (Vit E)
- NMDA receptor antagonists (Memantine)

13

Clinical features of OCD?

Obsessions:
- Recurrent, intrusive, anxiety-provoking thoughts, urges, images

Compulsions
- Response to obsessions w/repeated behaviors
- Behaviors not connected realistically w/ preventing feared event

Time-consuming (>1h/day)

14

Subdural hematoma on a CT scan

Crescent-shaped

Rupture of cortical bridging veins

15

Subdural hematoma clinical signs

- ^ed ICP (BP)

Young pts:
- Gradual onset of HA and confusion
- think MVA, bad fall

Elderly:
- Minor trauma
- Variety of neuro sx (gait, seizures, somnolence, confusion, memory loss)

16

CT scan of Dandy-Walker malformation

Hypoplasia/absence of cerebellar vermis

Cystic dilation of 4th ventricle

Posterior fossa enlargement

17

Clinical presentation of Dandy-Walker malformation

Present in infancy

- Developmental delay
- Progressive skull enlargement
- Cerebellar dysfunction
- Non-communicating hydrocephalus

18

Primary CNS lymphomas

- Associated w/ immunocompromised pts
- Arise from B cells
- Universally associated w/ RBV
- High grade => poor prognosis

19

Which drug group is associated with the majority of overdose-related deaths?

Opioid pain relievers

20

How do the meningicoccal vxs work?

- Produce Abs that prevent inhibit pilus-mediated attachment of the meningococcus to mucosal epithelium of nasopharynx
- Prevents colonization and invasion

21

Uncal herniation

- (Ipsilateral) Fixed, dilated pupil
- Ips oculomotor muscle paralysis
- Contra/ips hemiparesis
- Contra homonymous hemianopsia

22

What is a congenital malformation?

primary abnormality in the developmental process

23

Congenital disruption

secondary destruction of a previously well-formed tissue or organ

24

Congenital deformation

secondary to extrinsic compression

25

Congenital agenesis

complete absence of an organ

26

Holoprosencephaly

- Failure of forebrain cleavage into cerebral hemis
- Congenital malformation

27

Amniotic band syndrome

Can compress or amputate fetal limbs

Congenital disruption

28

Potter syndrome

- Congenital hip dislocation
- Clubbed feet
- Flat facies

Congenital deformation and sequence

29

Clozapine indications

Tx-resistant schizophrenia

Schizophrenia associated w/ suicidality

30

Adverse effects of clozapine

- Agranulocytosis
- Seizures
- Myocarditis
- Metabolic syndrome

Must regularly monitor PMNs

31

Lambert-Eaton syndrome

- Wkness improves during the day & w/exercise
- Wkness of proximal muscles
- Associated w/ pre-existing malignancy
- Abs against pre-synaptic Ca channels
- Tensilon test: no clinical improvement
- Nerve stimulation: incremental response

32

Which type of cancer is usually associated w/Lambert-Eaton syndrome?

Small cell lung cancer

33

Diabetic mononeuropathy

- Involves CNIII (down & out, normal light and accomodation)
- Causes by central ischemia => somatic nerve fibers
- Don't affect peripheral parasympathetic fibers

34

Measuring blood levels of what correlates closely with morbidity and mortality in N. meningitidis

Meningococcal lipooligosaccharide (LOS) => toxic effects observed in meningitis and meningococcemia

35

Clinical signs of tertiary syphilis

Tabes dorsalis:
- Affects dorsal columns and dorsal roots
- Loss of position and vibration sense
- Severe lancinating pains
- Absent peripheral reflexes

Argyll Robertson pupils:
- Small, irregularly shaped pupils
- Don't constrict in response to light
- Constrict w/ accomodation
- Midbrain tectum

36

Tetrahydrobiopterin (BH4)

- Cofactor used by hydroxylase enzymes
- synthesizes tyrosine, dopamine, serotonin

Deficiency:
- PKU