Neuro/Psych 8 Flashcards Preview

ID/LC Step Review > Neuro/Psych 8 > Flashcards

Flashcards in Neuro/Psych 8 Deck (51):
1

Congenital hydrocephalus presentation in an infant

- Poor feeding
- Cannot roll over from supine position or sit unsupported (developmental delay)
- macrocephaly (nl at birth though)
- Bulging fontanelle

2

Imaging of congenital hydrocephalus

Significant dilation of lateral ventricles

3

What happens when congenital hydrocephalus goes untreated?

- Spasticity & Hyperreflexia due to periventricular pyramidal tract stretching
- Developmental delays
- Seizures

4

Go look at a coronal slice of the brain and review anatomy

Including amygdala, caudate nucleus, globus pallidus, internal capsule, and putamen

5

Wilson disease

Cystic degeneration of putamen & other basal ganglia

6

Propionic acidemia presentation

Newborn

- Poor feeding
- Vomiting
- Hypotonia
- Lethargy
- Dehydration
- Anion gap acidosis

Due to inability to breakdown propionic acid

7

Propionyl CoA derivatives (aka propionic acid)

- Valine
- Isoleucine
- Methionine
- Threonine

8

Common peroneal nerve lesion

- Due to injury of lateral neck of fibula (compression fracture)

Wkness on foot dorsiflexion (foot drop) & toe extension --- deep peroneal branch

Impaired foot eversion, sensory loss of lateral leg and dorsolateral foot --- superficial peroneal branch

9

L5 (L5/S1) radiculopathy

Sensory loss:
- buttocks
- posterolateral thigh
- anterolateral leg
- dorsal foot

Weakness:
- Foot dorsiflexion & inversion
- Foot eversion
- Toe extension

No DTR

10

Fragile X

X-linked
- Most common inherited intellectual disability
- CGG expansion on FMR1

Key physical findings:
- Large jaw
- Protruding ears
- Macroorchidism

11

Interscalene nerve block

- Anesthetizes brachial plexus (C5-T1) as it passes through scalene triangle
- Provides anesthesia for shoulder/upper arm

Almost all pts develop transient ipsilateral diaphragmatic paralysis due to involvement of phrenic nerve roots as they pass through the interscalene sheath

12

Treatment for toxoplasmosis

Pyrimethamine & sulfadiazine

13

Charcot-Bouchard aneurysms

- Associated w/ HTN
- Location: basal ganglia, cerebellum, thalamus, pons
-

14

Saccular (berry) aneurysms

- Associated w/ ADPKD, Ehlers-Danlos, HTN
- Circle of Willis
- Variable size (2-25mm)
- Subarachnoid hemorrhage
- Sudden severe HA
- Focal neuro deficits are UNCOMMON

15

Function of morphine on mu receptors

- G protein linked
- Causes activation of K conductance
- K efflux increases and causes hyperpolarization of postsynaptic neurons => blocks pain transmission

16

CNS ischemia in brain after 3-7 days

- Microglia move in
- Phagocytosis begins

17

Shoulder dislocation & strenuous UE activity (baseball pitching) affects which nerve?

Musculocutaneous nerve (C5-C7)

18

Musculocutaneous nerve innervation

Motor:
- Forearm flexors (biceps brachii, brachialis)
- Coracobrachialis (flexes/adducts arm)

Sensory:
- lateral forearm

19

Acute extrapyramidal symptoms and cause

- Dystonic reactions
- Akathisia (restlessness)
- Parkinsonism

D2 blockage in nigrostriatal pathway

20

Which drugs causes acute extrapyramidal SEs?

First-gen high-potency antipsychotics

- Haloperidol
- Fluphenazine

21

Oxidation of very long chain FAs and phytanic acid

Think peroxisomal disease in newborn

Leads to neuro defects from improper CNS myelination

22

Vitamin B12 deficiency

- Presents w/ megaloblastic anemia (impaired DNA synthesis)
- Neuro defects (impaired myelin synthesis)
- Subacute degeneration of dorsal column and lateral corticospinal tract

23

Which molecules are elevated in Vit B12 deficiency?

Serum methylmalonic acid and homocysteine

24

Clinical presentation of epidural hematoma

- "lucid interval" --- doc I feel fine
- Followed by LOC

25

Epidural hematoma blood accumulation is where?

Between bone and dura mater

26

First gen H1-histamine receptor antagonists

- Penetrates BBB and accumulates in CNS
- Do not use with other sedatives (e.g. benzos)

Examples:
- Diphenhydramine (benadryl)
- Chlorpheniramine

27

Phrenic n. nerve roots

C3-C5

innervates the diaphragm (C3, 4, 5 keeps you alive)

28

PTSD

- Exposure to life-threatening trauma
- Nightmares, flashbacks, intrusive memories
- Avoidance of reminders, amnesia for event
- Emotional detachment, negative mood, anhedonia
- Sleep disturbance, hypervigilance, irritability
- >1 month

29

Treatment for PTSD

- SSRIs, SNRIs
- Trauma focused CBT

30

Thiopental

- Short-acting barb
- Used for inducing anesthesia
- Lipid soluble => accumulates in skeletal muscle and adipose tissue

31

lateral geniculate body

Think visual

32

Medial geniculate body

Think auditory

33

Damage to temporal hemiretina

Disrupts info along ipsilateral:
- Optic n
- Lateral optic chiasm
- Optic tract
- Lateral geniculate body
- Optic radiations
- Primary visual cortex

34

Organophosphate poisoning

Farmers

Inhibits muscarinic and nicotinic synapses

Decrease Ach degradation (^ [Ach] at synaptic cleft)

Presentation: DUMBELS (muscarinic), muscle paralysis (nicotinic)

35

DUMBELS

All muscarinic (not nicotinic)

- Diarrhea
- Urination
- Miosis
- Brochospasm
- Emesis
- Lacrimation
- Salivation

36

How to reverse DUMBELS?

Atropine

37

How to reverse all SEs from organophosphate poisoning?

Pralidoxime

Does both muscarinic and nicotinic

38

Paranoid personality disorder

- Pervasive pattern of distrust and suspiciousness
- Begins in early adulthood
- Interprets comments as threats, reacts angrily
- Grudges
- Questions loyalty of partner w/o justification

39

Loss of GABA-containing neurons

Huntington disease

- ^ed trinucleotide repeats on chromosome 4

40

Essential tremor

- Most common movement disorder
- slowly progressive, symmetric postural and/or kinetic tremor
- Commonly affects UEs
- AD inheritance

TX: propranolol

41

Wallerian degeneration

- Axonal degeneration and breakdown of myelin sheath
- occurs at distal injury site
- Does not occur in CNS b/c of persistence of myelin debris, secretion of neuro inhibitory factors, and development of dense glial scarring

42

Normal pressure hydrocephalus

- Occurs in elderly
- TRIAD: ataxic gait, urinary incontinence, then dementia

- Due to periventricular white matter distortion and descending cortical fibers

43

Clinical presentation of measles

Prodrome:
- fever, malaise, anorexia
- Conjunctivitis, coryza, cough, Koplik spots

Exanthem:
- Blanching maculopapular rash
- Cephalocaudal & centrifugal spread
- Spares palms/soles

44

Complications of measles

- Pneumonia
- Secondary bacterial infections
- Neuro crap: encephalitis (days), acute disseminated encephalomyelitis (weeks), subacute sclerosing panencephalitis (years)

45

Tracts affected by Vit B12 deficiency

- Dorsal column
- Lateral corticospinal tracts

Loss of position, vibration sensation, ataxia, spastic paresis

46

HIV associated dementia histopathologic findings

Microglial nodules:
- Groups of activated macros/microglial cells formed around small areas of necrosis
- May fuse to form multinucleated giant cells

47

CN through superior orbital fissure

III, IV, V(1), VI

Also:
- ophthalmic vein
- sympathetic fibers

48

CN through foramen rotundum

V(2) - maxillary

49

CN through foramen ovale

V(3) - mandibular

50

Classic triad for bacterial meningitis

- Fever
- Stiff neck
- Altered mentation

51

Benefits of methadone

- Potent
- Long-acting opioid agonist
- Good bioavailability
- Once-daily dosing
- Prolonged effects suppress withdrawal sx and cravings