Neuro Random facts Flashcards Preview

Step 1 > Neuro Random facts > Flashcards

Flashcards in Neuro Random facts Deck (109):
1

Meissner corpuscles

In the glabrous (hairless) skin, for dynamic, fine/light touch, position sense, adapt quickly

2

Pacinian corpuscles

Adapt quickly, in the deep skin layers, ligaments, joints, sense vibration and pressure

3

Merkel discs

Adapt slowly, in the fingertips and superficial skin, sense pressure, deep status touch (e.g., shapes, edges), position sense

4

Ruffini corpuscles

Adapt slowly, in the fingertips and joints, sense pressure, slippage of objects along surface of skin, joint angles change

5

What are does stress and panic

locus ceruleus (where norepi is synthesized)

6

Vitamin necessary for synthesis and catabolism of GABA

B6

7

How is GABA synthesized?

From glutamate by glutamate decarboxylase

8

Lateral hypothalamus

Hunger

9

Ventromedial hypothalamus

Satiety

10

Anterior hypothalamus

Cooling, parasympathetic

11

Posterior hypothalamus

Heating, sympathetic

12

Suprachiasmatic nucleus

Circadian rhythm

13

What causes the extra ocular eye movements during REM?

Paramedian pontine reticular formation/conjugate gaze center

14

VPL

Pain, temp; pressure, touch, vibration, proprioception (from the spinothalamic and DCML pathways)

15

VPM

Face sensation, taste (from the trigeminal and gustatory pathway)

16

LGN

Vision (goes TO the calcarine sulcus)

17

MGN

Hearing

18

VL

Motor

19

What are the output nerves from the cerebellum?

Purkinje cells to the deep nuclei of cerebellum to the contralateral cortex via superior cerebellar peduncle

20

Characteristic lesion for hemiballismus

Contralateral subthalamic nucleus

21

Which disease do you see Lewy bodies in?

PARKINSONS

22

Neurohormonal changes in Huntington's disease?

Increased dopamine, decreased GABA, decreased ACh

23

What causes neuronal death in HD?

NMDA-R binding and glutamate toxicity

24

Agraphia, acalculia, finger agnosia, left-right disorientation

Lesion to the dominant pariental-temporal cortex, Gerstmann syndrome

25

Damage to the PPRF

Eyes look away from the lesion

26

Damage to the frontal eye fields

Eyes look toward the lesion

27

What is cerebral perfusion driven by?

Pco2 (hypoxemia increases cerebral perfusion only when Po2 is less than 50)

28

Why do people faint in panic attacks?

Hyperventilation leads to decreased cerebral perfusion

29

Equation for cerebral perfusion pressure

CPP=MAP-ICP

30

Symptoms of lateral medullary syndrome

Vomiting, vertigo, nystagmus; decreased pain and temp sensation from ipsilateral face and contralateral body; dysphagia, hoarseness, decreased gag reflex; ipsilateral Horner syndrome; ataxia, dysmetria

31

What blood vessel is damaged to give Wallenberg syndrome

PICA

32

Symptoms of AICA damage

Lateral pontine syndrome. Similar to Wallenberg but PARALYSIS of FACE as well, decreased lacrimation, salivation. (NO dysphagia or hoarseness). "Facial droop means AICA's pooped"

33

Lesions where causes allodynia

Thalamus

34

What is an inherited disease that could look like polio?

Spinal muscular atrophy (Werdnig-Hoffmann disease), AR

35

What innervates the salivary glands

Facial nerve innervates submandibular and sublingual, glossopharyngeal innervates parotid

36

What produces aqueous humor?

Ciliary epithelium (beta)

37

What innervates the dilator and sphincter muscle of the eye?

Dilator is sympathetic (alpha-1), and spinchter is parasympathetic (M3)

38

Vision changes in glaucoma

Progressive peripheral visual field loss

39

What is glaucoma?

Optic disc atrophy with characteristic cupping (thinning of outer rim of optic nerve head) usually with elevated intraocular pressure and progressive peripheral visual field loss

40

Cause of open angle glaucoma

Primary is unclear. Secondary can be from blocked trabecular meshwork from WBCs (e.g., uveitis), RBCs (e.g.. vitreous hemorrhage), retinal elements (e.g., retinal detachment)

41

Cause of primary closed/narrow angle glaucoma

Enlargement or forward movement of lens against central iris causes obstruction of normal aqueous flow through pupil resulting in fluid build up behind the iris, pushing peripheral iris against the cornea and impeding flow through the trabecular meshwork

42

Secondary causes of closed/narrow angle glaucoma

Hypoxia from retinal disease induces vasoproliferation in iris that contracts angle

43

Painful red eye, sudden vision loss, halos around lights, rock-hard eye

Acute angle-closure glaucoma

44

Distortion and eventual loss of central vision

Age-related macular degeneration

45

Diabetic retinopathy

1. Nonproliferative- damaged capillaries leak blood->lipids and fluids seep into retina-> hemorrhages and macular edema. 2. Proliferative- chronic hypoxia results in new blood vessel formation with resultant traction on retina

46

Acute, painless monocular loss of vision

Central retinal artery occlusion/retinal detachment (?)

47

Bone spicule-shaped deposits around macula

Retinitis pigmentosa

48

What is retinitis pigmentosa

An inherited form of retinal degeneration. Painless, progressive vision loss beginning with night blindness (rods affected first)

49

What causes the ptosis in Horner's syndrome

Lack of sympathetic to the superior tarsal muscle

50

Fourth nerve palsy

Diplopia when trying to look down (reading or going downstairs) because eye is stuck up, tilt their head toward the opposite side of the affected eye`

51

Right MLF is which one

The one that connects the left CN VI nucleus to the right CN III nucleus (Directional term [ie right INO, left INO]) refers to which eye is paralyzed

52

Does ApoE2 increase or decrease the risk for Alzheimer's

Decrease

53

Histology of Alzheimer's

Senile plaques in gray matter (extracellular beta-amyloid core that may causes amyloid angiopathy), and neurofibrillary tangles (intracellular hyperphosphorylated tau protein, number of tangles correlates with degree of dementia)

54

Histology of frontotemporal dementia

Pick bodies: silver-staining spherical tau protein aggregates

55

Histology of Lewy body dementia

alpha-synuclein defect (Lewy bodies, primarily cortical)

56

Charcot triad of MS

Scanning speech, Intention tremor (also incontinency and internuclear ophthalmoplegia, nystagmus)

57

How does baclofen work?

GABA-B receptor agonist

58

Tx for neurogenic bladder in MS

catheterization, muscarinic antagonists

59

Tx for Guillan barre

Respiratory support, plasmapheresis, IV immunoglobulins

60

Charcot-Marie-Tooth disease

AD, aka hereditary motor and sensory neuropathy, defective production of proteins involved in the structure and function of peripheral nerves or the myelin sheath, associated with scoliosis and foot deformities

61

Krabbe disease

AR lysosomal storage disease due to deficiency of galactocerebrosidase. Buildup of galactocerebroside and psychosine destroys myelin sheath. Findings: peripheral neuropathy, developmental delay, optic atrophy, globoid cells

62

Metachromic leukodystrophy

AR lysosomal storage disease due to arylsulfatase A deficiency. Build-up of sulfatides causes impaired production and destruction of myelin sheath. Findings: central and peripheral demyelination with ataxia, dementia

63

Adrenoleukodystrophy

X-linked, disruption of metabolism of very-long-chain fatty acids causing buildup in the nervous system, adrenal gland, testes. Can lead to long-term coma/death and adrenal gland crisis

64

What can be used for migraine prophylaxis?

Propranolol, topiramate, Ca channel blockers, amitriptyline

65

What does positional testing show in peripheral and central vertigo

Peripheral-delayed horizontal nystagmus; central- immediate nystagmus in any direction, may change directions

66

Genetics of Sturge-Weber syndrome

Congenital, non-inherited (somatic), developmental anomaly of neural crest derivatives dues to an activating mutation of GNAQ gene

67

Sturge-Weber mnemonic

STURGE: Sporadic, port-wine Stain, Tram track calcifications, Unilateral, Retardation, Glaucoma, GNAQ gene, Epilepsy

68

Tuberous sclerosis

HAMARTOMAS: hamartomas, angiofibromas, mitral regurgitation, ash-leaf spots, cardiac rhabdomyoma, tubers, autosomal dOminant, mental retardation, renal Angiomyolipoma, Seizures, Shagreen patches

69

Features in vHL disease

Hemangioblastomas (high vascularity with hyper chromatic nuclei) in retina, brain stem, cerebellum, spine; angiomatosis (e.g., cavernous hemangiomas in skin, mucosa, organs); bilateral renal cell carcinomas; pheochromocytomas

70

What do meningiomas arise from?

Arachnoid cells

71

Histology of meningioma?

Spindle cells concentrically arranged in a whorled pattern; psammoma bodies (laminated calcifications)

72

What can hemangioblastomas produce?

Erythropoietin (so can cause secondary polycythemia)

73

What do Scwannomas stain positive for?

S-100

74

Histology of schwannoma

Spindle cells with palisading nuclei arranged around Verocay bodies and composed of eosinophilic cores (Antoni A pattern) and mixed regions of low cellularity (Antoni B)

75

Round nuclei with clear cytoplasm

"Fried egg" cells of an oligodendroglioma. May also see calcifications and "chicken wire" capillary pattern

76

Rosenthal fibers

Pilocytic astrocytoma (in children), optic glioma in an adult

77

Perivascular rosettes

Ependymoma

78

Rod-shaed blepharoplasts found near nucleus

Ependymoma. Blepharoplasts=basal ciliary bodies

79

Which alpha agonists can be used in glaucoma?

Epinephrine and brimonidine, both decrease aqueous humor synthesis. Do not use epic in closed-angle glaucoma because it causes mydriasis

80

Which beta-blockers are used in glaucoma?

Timolol, betaxolol, carteolol

81

MOA of pilocarpine, carbachol, physostigmine, and echothiphate in glaucoma

Increased outflow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork

82

What do you use for glaucoma in an emergency

Pilocarpine

83

Which prostaglandins can you use in glaucoma and what are their side effects?

Latanoprost and travoprost, SE: darkens color of iris

84

How do opioid analgesics work?

Act at opioid G-protein coupled receptors. Open K channels and close Ca channels, decreasing synaptic transmission. Inhibit the release of Ach, norepi, 5-HT, glutamate, and substance P.

85

MOA of tramadol

Very weak opioid agonist, also inhibits 5-HT and norepi reuptake

86

MOA of ethosuximide

Blocks thalamic T-type Ca channels

87

MOA of phenytoin

Increases sodium channel activation; zero-order kinetics

88

MOA of gabapentin

Primarily inhibits high-voltage-activated Ca channels; designed as a GABA analog

89

First line for seizures in neonates

Phenobarbital

90

Which anti-epileptic causes kidney stones?

Topiramate

91

What is vigabatrin used for?

Infantile spasms (West syndrome), but ACTH is a better treatment

92

First line for simple and complex partial seizures

Carbamazepine

93

Drugs with low solubility in the blood have what type of induction

Rapid

94

Drugs with high solubility in lipids have what type of potency

high

95

Cause of malignant hyperthermia

Due to abnormal ryanodine receptors on the surface of the sarcoplasmic reticulum releasing large amounts of calcium after exposure to an anesthetic

96

Why is thiopental so short acting?

Rapid redistribution into tissue

97

MOA of arylcyclohexylamines

(Ketamine) PCP analogs that act as dissociative anesthetics. Block NMDA receptors.

98

MOA of propofol

Potentiates GABA-A

99

Order of nerve blockades from local anesthetics

Small myelinated -> small unmyelinated -> large myelinated -> large unmyelinated. Order of loss: pain, temp, touch, pressure

100

MOA of local anesthetics

Block Na channels by binding to specific receptors on inner portion of channel. Preferentially bind to activated Na channels, so most effective in rapidly firing neurons

101

Reversal of blockade for non-depolarizing neuromuscular agents

Neostigmine (must be given with atropine to prevent muscarinic effects such as bradycardia)

102

Drugs for Parkinsons

BALSA: bromocriptine, amantadine, levodopa (with carbidopa), selegiline (and COMT inhibitors), antimuscarinics

103

MOA of pramipexole, ropinirole

Dopamine agonist

104

MOA of amantadine in Parkinsons

Increases dopamine release and decreases dopamine reuptake

105

Toxicity of amantadine

Ataxia, livedo reticularis

106

Use of benztropine in Parkinsons

Antimuscarinis, improves tremor and rigidity but has little effect on bradykinesia

107

Drugs used for Alzheimers

Memantine (NMDA receptor antagonist); helps prevent excitotoxicity (mediated by Ca); AChE inhibitores- donepezil, galantine, rivastigmine, tacrine

108

MOA of sumatriptans

5-HT-1B/1D agonists. Inhibit trigeminal nerve activation; prevent vasoactive peptide release; induce vasoconstriction

109

Treatment for RLS

Dopamine agonists (eg, pramiprexole)