Neuro-Rx Flashcards
(28 cards)
Is Wernicke/Broca aphasia problem of left or right hemisphere?
LEFT
so it is infarct of LEFT middle cerebral artery
how to treat cluster headache: acute treatment and prophylaxis?
acute treatment with sumatriptan
prophylaxis with verapamil
* vs. miagrine: prophylaxis is beta blockers, amitryptiline, valporate
Baby, high temperature, simple febrile seizure with no signs of meningitis. What should I think about
roseola (HHV-6)
- key word: FEBRILE, SIMPLE seizure
Where is postsynaptic dopamine receptor located in basal ganglia?
striatum (caudate/putamen)
- I picked substantia nigra, but rembmer it is the site of dopamine release in presynaptic level.
Released dopamine binds to either D1 (direct) or D2 (indirect) LOCATED IN STRIATUM
Which physical exam is sensitive for disc herniation? This test reveals disc herniation at what vertebrae level?
leg raise test
leg raise test stimulates sciatic nerve
sciatic nerve is further divided to peroneal and tibial.
So it is specific to L4-L5 or L5-S1 herniation
What three structures are contained in carotid sheath? what is location of each relative to each other
internal jugular vein
common carotid
vagus nerve
internal jugular vein is most lateral and anterior
vagus nerve is POSTEIOR to internal jugular
common carotid is medial
- this is kinda opposite with NAVL in inguinal ligament
Which nerve layer (epineurium, perineurium, endoneurium) serves as permeability barrier (greatest obstacle for drug administration)?
perineurium
What does positive white reflex of eye suggest (2)?
- retinoblastoma
- congenital cataracts
- white reflex suggests many other eye pathologies, but knowing these two should be enough for step 1
Regular round cells with spherical nuclei with finely granular chromatin in clear cytoplasm: what CNS tumor is this?
oligodendroglioma
- OligOdendrOgliOma: fried egg
- buzzword: round cells with CLEAR CYTOPLASM
- also can be described as perinuclear halo
Is sensation intact in locked in syndrome by basilar artery infarct? what about consciouness? sleep-awake cycle?
ALL of them are intact. Only total motor paralysis except vertical gaze
- Patient’s consciousness is fully intact as well
- normal sleep-awake cycle as pineal gland (which releases melatonin) is intact
Neuro symptoms and sings of infection. Two differential diagnosis? how to differentiate these two?
polio: only lower motor symptoms- anterior horn
Guian-Barre: motor and sensation, peripheral demylination, history of bloody diarrhea (campy)
Which cranial nerve pass through stylomastoic foramen?
facial nerve
Which local anesthetics cause cardiotoxicity?
bupivacaine
Where is fusiform gyrus?
inferior temporal lobe
PML (JC virus) vs. HIV encephalitis
- CD4 count
- infected cells
- symptoms
PML (JC virus)
- CD4 <100
- oligodendrocytes
- focal neuro deficits
HIV encephalitis
- CD4 <100
- microglia
- dementia
Hemangioblastoma: what neurocutanenous disorder?
VHL
- don’t confuse hemangioblastoma with harmatoma (tuberous sclerosis). These two sound kinda similar, but completely different
- hemangioblastoma: highly vascularized hyperchromic nuceli
- harmatoma: disorganized growth of normal tissue
Pts present with classic findings of Parkinson disease (pill rolling hand tremor, cogwheel rigidity, gait shuffling). What another piece of information would confirm diagnosis?
response to levodopa
- I picked alpha-synuclein histology, but technically brain biopsy is not feasible. Drug response can be used as diagnostic confirmation
Right facial numbness: which side/ which hypothalamus nuclei is impaired?
LEFT ventral postereoMedial nucleus
M- masking
- facial sensory is also contralateral
: remember trigeminal ganglia enters medulla, where is decussate and ascend signal upto hyopthalamus
( hypothalmus is located above medulla, so decussation happens before reaching to hypothalamus) - ONE trigeminal ganglia is located in each side. This one trigeminal ganglia branches off V1/V2/V3. All V1/V2/V3 signal is collected in trigeminal ganglia, sending signal to medulla -> decussates-> CONTRALATERAL hypothalamus/cortex
- BOTTOM LINE: ALL FACIAL sensation is CONTRALATERAL
Apart from Schwannoma, NF2 is also associated with what other brain tumors?
meningioma, ependymoma
multiple sclerosis is associated with what HLA type?
HLA-DR2
Where is osmotic receptors located? what stimuli stimulates it? what stimuli inhibits it? what is result of stimulation/ inhibition?
hypothalamus
- increased osmolarity-> stimulate osmotic receptors
- > increased thirst/ increased release of ADH (in supraoptic nuclei)
- decreased osmolarity -> inhibit osmotic receptors
- > decreased thirst/ decreased release of ADH
Defect in what ear structure leads to low frequency sensorineuronal hearing loss? what about hight frequency sensorineuronal hearing loss?
low frequency: increased volume of endolymph
=> too much liquid dissipates low frequency sound
high frequency: CN8, this is presbycusis, age-related hearing loss
pancoast tumor suppress what part of sympathetic nerve: fist neuron? second neuron? third neuron?
second neuron
- remember: first neuron runs through spinal cord, and second nerve runs through sympathetic chain.
Sympathetic chain is in close proximity to lung apex, thus compressed by pancoast tumor
Lesion to what structure may damage first neuron of sympathetic nerve, giving Horner syndrome phenotypes?
hypothalamus (origination of sympathetic nerve)
or spinal cord
