Neuro Things I Can't Remember

Question 1

Describe decerebrate posturing

Answer 1

Extension of both upper and lower extremities

Damage to the midbrain (red nucleus)

Question 2

Describe decorticate posturing

Answer 2

Damage to the cerebral hemisphere

Arm flexed and leg extended in response to pain

Question 3

What drugs may be used to slow Alzheimer’s Disease?

Answer 3

Central acetylcholinesterase inhibitors (donepezil, rivastigmine, or galantamine)

May add Memantine in later course

Question 4

What test may be used premortem to diagnosis Alzheimers?

Answer 4

Pittsburgh Compound B to bind Beta amyloid

Question 5

Agnosia occurs when there is damage to…

Answer 5

Sensory association cortex

Question 6

Perivascular Pseudorosettes are seen in what primary brain tumor?

Answer 6

Ependymoma

Question 7

After fixing an aneurysm, the patient may develop cerebral vasospasm in the next few days. How is this minimized (3 Hs)?

Answer 7

Hypertension (vasopressors)

Hypervolemia (IV hydration)

Hemodilution (phlebotomy)

Question 8

When is carotid endarterectomy indicated?

Answer 8

Symptomatic atheromatous lesion of 70-99% stenosis at origin of ICA

Question 9

Cheynes strokes breathing is indicative of what kind of damage to the brain?

Answer 9

Bilateral cortical involvement due to metabolic encephalopathy

Question 10

Two ways to reduce intracranial pressure

Answer 10

Hyperventilation and mannitol (osmotic diuretics)

Question 11

What is the preferred method of determining brain death now?

Answer 11

Radioisotope brain scan at the bedside

If there is no cerebral blood flow for 10 minutes, they are braindead

Question 12

How should essential tremor be treated?

Answer 12

Beta blockers or barbiturates

Question 13

How should choreoathesosis, hemiballismus, and tics be treated?

Answer 13

Dopamine antagonist drugs

Question 14

How should dystonia be treated?

Answer 14

Antichoinergics

Benzodiazepines

Botulinum toxin injections

Question 15

Fibrillary astrocytes are located where?

Answer 15

White Matter

Question 16

Protoplasmic astrocytes are located where?

Answer 16

Grey matter

Question 17

Describe satellitosis

Answer 17

Oligodendrocytes surrounding a neuron cell body in the CNS

Question 18

Describe cell appearance in Central Chromatolysis

What causes it?

Answer 18

Neuron cell body swells and pushes the nucleus to the side

In response to axonal destruction or transection

Question 19

Describe cell appearance in Neuronophagia

What causes it?

Answer 19

Neuron is surrounded by microglial cells

Caused by viral encephalitis

Question 20

Describe cell appearance in Acute Neuronal Injury

What causes it?

Answer 20

Cell body shrinkage, Red Dead Neurons
Cytoplasm is eosinophilic
Pyknotic nuclei
Loss of Nissl substance

Caused by hypoxia, ischemia, infarct, hypoglycemia

Question 21

Describe cell appearance in Ballooned Neurons

What causes it?

Answer 21

Neuronal cell body has swollen, but the nucleus is still in the center of the cell

Seen in neurodegenerative diseases

Question 22

When are Negri bodies seen?

Answer 22

Rabies

Question 23

When are Hirano bodies seen? What are they?

Answer 23

Alzheimer’s or CJD

Aggregations of alpha-actin

Question 24

When are Lewy bodies seen?

Answer 24

Parkinson’s

Dementia with Lewy Bodies

Question 25

Methanol poisoning causes atrophy of the...

Answer 25

Putamen

Question 26

CO poisoning causes hemorrhage of the...

Answer 26

Glubus pallidus

Question 27

Central Pontine Myelinolysis is caused by...

Answer 27

Rapid correction of hyponatremia

Question 28

Multiple System Atrophy What is the pathology seen? What part of the brain is involved?

Answer 28

Parkinsonism Cerebellar ataxia Autonomic dysfunction Expect to see glial cytoplasmic inclusions of alpha synuclein May see putamen, SN, pons, cerebellum, olive atrophy