Neuro- UWORLD Flashcards
(35 cards)
106- Q 15. What medication regimen is used to treat transient ischemic attack?
- blood pressure control (CCB)
- dyslipidemia control (statin)
- prevention of future stroke (aspirin, clopidogrel)
110- Q 2. superficial blanching nests of disintended capillaries. what is this? If this is shown with history of recurrent UTI and ataxia, what disease should I think?
telangiectasia
Ataxia-Telangiectasia, caused by mutation in ATM ( DNA double strand break repair)
110- Q7. Lactic acidosis, stroke like episodes, and ragged red fibers in muscle biopsy : what disease is this?
Mitochondrial mypopathy
*mitochondrial inheritance pattern
: ALL offsprings from affected mom will develop disease.
NON offsprings from affected dad will develop disease.
classic muscle biopsy shows RAGGED RED FIBERS (also described as BIOTCHY RED appearance)
- buzzword: RED appearance in muscle biopsy
110- Q 12. Where is MLF (for INO) located?
dorsal pons (also extends up to midbrain)
- Stabio lecture slide has clear location in spinal cord cross section
110- Q 24. Lateral medullar syndrome
- Infarction of which arteries (2) cause it?
- which nuceli/nerve tract are located in this region? wha are corresponding symptoms?
- classically caused by PICA, also can be caused by vertebral artery infraction
- nucleus ambiguous: hoarseness, dysphagia
- sympathetic : Horner
- CN6: nystagmus
- spinothalmic: pain/temp
- This question was little mean. They did not provide nucleus ambiguous symptoms (hoarseness/dysphagia)
110-Q25. Which drug is best anti-insomnia drug for old patients? why? MOA of this drug?
Ramelton
melatonin agonist with few side effects
- this drug is not on FA 2016, but on FA2017
110- Q 29. Arginase deficiency
- ariginase mediates what rxn?
- phenotypes (3)
- final step of urea cycle
: arginine -> urea + ornithine - Arginase deficiency phenotypes
1. mild or moderate hyperammonemia
2. spastic paresis
3. developmental delay
4. choreoathetoid movement - don’t assume Huntington’s disease. Huntington shouldn’t show above three
111- Q1. Pathophysiology of ataxia in ataxia telangiectasia ?
cerebellar atrophy
111- Q 12. What is the most common cause of recurrent lobar hemorrhage in elderly?
amyloid angiopathy
- buzzword: RECURRENT, ELDERELY
# 111- Q20. For what capsaicin can be used clinically? How does it work?
Capsaicin can be used as a pain reducer.
- capsaicin reduces SUBSTANCE P, a polypeptide neurotransmitter for pain signal transmission.
Initial exposure to capsaicin causes burning and erythema, but persistent exposure leads to moderate pain reduction
111- Q 23. Injection of anesthetic between anterior and middle scalene muscles can numb which two parts of body?
- shoulder and upper arm
- also cause diaphragmic paralysis.
Diaphragm is innervated by phrenic nerve (C3-C5), and this nerve passes scalene triangle - Another thing regarding scalene
: thoracic outlet syndrome -> compression of lower trunk of brachial plexus
111- Q 27. Which structure is the most common source of intraventricular hemorrhage in neonate?
germinal matrix
- germinal matrix is highly cellular and vascularized region within ventricle. Germinal matrix is source of neurons and glial cells
111- Q 33. What is pathogenesis of HIV induced dementia?
inflammatory activation of microglia, forming microglial nodules (group of microglia that chew up brain)
112- Q 1. Damage to which nerve is responsible for loss of sensation over suprapubic region?
iliohypogastric nerve
- iliohypogastric nerve (L1) gives
- sensation: suprapubic and gluteal regions
- motor: anterolateral abdominal muscles
112- Q 11. Triad of meningitis?
- fever
- headache
- nuchal rigidity
112- Q 17. What would be effect of buprenorphine if it is given together with other opioids?
If GIVEN TOGETHER with other full agonist opioids, buprenorphine can PRECEPITATE withdrawal symptoms as it is partial agonist.
- IN THE PRESENCE OF FULL AGONIST is key here!
- Buprenorphine alone can be used to treat opioid withdrawal symptoms.
- Also Buprenorphine is used with naloxone (antagonist) to prevent rapid withdrawal effect by naloxone
112- Q22. Explain how lesion in CN V3 otologic symtpoms
CN V3 has motor for majestication
also it has motor fibers that innervate tensor tymphani in the middle ear
113- Q5. Farmer developed miosis, bradychardia, sweating.
- What is happening?
- treatment?
- limitation of this treatment?
- organophosphate: AchEI
- atropine
- atropine is only anti-muscarinic. It will not reverse nicotinic activity- NMJ: muscle paralysis
113- Q 13. What is DRESS syndrome? What three drugs can cause it?
Drug Reaction with Eosinophilia and Systemic Symptoms
- fever, rash. lymphadenopathy, facial edema, EOSINOPHILIA
- phenytoin, carbamazepine, vancomycin
114 - Q 10. Explain how hyperventilation through ventilator can be used to reduce cerebral edema
hyperventilation
-> decrease in PaCO2
-> vasoconstriction
(remember, brain primarily responds to PaCO2, and CO2 is vasodilator)
- > decrease in cerebral blood flow
- > decrease in ICP
114- Q 18. Symptoms of restless leg syndrome? how to treat it?
- urge to move leg with unpleasant leg sensation (description in question may be vague)
- onset normally happens during rest or night. symptoms are relieved with rest
treated with Dopamine agonist (pramipexole)
114- Q20. What are two classic hemorrhage that suggest abusive head trauma to baby?
- subdural hemorrhage
: shaking hard can damage bridging veins - retinal hemorrhage
: retinal artery is weak and vulnerable
114- Q37. Cortical atrophy is characteristic of Alzheimer disease. Atrophy in which part of brain is prominent so that it can be detected even in early stage of Alzheimer?
hippocampus
- Hippocampus is also most vulnerable to hypoxia
- Think dumb (Alzheimer) hippo that doesn’t like oxygen (hypoxia) so that it only hangs out in the water
115- Q9. CNS lesion with EBV infection. What should i think about? What cells would comprise the lesion?
primary CNS lymphoma
: comprised of B cells, as PCNSL is B cell lymphoma
