Neurology # 1 Flashcards

1
Q

Epinephrine is an ____gonist at and ____ BP

A

agonist alpha 1, alpha 2, Beta 1, and beta 2 receptors. Increases

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2
Q

Phentolamine is an ___gonist at….

A

antagonist at alpha 1 and alpha 2

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3
Q

Epinephrine administration followed by phentolamine ____ BP

A

decreases (acts only B)

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4
Q

Neostigmine is ____ and ___ BP

A

acetycholinesterase inhibitor. indirectly decreases

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5
Q

Isoproterenol is ___ and ___ BP

A

nonspecific Beta-agonist. decreases

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6
Q

Atropine is

A

competitive muscarinic antagonist

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7
Q

Norepineprhine is ___gonist at and _____ BP

A

agonist at alpha 1 , alpha 2 and beta 1 receptors. increases

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8
Q

Propranolol is a ___gonist

A

antagonist for beta

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9
Q

phenylephrine is a ____gonist and ____ BP

A

agonist at alpha 1. Increases

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10
Q

Hexamethonium is

A

nicotinic ganglionic blocker

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11
Q

Huntington’s disease presentation, genetic defect and on what chromosome, what brain parts affected? mnemonic

A

chorea, dystonia, altered behavior and dementia. autosomal dominant disease of CAG triple repeats on chromosome 4p. Caudate and putamen affected. “Caudate loses ACh and GABA”

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12
Q

Alzheimer’s disease presentation, pathophysiology, parts of brain affected

A

progressive memory loss, cognitive impairment, deposition of neuritic plaques (abnormally cleaved amyloid protein) and neurofibrillary tangles (phosphorylated tau) in cerebral cortex. Cholinergic neurons in globus pallidus

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13
Q

Wilson’s disease presentation and pathophysiology

A

asterixis, parkinsonian symptoms, cirrhosis and Kayser-Fleischer rings (corneal deposits of copper), some chorea and dementia. caused by failure of copper to enter circulation bound to ceruloplasmin. accumulation of copper in liver, corneas and basal ganglia

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14
Q

Parkinson’s presentation and pathophys

A

presents with TRAPS (tremor at rest, cogwheel Rigidity, Akinesia (or bradykinesia), Postural instability and Shuffling gait)). loss of dopaminergic neuros and loss of pigmentation in substantia nigra + lewy bodies (alpha - synuclein)

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15
Q

MS presentation and pathophys

A

SIIIN (Scanning speech, Intention tremor, Incontinence and Internuclear opthalmoplegia, Nystagmus) + optic neuritis, hemiparesis, hemisensory symptoms. Scattered plaques of demyelination anywhere in CNS. Oligodendrocytes targeted by autoimmune disease

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16
Q

Lyme disease caused by, vector, in what animal, presentation, treatment

A
Borrelia burgdorferi transmitted by tick Ixodes, mouse.
Mnemonic: FAKE a key Lyme pie
Facial nerve palsy (typically bilateral)
Arthritis
Kardiac Block
Erythema migrans
treatment: doxycycline, ceftriaxone
17
Q

Tetracyclines: mechanism, pros, cons

A

bacteriostatic; bind to 30S nd prevent attachment of aminoacyl-tRNA; can be used in pts with renal failure. limited CNS penetration. do not take with milk or anti-acids or iron-containing preps.

18
Q

Tetracycline names

A

doxycline and minocycline

19
Q

tetracycline toxicity

A

GI distress, discoloration of teeth and inhibition of bone growth in children, photosensitivity, contraindicated in pregnancy

20
Q

Albinism problem and cause. increased risk for

A

normal melanocyte number with decreased melanin production due to decreased tyrosinase activity or defective tyrosine transport. can also be caused by failure of neural crest cell migration during development. Risk for squamous, basal cell carcinoma and malignant melanoma

21
Q

Neural crest derivatives

A

Melanocytes, odontoblasts, pia and archnoid mater, schwann cells, cells of the ganglia, parafollicular C cells of the thyroid, chromaffin cells, the aorticopulmonary septum, pharyngeal arch skeletal components and neurocranium

22
Q

How does subthalamic cause hemiballismus (sudden, wild flailing of 1 arm +/- ipsilateral leg)?

A

Subthalamic nucleus potentiantes (excites) the globus pallidus internus (GPi), which sends inhibitory input to the thalamus via the action of y-aminobutyric acid. When subthalamic nucleus is knocked out, there is less excitatory input to the GPi

23
Q

what is associated with S1 radiculopathy?

A

decreased sensation of the posterior leg and lateral foot, diminished ankle-jerk reflex and weakness to plantarflexion, toe flexion and inversion

24
Q

what is associated with L5 radiculopathy?

A

diminished sensation of the medial aspect of the foot, weakness to dorsiflexion

25
Q

what is associated with L2-L4 radiculopathy?

A

diminished knee-jerk reflex, weakness to knee extension, controlled by femoral nerve

26
Q

The cerebrocerebellum is responsible for? Lesions here cause what?

A

fine movements of the hands and face. Lesions here cause dysdiadochokinesis (impairment in rapidly alternatig hand movements) and intention tremor

27
Q

Wilson’s disease presentation

A

Mnemonic: Copper is Hella BAD
Ceruloplasmin (copper in cirulation) Cirrhosis, corneal deposists (Kayser-Fleischeer rings), Copper accumulation, Carcinoma (hepatocellular), Hemolytic anemia, basal ganglia degeneration (parkinsonian symptoms), Asterixis, Dementia, Dyskinesia, Dysarthria

28
Q

Wilson’s disease is caused by

A

autosomal recessive disorder caused by mutation of a gene on chromosome 13 that encodes a protein responsible for copper transport.

29
Q

Guillain-Barre syndrome pathophys and associations

A

autoimmune condition that destroys schwann cells leading to inflammation and demyelination of peripheral nerves and motor fibers. associated with campylobacter jejuni and CMV

30
Q

Guillain-Barre presentation

A

symmetric ascending muscle weakness / paralysis beginning in lower extremities. facial paralysis in 50% of cases.

31
Q

Myastenia gravis, pathophys, presentation, diagnosis

A

autoantibodies to postsynaptic ACh receptor, ptsosi, diplopia, weakness, worsens with muscle use, Anti-AChR (anti-acetylcholine receptor antobdy test)

32
Q

Atropine is what and overdose signs

A

muscarinic antagonist. HOT as a hare (increased body temperature), DRY as a bone (decreased sweating, dry mouth), RED as a beet (flushed skin), BLIND as a bat (cycloplegia) MAD as a hatter (disorientation), rapid pulse

33
Q

Atypical antipsychotics mnemotic and drugs

A

It’s atypical for Old CLOsets to QUIETly RISPER from A to Z

34
Q

Side effect of clozapine is ___ treatment

A

agranulocytosis. treated with granulocyte colony-stimulating factor (GCSF)

35
Q

Crytococcus neoformans

A

opportunistic fungal infections. cryptococcal meningitis, heavily encapsulated yeast. not dimorphic. found in soil, pigeon droppings. culture on sabouraud agar, stains with india ink and mucicarmine

36
Q

Amphotericin B

A

drug binds ergosterol, a compound unique to the fungal cell membrane and induces pore formation