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ACVIM General Boards - 2022 > Neurology > Flashcards

Neurology Flashcards

1
Q

Which organ is a specialized ganglion in which the preganglionic fibers innervate this organ directly?

A

Adrenal medulla - Preganglionic fibers innervate the chromaffin cells directly.

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2
Q

What hormones does the adrenal medulla secrete (and in what proportion)?

A

Epinephrine (80%)

Norepinephrine (20%)

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3
Q

Where are nicotinic receptors located?

A
  1. Autonomic ganglia (sympathetic and parasympathetic)
  2. Neuromucular junctions
  3. Adrenal medulla
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4
Q

Where are muscarinic receptors located?

A
  1. Heart
  2. Smooth muscle
  3. Glands
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5
Q

What are the three type of glial cells?

A
  1. Astrocytes
  2. Oligodendrocytes
  3. Microglial cells
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6
Q

What are astrocytes?

A

Supply metabolic fuels for neurons, secrete trophic factors and synthesize neurotransmitters

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7
Q

What are oligodendrocytes? What about Schwann cells?

A

Synthesize myelin in the CNS. Schwann cells synthesize myelin in the PNS.

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8
Q

What are microglial cells?

A

Proliferate following neuronal injury - scavenge for cellular debris

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9
Q

What are first-order neurons in the sensory pathway?

A

Primary afferent neurons that receive transduced signal and transmit it to the CNS.

Cell bodies in the dorsal root or spinal cord ganglia

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10
Q

What are second order neurons?

A

Located in spinal cord or brainstem - Transmit info from first order neurons to the thalamus (cross the midline).

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11
Q

What are third order neurons?

A

Relay sensory info from thalamus to cerebral cortex

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12
Q

What are fourth order neurons?

A

The received information results in a conscious perception of the stimulus

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13
Q

What retinal cells are better for night vision?

A

Rods

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14
Q

What retinal cells are better for color vision?

A

Cones

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15
Q

What decussates at the optic chiasm?

A

Neurons from the nasal hemiretina on each side.

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16
Q

What organ contains receptor cells for auditory stimuli?

A

Organ of Corti - inner ear

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17
Q

Lesions of what structures lead to paradoxical vestibular syndrome?

A

Cerebellum - Floculonodular node or caudal cerebellar peduncle

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18
Q

With paradoxical vestibular syndrome, what direction is the head tilt? What side postural reactions are affected?

A
  1. Head tilt is away from the lesion

2. Postural reaction deficits are ipsilateral

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19
Q

True or false - Paradoxical vestibilar syndrome is alway central.

A

True - Specifically cerebellum (floculonodular lobe, caudal cerebellar peduncle)

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20
Q

What are seizures?

A

Synchronized discharges are generated by the grey matter of the cerebral cortex

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21
Q

Do forebrain lesions affect gait?

A

No - The generators of gait are below the thalamus

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22
Q

In vestibular disease, the head tilt is (towards/away) the lesion and the fast phase of nystagmus is (towards/away) from the lesion.

A

Head tilt towards the lesion

Nystagmus fast phase away from the lesion

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23
Q

What are medical treatments for congenital hydrocephalus?

A

Acetazolamide/omeprazole - dec CSF production

Glucocorticoids

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24
Q

What are surgical treatments for congenital hydrocephalus? Prognosis?

A

Ventriculoperitoneal shunt - 85% have long term improvement

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25
How does surgical treatment of meningioma for dogs vs cats vary in terms of prognosis?
Feline - Sx may be curative Dogs - Debulk (Sx often not curative) + radiation/chemo
26
How does hypercapnia affect cerebral bloodflow?
Causes vasodilation
27
What is gabapentin's MOA?
Inhibition of voltage-gated Ca++ channels
28
Phenobarbital MOA
Gaba-chloride channel
29
Which anticonvulsant has been associated with blood dycrasias?
Phenobarb - bone marrow toxicity, pancytopenia, d/c pheno fast and should see improvement
30
How is pregabalin (Lyrica) similar to gabapentin?
Greater affinity for α2δ-subunit of voltage-gate Ca channels than gabapentin More effective as both analgesic and anticonvulsant
31
Which is the only anti-epileptic drug that is specifically approved for dogs in the US?
Primidone
32
What is Keppra's MOA?
Inhibits to SV2A (Calcium channel blocker)
33
How does phenobarbital affect the metabolism of Keppra?
Phenobarb increases Keppra's metabolism
34
What is Zonisamide's MOA
Blocks T-type Ca and voltage gated Na channels in the brain, facilitates dopaminergic and serotonergic neurotransmission, free radical scavenging, enhancing GABA activity, inhibition of glutamate, and inhibition of carbonic anhydrase
35
What is a potential side effect of zonisamide?
Hepatotoxicity
36
What medications can cause PERIPHERAL vestibular signs?
Aminoglycosides, furosemide, chlorhex topical ear cleaning solutions
37
What endocrinopathy can cause peripheral vestibular signs?
Hypothyroidism
38
What medication can cause CENTRAL vestibular disease?
Metronidazole
39
What gene is associated with degenerative myelopathy
SOD1 - Superoxide desmutase
40
AA lux in small breed dogs is usually (congenital/acquired)
Congenital - malformation of the dens of the atlas
41
AA lux in large breed dogs is usually (congenital/acquired)?
Acquired - trauma
42
What is the signalment for osseous Wobbler's?
Young, giant breed dog (great danes)
43
What is the signalment for disk associated Wobbler's?
Middle aged, large breed dogs (Dobermans)
44
Chiari-like malformation is associated with herniation of what structure?
Cerebellum
45
What dog breed is predisposed to lumbosacral stenosis?
German Shepherd
46
What is the treatment of choice for lumbosacral stenosis?
Dorsal laminectomy
47
What is congenital myesthenia gravis?
Hereditary disorder resulting in deficiency of Ach receptors on the postsynaptic membrane.
48
What is the prognosis for congenital myasthenia gravis?
Very poor - Treatment with pyridostigmine may be helpful, some animals may live up to 12 - 24 months
49
What tick has been associated with tick paralysis in the USA?
Dermacentor spp
50
What is the pathogenesis behind tick paralysis?
Female tick; saliva -> toxin in circulation-> NMJ: interfere with calcium function in release of Ach
51
How long after tick attachment does tick paralysis occur?
5-9 days after tick attachment
52
What is the difference between acute coonhound paralysis vs. botulism?
Botulism - Both smooth and skeletal muscle affected (weakness and autonomic signs) ACP - Only skeletal muscle affected
53
What are the clinical signs of botulsim?
LMN tetraparesis/plegia Cranial nerves often involved Autonomic signs (mydriasis, dysphonia, megaesohpagus)
54
What is the toxin associated with botulism?
Type C botulism toxin
55
How does the botulism toxin affect the neuromuscular junction?
Cleaves SNAP-25 and prevents ACH release
56
What is the pathogenesis of coonhound paralysis (acute canine polyradiculoneuritis)
``` Production of autoantibodies against axons and myelin (esp. against the ventral motor nerve root) ```
57
What are the clinical signs of coonhound paralysis?
LMN signs | NO smooth muscle involvement (no megaesophagus)
58
What is the prognosis of coonhound paralysis?
Once dog stabilized, can take between 2 weeks and 6 months to improve. Most recover fully
59
Which LMN diseases have megaesophagus? Myasthenia gravis Coonhound paralysis Botulism Tick paralysis
Myastheniag ravis | Botulism
60
Which LMN diseases DO NOT have megaesophagus? Myasthenia gravis Coonhound paralysis Botulism Tick paralysis
Coonhound paralysis | Tick paralysis
61
What is the pathogenesis of CONGENITAL myasthenia gravis?
Defect in the acetylcholine receptor (NOT immune-mediated)
62
What breed has been predisposed to congenital myasthenia gravis?
Jack Russell Terrier
63
How is masticatory muscle myositis diagnosed?
Biopsy of temporalis muscle, or Antibodies to type IIM fibers
64
What is dermatomyositis? What age does it occur?
Familial immune mediated inflammatory disease of striated muscle, skin, and microvasculature in collies/sheepdogs/collie-crossbred commonly Occurs within 6 months of age
65
How is myasthenia gravis diagnosed?
``` Tensilon test (Edrophonium) Acetylcholice receptor antibody test ```
66
What is a long term treatment for myasthenia gravis? Pyridostigmine or edrophonium?
Pyridostigmine
67
What breeds are predisposed to necrotizing encephalitis?
Pugs - NME Maltese - NME Yorkie - NLE
68
How is immune-mediated polymyositis diagnosed?
Muscle biopsy | CK levels are NORMAL
69
What are the spinal cord segments for the hypogastric nerve?
L1-L4 | Sympathetic innervation to bladder
70
What provides sympathetic innervation to the bladder?
Hypogastric (L1-L4)
71
What nerve provides parasympathetic innervation to the bladder?
Pelvic nerve (S1-S3)
72
What nerve innervates the external urethral sphincter?
Pudendal nerve
73
How is rabies definitively diagnosed?
Detection of rabies virus antigen in brain tissue by direct FA Also presence of intracytoplasmic inclusion bodies (Negri bodies) in neurons
73
How is rabies definitively diagnosed?
74
How does the tetanus toxin work?
Tetanospasmin blocks release of inhibitory neurotransmitters such as glycine and GABA
75
Does the tetanus antitoxin reverse tetanus?
No - Toxin binding is irreversible. New axons must form. Antitoxin prevents further toxin from binding
76
What is the pathogenesis of coonhound paralysis?
Immune mediated demyelination and axonal degeneration. Occurs at nerve roots (ventral) and peripheral nerves
77
How is coonhound paralysis diagnosed? EGM?
Based on clinical signs. | EMG - Fibrillation potentials, bizarre high frequency potentials (unique to this disease)
78
Which of the following may have increased sensitivity to muscle palpation? Myasthenia gravis Coonhound paralysis Tick paralysis Botulism
Coonhound paralysis
79
What are clinical signs of steroid-responsive meningitis-arteritis?
Neck pain, fever Neurologic deficits usually not present
80
What is the typical signalment for steroid-responsive meningitis-arteritis?
Young (<2 years old) Beagles Boxers
81
What are CSF findings for steroid responsive arteritis-meningitis?
Increased protein Neutrophilic pleocytosis Elevated IgA
82
What is the mechanism of anticonvulsant bromide?
Bromide migrates through neuronal chloride channels - hyperpolarizes the cell
83
What is the half-life of bromide?
LONG half life (3 weeks) - it takes about 3 months to reach steady state
84
What is a contraindication to bromide therapy?
Renal disease
85
What are some endocrine side effects of phenobarbital?
Can decrease thyroid levels (due to increased clearance)
86
Phenobarb induces metabolism of what drugs?
``` Lysodren Steroids Ketoconazole Theophylline Digoxin Propranolol ```
87
What is the antidote for organophosphate toxicity?
2-PAM
88
Which nerve fibers are the slowest at conducting?
C fibers (non-myelinated)
89
Lesion localization - Limp tail, hyperreflexive patella, diminished sciatic
S1-S3 (patella hyper-reflexive due to weak sciatic - pseudohyperreflexia)
90
How is masticatory muscle myositis best diagnosed if the patient has been on steroids?
Biopsy
91
What therapy is contraindicated in TBI?
Methylprednisolone
92
Which lower motor neuron disease has NORMAL spinal reflexes? Myasthenia gravis Coonhound paralysis Tick paralysis Botulism
Myasthenia gravis
93
What branch of the trigeminal nerve causes a dropped jaw?
Mandibular
94
What ion current causes release of acetylcholine?
Influx of calcium
95
What percentage of animals that have cerebrovascular events are hypertensive?
30%
96
You have a boxer with signs suspicious for steroid-responsive meningitis-arteritis. How do you confirm the diagnosis?
CSF IgA titers
97
What uncommon drug can be used for urinary incontinence?
Ephedrin - adrenergic agonist
98
How do seizures in cats start?
Complex focal
99
How do you confirm congenital myasthenia gravis?
Biopsy
100
What is the localization for a two engine gait?
C6-T2
101
What is the most common neurotransmitter in post ganglionic sympathetic nerves?
Norepinephrine
102
Neurotransmitters (Excitatory/inhibitory): Glutamate GABA Glycine
Glutamate - Excitatory GABA - inhibitory (brain) Glycine - Inhibitory (spinal cord)
103
How does CO2 concentration affect cerebral blood flow?
Increased CO2 causes vasodilation
104
How does oxygenation affect cerebral perfusion?
Decreased O2 causes vasodilation
105
What is cytotoxic brain edema?
Arises secondary to ischemia - decreased ATP leads to edema within the cells
106
What is vasogenic brain edema?
Increased vascular permeability - Edema is in interstitium

ACVIM General Boards - 2022 (16 decks)

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