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Step1 > Neurology > Flashcards

Neurology Flashcards

1
Q

Astrocyte

A 
Physical support
Repair
K+ metabolism
Removal of excess neurotransmitters
Component of blood brain barrier
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2
Q

Microglia

A

CNS phagocyte, derived from monocytes
Irregular nuclei, little cytoplasm, no discernible w/ Nissel stain
HIV infected microglia fuse to form multinucleate giant cells in the CNS

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3
Q

Oligodendroglia

A

Mylinates the axons of neurons in the CNS
Each oligodendroycte can myelinate many axons
Predominant type of glial cell in white matter
“Fried egg” appearance on H&E
Destroyed in MS and PML

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4
Q

Schwann cells

A

Each Schwann cell myelinated only 1 PNS axon
Also promotes axonal regeneration
Destroyed in GBS

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5
Q

Free nerve endings

A

C (slow), Adelta (fast)
Located in skin, epidermis, and some vicera
Pain and temperature

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6
Q

Meissner corpuscles

A

Large myelinated fibers, adapt quickly
Hairless skin
Dynamic, fine/light touch, position sense

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7
Q

Pacinian corpuscles

A

Large myelinated fibers, adapt quickly
Deep skin layers, joints
Vibration, pressure

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8
Q

Merkel discs

A

Large myelinated fibers, adapt slowly
Basal epidermal layer, hair follicles
Pressure, deep static touch, position sense

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9
Q

Right parietal temporal cortex lesion

A

Spatial neglect syndrome

Agnosia of the contralateral side of the world

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10
Q

Left parietal temporal cortex lesion

A

Gerstmann syndrome

Agraphia, acalculia, finger agnosia

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11
Q

Reticular activating system (midbrain) lesion

A

Reduced levels of arousal and wakefulness

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12
Q

Mammillary bodies lesions

A

Associated w/ thiamine deficiency

Wernicke-Korsakoff syndrome

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13
Q

Cerebellar hemisphere lesions

A

Intention tremor, limb ataxia, loss of balance
Fall toward side of lesions
Laterally located affecting lateral limbs

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14
Q

Cerebellar vermis lesions

A

Truncal ataxia, dysarthria

Centrally located, affects central body

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15
Q

Central pontine myelinolysis

A

Variant of osmotic demyelination syndrome
Acute paralysis, dysarthria, dysphagia, diplopia, and loss of consciousness
CAN cause locked in syndrome
Massive axonal demyelinaiton in pontine whir matter tracts 2ndary to osmotic forces and edema

Commonly iatrongenic, caused by overly rapid correction of hyponatremia

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16
Q

Broca aphasia

A

Broca Broken Boca (mouth)
Nonfluent aphasia with intact comprehension
Broca area: inferior front gyrus of front lobe

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17
Q

Wernicke aphasia

A

Wordy but makes no sense
Fluent aphasia with impaired comprehension and repetition
Wernicke area: superior temporal gyrus of temporal lobe

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18
Q

Global aphasia

A

Nonfluent aphasia with impaired comprehension

Both Broca and Wernicke areas affected

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19
Q

Conduction aphasia

A

Poor repetition but fluent speech, intact comprehension

Can be caused by damage to left superior temporal lobe and/or left supramarginal gyrus

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20
Q

Transcortical motor aphasia

A

Nonfluent aphasia w/ good comprehension and repetition

Motor: can’t really speak well but can feel (understand)

21
Q

Transcortical sensory aphasia

A

Fluent speech but poor comprehension, good repetition

Sensory: can speak but cannot feel (understand)

22
Q

Wallenberg syndrome

A 
Lateral medullary syndrome
Decreased pain and temperature sensation from ipsilateral face and contralateral body
Dysphagia, hoarsness
Decreased gag reflex
Ipsilateral Horner syndrome
23
Q

Brown-Sequard syndrome

A

Hemisection of spinal cord
Ipsilateral UMN signs below level of the lesion
Ipsilateral loss of tactile/vibration/proprioception at and below level of lesion
Contralateral pain and temperature loss below level of lesion
Ipsilateral loss of pain and temperature AT level of lesion
Ipsilateral LMN signs AT level of lesion

24
Q

Horner syndrome

A

Sympathectomy of face
Ptosis (slight drooping of eyelid)
Anhidrosis (absence of sweating) and flushing
Miosis (pupil constriction)
Associated w/ lesion of spinal cord about T1 (Pancoast tumor, Brown-Sequard syndrome, late stage syringomyelia)

25
Q

Landmark dermatones

A

T4 at the teat pore
T10 at the belly butten
L1 is the IL (inguinal ligament)

26
Q

Glaucoma

A

Optic disc atrophy atrophy w/ characteristic cupping, usually with increased intraocular pressure and progressive peripheral visual field loss

Open angle: blocked trabecular meshwork from WBC, RBC, or retinal elements

Closed angle: enlargement or forward movement of lens against central iris leading to obstruction of normal aqueous flow leading to impeding flow of trabecular meshwork

27
Q

Meyer loop (optic)

A

Sending info from inferior retina (sees up)

Loops around inferior horn of lateral ventricle (temporal lobe)

28
Q

Dorsal (down) optic radiation

A

Sending info from superior retina (sees down)

Takes shorted path via internal capsule (parietal lobe)

29
Q

Internuclear opthalmoplegia (INO)

A

Lesions seen in patients w/ demyeliation in the medial longitudinal fascicles (MLF)
Lack of communication such that when CN VI muscle activates ipsilateral lateral rectus, contralateral CN III nucleus does not stimulate medial rectus to fire and abducting eye gets nystagmus

30
Q

Acute inflammatory demyelinating polyradiculopathy

A

Autoimmune condition that destroys Schwann cells (GBS)
Inflammation and demylinaiton of peripheral nerves and motor fibers
Results in symmetric ascending muscle weakness/paralysis beginning in lower extremities

31
Q

Progressive multifocal leukoencephalopathy

A

Demylination of CNS due to destruction of oligoendrocytes
Associated w/ JC virus
Increased risk w/ use of natalizumab (anti-integrin)

32
Q

Acute disseminated (post infectious) encephalomyelitis

A

Multifocal perivenular inflammation and demylination after infection (commonly measles or VZV) or certain vaccinations (rabies, smallpox)

33
Q

Charcot-Marie-Tooth disease

A

Hereditary motor and sensory neuropathy

Defective production of proteins involved in the structure and function of peripheral nerves or the myelin sheath

34
Q

Sturge-Weber syndrome

A

Congenital non inherited developmental anomaly of neural derivatives
Affects small capillary sized blood vessels –> port wine stain of the face
Ipsilateral leptomenginal angioma –> seizure/epilepsy

35
Q

Brimondine

A

Alpha2 agonist decreasing aqueous humor synthesis
Treat glaucoma
Can cause blurry vision

36
Q

Timolol

A

Beta blocker decreasing aqueous humor synthesis
Treat glaucoma
No vision changes

37
Q

Azetazolamide

A

Diuretic decreasing aqueous humor synthesis via inhibition of carbonic anhydrase

Also act on proximal tubule of kidney, leading to increased secretion of bicarb and increased tubular pH

No vision change

38
Q

Tramadol

A

Very weak opioid agonist
Also inhibit serotonin and norepi reuptake
Treat chronic pain
Can cause serotonin syndrome and decrease seizure threshold

39
Q

Ethosuximide

A

Block thalamic T-type Ca2+ channels

Treat absence seizure

40
Q

Carbamazepine

A

Increase Na+ channel inactivation
Treat simple, complex, tonic-clonic seizure
1st line for trigeminal neuralgia
Can cause blood dyscrasias (agranulocytosis, aplastic anemia)

41
Q

Valporic acid

A

Increase Na+ channel inactivation
Increase GABA by inhibiting GABA transaminase
Treat tonic-clonic seizure, bipolar disorder
Hepatotoxicity

42
Q

Dantrolene

A

Prevent release of Ca2+ from sarcoplasmic reticulum of skeletal muscle
Use to treat malignant hyperthermia and neuroleptic malignant syndrome

43
Q

Bromocriptine

A

Dopamine agonist

Treat Parkinson’s

44
Q

L-dopa(levodopa)/carbidopa

A

Increase level of dopamine in brain
L-dopa can cross blood brain barrier
Carbidopa, a peripheral decarboxylase inhibitor, increase the bioavailability of L-dopa in the brain
Treat Parkinson’s
Can cause arrhythmias, long term use can lead to dyskinesia

45
Q

Selegiline

A

Selective MAO type B inhibitor, prevents dopamin breakdown

Treat Parkinson’s

46
Q

Donepezil

A

AChE inhibitor

Treat Alzheimer

47
Q

Bentropine

A

Antimuscarinic

Improves tremor and rigidity for Parkinson’s

48
Q

Memantine

A

NMDA receptor antagonist, help prevent excitotoxicity (mediated by Ca2+)
Treat Alzheimer

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