Neurology Flashcards
1
Q
Seen in acute hypoxia/ischemia
Evident by 12-24 hours
Shrinkage of cell body, pyknosis of nucleus, nucleolar disappearance, eosinophilia
A
Acute neuronal injury
Red neurons
2
Q
Hallmark of acute neuronal injury
12-24 hours
A
Loss of Nissl substance
3
Q
Seen in chronic and progressive neurodegenerative disease
Cell loss, reactive gliosis
A
Subacute and chronic neuronal injury
Degeneration
4
Q
Seen during regeneration
Increased protein synthesis with axonal sprouting
A
Axonal reaction
5
Q
Seen in aging, viral infections and degenerative diseases
Intracytoplasmic accumulation
A
Neuronal inclusions
6
Q
Site of protein synthesis of neurons
Granular bodies of RER
A
Nissl susbtance
7
Q
HSV body
A
Cowdry type A in temporal lobe
8
Q
Rabies body
A
Negri body in pyramida cells of hippocampus and purkinje cells of cerebellum
9
Q
Alzheimer’s body
A
Neurofibrillary tangles of hyperphosphorylated tau proteins
10
Q
Parkinson’s disease body
A
Lewy Body of alpha synuclein protein
11
Q
Hypertrophy and hyperplasia of astrocytes
A
Gliosis
12
Q
Astrocyte functions
A
Metabolic buffers/detoxifiers
Control flow of substances between BBB and CSF
Recycle glutamate
13
Q
Eosinophilic structures that occur within ASTROCYTIC processes that are found in regions of long-standing gliosis and pilocytic astrocytoma
A
Rosenthal fibers
14
Q
Basophilic and lamellated structures found in advancing age, representing a degenerative change in astrocytes
A
Corpora amylacea
15
Q
Sites where corpora amylacea are found
A
Brain
Lung
Prostate
16
Q
Sum of the components of the intracranial cavity is constant
Brain, Blood, CSF
A
Monroe Kelly Doctrine
17
Q
Sequence of compensation
A
CSF -> Venous blood -> Arterial blood (ischemia) -> Brain (herniation)
18
Q
Due to BBB disruption and increased vascular permeability
Increased fluid leakage
Seen in inflammation or neoplasms
A
Vasogenic edema
19
Q
Due to CNS injury that prevents maintenance of membrane ionic gradient
Increased CSF secretion
Seen in hypoxic/ischemic injury
A
Cytotoxic edema
20
Q
Only type of cerebral edema responsive to steroids
A
Vasogenic edema
21
Q
Increase in ventricular CSF volume due to loss of brain parenchyma
A
Hydrocephalus ex vacuo
Alzheimer’s
Dementia
22
Q
Most common cause of congenital hydrocephalus
A
Congenital Aqueductal Stenosis
23
Q
Cushing’s triad
A
Widened pulse pressure
Hypertension
Irregular breathing
Bradycardia
due to pressure on vagus nerve
24
Q
Asymptomatic bony defect or a severe malformation with a flattened, disorganized segment of spinal cord
A
Spina bifida
25
Extension of CNS tissue through a defect in the vertebral column
Myelomeningocoele
26
Diverticulum and malformed brain tissue extending through a defect in cranium
Encephalocoele
27
Malformation of the anterior end of the neural tube
Anencephaly
28
Completely open brain and spinal cord
Craniorachischisis
29
Occipital skull and spine defect with extreme retroflexion of the head
Iniencephaly
30
Deficiency of at least two vertebral arches
| Covered with lipoma
Closed spinal dysraphism
31
Prescribed period of intake of folic acid in women desirious of pregnancy
1 month before and first 3 months of pregnancy
400 mcg
0.4 mg
32
Reduced number of gyri
Lissencephaly
33
Small and irregular formed convolutions
Polymicrogyria
34
Incomplete separation of cerebral hemispheres across the midline
Holoprosencephaly
35
Associated with mental retardation
Agenesis of corpus callosum
36
Tonsillar extension into vertebral canal
Arnold Chiari Type I
37
Small posterior fossa
Vermis extension into foramen magnum
Hydrocephalus
Myelomeningocoele
Arnold Chiari Type II
38
Enlarged posterior fossa
+/- vermis
Large midline cyst
Dandy Walker
39
Fluid filled cavity in central canal from tumors or trauma
Pain centers of ventral white commisure damaged loss of pain and temp sensation in UE
Syringomyelia
40
Placque jaune are most commonly found at sites of
Can cause epileptic foci
contrecoup injury
41
Occurs in deep white matter region, cerebral peduncles, superior colliculi, deep reticular formation and brachium conjunctivum
Characterized by widespread and asymmetric axonal swellings
Coma shortly after trauma
Diffuse Axonal Injury
42
Pterion is the union of the
Frontal
Parietal
Sphenoid
Temporal
43
Chronic traumatic encephalopathy due to repeated head trauma causing accumulation of tangles in frontal and temporal lobes
Dementia pugilistica
44
Single most common cause of CVD
Cardioembolic stroke
45
Most sensitive neurons to hypoxia
Pyramidal cell layer of hippocampus (area CA1)
Cerebellar purkinje cells
Pyramidal neurons in cerebral cortex
46
Areas of the brain with little collateral flow
Thalamus
Basal ganglia
Deep white matter
47
Most common site of cardiam thromboemboli lodging
MCA
48
Most commonly associated with atherosclerosis and plaque rupture
Especially at Carotid bifurcation, MCA, Basilar artery
Thrombotic
49
Cytotoxic and vasogenic edema
| Loss of gray and white matter differentiation
First 12 hours CVD infarct
50
Neutrophils (weeks)
| Macrophages (months to years)
12-48 h CVD infarct
51
Reactive astrocytes
| May be cause of seizure
48h-1 week CVD infarct
52
Angiogenesis and gliosis
1 month onwards CVD infarct
53
Golden hour for rTPA therapy in CVD
3-4.5 hours
54
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Infarcts <15 mm
Most common in lenticular nucleus
Putamen
Thalamus
Internal capsule
Deep white matter
Caudate
Pons
```
Lacunar infarct
55
Slit-like cavities secondary to resporption of hemorrhage
Slit hemorrhage
56
Cortical > subcortical
Dementia
Gait
Pseudobulbar signs +/- focal neurologic deficits
Vascular dementia
57
Affects Subcortical > cortical
Dementia (parasagittal)
Gait
Incontinence
Binswanger disease
58
Most common cause of intraparenchymal hemorrhage
Ganglionic (basal ganglia and thalamus) - HTN Putamen
| Lobar - cerebral amyloid angiopathy
59
CHTN is associated with development of these microaneurysms in the basal ganglia (putamen)
Charcot bouchard
60
Cerebral amyloid angiopathy most commonly in lobar hemorrhages are located in
Leptomeningeal (arachnoid and pia)
| Cerebral cortical arterioles
61
SAH is increased in
Autosomal dominant polycystic kidney disease
Ehlera Danlos
Marfan
NF Type I
62
Pathognomonic finding of Waterhouse Friedrichsen Syndrome
Purpura fulminans
63
Most common cause of aseptic or acute viral meningitis
Enterovirus
64
Antibiotic approved for prevention of MAC
Azithromycin
65
Neurosyphilis patterns of involvement
Meningovascular
Paretic
Tabes dorsalis
66
Impaired joint position sense
Loss of pain sensation
Areflexia
Charcot joints (skin and joint)
Tabes Dorsalis
67
HSV meningitis affected site
Inclusion body
Inferior and medial regions of temporal lobes
Orbitofrontal gyri
Cowdry Type A
68
CMV Meningitis causes
Periventricular necrosis
Microcephaly and periventricular calcifications
Most common source of congenital infections
69
Polio virus affects
Anterior horn motor neurons of spinal cord
70
First symptom of rabies virus
Local paresthesia at site of bite
71
Rabies virus binds using
And inhibits
Glycoproteins
Nicotinic receptor in brain
72
Rabies body
Negri bodies
| Pyramidal neurons of hippocampus and purkinje cells of cerebellum
73
HIV infects the cell
Macroglia
| Because it contains CD4 receptors
74
HIV causes
IRIS (immune reconstitution inflammatory syndrome; paradoxical deterioration starting therapy)
Dementia due to inflammatory reactivation of microglia
75
JC Polyoma virus infects the cell
Oligodendrocyte causing demyelination
Immunosuppresed
76
JC Polyomavirus causes
Progressive multifocal leukoencephalopathy
77
C neoformans preferentially affects
Basal meninges hydrocephalus
| Soap bubble lesions
78
Most common cause of brain abscess in HIV individuals
Cerebral toxoplasmosis
79
Cerebral toxoplasmosis on MRI
Multiple ring-enhancing lesions
Central necrosis, organisms in the intermediate zone, tachyzoites and bradyzoites in periphery
80
Triad of congenital toxoplasmosis
Hydrocephalus
Chorioretinitis
Calcification
81
Naegleria from swimming in warm and still waters causes
Primary amebic encephalitis
82
Acanthamoeba resulting in coma and death in weeks to months is usually associated with immunosupression causes
Granulomatous amebic meningoencephalitis
83
Cerebral malaria is caused by
Plasmodium falciparum
vascular dysfunction and reduced blood flow
84
Prion
CJD
Gerstmann-Straussler-Scheinker
Fatal familial insomnia
Kuru
85
Spongiform change and rapid dementia
Prions
86
Most common prion disease
characteristic of
Creutzfeld Jacob Disease
Startle myoclonus
87
Autoimmune demyelinating disorder
Distinct episodes of neurologic deficits separated in tine, attributable to white matter lesions that are separated in space
Most common demyelinating disorder
Relapsing remitting
Multiple sclerosis
88
Multiple sclerosis radiographic feature
Dawson’s fingers
89
Mutliple sclerosis CSF analysis
+ oligoclonal IgG bands
90
Multiple sclerosis frequent initial manifestation
Visual impairment
| Internuclear opthalmoplegia
91
Criteria for diagnosis of Multiple Sclerosis
McDonald’s Criteria
2 or more clinical attacks
2 or more lesions
92
Syndrome with synchronous bilateral optic neuritis and spinal cord demyelination
“Asian MS”
Neuromyelitis optica
| Devic’s disease
93
Neuromyelitis optica antibody analysis
+ aquaporin 4
Tx plasmapharesis, anti-CD20
94
2-6 days after rapid correction of hyponatremia
acute disorder characterized by loss of myelin in the BASIS PONTIS and portions of PONTINE TEGMENTUM
Rapidly evolving quadriplegia
Central Pontine Myelinosis
Locked-in
95
Limit of correction for sodium
8-10 meqs/day
96
Most common cause of dementia in older adults
```
Agnosia
Aphasia
Apraxia
Visuospatial disorientatiob
Executive dysfunction
```
Alzheimer’s disease
97
Alzheimer’s treatment
Donepezil + Memantine
98
Cholinesterase inhibitor that improves memory and attention
Donepezil
99
NMDA antagonist acetylcholinesterase inhibitor for moderate to severe dementia
Memantine
100
Alzheimer Disease accumulation
```
Plaque (beta amyloid)
Neurofibrillary tangle (hyperphosphorylated tau) correlates better with degree of dementia
```
101
Most common terminal event in Alzheimer’s
Pneumonia
102
Prominent behavioral and personality changes
Language defixit
Memory loss
Frontotemporal dementia
103
Frontotemporal dementia hallmark
Pick bodies - aggregates of tau
| Atrophy of the frontal and temporal lobes
104
Parkinson’s disease accumulation
Lewy body (alpha-synuclein)
105
Parkinson’s anatomic changes
Pallor of substantia nigra
Basal nucleus of Meynert (cholinergic)
Dorsal motor nucleus of X
106
Multiple System Atrophy neuroanatomical circuits affected
Striatonigral (leading to Parkinsonism)
Olivopontocerebellar (leading to ataxia)
Autonomic nervous system (autonomic dysfunction with OH)
107
Parkinsonism
Ataxia
Autonomic dysfunction; OH
Multiple System Atrophy
108
Multiple System Atrophy radiographic feature
Hot cross bun sign
| Atrophy of pontocerebellar tract
109
Autosomal dominant
Progressive movement disorders
Dementia
Degeneration of striatal neurons
Generalized jerky and hyperkinetic movements (choreoathetosis)
Huntington disease
110
Huntington disease is characterized by
CAG repeat expansion
| Huntingin gene
111
Box car ventricle from atrophy of caudate nucleus
Huntington disease
112
Fragile X Syndrome trinucleotide repeat expansion
CGG
113
Myotonic dystrophy trinucleotide repeat
CTG
114
ALS mutation
SOD gene
115
ALS hallmark
Bunina bodies (remnants of autophagic vacuoles)
116
ALS anatomical changes
thin anterior roots of spinal cord
| atrophy of precentral gyrus
117
ALS tx
Riluzole
118
Progressive muscular atrophy
LMN>UMN
119
Primary lateral sclerosis
UMN>LMN
120
Progressive bulbar palsy
Cranial motor nuclei
121
Marked loss of lower motor neurons resulting in progressive weakness
Spinal Muscular Atrophy
122
Most severe form of SMA
Type I Werdnig Hoffman disease
123
Acute onset of psychotic symptoms
Opthalmoplegia
Reversible
Hemorrhage and necrosis in the mamillary bodies and walls of 3rd and 4th ventricle
Wernicke’s encephalopathy
124
Short term memory loss and confabulation
Irreversible
Lesions in the dorsomedial nucleus of the thalamus
Korsakoff syndrome
125
Alcohol causes impaired absorption of
Vit B1
126
Causes degeneration of ascending and descending tracts due to defect of myelin formation
B12 deficiency
127
Hypoglycemia Type II DM
<70 mg/dl
128
Hypoglycemia w/o T2DM
<50 mg/dl
129
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Confusion
Deliriun
Headache
Dizziness
Mood and personality changes
Paresthesia
Seizures
Blurred vision
```
Neuroglycopenic
130
Most common manifesfation of hepatic encephalopathy
Inverted sleep wake pattern
Asterixis
Seizure
131
Carbob monoxide causes selective injury of
Bilateral globus pallidus
Cerebral cortex
Hippocampus
Cerebellum
132
Ethanol causes atrophy of
anterior vermis
133
Drunk level
0.08 % blood alcohol
134
Radiation causes
Marked tissue edema
135
Most common CNS tumor
Glioma
| Astrocytoma
136
Fever, rash, sore throat, cervical and axillary LN
Hepatosplenomegaly
Young adult
Infectious Mononucleosis
137
Psammoma bodies
Papillary Thyroid carcinoma
Meningioma
Ovarian cystoadenocarcinoma
138
Most common primary site of originating metastases
Lung
139
Paraneoplastic syndrome
Antibodies against voltage-gated calcium channels in the presynaptic terminal of NMJ
Lambert-Eaton Myasthenic Syndrome
140
Small cell lung cancer
| Paraneoplastic Syndromes
ACTH
SIADH
LEMS
