PP Clues Neurology Flashcards
(189 cards)
1
Q
What is the central nervous system?
A
Brain and spinal cord; oligodendrocytes
2
Q
What is the peripheral nervous system?
A
Everything else; Schwann cells
3
Q
What does the autonomic nervous system do?
A
Automatic stuff
4
Q
What is the somatic nervous system
A
Moving your muscle
5
Q
What is the parasympathetic
A
Rest-and-Digest => slows stuff down
6
Q
How does the parasympathetic system behave?
A
DUMBBELS”:
Diarrhea
Urination
Miosis “constricts”
Bradycardia
Bronchoconstriction
Erection “point”
Lacrimation Salivation
7
Q
What is the sympathetic system?
A
Fight-or-Flight => speeds stuff up
8
Q
How does the sympathetic system behave
A
Opposite of Parasympathetics:
Constipation Urinary
retention
Mydriasis “eyes wide with fright”
Tachycardia Bronchodilate
Ejaculation “shoot”
Xerophthalmia (dry eyes)
Xerostomia (dry mouth)
9
Q
Where is NE synthesized in cns?
A
Locus coerelues of the pons
globally modulate arousal states and adaptive behavior
10
Q
what happens to NE in anxiety and depression?
A
up in anxiety
down in depression
11
Q
Dopamine in Huntington, parkinson and depression
A
up in Huntington
down in Parkinson
down in depression
12
Q
what is serotonin synthesized
pons
A
Raphe nucleus
part of reticular activating system regulating serotonin
13
Q
serotonin in Parkinson, anxiety, and depression?
A
up in parkinson
down in anxiety
down in depression
14
Q
What nucleus synthesized ach?
A
Basal nucleus of Meynert
15
Q
ACh in parkinson
Alzheimer
Huntington
A
up in parkinson
down in Alzheimer
down in Huntington
16
Q
what does the forebrain or prosencephalon give rise to?
A
Telencephalon = Cerebral Hemispheres
Diencephalon=Thalamus
17
Q
Midbrain or mesencephalon give rise to
A
midbrain=mesencephalon
18
Q
hindbrain or rhombencephalon give rise to
A
mesencephalon =pons and Cerebellum
Myelencephalon=medulla
19
Q
HTN, Bradycardia and high ICP Triad?
A
Cushing’s triad
20
Q
Budd-chiari?
A
hepatic vein obstruction
21
Q
Arnold-chiari
A
foramen magnum obstruction
22
Q
Anencephaly
A
Notochord did not make contact w/ brain= only have medulla
23
Q
Encephalocele
A
Brain tissue herniation
24
Q
Dandy walker malformation
A
no cerebellum, distended 4th/lateral ventricles
25
Arnold-chiari Malformation
Herniation of cerebellum through foramen magnum
Type I: cerebellar tonsils (asymptomatic)
Type II: cerbellar vermis/ medulla => hydrocephalus, syringomyelia (loss of pain/temp)
26
s Spina bifida occulta?
Covered by skin w/ tuft of hair
27
Spina bifida aperta?
Has opening (high AFP)
28
Meningocele
Sacral pocket w/ meninges in it
29
Meningomyelocele
Sacral pocket w/ meninges and nerves in it
29
Open-angle glaucoma?
Overproduction of fluid => painless
ipsilateral dilated pupil, gradual tunnel vision, optic disc cupping
30
Closed-angle glaucoma?
obstruction of canal of schlemm=>sudden onset, pain, emergency
31
Watershed areas?
Hippocampus, splenic flexture
32
CN III, CN IV, CN V(1), CN V (2), and CN VI, and postganglionic sympathetic fibers
What they have in common?
contents of the cavernous sinus?
33
bug that loves frontal lobe
Rubella
34
bug that loves temporal lobe
HSV
35
bug that loves parietal lobe
toxoplasma
36
bug that loves hippocampus
rabies
37
bug that loves posterior fossa
TB
38
bug that loves DCML
Treponema
39
migraines presentation
Aura, photophobia, numbness and tingling, throbbing HA, nausea
40
Tension HA presentation
Band-like pain starts in posterior neck, worse as day progresses, sleep disturbance
41
cluster headaches present
Rhinorrhea, unilateral orbital pain, suicidal, facial flushing, worse w/lying down
42
temporal arteritis
pain with chewing, blind in one eye
43
trigeminal neuralgia
sharp, shooting face pain
44
2 kinds of partial seizures
simple(aware), complex (not aware)
45
what are the 3 kinds of generalized seizures
Tonic-Clonic "Grand mal"
Absence "Petit mal"
Status Epilepticus
46
How does an epidural hematoma present?
🍋
Intermittent consciousness, "lucid interval
47
How does a subdural hematoma present
Biconvex Lens, crossing suture lines
🍌
48
Headache 4wks after trauma, elderly (loose brain)
subdural hematoma
| fragile vessel
49
How does a subdural hematoma look on CT?
| 🌙🌛
crescent shape, crosses suture lines, midline shift
50
subarachnoid hemorrhage presentation
worst headache of my life, h/o berry aneurysm
51
Astrocytoma
Rosenthal fibers, #1 in kids w/ occipital
52
Ependymoma
Rosettes, in 4th Ventricle, hydrocephalus
53
Craniopharyngioma
motor oil biopsy, tooth enamel, rathe's pouch, ADH problem, bitemporal hemianopsia
54
glioblastoma multiforme
pseudopalisading, necrosis, worst prognosis, intrapersonal hemorrhage
55
Meningioma
parasagittal, psammoma bodies, whorling pattern, best prognosis
56
MC place to metastasize to the brain
lung,
breast,
skin
seen at white grey junction
57
oligodendroglioma
nodular calcification and fried-egg appearance
58
pinealoma
loss of upward gaze, loss of circadian rhythms=>precocious puberty
59
Schwannoma
CN8 tumor, unilateral deafness
60
Neurofibromatosis
Café au lait spots (hyperpigmentation) => peripheral nerve tumors, axillary freckle
Type 1 "Von Recklinghausen's":
Peripheral (Chr#17), optic glioma,
Lisch nodules, scoliosis
Type 2 "Acoustic Neuroma": Central
(Chr#22), cataracts, bilateral deafness
61
Sturge-Weber?
Port wine stain (big purple spot) on forehead, angioma of retina
62
Brain: inhibitory NT
GABA: Chloride influx
63
NT inhibitory for Spinal cord
Glycine: chloride influx
64
Drug causing chloride influx
Benzo
Barbiturates
Alcohol
Opiates
65
Affecting glycine
Tetanus
Strychnine
66
Over stimulation of nerve
Excitotoxicity
67
Mediates reinforcement of addictive behavior
NMDA Pathway
| aspartate
68
Uses ach for pre and post ganglionic fiber
Depolarize head/neck and belt
Parasympathetic
69
Has longer preganglion and shorter post ganglionic
Hyper-polarizes thoracolumbar
ACH
70
Excitatory NT
Glutamate
Aspertate:NMDA
71
Memantine n Riluzole moa
Block glutamate
72
Catacholamines excitatory neurotransmitter
Dopamine
Norepinephrine
Epinephrine (Hormone)
73
Monoamines excitatory NT
Serotonin • Dopamine • Norepinephrine
74
Sympathetic in the CNS • Parasympathetic in the PNS • Made from tryptophan
Serotonin
75
Control Reticulate activating system (raphe nucleus0
Ands hallucinations
Helps focus on one thing at a time
Serotonin
76
Serotonin syndrome treat with
| (5HT)-1a and 5HT-2 receptors
Cyproheptadine
| altered mental status, autonomic instability, and tremor, hi reflex
77
Carcinoid syndrome
| treatment
Octriotide
78
Used in making Nor-epi, and made from tyrosine
Dopamine
79
Used by basal ganglia and vomitting center
Dopamine
Control urges(mesolimbic system)
80
Vomiting control
CNS chemotactic trigger zone area postrema
Promethazine
Perchloromethazine
GI- ondensitron
81
MCC of autonomic dysfunction
Diabetes
Riley-day syndrome
Shy-dragger
Sick sinus syndrome
Drugs
82
Catacholemine/monoamin that control sympathetic, no methyl group, made from tyrosine
Nor epi
83
Short acting adrenal stress hormone
Receptors
Epi-beta
Beta 2…1..then alpha 1&2
84
Beta 2 effects on bp
Lower BP
85
Polypeptides
Cck
Substance P
Neuropeptide
86
Neuropeptide Y
| most abundant
Response to stress; circadian rhythms; controls cardiovascular system; inhibits release of glutamate; increases appetite
87
what are the endo-opioids
Beta endorphins
Enkaphalins
Dynorphins
| pain relief and behavior reinforcemnt pathways
88
only retrograde neurotransmitter
endocannabinoids
89
What does NO and CO have in common
cGMP
NO> vasodilator
CO> help with smell (CN1)
| L-Arginine makes NO
90
preganglionic fibers for SNS releases
ACH
91
Primary postganglionic fibers
Nor Epi
| some pathways use DA or Serotonin
92
# SNS
sympathetic system depolarize and hyperpolarizes?
brain and thoracolumbar
Sacral
| long postganglionic fibers
93
# second Messengers
parasympathetic:
Sympathetic:
parasympathetic: c-GMP
Sympathetic: c-AMP
94
# 2nd msg
smooth muscle contraction by neurotransmitter or hormone
IP3/DAG
95
# 2nd msg
smooth muscle contraction by distention
Calcium-calmodulin
96
use to diagnose pheochromocytomas and neuroblastomas
VMA
HVA
Metanephrines
97
neuroblastomas signs
opsoclonus
myoclonus
Raccoon sign with no trauma
98
used to diagnose Carcinoid syndrom
5-HIAA
| txt: ceproheptadine
99
Parasympathetic receptor
mostly Muscarinic
Nicotinic at Ske. mm and ganglia
100
competitive inhibitor of choline with fight/flight response
Hemicholinium
101
# block vesiculation
vesamicol
| ACH
causes sympathetic SE
102
# Block vesiculation
Reserpine
| DA, NE
hypertention with autonomic dysfunction and parkinson-like
103
# promotes parasympathetic: relax
Cholinergic Agonists
ACH
pilocarpine
Bethanechol
Carbachol
methacholine
104
# Reversible
AchE Inhibitor
Edrophonium
Neostigmine
Pyridostigmine
Physostigmine(cns)
Rixastigmine
| promotes more parasympathetic
105
# Irreversible
AchE Inhibitors
| Everything relaxes
Echothiophate
DUMBELLS/SLUDGE
| remove clothing, Atropine and pralidoxime
106
# promotes sympathetic (antiparasympathetic)
Anticholinergic
Atropine
Homatropine
Tropicamide
Benztropine
Scopolamine
Ipratropium
Methylscopolamine
107
# amplify Dopamine
COMT inhibitor
Tolcapone
Betalcapone(entacapone)
108
# serotonin agonists
metoclopramide
high incident of drug induce parkinson
109
# serotonin agonists
methysergide
used for magrine but too strong
causes Retroperitoneal fibrosis
110
# serotonin agonists
Traptans
Magrine
causes stroke and MI
111
# serotonin agonists
affect P450 dependents
warfarin
estrogen
phenytoin
Theophyline
Digoxin
112
Migraine management
Prophylaxis: propranolon, topiramate
Abortive: Oxygen, Triptans
Chronic: Botox injections
113
sympathetic receptors are
nicotinic except of sweat glands which are muscarinic
114
# sympathetic
anticholinergic
can't sweat:
Hot dry skin
115
# Status Epilepticus
Continuous seizures for more than 20 min
| treatment
Lorazepam
Diazepam
116
Lennox Gastaut Syndrome
| TXT
Lobectomy
117
Myotonic seizures treatment
valproic acid
| Na/ca blocker
118
Infantile spasm treatment
ACTH injections
119
absence seizures treatment
ethosuximide
| Ca++
120
Febrile seizure treatment
acetaminophen
121
Temporal seizure treatment
carbamazepine
122
Generalized seizures treatment
children: phenobarbital
in adults: phenytoin
123
children with hundrends of seizures each day
Lennox Gastaut syndrome
124
myotonic seizure present
sudden contraction of abdominal muscles
125
Infantile spasms
sudden contration of abdominal muscle
126
Benign Rolandic seizures
child wakes up, eyes fluttering, falls back to sleep, no memory
127
Atonic seizure origin
frontal cortex
128
Febrile seizures last for
<20min
| complex recurrent last >20min
129
EEG and neurological exam in febrile seizure
| normal or abnormal
normal
130
mc seizure in children
| staring spells
absence seizures
131
Three per second spike and wave pattern on EEG
absence seizures
132
change in muscle follow by shaking and jerking
Tonic clonic seizure
133
pre-seizure hallucination
| smell, hearing or visceral
temporal lobe seizure
134
epilepsy management
treatment: least 2 years
must be seizure free : 6 months
135
mcc of seizure
uncontrolled depolirazation
Ischemia
| mass, CNS infection, metabolic disorders
136
unknown seizure etiology is called
seizure disorder
137
spinal cord lesion present with
pain and temp on opposite side of all other deficits
| location 2 dermatones above pain/temp
138
only 2 CN that crosses midline
CN 7 and 12
| CN 7: lower .5 of opposite face, LMN @ ganglion, entire .5 face droop
139
medulla CN
| breathing and HRT rate control
9,10,11,12
| 12 midline
140
Pons CN
| lock in syndrome
5,6,7,8
| 6 midline:
141
midbrain CN
3,4
| 3 midline
142
dorsal root ganglion dz
Polio-2 wks post GI enteritis
varicella-zoster
Rabies
143
sensitive to osmotic shifts
pons
| slowly correct glucose and Na
144
contains pneumotactic and apneustic center
pons
145
dz affecting spinocerebellar pathway
alcohol(vermis)
friedrieck's ataxia
ataxia telangiectasia
adrenoleukodystrophy
146
GI malabsorption, IgA, skin cancer, cerebellum symptom
ataxic telengiectasia
147
CAT 1 enzyme defficiency
adrenoleukodystrophy
148
scoliosis, telangiectasia
Friedrieck's Ataxia
149
intention tremor
dysmetria
dysdiodokinesis
romberg sign
spinocerebella lesion
| crosses twice: ipsilateral always
150
fibers enter S. cord assend 2 levels cross at antirior white commisure
spinothalamic tract
| Pain and temp
151
Dorsal column pathology
syphilis
B-12 def(type A gastritis)
Brown-sequard(hemisection)
152
medulla pushed through foramen magnum
all extremity extend
decerebrate posturing
153
herniation goes beyond the red nucleus
| extensors activated
CST, corticobulbar and rubrospinal tract lost
| Decerebrate posturing
154
first sign of herniation(trauma)
| compression of CST & Corticobulbar
CN III paralysis
loss of pupillary reflex
anisocoria
| herniate just above the red nucleurs
155
Decorticate presentation
| second sign of herniation
CN III compressed, still above red nucleus
156
Hi ICP u first see
papilledema
headache
157
Hi ICP 2nd sign
esotropia
diplopia/blurred vision
158
CST pathology
ALS
B-12 deficiency
Atonic seizure:frontal cortex
159
CST fibers originate from
frontal lobes and precentral gyri
160
which fibers descend the internal capsule and cross at medullary pyramids
CST
161
responsible for fine motor activity
inhibit extension
smooth flexion
Corticospinal tract
162
drug that decrease REM sleep
benzo and barbiturates
| REM rebound when drug are stopped
163
NT in REM
ACH
164
ADD/ADHD
| treatment
methylphenidate
promoline
dexadrine
adderall
165
night terrors
restless legs syndrome
bruxism
somnambalism
Delta wave
166
sleep spindles and k-complex
Theta:light sleep
167
maintains focus on 1 activity
require NE & serotonin
Reticular activating system
168
2nd msg of Reticular activating system
c-AMP
169
lacunar hemorrhage: HTN
lenticulostriate arteries
Internal capsule
170
Parkinson DZ treatment
L-dopa/carbidopa
Bromocriptine/carbergeline
Amantadine
selegiline
| increases Dopamine
171
initiates movement
substantia Nigra
172
what NT in Substantia Nigra
Dopamine
173
how is Substantia Nigra inhibited
Basal ganglia via ACH or GABA
174
subthalamic nucleus function
final relay for coordinating fine motor movements
| lesion: Ballismus and Hemiballismus
175
curling's ulcers
Burn
176
cushing's ulcers
brain
177
IBS: sym/parasym/both?
Parasym: Diarrhea
Sympathetic: constipations
178
drug causing hallucination
LSD: coloful
PCP:Strong
Ecstasy: strong/thrsty
| amphetamines
179
vertical nystagmus
Amphetamines
180
hallucination B4 seizure
schizo
dementias
Temporal lobe lesions
| Drugs: SSRI, amphetamines
181
Dementia: alzheimer& pick's dz
Schizo: loss of asymmetry
frontal lobe
182
lesion in calcarin fissure
quadrantanopia
pie in the sky deficit
| inferior or superior
183
monocular blindness in newborns
cataracts or retinoblastoma
184
monocular blindness children
optic nerve gliomas
NF
MEN 2b
185
monocular blindness adults
TIA
Acute retinal artery occlusion
acute retinal vein occlusion
186
monocular blindness Elderly
Macular degeneration
187
Newborn white reflex
Retinoblastoma
RB gene
Cancer
Ewing's sarc
188
90% idiopathic
diabetes or galactosemia
Rubella
| effect on eye
Opacification of the lens
