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Set 13 (Neurology) Flashcards

1
Q

Intestinal atresia DISTAL to duodenum

A

Vascular accidents in utero

ex: SMA obstructed –> “apple-peel” atresia

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2
Q

Toxic megacolon: imaging studies

A

Plain x-ray will do!
(Barium enema and colonoscopy = CONTRAindicated)
(US not useful)

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3
Q

hCG tx in infertility triggers?

A

LH surge

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4
Q

Menotropin + Large dose of hCG

A

Menotropin: act like FSH –> dominant ovarian follicle forms
hCG: act like LH –> LH surge –> ovulation

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5
Q

Lipids are digested in? absorbed in?

A

Digested in DUODENUM

Absorbed in JEJUNUM

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6
Q

Distended macrophages in intestinal LP

A

Whipple disease

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7
Q

Iron absorption

A

Duodenum

Proximal jejunum

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8
Q

Primary adrenal insufficiency: labs

A

HYPOnatremia, HYPERkalemia
HYPERchloremia
NON-AGAP metabolic acidosis

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9
Q

Standard deviation from the mean

A

1 std: 68%
2 std: 95%
3 std: 99.7%

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10
Q

Lactose

A

Glucose + Galactose

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11
Q

Viral gastroenteritis

Abdominal distention, flatulence, diarrhea after lactose ingestion

A

SECONDARY lactase deficiency

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12
Q

Glucokinase

A

Pancreatic beta cell

HIGH Vmax, HIGH Km

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13
Q

Gestational diabetes w/ family history

A

Glucokinase mutation

major glucose sensor in pancreatic cell

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14
Q

Gallstone ileus: stone stuck at?

A

Ileocecal valve

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15
Q

Gas seen in GB and biliary tree due to presence of fistula

A

Gallstone ileus

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16
Q

Tx of Congenital Adrenal Hyperplasia

A

Low doses of exogenous CORTICOSTEROIDS to suppress excessive ACTH secretion

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17
Q

Carcinoid tumor in the liver

A

Carcinoid SYNDROME! (secretory products NOT metabolized by liver):

Vasomotor instability (flushing, dizziness)
GI sx (diarrhea, abdominal pain)
Bronchoconstriction (dyspnea w/ wheezing)
Right-sided valvular heart disease
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18
Q

Insulin tx for DKA

A

Regular insulin PREFERRED

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19
Q

Peudomonas aeruginosa virulence factor exotoxin A is similar to?

A

Diptheria toxin

inhibit EF-2

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20
Q

Shiga-like toxin

A

EHEC

inhibit 60s ribosomal subunit in human –> block protein synthesis and preventing tRNA binding

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21
Q

Amiodarone: tests to monitor

A

LFT
PFT
TFT
(liver, pulmonary, thyroid)

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22
Q

Amiodarone: A/E

A

Hepatitis, Pulmonary fibrosis, Thyroid dysfunction
Corneal micro-deposits
Blue-gray skin discoloration

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23
Q

Pituitary apoplexy

A

Bleeding into PRE-existing pituitary adenoma

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24
Q

DOC of HYPERthyroidism in pregnancy

A

PTU

methimazole is teratogenic

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25
Major A/E of HYPERthyroid drugs
Agranulocytosis
26
Ulcer in duodenum | A/w severe trauma or burns
CURling ulcers
27
Ulcer in esophagus, stomach or duodenum | A/w increased ICP
CUSHing ulcer | particular prone to perforation
28
Chronic gastritis w/ antral sparing
AI gastritis | --> pernicious anemia
29
3 main causes of HIV-associated esophagitis
Candida CMV Herpes virus
30
Runs along lesser curvature of stomach | where great majority of GASTRIC ulcer occurs
L and R Gastric arteries
31
Strongyloidiasis: stool
Rhabditiform larvae
32
Tx of strongyloidiasis
Ivermectin
33
Detection of parasite EGG in stool
Schistosomiasis
34
Triple test (pregancy)
AFP hCG Estriol
35
Increased AFP
NT defect Anterior abdominal wall defect (omphalocele, gastroschisis) Multiple gestation and: most commonly: dating error.
36
Decreased AFP
Down syndrome
37
Cytokines that are chemotactic for neutrophils?
Leukotriene B4 C5a IL-8
38
Bilious vomiting WITHOUT abdominal distention | 1st day of life
HALLMARK of duodenal atresia | a/w Down syndrome
39
Lithium during early pregnancy
Ebstein's anomaly | atrialized RV due to downward displacement of tricuspid valve
40
Valproate in pregnancy
``` NT defect (Valproic acid inhibit folate acid absorption) ```
41
Pramidone
Antiepileptic Metabolized to phenobarbital and PEMA (also anticonvulsants) LETHARGY!
42
Restlessness, Agitation Dysphagia Coma Following exposure to cave BATS
Rabies encephalitis
43
Rabies virus: shape
(-)ssRNA | RNA dependent RNA polymerase
44
Rabies: prophylaxis
Rhabdovirus strains grown in tissue cell culture and then INACTIVATED to produce: KILLED virus vaccines.
45
tRNA: site of binding of amino acid
3' end
46
Lithium: check labs for
``` TSH (can cause HYPOthyroidism) Lithium levels (narrow therapeutic window) Renal fxn (nephrogenic diabetes insipidus) ```
47
Pufferfish poisoning
Tetrodotoxin | binds to VG-Na+ channel in nerve and cardiac tissue, preventing sodium influx and depolarization
48
Pica is a/w?
IDA | Common in pregnancy
49
Tumbling motility @22C Very narrow zone of B-hemolysis Multiply at really low temperature (4C)
``` Listeria monocytogenes (gram+ facultative intracellular) ```
50
Weak wrist extension | Sensation of arm intact
Radial head subluxation ("nursemaid's elbow). (sudden outward pulling on extended and pronated arm) Deep branch: carries ONLY motor, no sensory.
51
EXCELLENT alternative to SSRI for tx of depression (NO sexual dysfunction)
Bupropion!!! | also effective in tx of nicotine dependence
52
Works on D4 receptors (vs. D2 of most antipsychotics)
Clozapine | A/E: agranulocytosis, check CBC
53
Migraine: abortive therapy
Triptans (serotonin 5HT-1B or 1D agonist)
54
Buproprion
Dopamine and NE reuptake INHIBITOR | depression, smoking cessation
55
Venlafaxine
Serotonin-Norepinephrine reuptake inhibitor
56
Fluoxetine Sertraline Paroxetine
SSRI
57
Rate limiting step in heme synthesis
ALA synthase | require B6
58
Acute Intermittent Porphyria: tx
Glucose loading | IV heme preparations
59
Holoprosencephaly a/w?
``` Trisomy 13 (Patau) Trisomy 18 (Edward) Fetal alcohol syndrome ```
60
Malformation
PRIMARY defect in cell/tissues that form an organ
61
Deformation
Anomalies due to EXTRINSIC mechanical force
62
Deficient HGPRT
Lesch-Nyhan syndrome | XLR, failure of purine SALVAGE
63
First committed step of de novo PURINE synthesis
PRPP amidotransferase
64
Defect in alpha-keto acid dehydrogenase
MSUD | dystonia, poor feeding, inability to degrade BRANCHED chain a.a.
65
Classic homocystinuria: diet
Methionine RESTRICTION | Cysteine SUPPLEMENTATION
66
Benzodiazepine that treat insomnia but minimizes undesirable DAYTIME a/e
Triazolam
67
Serotonin vs. Neuroleptic malignant syndrome
NMS: absence of myoclonus, precence of rigidity
68
Neurofibromas in NF-1: embryology
Neural crest | since they are schwann cells
69
Rapid recovery from thiopental is from?
REDISTRIBUTION | NOT metabolism
70
HIGH blood/gas partition coefficient
MORE soluble in blood SLOWER equilibration w/ brain LONGER onset time
71
Best way to prevent tetanus in neonate
Maternal vaccination! | transfer of IgG anti-toxin across placenta
72
Which adrenergic receptor is on uterus?
B2 (stimulation --> RELAX uterus)
73
Triad of: Hydrocephalus Intracranial calcification Chorioretinitis
Congenital toxoplasmosis
74
A/E of bupropion
Seizure
75
Medication that can CAUSE seizures
``` Buropion Clozapine Isoniazid (if given w/o B6) Ciprofloxacin Imipenem ```
76
Trochlear nerve palsy
Vertical diplopia
77
Impaired transport of ornithine from cytosol to mito
Disorder of UREA cycle | Limit protein intake!
78
Calcified cystic tumor in brain | Cholesterol crystals
Craniopharyngioma | Rathke's pouch remnant
79
Organophosphate poisoning caused by?
Cholinergic excess due to: | CHOLINESTERASE inhibition
80
Cryptococcal meningitis: tx
Amphotericin B + flucytosine | Maintenance via: fluconazole
81
DOC for heroin addiction and abuse
Methadone | long acting opiod w/ good oral bioavailability
82
Express concern INDEPENDENT of understanding
Support
83
Total sensory loss on CONTRAlateral side of body
Thalamic syndrome
84
What causes lacunar infarct?
Small vessel lipohyalinosis and atherosclerosis
85
Oligodendrocyte apoptosis | Pink patches in white matter tract
Multiple sclerosis
86
Lancet-shaped Gram-positive cocci in pairs
Strep pneumo | THE m/c/c of bacterial meningitis in ADULTS of ALL ages
87
Bean-shaped Gram negative cocci in pairs
Neisseria meningitidis
88
Cafe-au-lait spots Neurofibromas Lisch nodules Pseudoarthrosis
NF-1
89
Carbachol and pilocarpine: used to tx?
Glaucoma
90
Substance abuse: violent behavior (MOST likely a/w?)
PCP abuse
91
Violent behavior, trauma Nystagmus Acute brain syndrome
PCP abuse
92
Artery responsible for SA and AV node perfusion
RCA
93
Ketamine
NMDA receptor antagonist
94
Benzodiazepine intoxication and overdose: tx
Flumazenil | GABA receptor angatonist
95
Suppression vs. Repression
Suppression is GOOD (mature and conscious) | Repression is IMmature and UNconscious
96
Inactivated by lead
Delta-aminolevulinate dehydratase | Ferrochelatase
97
Rate limiting step of heme synthesis
Delta-aminolevulinate SYNTHASE | require B6
98
Acute intermittent porphyria: defect
Uroporphyrinogen I synthase
99
NO photosensitivity | Urine darken upon exposure to light
Acute intermittent porphyria | uroporphyrinogen I synthase defect
100
Cystic tumor in cerebellum of child
Pilocytic astrocytoma
101
Spindle cells Hair-like glial processes a/w microcysts Rosenthal fibers Granular eosinophilic bodies
Pilocytic astrocytoma
102
Posterior fossa tumor in children | homer-Wright rosettes
Medulloblastoma (PNET)
103
Pseudorosettes w/ GFAP + processes tapering twd blood vessels
Ependymomas
104
Elevated HVA, VMA N-myc Neuropil NSE, chromogranin, synaptophysin, S100+
Neuroblastoma
105
Lateral vs. ventral spinothalamic tract
Lateral: pain and temperature Ventral: touch and pressure (minor role)
106
Bilateral disproportionate loss of pain and temperature sensation (disassociated anesthesia) involving arms and hands
Syringomyelia

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