Shit list 2 - Neuro Flashcards by Jenna Silverstein

Pilocytic Astrocytoma

Kids MCC.
Benign.
Posterior fossa i.e. cerebellum, but can be supratentorial.
GFAP +.
Rosenthal fibres (eosinophilic, corkscrew), spindle cells.
Cystic and solid.

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Medulloblastoma

Kids, 2nd MCC.
Highly malignant.
Type of PNET.
Compress 4th ventricle –> hydrocephalus and drop mets.
Always cerebellum, MC = vermis.
Homer-Wright rosettes.
Solid, small blue cells, high mitotic index.

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Ependymoma

Kids.
4th ventricle ependymal cells, so can cause hydrcephalus.
[adults MC is spine].
Perivascular pseudo-rosettes.
Rod-shaped blepharoplasts (basal ciliary bodies) near nucleus

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Craniopharyngeoma

Kids.
Benign.
Supra-tentorial.
Confused with pituitary adenoma as both cause bitemporal hemianopsia.
From rathke’s pouch derivatives, so can calcify.

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Pleiomorphic xanthoastrocytoma

Kids/teens.
Sudden onset seizures.
Leptomeningeal, reticulin deposits, chronic inflammatory cells.

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CYP 450 Inducers

Chronic alcoholism.
St. John's Wort.
Phenytoin.
Phenobarbital.
Carbamazapine.
Nevirapine (NNRTI).
Rifampin.
Greisofulvin.
Benzopyrines.

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CYP450 Inhibitors

Acute alcohol abuse.
Ritonavir (protease).
Amiodarone (III).
Cimetidine.
Ketoconazole.
Isoniazid (INH).
Grapefruit juice.
Quinidine (Ia).
Macrolides (not A, esp E)
Omeprazole
Ciprofloxacin

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Common CYP 450 substrates

Warfarin.
Anti-epileptics.
Theophylline.
OCP.

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Lithium: use, AE, toxicities

Use: bipolar and SIADH
AE: tremor, nephrogenic DI, hypothyroidism, Ebstein anomalie
Toxicity: via thiazides

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Atypical Antipsychotics: names, use, general AE. specific AE

Names: Quetiapine, olanzapine, risperidone, aripooprazole, ziprasidone, clozapine
Use: schizophrenia, bipolar, OCD, anxiety disorders, depression, mania, tourette’s
AE: QT prolongation
Spec AE:
- O/C = weight gain
- C = agranulocytosis (weekly WBC) and seizures (and weight gain)
- R = prolactin

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DOC trigeminal neuralgia

Carbamazapine

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Myotonic dystrophy: inheritance, s/s

AD.
CTG repeat.
Type I fibre destruction.
S/S: myotonia (can’t release door knobs), muscle wasting, frontal baldness, arrhythmia, testicular atrophy, cataracts

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Glioblastoma Multiforme

Adult.
MC malignant (1yr).
Can cross corpus callous to other hemisphere.
GFAP +.
Pseudopallisading, pleiomorphic, central necrosis and hemorrhage

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Meningioma

Adult.
Benign.
Convexities and parasaggital; extra-axial and may have tail.
From arachnoid cells.
Seizures of focal neurological signs.
Whorrled spindle-cells, psammoma bodies.

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Hemangioblastoma

Adult.
Cerebellar.
VHL when also have retinal.
Thin-walled capillaries.
Can make EPO.

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Schwannoma

Adult.
@ cerebello-pontine angle MC.
S-100+.
common on VIII - tinnitus, vertigo, sensory hearing loss - CONSTANT (ddx = mennieres = episodic).
Bilateral VII = NF-2

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Oligodendroglioma

Adult.
Frontal lobe white matter.
Chicken wire capillaries.
Fried eggs
Often calcify

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uveitis: causes

Systemic inflammatory diseases: B-27, sarcoidosis, RA, juvenile idiopathic arthritis

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Retinal detachment

Separation of photo-R layer from RPE –> photoreceptors degenerate –> vision loss.

Secondary to retinal breaks, diabetic traction, inflammatory effusions.

splaying and paucity of retinal vessels.

Flashed and floaters, then curtain drawn down on vision. Emergency

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Central retinal artery occlusion

Acute.
Painless monocular vision loss.
Cloudy/pale retina.
Attenuated vessels.
*Cherry red fovea*
MCC is ICA embolism --> opthalamic a. --> retinal a.

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Retinitis pigmentosa

Inherited retinal degeneration.
Starts with night blindness.
Bony spicule shaped deposits.

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Retinitis

Retinal edema and necrosis.
Via infection - HSV, VZV, CMV.
Also associated with immunosuppression.

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pupillary light reflex

4 neurons.
CN II (n1) --> pretectal nucleus (midbrain) --> bilateral n2 -->EW nucleus --> n3 --> ciliary ganglion --> short ciliary (n4) --> pupillary spincter muscles

N4 cell body degeneration = Adie’s pupil (mono argyll-robertsons)

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Mydriasis pathway

Study These Flashcards

3 neurons:
HYpothalamus –> n1 –> ciliospinal centre of bulge (C8-T2) –> n2 –> exit at T1 into superior cervical ganglion –> n3 travels up ICA, through cavernous sinus, enters orbit as named “long-ciliary nerves” to pupil dilators [also tarsal and sweat glands of head and face]

Pie in the sky

Meyer's loop (temporal radiation)

Pie on the floor

Dorsal optic radiation (parietal lobe)

INO: disease, convergence, directional term

MS, usually bilateral. Convergence in tact. Right INO = right MLF lesion = right eye paralyzed

``` Demetia diseases and key feature: Alz: Pick's: Lewy body: CJD: ```

Alz: A-beta amyloid and NF tangles, low Ach Pick's: personality - disinhibition; WITH parkinsonian Lewy: dementia BEFORE parkinsonian; visual hallucinations, lewy bodies (alpha-synneuclein) CJD: w-m dementia with startle myoclonus, no inflammation

Uthoff's phenomenon

Heat sensitivity in MS - worse s/s

Acute disseminates post-infectious encephalomyelitis

multifocal paraventricular inflammation and demyelination. | After VZV or measles, or rabies/smallpox vaccines

Charcot-marie tooth disease

AD. Motor and sensory. Abnormal proteins or peripheral nerves or the myelin sheath. Scoliosis, foot deformities i.e. pes cavus, common perineal = plantar-flexed DDX = Friedrichs

Krabbe vs. Metachromatic leukodystrophy

BOTH: Lysosomal storage disease, destroy myelin sheath, peripheral neuropathy Krabbe: Galactocerebroside ad psychosine buildup S/S = peripheral neuropathy, dev. delay, optic atrophy, GLOBOID CELLS MCLD: Arylsulfatase A defic. sulfatides buildup. peripheral neuropathy, ataxia, dementia

PML: cause, exacerbated by

Cause: JC in AIDS, destruction of oligodendrocytes | Exacerbated by: natalizumab, rituximab

adrenoleukodystrophy

X-linked VLCFA buildup in nervous system, testes, adrenals Coma/death, adrenal crisis

Prevent/treat brain vasospasms

nifedipine

steppage gait: nerve injured

Common peroneal

H1-gen1's:

Hzdroxyzine Promethazine Chlorpheniramine Diphenhydramine

ARMD: | 2 types, findings, and Rx

Dry = dursen = yellowish material; rx = multivitamin, antioxidants, zinc, stop smoking Wet = neovascularization from hypoxia via drusen; grey/green retina with fluid/bleed; Rx = anti-VEGF, later, Zn, smoking cessation

Absence Seizures: other names

- petit mal | - 3Hz spike wave complexes

Alzheimers drugs: mechanism and names

``` AchE inhibitors Names: - donepezil - galantamine - rivastigmine - tacrine ```

Pineal germinoma s/s

1) Precocious puberty via hCG 2) aqueductal compression causing non-communicating hydrocephalus 3) Tectum compression leading to impaired conjugate vertical gaze and convergence

superior vs inferior colliculi

Superior = vision (conjugate vertical gaze, convergence Inferior = auditory (sound localization)

Brainstem lesion shortcuts

Medial lesion = pure motor + CSTr (motor) | Lateral lesion = mixed + Horners and ALS

Relevant DA pathways

Mesolimbic-mesocortical - schizophrenia Nigrostriatal - parkinsons Tubuloinfundibular - inhibition of prolactin

Thiopental

IV barbiturate for anesthesia; redistributed into fat and muscle

Drug-induced parkinsonism

Typical antipsychotics > atypical antipsychotics | Anti-emetic/gastric motility: prochlorperazine, metochlopromide

Rx of drug-induced parkinsons

ACH ANTAGONIST! Benztropine, trihexyphenidyl *but don't use in old people with BPH or closed angle glaucoma etc...

Hyperacusis via:

VII damage impairing stapedius muscle contraction to dampen sounds [tensor tympany is the other muscle, innervated by motor V3]

Middle meningeal artery - where did it come from

MMA

Pteryon =

joining of frontal, temporal, parietal, and sphenoid bones

Clozapine AE

agranulocytosis, seizures, weight gain (olanzapine)

Myasthenia crisis vs cholinergic crisis

myasthenia crisis = not enough anti-AchE drug; improves with tensilon administration cholinergic crisis = too much anti-AChE drug causing depolarization blockade; no improvement with tensilon

SOD-1 mutations

ALS

Nerves that can be affected in vestibular schwannomas

VIII (obviously; @ CPA) - hearing loss, tinnitus, vertigo VII - facial paralysis, taste, hyperacusis (stapedius), lacrimation/salivation V - loss of facial sensation, mastication, and corneal reflex sensory Bilat = NF-2

Mixed agonist-antagonist opioids

Pentazocine Nalbuphine K agonist - spinal analgesia mu antagonist

Narcolepsy rx

``` Daytime = stimulants: amphetamines, modafinil Nighttime = sodium oxybate (GHB) ```

GFAP+

Astrocytes oligodendrocytes Ependymal

1st area damaged in global cerebral ischemia

Hippocampus (pyramidal neurons) [then also cerebellar pyramidal neurons]

Shit list 2 - Neuro Flashcards

(58 cards)