Shit list 2 - Neuro Flashcards Preview

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Flashcards in Shit list 2 - Neuro Deck (58):
1

Pilocytic Astrocytoma

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

2

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.

3

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

4

Craniopharyngeoma

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

5

Pleiomorphic xanthoastrocytoma

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

6

CYP 450 Inducers

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

7

CYP450 Inhibitors

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

8

Common CYP 450 substrates

Warfarin.
Anti-epileptics.
Theophylline.
OCP.

9

Lithium: use, AE, toxicities

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

10

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

11

DOC trigeminal neuralgia

Carbamazapine

12

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

13

Glioblastoma Multiforme

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

14

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.

15

Hemangioblastoma

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

16

Schwannoma

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

17

Oligodendroglioma

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

18

uveitis: causes

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

19

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

20

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.

21

Retinitis pigmentosa

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

22

Retinitis

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

23

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)

24

Mydriasis pathway

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]

25

Pie in the sky

Meyer's loop (temporal radiation)

26

Pie on the floor

Dorsal optic radiation (parietal lobe)

27

INO: disease, convergence, directional term

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

28

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

29

Uthoff's phenomenon

Heat sensitivity in MS - worse s/s

30

Acute disseminates post-infectious encephalomyelitis

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

31

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

32

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

33

PML: cause, exacerbated by

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

34

adrenoleukodystrophy

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

35

Prevent/treat brain vasospasms

nifedipine

36

steppage gait: nerve injured

Common peroneal

37

H1-gen1's:

Hzdroxyzine
Promethazine
Chlorpheniramine
Diphenhydramine

38

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

39

Absence Seizures: other names

- petit mal
- 3Hz spike wave complexes

40

Alzheimers drugs: mechanism and names

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

41

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

42

superior vs inferior colliculi

Superior = vision (conjugate vertical gaze, convergence

Inferior = auditory (sound localization)

43

Brainstem lesion shortcuts

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

44

Relevant DA pathways

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

45

Thiopental

IV barbiturate for anesthesia; redistributed into fat and muscle

46

Drug-induced parkinsonism

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

47

Rx of drug-induced parkinsons

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

48

Hyperacusis via:

VII damage impairing stapedius muscle contraction to dampen sounds

[tensor tympany is the other muscle, innervated by motor V3]

49

Middle meningeal artery - where did it come from

MMA

50

Pteryon =

joining of frontal, temporal, parietal, and sphenoid bones

51

Clozapine AE

agranulocytosis, seizures, weight gain (olanzapine)

52

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

53

SOD-1 mutations

ALS

54

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

55

Mixed agonist-antagonist opioids

Pentazocine
Nalbuphine

K agonist - spinal analgesia
mu antagonist

56

Narcolepsy rx

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

57

GFAP+

Astrocytes
oligodendrocytes
Ependymal

58

1st area damaged in global cerebral ischemia

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