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Flashcards in Smart book CNS & psych Deck (81):
1

Where craniopharyngioma come from?

what embryonal layer

Rathke's pouch - anterior pituitary

surface ectoderm

2

What drug class is used to treat Alzhiemers

which drug specifically?

AchE inhibitors

Donepezil, galantamine, rivastigmine

3

Which toxin is contained in mushrooms (when you eat them) that can cause bad effects like throwing up?

Muscarine which is a muscarinic agonist 

incr. parasympathetic

4

Activation of _______ promotes synthesis of nitric oxide

M3 receptors

5

A collection of snRNPs and other pre mRNA proteins are called ______

whats its function?

Spliceosomes

remove introns by cleaving

6

What is incidence?

The number of NEW cases of a illness each year

7

whats the triad for meningitis?

Fever, neck stiffness, altered mental status

8

what type of speech is involved in Broca? what other finding would you see?

nonfluent speech and right hemiparesis

9

Whats the function of the cerebellar hemispheres

what are the three signs of a lesion here?

Motor Planning and coordination of ipsilateral extremeties

-dysdiadochokinesia (impaired rapidly alternating movements)

-limb dysmetria, intention tremor

10

cognitive tests

11

whats the triad for Wernickes encephalopathy

what part of the brain is involved?

Confusion Ataxia Neurologic symptoms

Opthtalmoplegia

Mamillary bodies

12

What is anterograde (from axon to skin) axonal transport mediated by?

 

Kinesin

13

whats Akathisia

 

extrapyramidal side effect of antipsychotics

restlessness inability to sit still

14

what are the side effects of antipsychotics

15

when a patient is on isoniazid what should you give along with it?

b6-pyridoxine to prevent isoniazid neuropathy

16

patients with major depressive episodes should be screened for what before starting antidepressents?

SHould be screened for manic episodes

this is to rule out/differentiate between MDD and bipolar disorder

starting antidepressants in bipolar do can induce mania

17

what are the symptoms of PKU

due to decr. phenylalanine hydroxylase or tetrahydrobipterin

-mental retardation, seizures, growth retardation, fair skin, musty odor

18

whats the function of the obturator nerve

Adduction of thigh

cutaneous innervation of medial thigh

19

What are the symptoms of west nile virus

Encephalitis, meningitis, flaccid paralysis

(+) ssRNA flavi virus

20

what are the prenatal tests to check for Neural tube defects?

Incr. AFP & AchE

21

Whats the deficient in each nerve injury

Obturator

Femoral

Common peroneal

Tibial

Superior gluteal

obturator- leg Adduction/medial cutaneous

Femoral - leg extension/thigh flexion

C. peroneal - foot drop

Tibial - cant curl toes/ foot everted

S. gluteal- pelvis tilts

22

what is fragile X caused by?

Trinucleotide CGG repeat on FXMR1 (fragile X mental retardation) gene

Hypermethylation and inactivation of gene

23

what does rabies bind to in that leads to infection?

Ach receptors

24

what are the serum findings in wilson dz

how do you treat it?

Low Ceruloplasmin

high Copper

-D-penicillamine

25

what all bio reactions is thiamine involved in?

ATP

A-ketoglutarate, Transketolase, Pyruvate dehydrogenase

26

How would B12 deficiency present?

Megaloblastic anemia (impaired DNA synthesis) and

nuerologic deficits 

Subacute combined degeneration of dorsal column/lateral corticospinal

27

What symptom is permanent even after treatment in Wernicke encephalopathy?

Memory impairment

28

whats the first line drug for status epilipticus

Benzos!!!!

29

How does Fragile X syndrome present?

FMR1 gene mutation (Methylation --> inactivation)

CGG repeat

Fragile has eXtra large jaws, ears, testes

30

whats the physical presentation of downsyndrome?

Low ears, short neck, epicanthic folds

 

31

whats the physical presentation of Marfans syndrome

Arachnodactyl (long skinny fingers), scoliosis, lens dislocation 

32

Whats the physical presentation of Fetal alcohol syndrome

Thin vermillion border( thin upper lip), smooth philtrum (dip on upper lip) microencephaly, 

33

What happens with an Internal capsule lesion in the brain?

"clasp-knife" spasticity: initial resistance then flaccid extension.

34

what is deficient in Narcolepsy

Hypocretin1 aka Orexin

35

guy falls from a tree and grabs a branch. and now he cant really use his hand. what is it? and what nerves are messed up?

Klumpke palsy

-tear of Lower trunk of brachial plexus

36

where are the serotonin releasing nuerons located in the brainT

The Raphe nucleus

37

Bilateral infarcts of the brain should lead you to think _______

water shed areas - hypoxic ischemic stroke

as opposed to emoblism which would have infarcts everywhere in different locations

38

What all do you know about wilsons dz

young guy with ataxia and liver problems (incr. transaminase)

excessive copper deposition in

liver, basal ganglia, cornea

 

39

what are the muscles and bones associated with the pharyngeal pouches

1,2,3,4&6

1- muscles: mastication / bones: maxilla, mandible, incus mallus

2 - muscles: Facial expression muscles / bones: stapes, stylohyoid, lesser bone of hyoid

3 - muscles: stylopharyngeaus / bone: greater horn of hyoid

4&6- muscles: laryngeal/pharyngeal / bone: Cricord and thyroid cartilage

40

Ubiquination

plays an important role in: antigen processing, muscle wasting, Dna repair, disposal of misfolded proteins

41

2 year old with abdominal mass

dancing eyes dancing feet

Neuroblastoma

Neural crest cells - Nmyc overexpression

42

Stroke of the ACA presents as

why?

MCA

Contralateral paraylsis/sensory loss of LOWER

the ACA does the frontal lobe and sagital sulcus (hommunculus) which at the sulcus starts with feet

-mca would be more upper limb and face problems

43

what happens after neuronal damage to a section of brain (how does it get repaired)

Glial cells like AStrocytes go through hyperplasia to repair

Gliosis

44

whats parinaud? what causes it?

diminished vertical gaze due to lesion of superior caliculi

-stroke, hydroceph, pinealoma

45

where would you give a femoral nerve block?

Iliac crease

46

a person comes in with Subarachnoid hemorhage. wwhat do you give to prevent Cerebral vasospasm

CCB

47

got an old person suddenly going crazy

waxing and waning. how do you treat?

Delirium

haloperidol

48

how long does adjustment disorder last?

6 months

49

whats the route to the meninges for Nisseara meningitis

infected by respiratory droplets

pharynx-> blood -> Choroid plexus -> meninges

50

whats freidrich ataxia? where is the lesion in the spinal cord. most common cause od death?

Ataxia, with diabetes, hypertrophic heart, kyphoscoliosis

-lateral spinocerebellar/dorsal column degeneration

51

what nerve innervates the forearm flexors

and what about sensory innervation

Musculocutaneous

lateral forearm

52

why do you get GB (ascending paralysis) after camp or influenza. what kind of response?

Antibodies against the infectious agent also attack myelin of peripheral nerves

-endoneural inflam infiltrate

53

recurrant unilateral headaches

Lacrimation and rhinorhea. perioribtal pain

tx?

Cluster headaches 

acute: Sumatriptan

prophylaxis: verapamil

54

where are the muscarinic and nicotinic receptors?

M1: Nerves and CNS : Gq receptor(ip3dag)

M2: Heart, atria SA AV node : Gi (camp)

M3: Glands and smooth muscle : Gq ip3-dag

_______________

Nicotinic: Skeletal muscle (motor end plate) and Adrenals

55

Shoulder drop and cant lift pass the horizontal position. what muscle is fucked?

Trapezius

56

Most common Viral causes of meningitis

Enterovirus, Arbovirus, HSV 2

57

difference between normal pressure and obstructive (non communicating) hydrocephalus

Obstructive is due to aqueduct stenosis or tumor that leads to incr. ICP that causes headache N/V

58

Guy comes in with muscle weakness and paresthesias after eating fish at a japanese resturaunt. what is the cause and MOA

Puffer fish - Tetrodotoxin - Blocks Na channels

59

What nerve is messed up in bells palsy and what does it innvervate

Facial nerve CN 7

-face muscles, anterior 2/3 taste, hearing, salivary and lacrimal glands

60

what can occur after Subarachnoid hemmorage?

how do you treat it?

Vasospams causing 

CCB

61

What are the target organs for Alpha, Beta1, & Beta2 receptors

Stimulation

Alpha-vasoconstriction, urinary retntion, and mydriasis

Beta 1- Heart (incr. rate, contractility, conductance)

Beta2- Bronchodilation, uterus relaxation

 

62

Decerebrate vs Decortate posturing

Decerebrate: extension of extremities due to a lesion below the Red nucleus (pons, midbrain,) 

Decortate: flexion of arms due to a lesion above the red nucleus which disinhibits it.

*red nucleus causes flexing. so above or below will tell you 

63

Whats the bond types between primary and secondary protein structures?

Primary - Peptide bonds

Secondary - Hydrogen bonds

64

What should you know about glioblastoma?

Its an astrocytoma, common primary malignant

Buttergly Glioma, resides in Cerebral hemisphere

GFAP

necrosis and hemorrhage

65

What innervates dorsum of foot and if fucked can cause foot drop

Common Peroneal

66

Whats the function of Radial nerve

Extensors, skin sensory to posterior arm and forearm

67

whats the inheritance of Neurofibromatosis

Autosomal dominant

68

Spontaneous deep intercerebral stroke due to hypertension

Basal ganglia / lenticulostriate muscles

69

Route of Rabies

Wound- motor neurons -salivary glands

70

Difference between Oppositional Defiant disorder and Conduct disorder

OPP is argumentative, defiant behavior, with deliberate teasing and blaming others

Conduct is cruelty to others with no regards

71

what is acute stress disorder and its timeframe

hyperarousal and avoidance symptoms as a result of life threatening or traumatic event 

3 days to 1 months

72

Social anxiety do vs panic

Panic: recurrant episodes of stress and worrying about when the next one will come

Social anxiety: worried more about the criticism of others and not the stress itself

73

when you see ornithine you should think

UREA CYLCE

74

Whats a romberg test

Asking a patient who has ataxia to stand up and balance with eyes closed.'

Positve test: once they close their eyes they stumble (meaning that they were relying on other senes to balance which means the dorsal column is fucked)

Negative test: means that the ataxia is a cerebellar problem and not the spinal cord

75

whats diabetic retinopathy caused by?

poorly controlled diabetes leading to ischemia of the nerve

76

Which brain tumor has S100 +

Schwannoma 

CN VIII Cerebellar pontain angle

77

What part of the brain is first effected by ischemia 

pyramidal cells of the ​Hippocampus

purkinje cells of cerrebellum

78

how would dandy walker syndrome present

Absence of vermis

enlargment of 4th ventricle, noncommunicating hydrocephalus, large head, spina bifida

79

difference between Tourrettes and Chronic tic syndrome

Tourettes: both motor and vocal(phonic tic)

________

Chronic tic syndrome : one or the other for greater than a year

80

What do you tell a pt going through on off phenomenom of parkinsons treatment?

Its unpredictable 

thought to be due to closing therapuetic window

81

Upper vs Lower motor neuron problem

Upper: Babinski sign, hyper reflexia

Lower: fasiculations atrophy