5.21 Neuro Iii

Front 1

1. Which direction does aqueous humor flow in the eye?

2. From what structure is aqueous humor produced?

3. How to test for function of CNIV?

Back 1

1. Posterior→Anterior chambers

2. ciliary bodies

3. eye down AND IN (trochlear)

Front 2

1. Through what structures (two) does aqueous humor exit the eye?

2. Damage to what nerve and/or muscle causes ptosis?

3. Compare strabismus and amblyopia?

Back 2

1. trabecular meshwork (sponge) and the canal of schlemm

2. CNIII, levator palpebrae superioris

3. strabismus: misalignment of the eyes; amblyopia: loss of vision d/t disuse during critical period

Front 3

1. What drugs are useful in the treatment of Acute, closed angle glaucoma. How do they work? (2)

2. Draw the pupillary light reflex?

3. Describe CNIII in cross-section? Result of this design?

Back 3

1. Acetazolamide blocks ciliary bodies from producing aqueous humor; Pilocarpine stimulates ciliary muscle (M3) to open the angle between iris/lens

2. SEE SHEET

3. Central: IOMs; Peripheral: parasympathetics controlling pupil constriction; compression affects pupils first

Front 4

1. What is the cause of open-angle glaucoma?

2. What is the Edinger-Westfall nucleus responsible for?

3. What layers separate in a retinal detachment?

Back 4

1. decreased reabsorption or overproduction of aqueous humor

2. bilateral pupillary constriction in response to light

3. neurosensory layers from pigmented epithelium

Front 5

1. What drug is contraindicated in closed angle glaucoma?

2. Where is the damage with Marcus-Gunn pupil and how it presents?

3. Compare the mechanisms of dry macular degeneration and wet macular degeneration? Which is fast and which is slow?

Back 5

1. epinephprine

2. damage to optic n (CNII) prevents bilat. pupil response to light in the affected eye

3. wet (fast): blood vessels grow/obstruct macula; dry (slow): atrophy of neurosensory fibers

Front 6

1. Where is an occular lesion that causes hemianopsia with macular sparing?

2. What does the MLF connect?

3. When you hear MLF lesion, what condition should you immediately think of?

Back 6

1. in the occipital lobe

2. Connects VI nucleus to III

3. Multiple Sclerosis (MS)

Front 7

1. Describe S/S of a R. MLF lesion?

2. What are Lewy bodies and what condition are they seen in?

Back 7

1. on looking L, R side is stationary, L. eye shows lateral nystagmus

2. α-synuclein inclusions in neurons associated with Parkinson's

Front 8

1. What is the difference between a PPRF and a MLF lesion?

2. What are neurofibrillatory tangles and what condition are they seen in? Are the extra or intracellular?

Back 8

1. PRRF: Looks away from side of lesion; MLF, lesioned side stationary, opposite side lateral nystagmus

2. abnormal intracellular tau proteins seen in Alzheimer's

Front 9

1. What is the difference between Neurofibrillatory Tangles and B-amyloid plaques?

Back 9

1. NFT: intracellular, BA-plaques: extracellular

Front 10

1. Draw the pathways for motor control of the Facial Nerve (diagram the parts)?

2. What nerves control these sounds: K-L-M?

3. Compare the general locations of adult brain tumors versus pediatric brain tumors?

Back 10

1. SEE SHEET

2. K: X, L:XII, M:VII

3. adult: supratentorial, pediatric: infratentorial

Front 11

1. Describe an UMN lesion to CNVII?

2. What muscles open/close the mouth?

3. Adult or pediatric tumor: medullablastoma

4. Pediatric brain tumor which causes hydrocephalus?

Back 11

1. contralateral loss of muscle control in lower 2/3 of face, sparing of forehead

2. "Lateral Lower/M Munches"-Lateral Pterygoid (open), Masseter, Medial Pterygoid, teMporalis (close)

3. pediatric

4. ependymoma

Front 12

1. Describe a LMN lesion to CNVII?

2. All 'palat' muscles are controlled by what nerve with what exception?

3. Adult or pediatric tumor: meningioma

4. Which brain tumor is known to cross the corpus callosum?

Back 12

1. ipsilateral loss of muscle control in entire face

2. X, with the exception of tensor palatini (V)

3. adult

4. Glioblastoma multiforme

Front 13

1. What is Bell's palsy?

2. All 'glossus' muscles are controlled by what nerve with what exception?

3. Adult or pediatric tumor: Schwanoma?

Back 13

1. damage to facial nerve or to facial nucleus (CN VII)

2. XII, with the exception of palatoglossus (X)

3. adult

Front 14

1. Adult or pediatric tumor: ependymoma?

2. Most common type of pituitary adenoma?

Back 14

1. pediatric

2. prolactinoma

Front 15

1. Adult or pediatric tumor: hemangioblastoma?

2. What do pilocytic astrocytomas and GBM have in common?

3. How does Rinne test appear with conductive or sensorineural loss?

Back 15

1. pediatric

2. both are astrocyte tumor (high grade versus low grade)

3. conductive loss: bone better than air; sensorineural loss: air better than bone

Front 16

1. Adult or pediatric tumor: craniopharyngioma?

2. "Chickenwire capillary" pattern associated with what tumor?

3. Which is Weber and Which is Rinne?

Back 16

1. pediatric

2. oligodendroma

3. W: medial forehead (mirror letter), R: behind ear

Front 17

1. Adult or pediatric tumor: oligodendroma?

2. Which brain tumor might also cause polycythemia vera and why?

3. Why would a person lose control of their legs from herniation?

Back 17

1. adult

2. hemangioblastoma: EPO production

3. Cingulate herniation across falx cerebri causes compression of anterior cerebral artery

Front 18

1. Adult or pediatric tumor: pilocytic astrocytoma?

2. Which tumors stain positive for GFAP?

3. What are the functions of the utricle/saccule/semi-circular canals?

Back 18

1. pediatric

2. GBM, pilocytic astrocytoma

3. U/S: linear acceleration, Semi: angular acceleration

Front 19

1. Diagnosis: apparent calcification of pituitary gland?

2. How does Weber test appear with conductive loss or with sensorineural loss?

Back 19

1. associated with craniopharyngioma

2. conductive loss: louder on affected side; sensorineural loss, louder on non-affected side

Front 20

1. What are the S/S of Guillan Barre?

2. What is vertigo?

3. What are "ash leaf spots" and what are they associated with?

Back 20

1. ascending, acute, areflexic (all bilateral)

2. Illusion of movement

3. hypopigmented skin associated with Tuberous Sclerosis

Front 21

1. What CSF findings correlate with Multiple Sclerosis?

2. What is a primary precaution you must take with patients with Guillan-Barre?

3. What is the difference between a simple and a complex seizure?

Back 21

1. elevated IgG (immune process)

2. Ventilator support

3. Simple: consciousness intact, Complex: impaired consciousness

Front 22

1. What are the common S/S presenting with MS?

2. Describe the molecular method by which Guillain-Barre happens?

3. What inheritance pattern does Tuberous Sclerosis follow?

4. Most common reason for an elderly person to have a seizure?

Back 22

1. SIN: scanning speech, incontinence, nystagmus

2. molecular mimicry attack of myelin

3. AD

4. stroke

Front 23

1. AIDS patient presents with focal neural deficits; most likely diagnosis?

2. How are ALL neurocutaneous disorders inherited? List these if you can? (3)

3. What is a partial seizure? What is its opposite?

4. Most common reason for an adult to have a seizure?

Back 23

1. PML (JC virus)

2. AD: NF, TS, VHL

3. partial seizure only affects one part of the brain and is focal; generalized are diffuse

4. tumor

Front 24

1. What is the difference between central and peripheral vertigo? Which is more common*?

2. What is Meniere's disease?

3. Most common reason for a child to have a seizure?

Back 24

1. central: problem with vestibular nuclei; peripheral*: problem with vestibular apparatus

2. Rupture of labryinth; mixing of endolymph/perilymph

3. genetics or infection

Front 25

1. Describe an absence seizure? Is it partial or general?

2. What is the similarity and the difference between a myoclonic and a tonic seizure?

Back 25

1. blank stare; general

2 both are generalized seizures; myoclonic has quick repetitive jerks whereas tonic is just stiffening of the muscles

Front 26

1. Describe a grand-mal seizure? Aka?

2. What is the theory behind migraine seizures?

3. Which seizure drug is contraindicated in pregnancy?

Back 26

1. Tonic/Clonic: tensing/falling then rhythmic contraction

2. release of SubP, 5-HT from CNV

3. Valproic acid

Front 27

1. Describe a tension headache?

2. Describe pharmacotherapy for status epilepticus?

3. First/Second line drug for eclampsia seizures?

Back 27

1. band around head; not stimulated by light/sound

2. Rapid acting benzodiazepine followed by prophylactic Phenytoin

3. MgSO4, then Phenobarbital

Front 28

1. Describe a migraine headache?

2. First line drug for child seizures?

3. Compare MOA of benzodiazepine and barbiturates?

Back 28

1. aura followed by 4-72 hours of headache w/ photophobia

2. Phenobarbital

3. Both bind GABA to either ↑frequency(benzodiazepines) or ↑duration(barbiturates) of Cl- channel

Front 29

1. Decscribe a cluster headache? Who gets these most often?

2. First line drugs for Tonic/Clonic seizures?

3. What is the risk with short acting benzodiazepines? What are these?

Back 29

1. brief repetitive unilateral periorbital headaches; Males

2. Carbamezapine, Phenytoin

3. highest addictive potential; TOMthumb (short): Triazolam, Oxazepam, Midazolam

Front 30

1. How does epinephrine work as an anti-glaucoma agent?

2. How do inhaled anesthetics affect the heart?

Back 30

1. vasoconstriction causing a reduction in aqueous humor

2. myocardial depression

Front 31

1. How do muscarinics work as anti-glaucoma agents?

2. How do inhaled anesthetics affect the lungs?

3. How does MAC relate to potency?

Back 31

1. stimulate M3 receptor causing ciliary muscle contraction and opening of the angle

2. respiratory depression

3. inverse relationship between the two

Front 32

1. How does Latanoprost work as an anti-glaucoma agent?

2. How do inhaled anesthetics affect the brain?



3. How does blood solubility affect the use of inhalational anesthetics?

4. Describe the order of fibers that are anesthesized by local anesthetics?

Back 32

1. acts on prostaglandin receptor to increase outflow of aqueous humor

2. increase cerebral blood flood (but decrease demand)

3. ↓blood solubility will ↑onset

4. sm myelin > sm unmyelin > large myelin > large unmyelin

Front 33

1. Which two anesthetics are known for their fast induction/slow procedure status?

2. How to tell the difference between amide and ester anesthetics?

3. How does lipid solubility affect the use of inhalational anesthetics?

Back 33

1. propofol, thiopental

2. amides: two I's, esters: one I

3. ↑lipid solubility, ↑potency

Front 34

1. What is MAC when referring to inhalation anesthetics?

2. Why is more anesthetic required in acidic tissues?

3. Describe the order in which anesthetics take away sensation modalities?

4. What is an absolute contraindication for barbiturate use?

Back 34

1. minimal alveolar concentration at which 50% of population is anesthetized

2. Acidic tissues will place a charge on the anesthetic and slow its crossing membranes

3. "Pain Tends To Provoke": Pain, Temperature, Touch, Pressure

4. porphyrias