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126 Cards in this Set

  • Front
  • Back
Cells destroyed in Multiple Sclerosis
Oligodendrcytes
Cells look like fried eggs on H&E Stains
Oligodendrocytes
Phagoctes in the CNS that fuse to form Multinucleated Giant Cells when infected with HIV
Microglia
Astrocyte response to injury
Reactive gliosis
Wallerian degeneration
neuron degeneration distally when axon is injured
Emerge from neural crest cells
Schwann cells; PNS neurons
Cells that are destroyed in Guillain Barre
Schwann Cells
Typical neuron found in internal acoustic meatus
Acoustic neurooma- a type of scwanoma
Anxiety NT Changes
Increased Norepinephrine
Decreased Serotonin
Decreased GABA
Depression NT Changes
Decreased Norepinephrin
Decreased Dopamine
Decreased Serotonin
Schizophrenia NT Changes
Increased Dopamine
Parkinsons NT Changes
Decreased Dopamine
Increaesd ACh
Huntingtons NT Changes
Decreased ACh
Decreased GABA
Increased REM Sleep NT Responsible
Increased ACh
Alzheimers NT Changes
Decreased ACh
What vitamin is needed for conversion from Glutamate to GABA?
Vitamin B6- without it, you get convulsions
How do glucose and amino acids cross the BBB?
Slowly- by carrier mediated transport
How do lipid soluble substances cross the BBB?
Rapidly- via diffusion
Lateral area hypothalamus
Controls hunger
Ventromedial area hypothalamus
Controls satiety
Posterior pituitary products
Oxytocin; ADH
Thalamic nucleus for face sensation and taste
Ventral Posteromedial Nucleus (VPM
What is the limbic system responsible for?
The famous 5 F's:
Feeding, Fleeing, Fighting, Feeling, and sex.
Injury to the medial cerebellum leads to propensity to fall toward
Ipsilateral side
Lesion to Substantia Nigra pars compacta
Causes hypokinesis because the SNpc functions to stimulate movement
Lesion to the caudate
Causes hyperkinesis (Huntingtons) because the caudate functions to inhibit movement
Degeneration of Putamen
Causes Wilson's disease
Two causes of hyporeflexia
Peripheral nerve lesion
Mg+2 XS
Lesion to the contralateral subtalamic nucleus
Sudden, wild flailing of an arm and/or leg...hemiballismus
Athetosis
Slow, writhing movements, esp. fingers. (basal ganglia lesion)
Central sulcus
Separates principal motor and principal sensory areas
Broca's area
Frontal lobe
Wernicke's area
Temporal lobe
Arterial supply to lower limbs areas of sensory and motor areas
Anterior cerebral artery
Arterial supply to face and upper extremities
Middle cerebral artery
Disinhibited behavior, hyperorality, hypersexuality associated with HSV 1
Kluver Bucy Syndrome
Confusion, ophthalmoplegia, Ataxia, Memory loss, confabulation, personality changes associated with thiamine deficiency
Wernicke Korsakoff Syndrome (lesion to the mammillary bodies)
Intention tremor from lesion
Cerebellar hemisphere
Truncal ataxia, dysarthria results from lesion
Cerebellar vermis
Commonly caused by very rapid corection of hyponatriemia
Central pontine myelinolysis
Can't repeat phrases such as "No ifs, ands, or buts"
Conduction aphasia
Pulsating exopthalmos indicates what?
Rupture of Internal Carotid Artery
Most common site for berry aneurysms
Bifurcation of Anterior Communicating Artery
Common site for berry aneurysms causing CN III palsy (eye is "down and out")
Psoterior Communicating Artery
Wallenberg's syndrome
Lateral medullary syndrome- lots of different symptoms (vomiting, vertigo, decreased sensation to face, dysphagia, hoarseness). Damage to PICA
Middle meningeal artery rupture
Epidural hematoma
Bloody or yellow spinal tap
Xanthochromia indicative of subarachnoid hemorrhage
Tx for Subarachnoid hemorrhage
Nimodipine
Layers of tissue for lumbar puncture
Skin, fascia, supraspinous ligament, infraspinous ligament, ligamentum flavum, epidural space, dura mater, sub dural space, arachnoid mater, subarachnoid space
Placement of Lumbar puncture
Between L3 and L5 in Adults
Between L5 and S1 in Kids
Commonly used by patients first line for insommnia treatment
Antihistamines
Antideppressent also used for sleep
Trazodone
First line treatment for narcoleps
Modafinil
When can nocturnal enuresis be treated?
Diagnosed at 5yo
Treatment is delayed until 7yo
EEG waveform awake
Beta wave
EEG waveform eyes closed
Alpha wave
EEG Stage 1
Theta wave
EEG stage 2
Sleep spindles and K complexes
EEG stage 3
Delta wave
REM EEG
Beta wave
Cranial nerves with nuclei in medulla
CN IX, X, XI, XII
Cranial nerves with nuclei in pons
CN V, VI, VII, VIII
Cranial nerves in midbrain
CN III, IV
Information communicated at nucleus solitarius
Sensory Info
Information communicated at nucleus ambiguus
Motor Info
Information communicated at the dorsal motor nucleus
Autonomic info
Muscles of mastication
Masseter, Medial pterygoid, temporalis, Lateral pterygoid
Deviation of tongue CN XII LMN lesion
Toward side of lesion
Deviation of CN V motor lesion
Jaw deviates toward side of lesion
Distinguish Bells Palsy from Stroke
Stroke will affect contralateral lower face; bells palsy will affect ipsilateral entire face
Patient with bilateral Bell's Palsy
Guillan Barre
Midbrain infarction with oculomotor nerve palsy and contalateral hemiparesis
Weber syndrome
Roral medulla infarction causing contalateral pain/temp loss, ipsilateral face pain and temp loss, difficulty swallowing, ipsilateral horner's
Wallenberg Syndrome
Lesion of what artery causes locked in syndrome?
Basilar artery
Presents as floppy baby with tongue fasciculations
Werdnig Hoffman disease
Transmitted by the fecal oral route, causes destruction of cells in anterior horn of spinal cord leading to flaccid paralysis, hyporeflexia, atrophy
Polio virus
Can be caused by defect in superoxide dismutase
Amyotrophic lateral sclerosis
Degeneration of dorsal columns and dorsal roots due to tertiary syphilis resulting in impaired proprioception and locomotor ataxia
Tabes dorsalis
Autosomal recessive rinucleotide repeat disorder (GAA) in a gene that encodes frataxin
Friedreich's ataxia
Brown sequard syndrome
Contralateral loss of pain and temperature below
Ipsilateral loss of vibration, proprioception, fine touch below
Ipsilateral UMN signs below
Ipsilateral loss of all sensation at level
LMN signs at level
Differential diagnosis for cotton wool spots
DM, HTN, AIDS
Obstructed outflow at Canal of Schlemm- bilateral, black, 40yo, Diabetes
Open angle glaucoma
Afferent pupillary defect with decreased bilateral pupillary constriction when light is shone in affected eye
Marcus Gunn pupil
Lesion in medial longitudinal fasciculus
Internuclear ophthalmoplegia
Amyloid Precursor Protein on Chromosome 21 (hence, Down syndrome associated) associated with this dementia
Alzheimer's Disease
Dementia caracterized by personality and behavioral changes
Pick's Disease (Frontotemporal dementia)
Parkinsonism with dementia and hallucinations
Lewy Body Dementia
Rapidly progressive dementia with myoclonus
Creutzfeld Jakob Disease
Charcot's triad for Multiple Sclerois
Scanning speech, Intention Tremor, Nystagmus ("SIN")

I can also mean Incontinence or Internuclear ophthalmoplegia
Periventricular plaques
Multiple sclerosis
Mechanism for Guillain Barre
Postinfection; autoimmune attack of peripheral myelin due to molecular mimicry
Seizure in one area of brain in which consciousness is impaired
Complex partial seizure
Diffuse seizure with blank stare
Absence seizure
Treatment for migraine headache
Propranolol, NSAIDs, Sumatriptan
Treatment for cluster headache
Inhaled oxygen, sumatriptan
Maneuvers for vertigo
Dix-Hallpike Test; Epley maneuver seem to work for misplaced otoliths
Excess fluid in inner ear causing vertigo
Meniere's Disease
Port wine stains, glaucoma, seizures, hemiparesis, mental retardation
Sturge Weber Syndrome
Tuberous sclerosis tumors
Adenoma sebaceum; Cardiac Rhabdomyopa; Renal angiomyolipoma
Mutated gene on chromosome 17 causing Cafe au lait spots and Lisch nodules
Neurofibromatosis type I
Drugs that decrease aqueous humor synthesis for glaucoma
Alpha agonists- Epinephrine, Brimonidine
Beta blockers- Timolol, betaxolol, cartelol
Diuretics- Acetazolamide
Side effect of epinephrine use in glaucoma
Mydriasis; therefore, do not use in closed-angle glaucoma
Glaucoma drugs that increase outflow of aqueous humor
Cholinomimetics:
Direct- pilocarpine, carbechol
Indirect- physosigmine, echothiophate
Prostaglandins:
Letanoprost
Side effect of letanoprost
(Used in glaucoma tx)
Darkens color of iris
Drug of choice in glaucoma emergency
Pilocarpine
Mechanism of action of opiod analgesic
Agonists at opiod receptors in medial thalamus, brainstem, and spinal cord to open potassium channels and close calcium channels leading to decreased synaptic transmission.
Reverses overdose of opiates
Naloxone or Naltrexone
Acetylation is the reason this drug is three times more potent than morphine
Heroin
Overdose of Opioid leads to this clinical picture
Respiratory depression, miosis
Drug of choice for partial seizures (simple and complex)
Carbamazepine
1st line drugs for tonic clonic seizures
Phenytoin, Carbamazepine, Valproic acid
Absence seizure DOC
Ethosuximide
DOC to stop ongoing or recurrent febrile seizures
Phenobarbital
Drug of Choice in Status Epileptius treatment
Prophylaxis: Phenytoin
Acute: Diazepam/Lorazepam
Seizures of ecclampsia
IV Mg Sulfate
Diazepam
SE gingival hyperplasia
Phenytoin
Fetal hydantoin syndrome SE
Phenytoin
Fetal neural tube defects SE
Valproic acid
Epilepsy drugs taht cause SJS
Carbamazepine, Ethosuximide, Lamotrigine
Difference between Barbituates and Benzodiazepines MOA
Barbs increase duration of Cl channel opening; Benzos increase frequency of Cl channel opening
Most common drug used for endoscopy
Midazolam
Contraindicated in patients with intermittent porphyria
Thiopental
IV anaesthetic contraindicated in HTN or stroke patients
Ketamine
Order of nerve blockade by local anesthetics
Small myelinated>small unyelinated>large myelinated>large unmyelinated
Types of local anesthetics
Esters and Amides. Amides have "two eyes" ex: mepIvacaIne (mepivacaine)
Explain the strategy of the following drugs in Parkinson treatment:
Bromocriptine
Amantadine
Levodopa
Selegiline
Antimuscarinics
Bromocriptine: agonize DA receptors
Amantadine: may incr. DA release
Levodopa: converted to DA
Selegiline: MAO type B inhibitor (prevents DA breakdown)
Antimuscarinic: benztropine- improves tremor and rigidity, little effect on bradykinesia