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104 Cards in this Set

  • Front
  • Back
what waveform is present when awake with eyes open?
awake with eyes closed - what waveform?
stage 1/light sleep - what waveform?
stage 2/deeper sleep - what waveform?
sleep spindles and K complexes
stage 3-4/deepest, non-REM sleep, sleepwalking, night terrors, bed-wetting (slow-wave) - what waveform?
delta - lowest frequency, highest amplitude
in what stage of sleep is there dreaming, loss of motor tone, possibly a memory processing function, erections, increased brain O2 use?
what waveform is associated with REM sleep?
serotonergic predominance of raphe nucleus is key to initiating what?
what neurotransmitter reduces REM sleep?
what is responsible for the extraocular movements seen during REM sleep?
PPRF (paramedian pontine reticular formation/conjugate gaze center)
what drugs shorten stage 4 sleep? what are they therefore useful for?
benzodiazepines - night terrors and sleepwalking
why is imipramine used to treat enuresis?
because it decreases stage 4 sleep
what happens to pulse and BP during REM sleep?
increased and variable
how often does REM sleep occur?
every 90 minutes - duration increases throughout the night
what is the principal neurotransmitter involved in REM sleep?
where's the lesion: motor (nonfluent/expressive) aphasia with good comprehension
Broca's area
where's the lesion: sensory (fluent/receptive) aphasia with poor comprehension
Wernicke's area
where's the lesion: conduction aphasia; poor repetition with good comprehension, fluid speech
arcuate fasciculus
where's the lesion: Kluver-Bucy syndrome (hyperorality, hypersexuality, disinhibited behavior)
bilateral amygdala
where's the lesion: personality changes and deficits in concentration, orientation, and judgement; may have reemergence of primitive reflexes
frontal lobe
where's the lesion: spatial neglect syndrome (agnosia of the contralateral side of the world)
right parietal lobe
where's the lesion: coma
reticular activating system
where's the lesion: Wernicke-Korsakoff syndrome
bilateral mammilary bodies
where's the lesion: tremor at rest, chorea, or athetosis
basal ganglia
where's the lesion: intention tremor, limb ataxia
cerebellar hemisphere (laterally located, affect lateral limbs)
where's the lesion: truncal ataxia, dysarthria
cerebellar vermis (centrally located - affects central body)
where's the lesion: contralateral hemiballismus
subthalamic nucleus - loss of inhibition of thalamus through globus pallidus
what do you call slow, writhing movements, especially of fingers? what are these characteristic of?
athetosis; basal ganglia lesion
where is Broca's area?
inferior frontal gyrus
where is Wernicke's area?
superior temporal gyrus
familial form of AD (10%) is associated with genes on what chromosomes?
1, 14, 19 - APOE4 allele
21 - pApp gene
intracellular, abnormally phosphorylated tau protein is associated with what?
neurofibrillary tangles in AD
dementia, aphasia, parkinsonian aspects & specificity for frontal and temporal lobes?
Pick's disease
intracellular, aggregated tau protein is associated with what?
Pick bodies
what disease is associated with Lewy bodies?
what 2 degenerative diseases are associated with spinocerebellar atrophy?
olivopontocerebellar atrophy, Friedreich's ataxia
this disease is associated with degeneration of anterior horns
Werdnig-Hoffman disease
this disease presents at birth as a 'floppy baby'; tongue fasciculations are characteristic
Werdnig-Hoffman disease
how is Werdnig-Hoffman disease inherited; what is the median age of death?
AR, 7 months
polio is associated with degeneration of what?
anterior horns - LMN destruction
how is poliovirus transmitted?
what are the CSF findings in poliomyelitis?
lymphocytic pleocytosis with slight elevation of protein
what is the classic triad associated with MS?
scanning speech, intention tremor, nystagmus (SIN)
what is the treatment for MS?
beta-interferon or immunosuppressant therapy
the prevalance of this disease increases with distance from equator
what are periventricular plaques?
areas of oligodendrocyte loss and reactive gliosis seen in MS (preservation of axons)
patients with what disease can present with optic neuritis, MLF syndrome, hemiparesis, hemisensory symptoms, or bladder/bowel incontinence?
what is progressive multifocal leukoencephalopathy associated with?
JC virus - seen in 2-4% of AIDS patients (reactivation of latent virus)
what is the treatment for Guillain Barre?
respiratory support until recovery; plasmapheresis, IVIg
symmetric ascending muscle weakness beginning in distal lower extremities is seen in what disease?
Guillain Barre
what are the CSF findings in Guillain Barre?
elevated CSF protein with normal cell count - albuminocytologic dissociation; elevated protein leads to papilledema
this disease is marked by inflammation and demyelination of peripheral nerves and motor fibers of ventral roots
Guillain Barre - sensory effect is less severe than motor
what are the causes of seizures in children?
genetic, infection, congenital, trauma, metabolic
what are the causes of seizures in adults?
tumors, trauma, stroke, infection
what are the causes of seizures in elderly?
stroke, tumor, trauma, metabolic, infection
this type of seizures involves one area of the brain
rupture of middle meningeal artery causing an epidural hematoma is often secondary to what?
fracture of temporal bone
what does CT show in epidural hematoma?
biconvex disk not crossing suture lines
what kind of intracranial hemorrhage is most likely to be seen in a shaken baby, elderly person, or alcoholic?
subdural hematoma - rupture of bridging veins
this type of intracranial hemorrhage is caused by hypertension, amyloid angiopathy, DM, and tumor
parenchymal hematoma
what does CT show in the case of subdural hematoma?
crescent-shaped hemorrhage that crosses suture lines
what is the drug of choice for status epilepticus?
what is the most common site of obstruction causing hydrocephalus?
aqueduct of sylvius
what is the underlying lesion in retinopathy of prematurity?
inappropriate proliferation of vessels in the inner layers of the retina
location at the junction of cortical gray and white matter is typical for what type of tumor?
metastatic; round shape is also characteristic
progressive dementia with diffuse loss of deep hemispheric white matter?
subcortical leukoencephalopathy - Binswanger disease - one of the neurologic syndromes associated with hypertension
what degenerative disorder is characterized by ophthalmoplegia, pseudobulbar palsy, axial dystonia, and bradykinesia?
progressive supranuclear palsy - widespread neuronal loss and gliosis in subcortical sites with sparing of the cerebral and cerebellar cortices
confusion, ataxia, vestibular dysfunction, sluggish pupillary light reflexes, anisocoria, and oculomotor dysfunction are acute sympmtoms as what?
Wernicke's syndrome - thiamine deficiency usually second to chronic alcohol abuse
chronic form includes anterograde amnesia and confabulation and is called Wernicke-Korsakoff
syringomyelia is often associated with what?
Arnold-Chiari malformation, in which there is a congenital protrusion of the cerebellum and medulla through the foramen magnum
this type of benign tumor often involves the lateral ventricles of young boys
choroid plexus papilloma - can affect the caudate because it comprises part of the wall of the lateral ventricle
atrophy of the caudate and putamen can make what look large on imaging?
a pituitary tumor that expands laterally will first affect what?
abducens nerve
lesion of the right parietal lobe will cause what?
sensory neglect syndrome of left side (most common pattern in right handed patients)
what is the most common primary brain tumor?
glioblastoma multiforme - grade IV astrocytoma
what stains astrocytes?
this type of tumor has 'pseudopalisading cells' that border central areas of necrosis and hemorrhage
glioblastoma multiforme
this type of brain tumor has spindle cells concentrically arranged in a whorled pattern' psammoma bodies (laminated calcifications)
this is the second most common type of brain tumor - most often occurs in convexities of hemispheres and parasagittal region
from what does a meningioma arise?
arachnoid cells external to brain
this is the third most common primary brain tumor - originates from Schwann cells
Schwannoma - often localized to 8th nerve (acoustic neuroma)
this tpe of tumor contains 'fried egg' cells
oligodendroglioma - often calcified
where are oligodendrogliomas most frequently found?
frontal lobes
the majority of adult primary tumors are located where?
the majory of childhood primary tumors are found where?
this tumor has a peak incidence in childhood - diffusely infiltrating glioma, most often found in posterior fossa; benign with good prognosis
pilocytic (low-grade) astrocytoma
this type of childhood peak incidence brain tumor has Rosenthal fibers - eosinophilic, corkscrew fibers
pilocytic (low-grade) astrocytoma
this is a highly malignant cerebellar tumor & a form of primitive neuroectodermal tumor (PNET); found primarily in children; can compress the 4th ventricle to cause hydrocephalus
this type of childhood tmor contains rosettes or perivascular pseudorosete pattern of cells & is radiosensitive
where are ependymomas most commonly found? what is the prognosis?
4th ventricle; poor prognosis
foamy cells and high vascularity are characteristic of what type of childhood-predominant tumor?
this type of brain tumor is associated with von Hippel-Lindau
this type of tumor shows characteristic perivascular pseudorosettes; rod-shaped blepharoplasts are found near the nucleus
this type of child-predominant tumor can produce EPO, leading to secondary polycythemia
this is a benign childhood tumor, confused with pituitary adenoma
this is the most common childhood supratentorial tumor
where does syringomyelia most commonly occur?
contralateral paralysis of lower face only
lesion of motor cortex or connection between cortex and facial nucleus (UMN CN VII)
cingulate herniation under falx cerebri can compress what?
anterior cerebral artery
what results with downward transtentorial (central) herniation?
coma and death - if compress brainstem
ipsilateral dilated pupil/ptosis in uncal herniation results from what?
stretching of CN III
contralateral homonymous hemianopia in uncal hernaition results from what?
compression of ipsilatearal posterior cerebral artery
ipsilateral paresis in uncal herniation results from what?
compression of contralateral crus cerebri (Kernohan's notch)
Duret hemorrhages - paraemdian artery rupture in uncal herniation results from what?
caudal displacement of brain stem
lesion in MLF results in what on attempted lateral gaze?
medial rectus palsy; nystagmus is seen in the abducting eye; convergence is normal