Sileramram Usmle Neuro Flashcards

Front 1

lesion in hemiballismus

Back 1

contralateral subthal nucleus
- lacunar stroke in pt with hypertension
- loss of inhibition of the thalamus

Front 2

athetosis

Back 2

slow, writhing movements

- basal ganglia lesion (huntigton's)

Front 3

myoclonus

Back 3

sudden, brief muscle contraction

Front 4

dystonia

Back 4

sustained, involuntary muscle contraction

Front 5

tremor that worsen's when holding posture

Back 5

essential tremor

Front 6

tremor when pointing toward a target

Back 6

intention tremor
- cerebellar dysfunction

Front 7

Cerebellar defects effect....

Back 7

ipsilateral side- fall toward side of lesion
- limb ataxia

Front 8

truncal ataxia

Back 8

cerebellar vermis

Front 9

lesion in hippocampus

Back 9

anterograde amnesia- inability to make new memories

Front 10

PPRF

Back 10

pons- near abducens nucleus
- vertical and horizontal saccades

Front 11

PPRF lesion

Back 11

eyes look away from side of lesion

Front 12

Frontal eye field lesion

Back 12

eyes look toward lesion
- part of initiation of eye movements

Front 13

Rapid correction of hyponatremia...

Back 13

basis pontis- anterior part of pons
- central pontine myelinolysis
--> acute pararlysis, dysarthria, dysphagia, diplopia, loss of consciousness
Can cause "locked in" syndrome- damage to ventral part of pons

Front 14

medial medullary syndrome

Back 14

anterior spinal artery in the medulla
- contralateral hemiparesis (pyramid)
- decreased contralateral proprioception (Medial lemniscus)
- tongue points to lesion (ipsilateral paralysis of hypoglossal nerve) - XII nucleus lesion

Front 15

MLF syndrome

Back 15

internuclear opthalmoplegia
- medial rectus palsy on attempted lateral conjugate gaze
- nystagmus in abducting eye

Front 16

Lateral inferior pontine syndrome

Back 16

AICA
- Loss of facial nucleus- no ipsilateral tase, lacrimation, reduced salivation
- unilateral central deafness
- ipsilateral gait and limb problems

Front 17

Most common site of circle of willis aneurysm

Back 17

Anterior communicating artery
- visual field defects

Front 18

Posterior communicating aneurysm

Back 18

CN III palsy

Front 19

Laterial striate aneurysm

Back 19

posterior limb of internal capsule infarct --> pure motor hemiparesis

Front 20

basilar artery aneurysm

Back 20

locked in syndrome

Front 21

Charcot-Bouchard microaneurysm

Back 21

chronic hypertension --> small vessels- basal ganglia, thalamus

Front 22

lucid interval

Back 22

Epidural hematoma
- fracture of temporal bone --> middle meningeal artery rupture
- can lead to a transtentorial herniation (uncal) --> CNIII palsy

*Biconvex, doesn't gross suture lines, can cross falx and tentorium

Front 23

blunt trauma

Back 23

subdural hematoma-
- crescent shaped
- crosses suture lines
- CANNOT cross falx or tentorium

Front 24

Risk after subarachnoid hem?

Back 24

vasospasm from blood breakdown products --> irritates vessels

Tx: calcium channel blockers

Front 25

Best imaging for a stroke?

Back 25

3-30 minutes - MRI --> bright area, remains bright for 10 days
~24 hrs - CT --> dark

Front 26

stroke progression?

Back 26

5 minutes- irreversible damage
12-48 hrs- irreversible neuron injury - red neurons
24-72 hrs- necrosis + neutrophils
3-5 days- macrophages
1-2 weeks- reactive gliosis + vascular proliferation
> 2 weeks-- glial scar

Front 27

location of area postrema

Back 27

4th ventricle
- responds toxin- not in BBB

Front 28

normal pressure hydrocephalus

Back 28

ventricles distort --> dementia, ataxia, urinary incontinence

"Wet, wobbly, wacky"

Front 29

lumbar puncture goes into which space

Back 29

subarachnoid
- does not pierce pia

Front 30

Werdnig Hoffman

Back 30

autosomal recessive
- presents like poliomyelitis
- floppy baby

Front 31

riluzole

Back 31

ALS drug that blocks Glu excitatory toxicity

Front 32

Friedreich's ataxia defect

Back 32

impaired mitochondria
- hypertrophic cardiomyopathy

Front 33

golgi tendon

Back 33

perpedicular to intrafusal fibers
- provides information on tension --> inhibitory to alpha neuros from spine
- prevents tendon tear

Front 34

Parinaud syndrome

Back 34

paralysis of conjugate vertical gaze due to lesion in superior colliculi

Front 35

parotid gland innervation

Back 35

CN IX- glossopharyngeal

Front 36

1st nerve affected if pituitary tumor grows laterally?

Back 36

abducens

Front 37

Bell's palsy causes

Back 37

complications in AIDS
Lyme disease
Herpes Zoster
Sarcoidosis
Tumors
Diabetes

Front 38

muscle that opens jaw

Back 38

lateraly pterygoid (V3)

Front 39

palat muscles

Back 39

Vagus
- Except - tensor veli palatini - CN V

Front 40

The only cranial nerve with a dorsal exit from brain stem

Back 40

CN IV- superior oblique
- worse on downward gaze- going down stairs etc

Front 41

What treatment can exacerbate wernicke's encephalopathy?

Back 41

Glucose
- thiamine needed for enzymes that break down glucose

Front 42

gingival hyperplasia

Back 42

phenytoin
- increased PDGF --> stimulates macrophages --> stimulates gingiva and bone

Front 43

Cryptoccocus neoformans virulence

Back 43

polysaccharide capsule
- latex agglutination test detects capsule
INDIA INK

Front 44

Defect in alzheimer's

Back 44

decreased APP degradation

Front 45

late onset alzheimer's associated with...

Back 45

ApoE4

Front 46

Protective against Alzheimer's

Back 46

ApoE2

Front 47

Lewy Body dementia

Back 47

alpha-synuclein defect
- parkinsonian with dementia and hallucinations

Front 48

PML

Back 48

JC virus in HIV patients
- demyelination because of destruction of oligodendrocytes

Front 49

heat shock protein mutations and dysmyelination

Back 49

Charcot-Marie Tooth disease

Front 50

where does a partial seizure originate?

Back 50

mesial temporal lobe

Front 51

simple vs complex seizures

Back 51

conscious vs. impaired consciousness

Front 52

periorbital pain, ipsilateral lacrimation, rhinorrhea, Horner's

Back 52

Cluster headache
- more common in males
- Tx: sumatriptan (migraines too)

Front 53

Most common supratentorial brain tumor in children

Back 53

craniopharyngioma-

Front 54

pseudorosettes

Back 54

Medulloblastoma
- neuronal + glial
- cerebellar tumor

Front 55

psammoma bodies- brain tumor

Back 55

meningioma

Front 56

marker on schwannoma

Back 56

S-100

Front 57

chicken wire capillary pattern + fried egg appearance

Back 57

oligodendoglioma

Front 58

tumor found in 4th ventricle

Back 58

ependymoma

Front 59

brain tumor that can produce EPO

Back 59

hemangioblastoma
- VHL syndrome (+ retinal angiomas)
- cerebellar
- foamy cells, highly vascular

Front 60

most common brain tumor in children

Back 60

astrocytoma

Front 61

enamel like tumor

Back 61

craniopharyngioma

Front 62

uncal herniation- what herniates

Back 62

medial temporal lobe
- ipsilateral dilated pupils, ptosis
- contralateral homonymous hemianopia
- ipsilateral paresis

Front 63

How does phenytoin cause megaloblastic anemia and fetal hydantoin syndrome?

Back 63

Decreases folic acid

Other SE: nystagmus, diplopia, ataxia, sedation, GINGIVAL HYPERPLASIA, SLE like syndrome, P450 inducer

Mechanism: Increase refractory period by blocking Na+ channels --> inhibition of glutamate release

Front 64

hepatotoxic seizure med

Back 64

Valproic acid- measure LFTs
- nonsedating

Other SEs: GI, neural tube defects, tremor, weight gain

Front 65

barbiturate mechanism

Back 65

Increases DURATion of Cl channel opening --> increased GABA --> decreased neuronal firing

- phenobarbital, thiopental

SEs: dependence, CNS depression, P-450 inducer

* Don't give with actue intermittent porphyria - will induce d-ALA synthase to make more D-ALA --> accumulation

Front 66

Benzodiazepine mechanism

Back 66

Increases frequency of Cl opening --> increase GABA

- Decreases REM sleep

Treat overdose with flumazenil

Front 67

MAC

Back 67

minimum alveolar concentration at which half of the population is anesthetized

Front 68

high blood solubility, high lipid solubility?

Back 68

slow onset of action

Front 69

halothane toxicity

Back 69

hepatotoxicity

Front 70

thiopental use

Back 70

barbituate
- anesthesia induction
- rapid redistribution in tissue and fat so action is short

Front 71

benzo used in endoscopy

Back 71

midazolam- IV
- post op depression
- amnesia
- decreased BP

Front 72

ketamine

Back 72

PCP analog- dissociative anesthetic
- Blocks NMDA receptor
- cardio stimulant
- causes disorientation, hallucination, bad dreams, increased blood flow

Front 73

opiod that does not cause contraction of the sphincter of oddi

Back 73

meperidine

Front 74

propofol

Back 74

rapid anesthesia induction
short procedures
- less nausea than thiopental

- potentiates GABA

Front 75

ester and amide local anesthetics mechanism

Back 75

binds active Na channels- most effective at blocking rapidly firing neurons
- block small>large, myelinated>unmyelinated
*small more important

Front 76

amide with SE of cardiotoxicity

Back 76

bupivicaine

Front 77

nondepolarizing neuromuscular block

Back 77

pancuronium- competitive for ACh receptors

- depolarizing neuromuscular block- succinylcholine

Front 78

schizoaffective disorder

Back 78

2 weeks stable mood + psychotic symptoms
- depresses, manic or mixed episode

Front 79

Shizophreniform disorder

Back 79

like schizophrenia but 1-6 months

Front 80

Schizoid

Back 80

voluntary social withdrawl
limited emotional expression
content with social isolation

Front 81

Shizotypal

Back 81

eccentric appearance
odd beliefs, magical thinking
interpersonal awkwardness

*Shizoid + odd thinking

Front 82

Schizophrenic

Back 82

2 of following
- delusions
- hallucinations
- disorganized speech
- disorganized or catatonic behavior
- negative symptoms

Front 83

belligerence and psychomotor agitation

Back 83

PCP (hallucinogen)

- amphetamines- euphoria
- cocaine- paranoid ideations, angina etc

Front 84

Listeria tx

Back 84

facultative intracellular
- ampicillin

Front 85

Phenelzine

Back 85

MAO inhibitor
- tyramine hypertensive crisis

Front 86

P450 inducers

Back 86

Queen Barb Steal Phen-phen and Refuses Greasy Carbs Chronically

Quinidine
Barbiturates
St. John's wort
Phenytoin
Rifampin
Griseosulvin
Carbamazepine
Chronic EtOH

Front 87

P450 inhibitors

Back 87

KEG --> Acutely SICk

Ketoconazole
Erythromycin
Grapefruit juice
Acute EtoH, Amiodarone
Sulfonamides
Isoniazid
Cimetidine

Front 88

Nucleus ceruleus

Back 88

NE

Front 89

Raphe nucleus

Back 89

5HT
- Raphe makes you happy!

Front 90

phrenic nerve

Back 90

C3,4,5
- hiccups

Front 91

thalamic lesion

Back 91

contralateral sensory loss

Front 92

antipsycotic and corneal deposits?

Back 92

chlorpromazine- typical

Front 93

Thioridazine

Back 93

typical antipsycotic
- retinal deposits

Front 94

pentazozine

Back 94

opioid with some antagonistic properties --> can precipitate withdrawl

Front 95

alpha and insulin?
Beta and insulin?

Back 95

alpha- decreases insulin secretion
beta- increases insulin secretion

Front 96

tolerance to these opioid side effects does not go away

Back 96

constipation
miosis

Front 97

Death from TCA overdose? mechanism?

Back 97

TCA
- inhibits NE and 5HT reuptake
- inhibits fast Na channels --> arrhythmias and death

TriCs: convulsions, cardiotoxicity, coma
Tx: NaHCO3

Front 98

weakness, difficulty relaxing, gonadal atrophy, cataracts, baldness

Back 98

myotonic dystrophy
- type 1 fibers affected mostly

Duchenne's- would see fatty deposits in place of muscle fibers

Front 99

venlafaxine

Back 99

SNRI

Front 100

hyperacusis for sounds

Back 100

Bell's palsy- CN VII palsy
- stapedius muscle

Front 101

Result of trinucleotide repeats in fragile X syndrome

Back 101

hypermethylation --> no transcription

Front 102

Antidepressant without sexual side effects?

Back 102

Buproprion- increases 5HT and dopamine

Other SEs: simulant, DO NOT USE IN BULIMIA

Front 103

1 st generation H1 blockers, SEs?

Back 103

Sedation
Antimuscarinic
Anti alpha adrenergic

Front 104

virulence factor of E Coli that causes neonatal meningitis

Back 104

K-1 antigen on capsule
- capsule allows hematogenous spread

Front 105

Inhibits uterine tone

Back 105

Beta 2

Front 106

stimulation of this receptor dilates the pupil

Back 106

alpha 1

Front 107

stimulation of this receptor increases insulin release? decreases?

Back 107

increase- beta 2
decrease- alpha 2

Front 108

cholinomimetics on vasculature

Back 108

binds endothelin cells --> NO release --> vascular relaxation