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82 Cards in this Set
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Thalamic Nuclei
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VPL
--incoming from Spinothalamic (pain & temp) tract and Medial Lemniscus (position, proprioception), ---relays to Somatosensory Cortex (Brodman's areas 1-3) VPM Ventral Posteromedial Nucleus ---incoming from Trigeminal & Gustatory pathways ---relays to same Lateral Geniculate --Relay for Vision Medial Geniculate: relay for audition --input from superior olivary nucleus & inferior colliculus NB: smell not relayed through thalamus |
#neurology #cns #anatomy
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VPL Nucleus
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Thalamic Nucleus
--incoming from Spinothalamic (pain & temp) tract and Medial Lemniscus (position, proprioception), ---relays to Somatosensory Cortex (Brodman's areas 1-3) NB: does not relay face/pharynx that is VPM |
#neurology #cns #anatomy
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VPM Nucleus
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Ventral Posteromedial Nucleus iof the Thalamus
---incoming from Trigeminal & Gustatory pathways ---relays to Somatosensory Cortex (Brodman's areas 1-3) |
#neurology #cns #anatomy
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Lateral Geniculate Nucleus
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Thalamic Nucleus Responsible for Vision
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#neurology #cns #anatomy
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Medial Geniculate Nucleus
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Thalamic Nucleus Responsible for Audition
input from superior olivary nucleus & inferior output to temporal lobe |
#neurology #cns #anatomy
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Myasthenia Gravis vs Lambert Eaton Sro
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MG:
Begins with Optic Muscles Worsens at End of Day & after effort Risk of Thymoma Anti-ACh receptor antibodies Edrophonium improves weakness Nerve Stimulation → decrementalresponse LE: Begins with proximal muslces improves through day & w/ exercise 2° to an already existing malignancy Anti-Pre-Synaptic Ca2+ channel Antibodies Edrophonium does not improve Nerve Stimulation → incremental response |
#neurology #neoplasia #pathology
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Preventing Morbidity of Subarachnoid Hemorrhage
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Calcium Channel Blockers
Nimodipine prevents vasospasm → ischemia, the real cause of morbidity |
#neurology #pharmacology
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Nimodipine
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calcium channel blocker
used both for hypertension and uniquely used to prevent mobidity following SubArachnoid Hemorrhage |
#neurology #cardiovascular #pharmacology
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most important strx/molecular defects in Alzhemiers
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↓ ACh in Nucleus Basalis and Hippocampus
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#pathology #neurology #dementia
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The first portion of the brain damaged during global ischemia
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The Hippocampus goes first, within 5 minutes
Then watershet ischemia follow LATER |
#neurology #pathology #shock
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First sign of uncal herniation
sequelae thereof |
ipsilateral dilated pupil from compression of CN3
sequelae: down & out eye PCA compression → homonymous hemianopia contralateral cerebral peuncle → ipsilateral hemiparesis alternatively isilateral " " → contralateral brainstem duret hemorrhages 2° rupture of basilar artery → fatal |
#neurology #pathology
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unilateral dilated pupil
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uncal herniation compressing CN3
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#neurology #pathology
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describe mechanism of hearing in the inner ear
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3 chambers: scala vestibuli: Na+ rich, onnected to oval window
scala media: K+, organ of corti basilar membrane separates media from tympani scala tympani: Na+: connected to round window scala vestibuli and scala tympani meet at helicotremma at top low freq's cause vibration at top near helicotremma high freqs at base near oval window |
#neurology #physiology
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Cystic degeneration of putamen likely 2° to
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Wilson's Dz
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#pathology #neurology
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Pick's Dz: brain region
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frontotemoral specificty
inappropriate behavior and speach decline unknown genetic basis |
#neurology #pathology
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Vitamin E deficiency
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anti-oxidant which preserves cell membranes
most affected: neurons (large surface area) RBC's (poor antioxidant fnx) manifestation: Friederick's ataxia-like neuropathy w/ ataxi a & loss of proprioception and vibration + hemolytic anemia |
#pathology #nutrition #neurology #hematology
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Familial QT prolongation
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predisposes to TdP
accompanied by neurosensory deafness |
#pathology #cardiovascular #neurology #geneticdzs
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Familial Neurosensory Deafness
Likely Accompanying Condition? |
Familial QT prolongation
predisposes to TdP |
#pathology #cardiovascular #neurology #geneticdzs
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Brief uncontrollable jerky movements which occur episodically
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Myoclonic Seizures
DOC: Valproate |
#neurology #pharmacology
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DOC: Tourettes
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Haloperidol
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#neurology #pharmacology
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Neurophysiology of Urination
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Sacrial mMicturation center S2-4
Pontine center: coordinates sphincter relaxn Cerebral corteex: inhibits sacral center normal pressure hydrocephalus (elderly) ↑ ventricular area stretches descending cortical fibers → urinary incontenence |
#neurology #physiology
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Urinary incontenence of demention: pathophysiology
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Sacrial mMicturation center S2-4
Pontine center: coordinates sphincter relaxn Cerebral corteex: inhibits sacral center normal pressure hydrocephalus (elderly) ↑ ventricular area stretches descending cortical fibers → urinary incontenence |
#neurology #pathology
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Where do the respiratory drive signals originate
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Hypercapnea (normal individuals):
-Medulla detects pH Hypoxia (<60 mmHg or chronic hypercapnics) -Chemoreceptors in aotic arch and carotid bodies via CN9 |
#cardiovascular
#pulmonary #neurology #physiology |
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Horner's Sro + UE LMN signs
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pancoast tumor esp adenocarcinoma from apex of lung
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#pathology #neurology #neoplasia
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Organ of Corti
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The actual part of the inner ear that takes mechanical sound and turns it into energy signals
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#neurology
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Cupula of the Cochlea
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the very apex of the cochlea
houses the cells that sense rotation |
#neurology
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What exacerbates Multiple Sclerosis?
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heat leads to worsening fatigue and deficits
heat = ↓ axona transmission |
#pathology #neurology
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neurologic condition worsened by heat
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Multiple Sclerosis
heat = ↓ axona transmission |
#pathology #neurology
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Rining Ears, Dizziness, and Difficulty Hearing
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Meniere's Dz: failure to resporb endolymph
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#pathology #neurology
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Failure to resporb endolymph in the inner ear
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Meniere's Dz:
Triad of Tinnitus, Vertigo and Hearing Loss |
#pathology #neurology
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NF-2
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Autosomal Dominant
Tumor suppressor gene merlin on chrom 22 --bilateral accoustic shwannomas --few cutaneous signs |
#pathology #neurology #neoplasia
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merlin protein
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Autosomal Dominant
NF-2 Tumor suppressor gene merlin on chrom 22 --bilateral accoustic shwannomas --few cutaneous signs |
#pathology #neurology #neoplasia
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Neurons with eosinophilic cytoplasm, no nisssl substance, and pyknosis of nucleus
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Red Neuron
Transient Severe Insult which Will Result in Death |
#pathology #neurology
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Neuron with enlarged body, dispersed nissl substance, and eccentric nucleus
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Axonal Reaction, about to regrow axon
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#pathology #neurology
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Anti-epileptic drug metzd to barbituate
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Primidone
metabolized to phenobarbital and PEMA (phenylethylmalonamide) All 3 compounds are anticonvulsants |
#pharmacology #seizures #neurology
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Primidone
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Anti sieizure drug Primidone
metabolized to phenobarbital and PEMA (phenylethylmalonamide) All 3 compounds are anticonvulsants |
#pharmacology #seizures #neurology
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Lipid containing cells 1 week post stroke
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M∅'s arrive day 3-5
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#pathology #neurology
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Rx: Alzhemier's Demetia
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Central acting Cholinergic enhancers:
Donepezil, Rivastigmin NMDA antagonists: memantidine Antioxidants: Eitamin E |
#pharmacology #neurology
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Lewy Bodies
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Parkinsons & Lewy Body Dementia
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#pathology #neurology #dementia
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Hypotonic Baby dies at 7 mo
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Werdnig Hoffman
infantile spinal muscular atrophy AR degeneration of anterior horn cells LMN involvment only Floppy at birth, dies w/in year |
#pathology #genetics #neurology
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Werdnig Hoffman
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Werdnig Hoffman
infantile spinal muscular atrophy AR degeneration of anterior horn cells LMN involvment only Floppy at birth, dies w/in year |
#pathology #genetics #neurology
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infantile spinal muscular atrophy
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Werdnig Hoffman
infantile spinal muscular atrophy AR degeneration of anterior horn cells LMN involvment only Floppy at birth, dies w/in year |
#pathology #genetics #neurology
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GABAa
GABAb GABAc |
GABAa in brain Cl- Ion Channel
GABAb in brain G protein K+ efflux ↓ Ca2+ influx inhibis cAMP GABAc in Retina Cl- Ion Channel |
#biochemistry #pharmacology #neurology
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GABA synthesis and metzm
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Gluatamte Decarboxylase +B6 (Glutamate → GABA)
GABA transaminase +B6 (GABA → nonfnx something) |
#biochemistry #pharmacology #neurology
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Ventral Spinothalamic Tract
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Light Touch and Pressure Sensation
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#neurology
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Part of Spinal Cord Responsible for Light Touch and Pressure Sensation
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Ventral Spinothalamic Tract
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#neurology
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Lateral Spinothalamic tract
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Pain and Temperature Sensation
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#neurology
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Pain and Temperature Sensation in the Spinal Cord
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Lateral spinothalamic tract
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#neurology
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Stroke: ataxia-hemiplegia
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base of pons
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#neurology #strokes
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Stroke: dysarthria, clumsy hands
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base of parns, or genu of internal capsule
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#neurology #strokes
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Stroke: base of pons
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ataxia-hemiplegia
or dysarthria, clumsy hands (may be genu of internal capsule) |
#neurology #strokes
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Stroke: genu of internal capsule
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dysarthria, clumsy hands (may be base of pons)
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#neurology #strokes
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Distinguishing Neuroleptic Malignant Sro from Serotonin Sro
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Serotonin Sro: Myoclonus
NMS: Rigidity s Myoclonus |
#pharmacology #toxicity
#neurology |
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route of median nerve
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C6-T1
with brachial artery between biceps brachii and brachialis muscle medial aspect of antecubital fossa crosses between humeral and ulnar heads of pronator teres muscle between flexor digitorum superficialis and flexor digitorum profundus muscles enters hand within flexor retinaculum denervation → thenar atrophy, ape hand deformity lost sensation on palmar surface of first 3.5 digits |
#anatomy #neurology
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route of the ulnar nerve
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between olecranon and medial epicondyle "funnybone" injury
between flexor carpi and flexor digitorum profundus injury paralyses intrinsic muscles of hand → claw hand |
#anatomy #neurology
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Gram positive rods found in CSF tap
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Listeria monocytogenes
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#microbiology #neurology
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Gram negative rods found in CSF tap
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E coli
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#microbiology #neurology
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Precocious puberty + Paralysis of Upward Gaze
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Paralyzis of upward gaze = parinaud sro aka dorsal midbrain sro
consistent with tumor in pineal region and germinomas are most common tumor of pineal gland precocious puberty induced by βHCG prodxn may proceed to obstructive hydrocephalus |
#pathology #neoplasia #neurology
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Pineal Tumor
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germinomas are most common tumor of pineal gland
precocious puberty induced by βHCG prodxn Paralyzis of upward gaze = parinaud sro aka dorsal midbrain sro consistent with mass occupying lesion may proceed to obstructive hydrocephalus |
#pathology #neoplasia #neurology
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Spontaeous Intraranial Hemorrhage in a young adult
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likely cocaine (or sympatheticomimetics)
coarctation of aorta → berry aneurysm (htn) [AV malformation] |
#pathology #cardiovascular #neurology
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Characterize eosinophil fnx
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Antibody-dependent cytotoxicity
Eosinophils have an IgE Fx degranulation releases major basic protein eosinophils also contain histaminase which degraes histamine and decreases severity of atopy also leukotrienes and peroxidases which ↑ inflammation |
#immunology
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Hydrocephalus ex vacuo
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hydrocephalus which exists not because of a Δpressure, but rather because the brain has shrunk
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#pathology #neurology
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Nerve Injury
Sign: Flattened Deltoid Nerve, Levels, Cause, Motor & Sensory Deficits? |
Axillary Nerve
C5- C6 Injury: Fx surgical neck of humerus or dislocated humoral head Motor: detloid Sensory: skin over deltoid Sign: Flattened Deltoid |
#anatomy #neurology
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Charcot-Bouchard pseudoaneurysms v Berry Aneurysms
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Charcot-Bouchard
Hypertension Small arteries of basal ganglia & internal capsule <1mm sudden onset of focal deficits from intracerebral hemorrhage in basal ganglia, itnernal capsule, thalamus, and pons Berry (saccular aneurysms) ADPKD, Marfan, Ehlrs-Danlos sros Circle of Willis, APC, or middle cerebral artery Size variable 2-25 mm sudden onset of headache and AMS from subarachnoid hemorrhage |
#pathology #neurology #strokes
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Aseptic Meningitis in Children
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Most commonly Enteroviruses:
Coxsackie virus, echovirus, poliovirus and enterovirus |
#microbiology #neurology
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Otherwise healthy pt unable to tolerate everyday sounds?
Which cranial nerve has been injured? |
Faical: stapedius muscle paralysis → no mitigation of sound "hyperacusis"
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#pathology #neurology
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Describe the neurologic pathway by which the eyes accomodate to light
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optic nerve branches branches to ispilateral pretectal nucleus in superior colliculus
fibers project to both ipsilateral and cotnralateral Edinger-Westphal nuclei, the site of preganglionic PSNS neurons neurons project out within CN3 to ciliary ganglion and then into the eye |
#neurology
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DOC: narcolepsy
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Modafinil
non-amphetamine stimulant not sympatheticomimetic, lower risk for dependency |
#pharmacology #drugs #neurology
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Modafinil
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DOC: narcolepsy
non-amphetamine stimulant not sympatheticomimetic, lower risk for dependency |
#pharmacology #drugs #neurology
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DOC: Trigeminal Neuralgia
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carbapamazine
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#pharmacology #drugs #neurology
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DOC: Absence + Tonic-Clonic
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Valproate
Ethosuximide DOC for Absence, but does not help Tonic CLonic |
#pharmacology #neurology
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Recurrent Lobar Hemorrhagic CNS Strokes
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Lobar = cerebral hemispheres ie not lacunar
most common presentation of cereberal amyloid angiopathy low mortality rate 2° to β amyloid deposition, not related to systemic amyloidosis NB: β amyloid is from amyloid precursor protein, cause of late onset alzhemiers |
#pathology #neurology #rheumatology
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Parkinsoner on levodopa carbidopa
some good days some lock ups wants better medicine routine |
on-off phenomenon
unpredictable and dose independent higher doses have no benefit, nor do drug holidays best prevention: maintaining a constant dose |
#pharmacology #neurology
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Parkinsoner
medicine not working as well as before |
continued destruction of striatonigral DA neurons
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#pharmacology #neurology
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Night Blindness DDx
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Most common cause: hereditary retinitis pigmentosa
Acquired: 1. toxic retinopathy 2° phenothiazines or chloroquine 2. vitamin A deficiency 3. Congenital rubella, syphilis, or infx 4. diabets |
#pathology #neurology
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Internal Capsule Stroke
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Unilateral Motor Deficit
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Thalamus Stroke
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Unilateral Sensory Deficit
dmage to the VPL and VPM nuclei |
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Caudate Nucleus Stroke
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Transietn Hemiparesis and Frontal Lobe Syndromes
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Pons Strok
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Coma, Bilateral Paralysis, Decerebrate Ridigity, Pinpoint Pupils, often death
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1° cause of Lacunar infarcts
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lipohyalinosis and microatheromas
lipohyalinosis is a desctructive vessel lesion characterized by loss of normal architecture, mural foam cells, and fibrinoid vessel wall necorsis microatheromas are masses of lipid laden M∅in intimal layer |
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microatheromas
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with lipohyalinosis, the 1° cause of lacunar infarcts
microatheromas are masses of lipid laden M∅in intimal layer |
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lipohyalinosis
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with microatheromas, the 1° cause of lacunar infarcts
lipohyalinosis is a desctructive vessel lesion characterized by loss of normal architecture, mural foam cells, and fibrinoid vessel wall necorsis |
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