Neurology

Front 1

in neurons - where is nissl lcoated? what protein can you stain for? what does axonal transection?

Back 1

nissl in cell body and dendrites, NOT axon
stain for synaptophysin (protein for presynaptic vesicles)
axonal reaction = enalrged cells, peripheral nuclei and nissl dispersion (changes in cell body)

Front 2

what cells have irregular nuclei and little cytoplasm? with tissue damage, what do they turn into?
what stain doesn't work for them?

Back 2

microglia
turn into large ameboid phagocytes
not readily seen in Nissl stain

Front 3

oligodendroglia - what do nuclei and chromatin and cytoplasm look like?

Back 3

predominant type of glial cell in white matter
nuclei are small
dark chromatin
little cytoplasm

Front 4

which nerves are characteristically unmyelinated? name 3

Back 4

C fibers for slow pain/heat, olfaction, and postganglionic autonomic neurons

Front 5

where are meissner's corpuscle located, what does it sense?

Back 5

in glabrous (hairless) skin, detects poistion, dynamic fine touch (manipulation) and rapidly adapt

Front 6

pacinian corpulscles? where located, what does it detect

Back 6

in deep skin layers, ligaments, and joints
detects vibration, pressure

Front 7

merkel's disk - located where? what does it sense?

Back 7

hair follicles
sense poisiotn, static touch (shapes, edges, textures), adapts slowly

Front 8

what par to fhte nerve must be rejoined in microsurgery for limb reattachment?

Back 8

perineurium
it's a permeability barrier also

Front 9

what are 3 changes of neurotransmitter in anxiety?

Back 9

increase NE, low serotonin and GANA

Front 10

what are the 2 locations of dopamine sytnehsis?what about GABA?

Back 10

dopamine - SNc and ventral tegmentum
GABA- nucleus accumbens (for reward, pleasure, addiciton, fear along iwht septal nuclei)

Front 11

name 3 places with no BBB

Back 11

area postrema, OVLT - osmotic sensing and neurohypophysis for neurosecretory relase of ADH

Front 12

how is vasogenic edema produce?

Back 12

infarctin destory endothelial cell tight junction (can be produced by a tumor)

Front 13

which nucleus makes ADH? oxytocin

Back 13

ADH = SON
oxytocin = paraventricular nucleus (O for the P)

Front 14

what area of the brain does leptin stimulate?

Back 14

ventromedial hypothalamus

Front 15

what does the anterior hypothalamus control? posterior hypothalamus? septal nucleus?
is SCN in hypothalamus

Back 15

anterior = cooling, parasymp mediated
posterior = heating, symp mediated
septal nucleus = sexual urges
SCN is part of hypothalamus

Front 16

how does teh LGN project to occiptal coretx?

Back 16

optic radiations (remember the optic tract ends in the LGN, which sends the meyers loop and dorsal loop)

Front 17

what do the ventral anterior and ventral lateral nuclei of the thalamus do?

Back 17

motor nuclei

Front 18

blood supply of thalamus?

Back 18

posterior communicating, posterior cerebral, ICA (anterior choroidal arteries)
anterior choroidal is a branch directly off ICA (internal carotid), just like the ophthalmic artery

Front 19

name 9 groups of thalamus?

Back 19

anteiror, mediodorsal, VA, VL, VPL, VPM, LGn, MGN, pulvinar

Front 20

what is part of the limbic system?

Back 20

cingulate gyrus, hippocampus, fornix, mammillary bodies
for feeding, fleeing, fighting, feeling, sex

Front 21

in cerebellum, what does middle peduncle do? what about SCP and ICP? what are the mosy, climbing, and purkinje fibers?

Back 21

MCP received cortical input from contralateral cortex.
ICP feed ipsilateral proprioceptive information (input fibers use climbing and mossy fibers).
SCP - provides stimulatory feedback to contralateral cortex to modulate movement (purkinje fires to deep nuclei out to cortex)

Front 22

from lateral to medial name the deep nuclei f cerebellum?

Back 22

dentate, emboliform, globose, fastigial

Front 23

for basal ganglia, what inut does cortex hae? what does the excitatory pathway use as inhibitors? what about indirect?

Back 23

cortex has positive input
direct = GABA, substance P
indirect - GABA, enkephalin

Front 24

what nuclei do both BG pathways go to in order to inhibit the thalamus?

Back 24

GPi/SNr
remember it stars from striatum

Front 25

in the striatum, which is cognitive, which is motor

Back 25

cognitive = caudate
motor = putamen

Front 26

in parkinson's, what is the cell finding? what does it has in it? is teh SNc and SNr lost? What is MPTP

Back 26

cell is lewy body with alpha synuclein
only SNc is lost
MPTP is analogue of meperidine

Front 27

what 2 disease have myoclonus predominantly?

Back 27

epilepsy, CJ disease
also think jerks, hiccups

Front 28

what time of tremor is a essential tremor, how does it occur, what is the inheritance?

Back 28

it is an postural tremor and occurs when holding positions against gravity
AD

Front 29

what is kluver bucy syndrome? what is lesioned?

Back 29

amygdala (bilaterally) is leisoned - hyperorality, hypersexuality,, disinhibited behavior

Front 30

frontal lobe amage may have reemergence of what?

Back 30

primitive reflex

Front 31

damage of right parietal lobe produces ipsilateral or contralateral neglect?

Back 31

contralateral

Front 32

in cerebellar vermis injury, what else do you get besides truncal ataxia?

Back 32

dysarthria

Front 33

lesion of hippocampus damages what?

Back 33

anterograde, not retrograde, amnesia

Front 34

damage of what causes eyes to look contralaterally? what about ipsilaterally?

Back 34

contralaterally = PPRF
ipsilateral = frontal eye fields

Front 35

List the facultative intracellular bacteria.

Back 35

Mnemonic:

Mnemonic: My Liege, Your Niece Lists Frank, Bruce and Sam.

Mycobacterium, Leigonella, Yersinia, Neisseria, Listeria, Francisella, Brucella, Salmonella.

Front 36

in broca's, are they aware of aphasia? can they repeat words?

Back 36

they are aware and have poor repetition

Front 37

in wernickes, what is impaired (3 things)? how do you get visual damage?

Back 37

reading, writing, comprehension
visual damage if stroke impairs optic radiations

Front 38

in global aphasia, what is it like?
in conduction aphasia, what is it like?

Back 38

like wernicke's, but nonfluent

conduction - like broca, but fluent (poor repetition

Front 39

what artery supplies most of the base of brain? what about medial brain?

Back 39

base = posterior cerebral
medial front 2/3 = anterior cerebral

Front 40

aneurysm of what 2 arteries compreses cnIII?

Back 40

PCA, Superior cerebellar

Front 41

lesion of anterior spinal artery causes what?

Back 41

medial medullary sundrome (contralateral hemiparesis, medial lemniscus, ipsilateral paralysis of hypoglossal nerve

Front 42

lateral medullary syndrome?

Back 42

PICA - contralateral loss of pain and temp, ipsilateral dysphagia, hoarseness, no gag reflex, vertigo, diplopia, nystagmus, vomitng, ipsilateral hornoer's, ipsilateral facila pain and temp, trigeminal nucleus (spinal tract and nucleus), ipsilateral ataxia
basically CN 9, 10, spinal tract V, spinothalamic, ipsilateral cerebellar sings

Front 43

AICA damaged whats?

Back 43

lateral infeiror pontine syndrome
ipislatareal facial paralysis, ipsilateral cochlear nucleus, nystagmus, ipsilateral facial pain and temp, ipsilateral dystaxia (middle and inferior cerebral peduncle)
basically CN 7, 8, ipsilateral cerebellar signs

Front 44

where do the lenticulostriate arteries fo rthe internal capusle come from?

Back 44

MCA

Front 45

most common location of berry aneurysm?

Back 45

Anterior communicating artery, which can compress optic chiasm

Front 46

lateral striate artery supplies what?
what happens if you stroke posterior internal capusle

Back 46

internal capsule, caudate, putamen, GP (basal ganglia)
note if you infarct posteiror limb of internal capusl,e pure motor hemiparesis

Front 47

the basal artery supplies what part of brain? what can stroke cause?

Back 47

supplies pons - cause slocked in syndrome with CN 3 and 4 intact (interrupts corticobulbar, corticospinl
tegmentum of pons is spared and you can blink cause you relax levator palpebrae

Front 48

charcot bouchard aneurysms affect what

Back 48

small vessels in basal ganglia, thalamus
from HTN chronically

Front 49

T of epidural hematoma shows what? does it cross suture line? falx? tentorium?

Back 49

shows ciconvex disk
can't cross stureu line, but can cros falx, tentorium

Front 50

subdural - CT shows what? does it cross suture line, fal, tentorium? what is a hygroma?

Back 50

CT shows crescent shaped bleed
crosses sture lines, but not falx or tentorium
hygroma - CSF replaces blood

Front 51

subarachnoid causes? what does spinal tap show? what is a complociation and how do you treat it?

Back 51

aneurysm or AVM (bleeding in cerebrum that occurs in early adulthood). exanthocrhomic spinal tap. risk of vasospasm lateral 9treat iwth CCBs)

Front 52

parenchymal bleed - caused by what? where does it occur?

Back 52

hypertension (hyaline arteriosclerosis-->charcot-bouchard), amyloid angiography with lobar strokes (parietal lobe), DM.
occurs in basal ganglia and internal capsule

Front 53

anterior limb of internal capsule has what? genu? posterior limb?

Back 53

anteior limb - spearates caudate from lentiform
genu - corticobular tract
psoterior limb - thalamus from lentiform

Front 54

most vulnerable areas of brain to hypoxia

Back 54

hippocampus (pyramidal cells, first damaged), enocortex, purkinje cells of cerebellum, watershed areas (wedge shaped infart)

Front 55

what are signs of irreversible neuronal injury?

Back 55

red neurons within 12-48 hours (loss of Nissl, pyknosis, eosinophilia of cytopalsm
necrosis and neurtrophils 1-3 days
macrophages 3-5 days
reactive gliosis and vascular prolfieration 1-2 weeks
scar >2 weeks

Front 56

stroke imaging - what does it look like on MRI between 3-30 minutes and how long does it stay that way? what about CT

Back 56

bright on diffusion weighted MRI, stays like that for 10 days
dark on CT in 24 hours

Front 57

what does the cavernous sinus receive blood from?

Back 57

The cavernous sinus receives the superior ophthalmic vein through the superior orbital fissure, some of the cerebral veins, and also the small sphenoparietal sinus, which courses along the under surface of the small wing of the sphenoid.

Front 58

colloid cysts? what is it? what does it have in it?

Back 58

from misplaced endoerm that have mucin in cells
it obstruct CSF flow

Front 59

in nomrla pressure hydrocephalus, what are the characteristics? what fibers or messed up? what are the first symptoms?

Back 59

urinary incontence and ataxia are first symptoms. then dementia, though reversible.
incontinence = loss of cortical inhibition on sacral micturition

Front 60

vertebral disk herniation happen show? where does it occur most? what is impinged?

Back 60

nucleus puposus herniated through anulus fibrosus
L5-S1
injures spinal nerve

Front 61

where does the subarachnoid space extend to in the spinal cord?

Back 61

S2 (cord goes to L2)

Front 62

what do you go through for an LP?

Back 62

skin
ligaments (supraspinous, interspinous, interlaminar in lumar region only)
epidural
dura mater
subdural
arachnoid

Front 63

in lateral corticospinal tract and spinothalamic tract, where are arms and legs located?

Back 63

legs are lateral, arms are medial

Front 64

cauda equine syndrome?

Back 64

rupture of intervertebral disc and compresses those nerves - get saddle anesthesia, loss of bowel/bldder function, sciatica. damage to S2-4 = loss of anocutanoeus reflex

Front 65

UMN or LMN:
weakness? atrophy? fasciculation?
spastic paralysis?

Back 65

weakness is both
atrophy = LMN
fasciculation = LMN
spastic paralysis (hard to passive move limbs) = UMN

Front 66

where does poliovirus replicate?

Back 66

oropharynx, throat

Front 67

how is werdnig-HOffman inherited? what does the tongue do? when do they die?

Back 67

AR, tongue fasciculation, death at 7 months of age

Front 68

what does riluzole do?

Back 68

inhibits glutaminergic transmission in ALS

Front 69

in anterior spinal injury, what is spared (2 things)? why is upper thoracic ASA territory a watershed region?

Back 69

sparing of dorsal columsn and tract of lissauer
watershed cause artery of adamkkieicz supplies ASA below T8
Dorsolateral (posterolateral) fasciculus (Lissauer's tract) at the apex of the dorsal horn consists of short ascending and descending Aδ and C dorsal root fibers carrying pain and temperature sensations. Each branch gives off numerous collaterals that synapse in the dorsal horn.situated near posterior nerve roots.

Front 70

vitamin B12 neuropathy - what are mimickers? can you have lhermitte's sign? what are demyelianted?

Back 70

vitamin E and friedreich's ataxia are mimickers
yes to lhermitte's sign
demyelinated - dorsal columns, lateral corticospinal tract, and spinocerebellar tracts

Front 71

tabes dorsalis - what's affected, what kind of pain, sensory ataxia occurs when?

Back 71

in dorsal column and dorsal root (not ganglia?), pain is shooting, sensory ataxia at night

Front 72

friedreich's ataxia - chromosome? inheritance? funcitonal defect? characteristics?

Back 72

chromsome 9, AR, defec tin mitochondria
spinal cord degeneration (DRG degernate, causing transypantic degernation in dorsal column), also spinocerebellar tract degeneration. leads to pes cavus, hammer toes, nystagmus, kyphoscoliosis in childhood

Front 73

if brown sequard occurs above T1, what else will you see?

Back 73

horners syndrome

Front 74

what muscle does SNS innervate to open eyelid? in horner's, what happens to face?what is it assoicated with?

Back 74

SNS innervates suprior tarsal muscle
face is blushed without vasomotor action
ue to pancoast's tumor, brown sequard, late stage syringomyelia

Front 75

what is the 3 neuron arc from hypothalamus to the face? At what level is superior cervical ganglion

Back 75

hypothalamus-->intermediolateral column of spinal cord--> superior cervical ganglion AT T1--> pupil, eyelids, sweat glands
T1 - that's why lesion above it causes horners

Front 76

landmarks - C2, C3, C4, T7, L1, L4, S2-4

Back 76

C2 - posterior half o fskull cap (V1 is anterior)
C3 - high turtle neck
C4 - low collar shift
T7 - xiphoid process
L1 - inguinal ligmanet
S2-4 = erection and sensation of penile and anal zones
gallbladder/diaphragm referred to shoulder cause of phrenic nerve

Front 77

muscle spindle have what inside? what do they monitor? how are they arranged with extrafusal muscles (the ones that produce tension)

Back 77

muscle spindles contain intrafusal muscle fibers for monitoring muscle length
they are arranged in parallel with extrafusal fibers

Front 78

describe the muscle stretch arc (knee jerk reflex)

Back 78

muscle stretch--> intrafusal stretch--> Ia afferent--> dorsal horn--> stimulates alpha motor neuron--> reflex extrafusal contraction

Front 79

what does teh golgi tendon monitor? what kind of feedback does it produce? what is a pathologic extreme?
what is the afferent nerve and how is it aranged in relation to intrafusal muscles?

Back 79

monitors muscle tension
produces negative feedback (inverse myotactic reflex)
extreme example is clasp knife reflex
arranged perpendicularly to intrafusal fibers and use Ib as afferent arc

Front 80

what is the gamma motorneuron loop?

Back 80

it's a way to increase sensitivity of refle arc. the CNS stimultes the gamma motoneuron which contracts the intrafusal fiber at the central part of the muscle spindle to increase sensitiviyt of the reflex arc

Front 81

what muscles plantarflexthe ankle in the achilles reflex? what are the innervation

Back 81

peroneus longus, brevis and tibilar posterior
the first 2 are innervated by superficial peroneal

Front 82

what is the suckling reflex? and palmar/plantar reflexes?

Back 82

sucking - sucking response when roof of mouth is touched
palmar/plantar = curling of digits if the palms/soles are stroked

Front 83

how dose CN IV arise?

Back 83

from teh dorsum of the brian an dimmediately decussates

Front 84

trapezius shurgg shoulder and also does what?

Back 84

abduct arm post horizontal

Front 85

what line separate medial nuclei (motor basal plate) from lateral nuclei 9sensory alar plate)

Back 85

sulcus limitans

Front 86

lacrimation reflex?

Back 86

afferent = V1 (loss of reflex does not preclude emotional tear), efferent = 7

Front 87

corneal reflex - what is the specific branch of V1 that is afferent? what about efferent?

Back 87

afferent = nasociliary branch of V1, efferent = temporal branch of 7

Front 88

vagal nuclei - solitarius? ambiggus, dorsal motor nucleus?

Back 88

solitarius -= visceral sensory (taste, barorceptors, gut distention) from 7, 9, 10
ambiguus = motor of pharyn, larynx, upper esophagus for 9 (stylopharyngeus), 10
Dorsal motor nuclues - autonomic fibers to heart, lungs, upper GI

Front 89

what foramen does opthalmic artery and vein enter? what about sympathetic fibers?

Back 89

opthlamic arteyr = optic canal
vein = superior orbital fissure
symp fibers = suprior orbital fissure

Front 90

which nerve is free flaoting in cavernous sinus? which is the most medial? which nerve specifically is not part of it?

Back 90

both are cranial nerve 6
V3 is not there, but V2 is

Front 91

CN 5 lesion, what happens to jaw?

Back 91

deviates toward side of lesion. note lateral pterygoid muscle has bilateral cortical input

Front 92

UMN lesio of the facial tract causes contralateral parslysis fo what?

Back 92

lwoer face only

Front 93

bell's palsy causes?

Back 93

AIDS, lyme disease, herpes zoster, sarcoidosis, tumors, diabetes

Front 94

what does genioglossus do? palatoglossus?

Back 94

palatoglossus elevates tongue. genioglossus protrudes tongue

Front 95

what 2 parts of cochlea have perilymph? what is it rich in? what has endolymph

Back 95

scala media has endolymph (K)
scala vestibuli and tympani have perilymph (na)

Front 96

within the bony labyrinth, the membranous labyrinth has mostly what?

Back 96

endolymph, has cochlear duct, utricle, saccule (within the vestibule), and semicrulcar canals

Front 97

what is the organ of corti

Back 97

basically the hair cells, which exists in vestibular appartus and cochlea

Front 98

what makes endolymph?

Back 98

stria vascularis

Front 99

utricle detects what, saccule? what device do they have for this?

Back 99

utricle = horizontal
saccule = vertical
both contain maculae

Front 100

seimicrcular canals contain what?

Back 100

ampullae for angular acceleration

Front 101

the hair cells are on waht? what about the cilia?

Back 101

hair cells in the basilar membrane and cilia are embedded in the tectorial membrane. basilar membrane VIBRATES and causes bending of the hairs

Front 102

what 2 parts does the basilar membrane separate?

Back 102

scala tympani and media

Front 103

in the basilar membrane - where is low frequencies detected?

Back 103

low frequencies (high wavelength) are detected near the apex at helicotrema, where scala tympani and vestibuli meet (vestibuli starts at the oval window)

Front 104

in conductive hearing loss, how does weber lateralize? what about rinne test?

Back 104

weber lateralizes to the affected ear and rinne test shows bone conduction > air conduction
opposite for sensorineural

Front 105

the fovea has lots of what? what is the blood supply?

Back 105

has lots of cones, 1:1 ratio of photoreceptors to bipolar cells
blood supply from choroid vessels

Front 106

what receptor in eye causes miosis? what causes mydriasis. what produces aqueous humor? wat causes accomodation?

Back 106

miosis = M3
mydraisi = alpha1
humor = B (from ciliary process
accomodation = M3

Front 107

what happens to optic disk in glaucoma? what are risk factors for open angle?

Back 107

cupping of the optic disk
asscoaite with myopia, age, african american race

Front 108

what are risk factors for cataracts?

Back 108

age, smoking, ehtanol, sunlight, galactosemia, galactokinase defciency, diabetes, trauma, infection
decreased color perception and increased glare (poor night driving)

Front 109

what is the sign of papilledema

Back 109

blurred margins at the optic disk, bigger blind spot

Front 110

where is the infraorbital nerve? what was it before? what does it do?

Back 110

was part of maxillary nerve
at the base of the orbit
This nerve innervates the lower eyelid, upper lip, and part of the vestibule and exits the infraorbital foramen of the maxilla.

Front 111

what are the 3 actions of superior oblique

Back 111

The primary (main) action of the superior oblique muscle is intorsion (internal rotation), the secondary action is depression (primarily in the adducted position) and the tertiary action is abduction.

Front 112

what is the pathway for constriction of eye? for dilation?

Back 112

constriction - CNIIII from E-W nucleus to ciliary ganglion
dilation = T1 preganglionic sympathetic to superior cervical ganglion to pontganglionic sympathetics to long ciliary nerve

Front 113

what kind of defect is the Marcus Gunn pupil
what is the pathway?

Back 113

afferent pupillary defect (optic nerve damage or retinal detachment
light in nerve goes bilatareally to pretectal nucleus to E-W nucleus

Front 114

where are the parasympathetics located in CN III? what primarily affects the motor ouptut?

Back 114

parasymp are located peripherally
in center, affected by diabetes!

Front 115

where are the parasympathetics located in CN III? what primarily affects the motor ouptut?

Back 115

parasymp on the outside
motor ouput affected by diabetes due to decreased diffusion t ointerior!

Front 116

what lesions can cause upper and lower quandrantopia?

Back 116

MCA lesions

Front 117

in internuclear ophthlamoplegia, what happens to the abducitng eye? which nucleus fires when looking left?

Back 117

contralateral nystagmus
if looking left - right MLF contracts right MLF

Front 118

in progressive supranuclear palsy, what are the symptoms? what happens to neurons?

Back 118

opthalmoplegia, pseudobulbar palsy, axkal dystonia, bradykinase
widespread neuronal loss and gliosis subcortically
sprares cerebral and cerebellar cortices
can't look up

Front 119

in Alzheimers, what genes are associated? what are tau proteins? what other bodies are seen?

Back 119

APP = 21, presenilin-1 = 14, presenilin-2 = 1
tau proteins are intracellular phopshyrlated cytoskeletal elements
hirano bodies (cytopalsmic actin) and granulovasculolar degernation also seen

Front 120

what are the characteristics of Pick's disease
what is a pick body

Back 120

dementia, aphasia, parkinsonian aspects with change in perosnality (behavioral disnhibition). spares parietal lobe and posterior 23 of superior temporal gyrus
pick body = tau protein

Front 121

in lewby body dementia, what accompnies parkinsonism and dementia? what is protein aggregated

Back 121

hallucinations are characterisitc
lewy body is alpha synuclein or ubiquitin

Front 122

2nd most common cause of dementia?

Back 122

multi infarct

Front 123

MS is what kind of autoimmune disease? what has to optic nerve? motor or sensor or both? what protein is increased in CSF? what kind of tremor? what kind of speech?

Back 123

Th1 response
optic neuritis
both motor and sensory (demyelinating
IgG is increased
intention tremor
scanning speech (sound drunk)

Front 124

in Guillain Barre, what happens to the motor roots (and some sensory). is it consistent?what are autonomic effects? what is CNS finding? what infections are associatied? treatment?

Back 124

demyelination that is patchy and segmental and endoneurial inflammation
autonomic instability (cardiac, HTN, hypotension)
CNS = albuminocytologic dissociation (increased protein wiht normal cell count causing papilledema)
Campylobacter and herpes associated
give plasmapharesis and IvIg

Front 125

in PML, is infection in AIDS primary or reactivation?

Back 125

reactivation?
destroys olgiodendrocytes

Front 126

acute disseminated postinfecitous encephalomyelitis?

Back 126

multifocal perivenular demyelination post infections (chickenpox, measles) or vaccination (rabies, smallpox)

Front 127

metachromatic leukodystrophy is an AR lysosomal storage disease that leads toa deficiency of what?

Back 127

myelin

Front 128

charcot-marie-tooth - motor or sensory? deficits in what? what do legs look like

Back 128

motor and sensory
defective proteins in structure and funciton of nerves an dmyelin
store like appearance if damage to anterior compartment

Front 129

what are partial versus generalized seizures? where do most partial seizures begin?

Back 129

partial seizures begin focally
simple seizures have no loss of consciousness
partial seizures often begin in mesial temporal lobe with aura

Front 130

in absence sezireus (a generalized seizure) what is the hertz and wave look like?

Back 130

3 hz
spike and slow wave

Front 131

what are casues of seizures as kids? adults? elderly?

Back 131

kids = genetic, infections (febrile), trauma, congenital, metabolic
adults - tumors, trauma, stroke, infection
eldelry - stroke, tumor, trauma, metabolic infection

Front 132

migraines - unilateral or bilateral? how long? what are some symptoms? what is an aura? cause of migraines? treatment?

Back 132

unilateral
4-72 hours
symptoms = nausea, photophobia, phonophobia
aura = neurologics symptoms including ivsual, sensoyr, speech disturbances
cause = CNV irritation and release of substance P, CGRP, vasoactive peptides
treat - propranolol, NSAIDS, sumatriptan

Front 133

tension headaches - uni or bilateral?

Back 133

bilateral
no aura

Front 134

cluster headaches - uni or bilateral? what kind of pain? what symptoms?treatment?

Back 134

unilateral
brief heaches, periorabitla pain, lacirmaiton, rhinorrhea, horner's syndrome
treat with sumatriptan

Front 135

peripheral vertigo - more or less common, what are 2 causes? what does positional testing show?

Back 135

more common than central
semicircular canal debris, meniere's disease (tinnitus, vertigo, sensorineural hearing loss, due icrease endolymph
positonal testing shows delayed horziontal nystagmus

Front 136

what does central vertigo show on positional testing?

Back 136

immediate nystagmus in any direction and may change positions

Front 137

what neurocutaneous disorder besides NF is associated with pheochromocytomas, glaucoma, mental retardation?

Back 137

sturge weber

Front 138

what conditoin is associated with subependymal giant cell astrocytoma, mitral regurgitation, angiofibromata?

Back 138

tuberous sclerosis
sebaceous adenoma - papules that are red/brown

Front 139

neurofibromas have what on exam?

Back 139

buttonholing (right hrough the skin)

Front 140

what condition has congenital cysts of liver pancreas, kidney along with hemangiomas of the skin and mucosa?

Back 140

VHL

Front 141

antoni A and B bodies seen in what tumor?

Back 141

schwannoma
A = highly cellular

Front 142

oligodendroglioma? fast or slow growing? what is the capillary pattern? where is it located?
what do the cell slook like

Back 142

slow groiwng
chicken wire capilaries
round nuclei with clear cytopalsm, often calcified

Front 143

pilocytic tumor - cystic or solid? what are rosenthal fibers?

Back 143

cystic and solid
spindle cells, hair lik eprocesses, rosenthal fibers are corkscrew fibers that are eosinophilic

Front 144

medulloblastoma - derived from what? where is it located? treatment modality?

Back 144

neurla and glial tumor
in cerebellum, can compress 4th ventricle
rosettes and pseudorosettes (small blue cell tumor = PNET), radiosensitive

Front 145

what are the cahracteristic findings in ependymoma?

Back 145

perivascula rpseudorosettes, rod shaped blepharoplasts (basal ciliary bodies) found near nucleus

Front 146

what is the most common kid supratentorial tumor? how many components does it have?

Back 146

cranipharyngioma
has solid, cystic, calcified components

Front 147

in a subfalcine herniation, what is comprossed?

Back 147

ACA via the cingulate gyrus

Front 148

in uncal herniation, what nerve is compressed? what 2 artery? why is there a false localized sign?

Back 148

CN3 compressed (dilated pupil and ptosis)
ipsilateral PCA
kernohan's notch is compression of contralateral crus cerebri (ipsilateral paresis)
duret hemorrhages from paramedian arteyr rupture (basilar artery - caused by caudal displacement of brian stem)

Front 149

arnold chiari - which type is asymptomatic in infants and can present late in adults. just the tonsils herniate?

Back 149

type I - which is more common

Front 150

heterogeneously enhancin glesions? unifrmonly enhancing? ring enhacing?

Back 150

heterogeneous = glioblastoma
uniformly - lymphoma, meningioma
ring enhancing - toxo, AIDS lymphoma, abscesses, mets

Front 151

how do epinephrine and brimonidine trat gluaucoma?

Back 151

epi vasoconstrict wiht alpha 1, brimonidine is alpha 2 agonist (andno pupillayr or vision changes!)

Front 152

which glaucoma drugs are used in emergencies?

Back 152

IV acetazolamide
pilocarpine

Front 153

receptor for dynoprhin, enkephalin?

Back 153

dynoprhin = kappa
delta = enkephalin

Front 154

which drug do you use for cough suppression? diarrhea? acute pulmonary edema? gallstones or pancreatitis?

Back 154

cough = dextromethorphan
diarrhea = loperamide and diphenoxylate
gallstones = meperidine

Front 155

which symptoms do you not build tolernace to for opiods?

Back 155

miosis and constipation

Front 156

what is butophanol? what are other alike agents?

Back 156

partial agonist at mu and kappa receptors, causes less respiraotyr depression (really it's an agonist at kappa, antagonist at mu). like pentazocine, nalbuphine. buprenorphine is a true partial agonist

Front 157

tramadol MOA?

Back 157

very weak opiod agonist, also inhibits serotonin and NE (work son many neurotransmitters?

thus can be used for mild to moderate pain

Front 158

pentazocine?

Back 158

for analgesia without abuse, partial agonist at mu

Front 159

what is the equivalen tof phenyotin for parenteral use? what is DOC for tonic clonic, partial seziures?

Back 159

fosphenytoin
carbamazepin, also good for trigeminal neuralgia and bipolar (blocks sodium channel)

Front 160

gabapentin - MOA?
topiramate MOA?

Back 160

not GANA agonist, it inhibits HVA (high voltage activated) calcium channels
dopiramate - blocks Na/ increases GABA

Front 161

what drug is good for pregnant women for epilepsy? what is it a metabolite of?

Back 161

phenobarbital
primidone i smetabolize dinto phenobarbital and PMEA (all active anticonvulsant)

Front 162

first line for acute status epileptic? for prophylaxis? for eclampsia seizures?

Back 162

for status - give benzos
for prophylaxis - give pheyntoin
for preecampsia - benzos (diazepam, lorazepam)

Front 163

how do tiagabine, vigabatrin work?

Back 163

tiagabine - inhibits gABA reuptake
vigabatrin - inhibits GABA transaminase irreversibly

Front 164

toxicity of carbamazepine?

Back 164

agranulocytosis, aplstic anemia, livery toxicity, indcer, SIADH, stevens Johnson

Front 165

phenytoin side effects?

Back 165

nystagmus, gingival hyperplasia, hirsutism, megaloblastic anemia, fetal hydantoin syndrome, SLE like syndrome, gneeral lymphadenopathy (pseudolymphoma)

Front 166

valproic acid - side effects? what is good about it?

Back 166

thrombocytopenia, hepatotoxic, weight gain
but it's non sedating

Front 167

what are the 3 causers of stevens Johnson

Back 167

lamotrigine, carbamazepine, ethosuximide (laise and fever followed by erythematous macules in mouth, eyes, genitals. then slouging of skin

Front 168

side effects of topiramate?

Back 168

mental dulling, kidney stones, but weight loss

Front 169

fetal hydantoin syndrome?

Back 169

Fetal Hydantoin Syndrome is a rare disorder that is caused by exposure of a fetus to the anticonvulsant drug phenytoin (Dilantin). The symptoms of this disorder may include abnormalities of the skull and facial features, growth deficiencies, underdeveloped nails of the fingers and toes, and/or mild developmental delays. Other findings occasionally associated with this syndrome include cleft lip and palate, having an unusually small head (microcephaly) and brain malformations with more significant developmental delays.

Front 170

which benzos are short acting? which used in status epilepticus? which are long acting?

Back 170

short acting = triazolam, oxazepam, midazolam, alprazolam.
long acting 0 chlordiazepoxide, flurazepam, diazepam

Front 171

which drugs have rapid induction and recovery? which drugs are most potent? what is the effect of a large AV concentration gradient?

Back 171

rapid induction and recovery = low blood solubility
potency = increased lipid solubility
large AV = slower onset of action (more gas required to saturate tissue)

Front 172

inhaled anesthetics do what to cerebral blood flow? which is hepatotoxic? nephrotxoci? proconvulsant? expansion o ftrapped gas?

Back 172

increase cerebral blood flow
halothae is hepatotoxic
methoxyflurane is nephrotoxic
enfluranc eis a proconvulsant
N2O can be trapped in gas
other toxicities = myocardial depression, hypotension, resp depression

Front 173

thiopental effect on cerebral blood flow? is it hihgly lipid soluble?

Back 173

decreases cerebral blood flow
high potency high lipid solubililty (remember it redistributes to fat)

Front 174

midazolam is used for what?

Back 174

benzo for endoscopy, adjunct iwth gas anesthetics

Front 175

ketamine is a type of what class of drug? how does it interact iwht morphine
what does it do to CV system? cerebral blood flow?

Back 175

arylcyclohexylamine, a PCP analogue, dissociative anesthetic
blocks NMDA receptives to decrease morphine tolerance.
CV stimulant, hallcuinations, bad dreams, increases cerebral blood flow

Front 176

what is MOA of propofol?

Back 176

rapid anesthesia induction for short procedures tha tpotentiates GABA

Front 177

how do local anesthetics work? how do tertiary amines work?

Back 177

block Na channels
teritary amines penetrate membrane uncharged, then bind to ion channels as charged form

Front 178

local anesthetics - what nerves do they afect most? why is acidic environment bad? which sensation do you lose first an dlast?

Back 178

affect smaller fibers and myelianted fibers most (small myelinated>small unmeylianted>large myelianted, etc.)
acid charges basic anesthetics and can't penetrate membranes
you lose pian first, then temp, then touch, last is pressure

Front 179

toxicity for bupivacaine? other local anesthetic toxicities?

Back 179

bupivicaine = CV toxicity
can cause CNS excitation, hypertension ,hypotension, arrhythmias (cocaine)

Front 180

complciation sof SUX

Back 180

hypercalcemia, hyperkalemia (do to depolarzing nature which makes potassium efflux), so very bad in burn patietns, spinal cord injury

Front 181

phase I v. phase II

Back 181

phase I = no antidote, block potentiated by cholinesterase inhibitor
phase II - repolarized by blocked, antidote consists of cholinesterase inhibitors

Front 182

all inhalation anesthetics can caus emalignant hyperthermia except?

Back 182

N2O

Front 183

what are the ergot alkaloid? non ergot? which are better?

Back 183

ergot = bromocriptine, pergolide
non ergot = pramiprexole, ropinirole
non ergots are preferred

Front 184

entacapone and tolcapone? what do they do, where do tehy work?

Back 184

inhibit COMT, inhibit peripheral metabolism

Front 185

benztropine has little effect on what?

Back 185

bradykinesia, but helps tremor and rigidity

Front 186

what are the toxicities of peripheral carbidopa

Back 186

nausea, arrhthmias, hypotention, hot flashs
not anxiety affecting

Front 187

memantine blocks what? what si another vitamin for alzheierms

Back 187

NMDA blocker (ligand and voltage gated channel that lets Ca and na through. depoalrization releases magnesium)
vitamin E is also good

Front 188

what are the huntingdon drugs?

Back 188

reserpine and tetrabenazine - amine depleting
haloperidol - dopamine antagonist

Front 189

sumatriptan half life? uses?

Back 189

<2 hour half life
use for migraines and cluster headaches

Front 190

alzheimer anti-AChesterase drugs?

Back 190

donepezil, galantamine, rivastigmine

Front 191

dopamine agonsits work mostly on which receptor?

Back 191

D2