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153 Cards in this Set
- Front
- Back
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Schwann cells: origin
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Neural crest
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Microglia: origin
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Mesoderm
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Macrophages: origin
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Mesoderm
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ACh: synthesis
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Basal nucleus of Maynert
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GABA: synthesis
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Nucleus accumbens
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Nucleus accumbens and septal nucleus
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Reward, pleasure, addiction, fear
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How do glucose and AA's cross BBB?
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Slowly: carrier mediated
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Vomiting after chemo?
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Area postrema (fenestrated capillaries, no BBB)
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Osmotic sensing?
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OVLT
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3 areas of no BBB, just fenestrated capillaries
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- area postrema
- OVLT - neurohypophysis |
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Functions of HTH:
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TAN HATS
Thirst and water balance Adenohypophysis control Neurohypophysis release of hormones Hunger Autonomic regulation Temperature contol Sexual urges |
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Inputs to HTH:
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- OVLT - senses change in osmolality
- area postrema - responds to emetics |
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Propensity to fall towards ipsilateral side: controlled by...
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Medial part of cerebellum
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Brain lesion of what would lead to Wernike-Korsakoff
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Mamillary bodies (bilateral)
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Anterograde amnesia
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Can't make new memories
Hippocampus |
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Rapid correction of hyponatremia -->
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Central pontine myelinolysis
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MRI of central pontine myelinolysis -->
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Increased signal in pons
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Infarct lateral striate
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Pure motor hemiparesis
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Parenchymal hematoma: typical location
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Basal ganglia
Internal capsule |
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Kallmann's syndrome: defect
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Failure of GnRH secreting neurons to migrate from olfactory lobes to hypothalamus
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Kallman's syndrome: clinical
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- anosmia
- lack of secondary sexual characteristics |
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Xanthochromia indicates...
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Subarachnoid hemorrhage
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Anterior spinal artery: associated syndrome
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Medial medullary syndrome
- contralateral hemiparesis - medial lemniscus (contralat proprioception) - ipsilateral hypoglossal |
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PICA: syndrome
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Lateral medullary syndrome
Wallenberg's - vestibular --> vertigo - ICP --> ataxia |
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AICA: syndrome
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Lateral inferior pontine syndrome
- ipsilateral facial paralusis - ipsilateral cochlear nucleus - vestibular - ipsilateral facial pain & temp - ipsilateral dystaxia (ICP, MCP) |
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CNIII Palsy: Where?
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PComm
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Locked in syndrome: Where?
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Basilar artery
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Vision info goes to....
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Calcarine sulcus
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Auditory info goes to...
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Auditory cortex of temporal lobe
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Infarction destroys endothelial cell tight junctions -->
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Vasogenic edema
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Ischemic brain disease: irreversible after ... mins
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5 mins
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Areas most vulnerable to ischemic brain disease
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His New Cerebellum Withers
Hippocampus Neocortex Cerebellum Watershed areas |
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CSF return from arachnoid granulations -->
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Superior sagittal sinus
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Foramen of Luschka and Magendie lead into...
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Subarachnoid space
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Normal pressure hydrocephalus: triad
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Wet (urinary incontinence)
Wobbly (ataxia) Wacky (dementia) |
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Postmeningitis arachnoid scarring -->
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Communicating hydrocephalus
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Vertebral disc herniation - usually between:
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L5-S1
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Adult lumbar puncture between:
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L3 - L5
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Poliomyelitis: CSF findings
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- lymphocytic pleocytosis
- slight inc protein |
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Poliomyelitis: virus recovered in...
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throat or stool
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Werdnig-Hoffman disease:
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LMN disease in children
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ALS: defect in...
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Superoxide dismutase 1
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ALS: Rx
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Riluzole
- lengthens survival by decreasing presynaptic glutamate release |
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Watershed area of ASA:
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Upper thoracic
- Artery of Adamkiewicz supplies below T8 |
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Friedrich's ataxia: gene encodes...
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frataxin
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Three probs causing demyelination of:
- Dorsal column - Spinocerebellar - Lateral corticospinal tracts |
- Vit B12 deficiency
- Vit E deficiency - Friedrich's ataxia |
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Friedrich's ataxia - cause of death:
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Hypertrophic cardiomyopathy
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Diaphragm and gallbladder pain refer to...
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Right shoulder
via phrenic nerve |
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Parinaud syndrome
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Paralysis of conjugate vertical gaze
Due to: lesion in superior colliculi (ie: pinealoma) |
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Only CN without thalamic relay to cortex
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CN I
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Which CN monitors carotid body & chemo- and baroreceptors?
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CN IX
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Which CN elevates pharynx, larynx?
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CN IX (stylopharyngeus)
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Which CN monitors aortic arch chemo- and baroreceptors?
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CN X
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Which CN is responsible for palate elevation?
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CN X
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Which CN is responsible for innervating thoracoabdominal viscera?
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CN X
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Which CN controls lacrimation?
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CN VII
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Which CN is responsible for a midline uvula?
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CN X
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Bell's Palsy: associated conditions
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AIDS
Lyme HSV (most common) Sarcoidosis Tumor Diabetes |
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Muscle that opens mouth
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Lateral pterygoid
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Retinitis
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Retinal necrosis and edema --> atrophic scar
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Macula blood supply
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Choroid artery
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Pale retina and cherry-red macula: means??
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Retinal artery occlusion
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Cornea and lens: nourished by?
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Aqueous humor
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Acute
Painless Complete loss of vision in one eye |
Retinal artery occlusion
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Causes of cataracts
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TEASeD and GIGgleS at the guy with cataracts
Trauma EtOH Age (most common) Smoking Diabetes (sorbitol - osmotic) Galactosemia Infection (rubella) Galactokinase deficiency Sunlight |
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CNIII Palsy: Clinical
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- down and out
- ptosis - pupillary dilation - loss of accomodation (unopposed sympathetics) |
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CN IV damage: Clinical
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vertical diplopia
probs: - reading newspaper - going down stairs |
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Marcus Gunn pupil
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afferent pupillary defect
- optic nerve damage - retinal detachment dec bilateral pupillary constriction |
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Pupil parasympathetic output affected by:
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Compression
- PCA berry aneurysms - Uncal herniation |
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Pupil output to ocular muscles affected by:
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Vascular disease
- Diabetes (glucose --> sorbitol) |
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Retinal detachment: vision loss due to...
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Degeneration of photoreceptors
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Scotoma
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Loss of central vision (macular degeneration)
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Pick's disease: histology
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Pick bodies (intracellular, aggregated tau protein)
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Lewy bodies:
- found in... - made of... |
Parkinson's
Lewy Body dementia a-synuclein |
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Difference between Lewy body dementia and parkinsonism
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Lewy Body Dementia =
Parkinsonism + dementia + visual hallucinations |
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Other causes of dementia
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B12 deficiency
Wilson's disease Multi-Infarct HIV Syphillis |
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Multiple sclerosis: Triad
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SIIIN
Scanning speech Intention tremor Incontinence Internuclear opthalmoplegia Nystagmus |
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Multiple sclerosis: Findings in CSF
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inc protein (IgG)
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Multiple sclerosis: gold standard
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MRI
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Multiple sclerosis: HLA
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D2
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Multiple sclerosis: Treatment
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beta-interferon
immunosuppressant |
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Guillain-Barre: treatment
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RESPIRATORY SUPPORT
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Guillain-Barre: associated microorganisms
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CCHHE
Campylobacter CMV HSV HIV EBV |
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PML: pathogenesis
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demyelination of CNS due to destruction of oligodendrocytes
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Metachromic leukodystrophy: deficiency of...
Leads to buildup of... |
I MET LEU. ALright!
Arylsulfatase A --> sulfatides |
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Metachromic leukodystrophy: impairment
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Can't produce myelin sheath
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Migraine: how long
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4-72 hours
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Migraine: irritation of what nerve
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CN V
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Cluster headache: periorbital pain associated with...
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ipsilateral
- lacrimation - rinorrhea - Horner's |
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Cluster headache: more common in who
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Males
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Meniere's disease: pathogenesis
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inc endolymph in inner ear
--> loss of cochlear haires --> sensorineural hearing loss |
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Neurofibromatosis I (von Recklinghausen's disease)
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NF1 COOL
Neurifibromas Freckles (Crowe's sign) 1st degree relative with NF-1 Cafe au lait macules (6+) Osseous lesion Optic glioma Lisch nodules |
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Charcot-Bouchard:
- caused by - location |
Chronic HTN
Basal ganglia, thalamus |
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Lateral striate: supply...
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Posterior limb of internal capsuls
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MRI after stroke: timeframe it's bright
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3-30 mins - 10 days
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CT after stroke: dark in...
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24 hours
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Tabes dorsalis: impairment of...
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- dorsal roots
- dorsal columns |
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Tabes dorsalis: clinical (4)
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- dec proprioception
- dec DTR - locomotor ataxia - Positive Rhomberg |
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Migraine: Rx (3)
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- propanolol
- NSAIDs - Sumaptriptan |
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Cluster headache: Rx
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Sumaptriptan
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Name a form of primitive neuroectodermal tumor
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Medulloblastoma
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Which tumor often calcifies?
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Oligodendroglioma
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Hemangioblastoma + retinal angiomas =
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von Hippel Lindau
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Hemangioblastoma can produce...
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EPO --> secondary polycythemia
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Latanoprost: derivative of...
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PGF-2a
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What opioid to use for diarrhea?
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Loperamide
Diphenoxylate |
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Butorphanol: mechanism
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- mu: partial agonist
- kappa: agonist |
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Butorphanol: advantage
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Less respiratory depression than full agonists
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Which opioid decreases the seizure threshold
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Tramadol
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What NTs does Tramadol act on
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- opioid - weak agonist
- serotonin, NE - block reuptake |
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First line for trigeminal neuralgia
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Carbamazepine
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Drugs that lead to stevens johnson (epilepsy drugs)
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Phenytoin
Lamotrigine Ethosuxamide Carbamazepine |
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Drug for myoclonic seizures
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Valproic acid
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Ethosuxamide: mechanism
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Block T-type Ca2+ channels
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1st line antiepileptic in pregnant women, children
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Phenobarbital
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Limiting side effect of Phenobarbital
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Sedation
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Benzodiazepines: use
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Acute status epilepticus
Seizures of eclampsia |
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1st line for seizures of eclampsia
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MgSO4
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Benzodiazepines: Treat overdose with...
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Flumenazil - competitive antagonist at GABA benzo receptor
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Zolpidem: acts via which receptor
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BZ1
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Zolpidem: reversed by...
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flumenazil
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Embolus from heart goes to...
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Middle cerebral artery
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Zolpidem: duration
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Short - rapid metabolism by liver enzymes
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MAC
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minimum alveolar concentration at which 50% of population is anesthetized
varies with age |
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low solubility in blood -->
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rapid induction
rapid recovery |
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high solubility in lipids -->
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high potency
high 1/MAC |
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Drug with:
high lipid & blood solubility |
Halothane
- slow induction - high potency |
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Drug with:
low lipid & blood solubility |
N2O
- fast induction - low potency |
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Order of sensory loss with local anesthetics
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Pain
Temp Touch Pressure |
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Order of nerve blockade with local anesthetics
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Small myelinated
Small unmyelinated Large myelinated Large unmyelinated |
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Dantrolene: Mechanism
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Prevent the release of Ca2+ from sarcoplasmic reticulum
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Malignant hyperthermia: caused by...
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Inhalation anesthetics (except N2O)
Succinylcholine |
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Dantrolene: treatment for (2)
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Malignant hyperthermia
Neuroleptic malignant syndrome |
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Succinylcholine: mechanism
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Bind nicotinic acetylcholine receptors (Nm) --> channels open, neuromuscular membrane depolarizes
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Antidote to Phase I succynylcholine NMJ blockage:
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NO ANTIDOTE
- Block potentiated by cholinesterase inhibitors |
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Antidote to Phase II succinylcholine NMJ blockade:
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cholinesterase inhibitors
- neostigmine |
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Pancuronium: mechanism
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COMPETITIVE antagonist of Nm ACh receptors
--> can be overcome with neostigmine |
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Sumaptriptan: mechanism
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5-HT(1B/1D) agonist
--> vasoconstriction, inhibit trigeminal activation & vasoactive peptide release |
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Sumpatriptan: half life
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<2 hours
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Sumaptriptan: contraindication
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CAD or Prinzmetal's angina
- can cause coronary vasospasm |
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Opioids: no tolerance develops to...
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Miosis
Constipation |
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Vigabatrin: mechanism
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Irreversibly inhibits GABA transaminase
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How might depression present in an older person?
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Dementia (pseudodementia)
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Location of HSV-1 acute encephalitis
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temporal lobe
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Decreased abstract thought
Aphasia, apraxia, agnosia |
Dementia
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Barbiturates: contraindicated in...
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Porphyria (Barbiturates induce ALA synthase --> accum precursors)
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Opioids: mechanism of synaptic transmission modulation
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open K+ channels
close Ca2+ channels --> decrease synaptic transmission Inhibit release of ACh, NE, 5HT, glutamate, substance P |
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Uncal herniation: compression of contralateral crux cerebri (Kernohan's notch) -->
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Ipsilateral paresis
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Duret hemorrhages
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Paramedian artery rupture
- from caudal displacement of brainstem in uncal hemorrhage |
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DMX - innervation
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ANS: heart, lungs, upper GI
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Nucleus ambiguous: function
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Motor - swallow
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NTS: function
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Visceral sensory - taste, baroreceptors, gut distention
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Measles virus missing an antigen -->
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Subacute sclerosing panencephalitis
(missing M protein --> no Ab to M component of virus found) |
