Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
440 Cards in this Set
- Front
- Back
free nerve endings are present in all ___ and some ___
they sense ___ (2) 2 kinds are ___ |
skin
viscera pain temperature Adelta C |
|
Adelta fibers are ___ (2)
|
fast
myelinated |
|
Meissner corpuscles are present in ___
they sense ___ (2) they are attached to ___ fibers |
glabrous skin
fine touch position Abeta |
|
Pacinian corpuscles are present in ___ (3)
they sense ___ (2) they are attached to ___ fibers another structure with the same functional charateristics is ___ |
deep skin layers
ligaments joints vibration pressure Abeta Ruffini ending |
|
Merkel disks are present in ___
they sense ___ (2) they are attached to ___ fibers |
hair follicles
static touch position Abeta |
|
NE is ___ in depression, ___ in anxiety
it is made in ___ |
low
high locus ceruleus |
|
DA is made in ___ (2)
|
ventral tegmentum
SNc |
|
5-HT is ___ in depression, ___ in anxiety
it is made in ___ |
low
low raphe nuclei |
|
ACh is ___ in Alzheimer's, ___ in Huntington's, ___ in REM sleep
it is made in ___ |
low
low high nucleus basalis of Meynert |
|
GABA is ___ in anxiety, ___ in Huntington's
it is made in ___ |
low
low nucleus accumbens |
|
___ (2) cross BBB by carrier-mediated transport
|
Glc
amino acids |
|
___ molecules cross BBB by diffusion
|
nonpolar
|
|
ADH is made in HTh ___ nucleus
|
supraoptic
|
|
oxytocin is made in HTh ___ nucleus
|
paraventricular
|
|
leptin acts on ___ HTh to block hunger and on ___ HTh to cause satiety
|
lateral (inhibitory)
ventromedial (stimulatory) |
|
loss of ___ HTh causes failure to thrive
|
lateral
|
|
loss of ___ HTh causes hyperphagia
this can be caused by ___ |
ventromedial
craniopharyngioma |
|
___ HTh nucleus heats the body in reponse to cold by boosting ___ tone
|
posterior
SYM |
|
___ HTh nucleus cools the body in reponse to heat by boosting ___ tone
|
anterior
PARA |
|
___ HTh nucleus drives sexual urges
|
septal
|
|
___ HTh nucleus drives circadian rhythm
|
suprachiasmatic
|
|
posterior pituitary receives projections from ___ (2) HTh
|
supraoptic
paraventricular |
|
MGN of thalamus receives ___ info
|
auditory
|
|
VPLN of thalamus receives ___ info
via ___ (2) tracts |
somatosensory from body (touch, pain, proprioception, etc)
spinothalamic dorsal columns |
|
VPMN of thalamus receives ___ info
via ___ (2) tracts |
somatosensory for face
trigeminal discriminative touch trigeminothalamic |
|
motor region of thalamus is anterior/posterior
|
anterior
|
|
3 parts of limbic system
|
cingulate gyrus
hippocampus amygdala |
|
cerebellum receives ipsilateral input via ___ cerebellar peduncle
|
inferior
|
|
cerebellum receives contralateral input via ___ cerebellar peduncle
|
middle
|
|
cerebellum sends output via ___ cerebellar peduncle
|
superior
|
|
cerebellar output pathway
|
purkinje cells
deep nuclei cortex (via superierior CP) |
|
lateral cerebellum controls ___
|
limbs
|
|
medial cerebellum controls ___
|
gait
balance |
|
2 motor control pathways from basal ganglia (BG)
|
direct
indirect |
|
direct BG pathway is driven by ___ (2)
|
DA tone at striatum D1Rs
Glu tone at striatum |
|
Glu tone at striatum is from ___
|
cortex
|
|
indirect BG pathway is driven by ___ and inhibited by ___
|
Glu tone at striatum
DA tone at striatum D2Rs |
|
direct BG pathway:
striatum stimulates/inhibits ___ which stimulates/inhibits ___ which stimulates/inhibits ___ |
inhibits
GPi/SNr inhibits thalamus stimulates cortex |
|
indirect BG pathway:
striatum stimulates/inhibits ___ which stimulates/inhibits ___ which stimulates/inhibits ___ which stimulates/inhibits ___ which stimulates/inhibits ___ |
inhibits
GPe inhibits STN stimulates GPi inhibits thalamus stimulates cortex |
|
loss of DA in PD causes shift of tone to ___ pathway
this causes ___ of movement |
indirect
inhibition |
|
2 pathological changes in PD
|
depigmentation of SNc
Lewy bodies |
|
Lewy bodies are made of ___
|
alpha synuclein
|
|
___ is a street drug contaminant which can cause parkinsonism
|
MPTP
|
|
lacunar stroke in ___ causes hemiballismus
|
STN
(why not GPi also?) |
|
Huntingtons is a ___ trait linked to Chromosome ___.
|
AD
4 |
|
neurotoxicity in Huntington's is because of ___ from ___
|
excitotoxicity
Glu at NMDAR |
|
Huntington's is caused by expansion of ___ repeats.
<= ___ repeats is normal >= ___ repeats causes disease |
CAG (Q)
27 36 |
|
chorea is caused by ___ lesions
|
BG
|
|
athetosis is caused by ___ lesions
|
BG
|
|
essential tremor is worsened by ___
it is improved by ___ it is txed with ___ |
maintaining a posture
alcohol beta blockers |
|
intention tremor is caused by ___ lesions
|
cerebellar
|
|
motor homonculus from inferolateral to superomedial (6)
|
larynx
face (inferior to superior) hand (radial to ulnar) arm (distal to proximal) trunk (proximal to distal) leg (proximal to distal) |
|
lesion in amygdala causes ___ (3)
|
hyperorality
hypersexuality disinhibition (Klüver-Bucy syndrome) |
|
frontal lobe lesions cause ___ (2)
|
disinhibition
problems with attention |
|
bilateral mamillary body lesions cause ___ (4)
|
confusion
ophtalmoplegia memory loss ataxia (Wernicke-Korsakoff syndrome) |
|
lesions in PPRF cause ___ gaze deviation
|
contralateral
|
|
lesions in frontal eye field cause ___ gaze deviation
|
ipsilateral
|
|
too fast correction of hyponatremia causes ___
|
central pontine myelinolysis
|
|
in broca's aphasia ___ is intact
|
comprehension
|
|
in wernicke's aphasia ___ is intact
|
word pronunciation
|
|
in global aphasia ___ is intact
|
nothing (both broca's & wernicke's areas affected)
|
|
in conduction aphasia ___ is intact
|
comprehension
speech production |
|
in conduction aphasia ___ is impaired
it is caused by lesion of ___ |
repetition
arcuate fasciculus |
|
medial medullary syndrome is caused by ___
Sx are ___ (3) |
basilar or vertebral artery occlusion
contralateral hemiparesis contralateral deep hypoesthesia ipsilateral hypoglossal palsy |
|
hypoglossal palsy in medial medullary syndrome
causes ___lateral tongue deviation |
ipsi
|
|
lateral medullary syndrome is caused by ___
it is aka ___ (2) |
occlusion of posterior inferior cerebellar a.
PICA syndrome Wallenberg syndrome |
|
5 symptoms of lateral medullary syndrome
|
contralateral pain/temp hypoesthesia
ipsilateral facial pain/temp hypoesthesia ipsilateral Horner's syn ipsilateral nucleus ambiguus symptoms vestibular sx |
|
3 nucleus ambiguus sx
|
dysphagia (CN9)
hoarseness (CN10) reduced gag reflex |
|
4 vestibular sx
|
nystagmus
vertigo vomiting diplopia |
|
lateral pontine syndrome is aka
|
AICA syndrome
|
|
5 sx of lateral pontine syndrome
|
contralateral pain/temp hypoesthesia
ipsilateral facial hypoesthesia ipsilateral facial palsy ipsilateral vestibulocochlear sx ipsilateral ataxia |
|
lateral pontine syn facial hypoesthesia includes ___ and ___
|
pain/temp
light touch |
|
lateral pontine syn facial palsy includes ___ and ___
|
mastication
facial expression |
|
lateral pontine syn vestibulocochlear sx
|
nystagmus
hearing loss |
|
PCA strokes cause ___ visual deficit with ___
|
homonymous hemianopia
macular sparing |
|
most common site of circle of Willis aneurysm
|
anterior communicating a.
|
|
ant. communicating a. lesions cause ___
|
visual field defects
|
|
post communicating a. aneurysms cause ___
|
CN3 palsy
|
|
lateral striate a.s are branches of ___
they perfuse ___ (2) |
MCA
striatum internal capsule |
|
stroke in ___ causes pure motor hemiparesis
|
posterior limb of internal capsule
|
|
ischemia to watershed zones happens in severe ___
it presents as ___ (2) |
hypotension
upper arm/leg weakness high level visual processing defects |
|
occlusion of ___ causes locked in syn
|
basilar
|
|
3 genetic diseases associated with berry aneurysms
|
Ehler-Danlos
ADPKD Marfan's syn |
|
Charcot-Bouchard aneurysms cause ___ associated with ___
|
BG hemorrhage
HTN |
|
epidural hematomas are ___ shaped
they are/aren't contained by dural folds |
lentil
aren't |
|
subdural hematomas are ___ shaped
they are/aren't contained by dural folds |
crescent
are |
|
4 causes of parenchymal hemorrhage
|
HTN
amyloid angiopathy DM tumor |
|
2 most common sites of parenchymal hemorrhage
|
BG
internal capsule |
|
4 regions most vulnerable to ischemia
|
hippocampus
neocortex cerebellum watershed regions |
|
5 stages in infarction
|
red neurons
neutrophilic infiltration MQ infiltration reactive gliosis glial scar |
|
red neurons are present after ___ hours
|
12-48
|
|
neutrophilic infiltration happens at ___ days
|
1--3
|
|
MQ infiltration happens at ___ days
|
3--5
|
|
reactive gliosis happens at ___ weeks
|
1--2
|
|
ischemic strokes can convert to hemorrhagic because of ___
|
increased vessel fragility
|
|
a stroke appears ___ on diffusion MRI after ___ hours
it remains that way for ___ days and ___ on CT after ___ hours |
bright
.05--.5 10 dark 24 |
|
dural sinuses empty into ___
|
internal jugular vein
|
|
main location of CSF return is into ___
|
sup. sagittal sinus
|
|
5 sinuses which meet at the confluence of sinuses
|
superior sagittal
L+R transverse occipital straight |
|
straight sinus is fed by ___ (2)
|
inf. sagittal sinus
great vein of Galen |
|
communicating hydrocephalus is caused by ___
|
reduced CSF return at arachnoid granulations
|
|
NPH has elevated ___
sx are ___ (3) it is a kind of ___ hydrocephalus |
ventricular volume
dementia ataxia incontinence communicating |
|
ICP in NPH is ___
|
high normal
|
|
hydrocephalus ex vacuo is caused by ___
|
brain atrophy
|
|
spinal nerves ___ exit via IV foramen above corresponding vertebra
spinal nerves ___ exit via IV foramen below corresponding vertebra ___ is a freak |
C1-C7
T1-12, S1-5, Co C8 |
|
C8 spinal nerve exits above ___
|
T1
|
|
IV disk most commonly herniated
|
L5-S1
|
|
SC usually extends to ___
subarachnoid space extends to ___ LP is performed at ___ or ___ |
L1-L2
S2 L3-L4 L4-L5 |
|
7 layers pierced in LP
|
skin
fascia supraspinous ligament interspinous ligament ligamentum flavum dura arachnoid |
|
fibers for legs are medial/lateral in corticospinal tract
|
lateral
|
|
fibers for legs are medial/lateral in lateral spinothalamic tract
|
lateral
|
|
fibers for legs are medial/lateral in dorsal columns
|
medial
|
|
soma of 1' neuron of dorsal column tract pathway is in ___
it terminates proximally in the ___lateral ___ or ___ |
DRG
ipsilateral nucleus cuneatus nucelus gracilis |
|
decussation of dorsal column pathway is in the ___
|
medulla
|
|
decussation of dorsal column pathway is done by ___ neuron
|
2'
|
|
soma of 1' neuron of spinothalamic tract pathway is in ___
it terminates proximally in the ___lateral ___ |
DRG
ipsilateral substantia gelatinosa |
|
decussation of spinothalamic tract is done by ___ neuron
|
2'
|
|
decussation of spinothalamic tract is in the ___
|
anterior white commisure (SC at level of entry)
|
|
2 causes of pure LMN disease
|
polio
Werdnig-Hoffman disease |
|
Werdnig-Hoffman disease is aka ___
|
infantile SMA
|
|
Werdnig-Hoffman disease is a ___ trait
it presents as ___ with ___ median life expectancy is ___ |
AR
floppy baby tongue fasciculation 7 months |
|
syringomyelia typically affects cord levels ___
it is associated with ___ |
C8-T1
arnold-chiari II |
|
in arnold-chiari I ___ herniates
in arnold-chiari II, ___ herniates ___ is associated with myelomeningocele |
cerebellar tonsils
cerebellar tonsils + medulla arnold-chiari II |
|
syringomyelia disrupts ___ tract at ___
|
spinothalamic
anterior white commisure |
|
B12 deficiency affects ___ (3) tracts
same lesions can be caused by ___ |
dorsal columns
spinocerebellar lateral corticospinal Vit E deficiency Friedreich's ataxia |
|
poliovirus is transmitted by ___ route
it replicates in ___ |
fecal-oral
oropharynx small intestine |
|
5 non-neurological polio sx
|
headache
fever nausea abdominal pain sore throat |
|
3 CSF findings in polio
|
lymphocytosis
moderate protein elevation normal glucose |
|
2 causes of ALS
|
SOD1 mutation
betel nut |
|
tabes dorsalis is caused by ___ syphilis
___ reflexes are lost ___ pupils are present |
tertiary
deep tendon Argyll Robertson |
|
Argyll Robertson pupils are sensitive to ___ but not ___
|
accomodation
light |
|
hemisection of the SC above T1 causes ___
|
Horner's syn
|
|
Horner's syndrome is caused by a lesion in ___ pathway
|
oculosympathetic
|
|
first neuron in oculosympathetic pathway is in ___ and ends in ___
|
HTh
intermediolateral colum of T1 |
|
second neuron in oculosympathetic pathway is in ___ and ends in ___.
|
IML column of T1 SC
superior cervical ganglion |
|
diaphragm and gallbladder pain can be referred to ___ by ___ n.
|
right
phrenic |
|
xiphoid process dermatome
|
T7
|
|
inguinal ligament dermatome
|
L1
|
|
kneecaps ligament
|
L4
|
|
penis dermatomes
|
S2-3
|
|
ankle jerk is from ___ cord levels
|
S1-2
|
|
knee jerk is from ___ cord levels
|
L3-4
|
|
biceps reflex is from ___ cord levels
|
C5-6
|
|
triceps reflex is from ___ cord levels
|
C7-8
|
|
___ is superior to superior colliculi
|
pineal gland
|
|
lesion of superior colliculi causes ___
this is called ___ it can be caused by ___ |
upgaze palsy
Parinaud syn pinealoma |
|
afferent arm of gag reflex is via CN ___
|
9
|
|
efferent arm of gag reflex is via CN ___
|
9 and 10
|
|
3 medullary vagal nuclei
|
NTS
ambiguus dorsal motor |
|
NTS processes ___ info from CNs ___
|
SVA + GVA
7 9 10 |
|
part of NTS which receives input from CN7
|
gustatory nucleus
|
|
nucleus ambiguus processes ___ info for CNs ___
|
SVE + GVE
9 10 11 |
|
dorsal motor nucleus processes ___ info for CNs ___
it controls ___ |
GVE
10 vagal tone to heart, lungs and upper GIT |
|
cribriform plate transmits ___ from ___ to ___ through ___
|
olfactory nerve
anterior cranial fossa nasopharynx ethmoid bone |
|
optic canal transmits ___ (3) from ___ to ___ through ___
|
optic nerve
ophthalmic a. central retinal v. middle cranial fossa orbit sphenoid bone |
|
superior orbital fissure transmits ___ (6) from ___ to ___ through ___
|
oculomotor n.
trochlear n. ophthalmic division of trigeminal n. abducens n. ophthalmic vein sympathetic fibers middle cranial fossa orbit sphenoid bone |
|
foramen rotundum transmits ___ from ___ to ___ through ___
|
maxillary division of trigeminal n.
middle cranial fossa pterygopalatine fossa sphenoid bone |
|
foramen ovale transmits ___ from ___ to ___ through ___
|
mandibular division of trigeminal n.
middle cranial fossa infratemporal fossa sphenoid bone |
|
foramen spinosum transmits ___ (2) from ___ to ___ through ___
|
middle meningeal a.
meningeal branch of mandibular n. (nervus spinosus) middle cranial fossa infratemporal fossa sphenoid bone |
|
internal auditory meatus transmits CNs ___ and ___ from ___ through ___
|
7
8 posterior cranial fossa temporal bone |
|
internal auditory meatus transmits CN7 to ___ (3) and CN8 to ___
|
stylomastoid foramen
petrotympanic fissure greater petrosal foramen membranous labyrinth |
|
stylomastoid foramen contains CN7 ___ fibers
|
SVE
|
|
petrotympanic fissure contains CN7 ___ fibers, aka ___ n.
|
GVE
SVA chorda tympani |
|
GVE fibers of chorda tympani nerve synapse in ___ ganglion
|
submandibular
|
|
greater petrosal foramen contains CN7 ___ fibers, aka ___ n.
these fibers terminate at ___ ganglion |
GVE
greater petrosal pterygopalatine |
|
jugular foramen transmits ___ (4) from ___ to ___ through ___
|
CN9
CN10 CN11 internal jugular vein posterior cranial fossa base of skull temporal and occipital bones |
|
foramen magnum transmits ___ (2) from ___ to ___ through ___
|
brain stem
spinal part of CN11 posterior cranial fossa base of skull occipital bone |
|
cavernous sinus contains ___ (7)
|
CN3
CN4 CNV1 CNV2 CN6 postgang. sympathetic fibers internal carotid ar. |
|
CN12 lesion causes ___lateral deviation of ___
|
ipsi
tongue |
|
CN5 lesion causes ___lateral deviation of ___
|
ipsi
jaw |
|
CN10 lesion causes ___lateral deviation of ___
|
contra
uvula |
|
CN11 lesion causes ___lateral rotation of ___
|
contra
head |
|
CN11 lesion causes ___lateral shoulder droop
|
ipsi
|
|
CN7 UMN lesion causes ___
|
contralateral lower face palsy
|
|
CN7 LMN lesion causes ___
this is aka ___ |
ipsilateral upper and lower face palsy
Bell's palsy |
|
Bell's palsy is associated with ___ (6)
|
AIDS
Lyme disease HZV sarcoidosis tumors DM |
|
K sounds test
|
CN10
|
|
L sounds test
|
CN12
|
|
M sounds test
|
CN7
|
|
all muscles with glossus in their names except ___ are innervated by ___
|
palatoglossus
CN12 |
|
all muscles with palat in their names except ___ are innervated by ___
|
tensor veli palatini
CN10 |
|
palatoglossus is innervated by ___
|
CN10
|
|
tensor veli palatini is innervated by ___
|
CNV3
|
|
___ tone on ___ receptors causes ciliary muscle relaxation for accomodation
|
ACh
M3 |
|
___ tone on ___ receptors causes secretion of aqueous humor
|
NE
beta adrenergic |
|
___ tone on ___ receptors causes sphincter pupilae contraction
|
ACh
M3 |
|
___ tone on ___ receptors causes pupil dilator contraction (mydriasis)
|
NE
alpha1 adrenergic |
|
___ glaucoma is insidious
___ glaucoma is acute |
open angle
closed angle |
|
angle which distinguishes open and closed angle glaucoma is between ___
and ___ |
iris
cornea |
|
in open angle glaucoma, flow is obstructed because ___
|
canal of Schlemm is occluded
|
|
in closed angle glaucoma, flow is obstructed because ___
|
iris is compressing trabecular meshwork
|
|
___ glaucoma is an emergency
|
closed-angle
|
|
8 risk factors for cataract
|
smoking
alcohol sunlight galactosemia galactokinase deficiency DM trauma infection |
|
___ lesion causes superior quadrantanopia
this can be caused by a ___ stroke part of visual pathway affected is ___ |
temporal lobe
MCA Meyer's loop |
|
___ causes inferior quadrantanopia
this can be caused by a ___ stroke part of visual pathway affected is ___ |
parietal lesion
MCA dorsal optic radiation |
|
caloric stimulation with cold water has ___lateral slow phase deflection and
___lateral fast phase deflection |
ipsi
contra |
|
caloric stimulation with warm water has ___lateral slow phase deflection and
___lateral fast phase deflection |
contra
ipsi |
|
___% of Alzheimer's is familial
2 kinds of familial AD ___ is more common |
10
early onset late onset late onset |
|
3 genes associated with early onset familial AD
|
APP
presenilin-1 presenilin-2 |
|
APP is on chromosome ___
|
21
|
|
gene associated with late onset familial AD
|
ApoE4
|
|
amyloid plauqes are made of ___
they are intra/extracellular |
Abeta
extra |
|
neurofibrillary tangles are made of ___
they are intra/extracellular |
hyperphosphorylated tau
intra |
|
degree of dementia correlates better with # of ___ than with # of ___.
|
NFTs
amyloid plaques |
|
Pick's disease is aka ___
main histopath finding is ___ |
frontotemporal dementia
Pick bodies |
|
Pick bodies are made of ___
|
tau
|
|
FTD affects anterior/posterior temporal lobe
|
anterior 1/3
|
|
histopath finding in Lewy Body Dementia
these are made of ___ |
Lewy Body
alpha synuclein |
|
prions in CKD cause ___ structure to change to ___
|
alpha helix
beta sheet |
|
2 CSF findings in MS
|
elevated protein
oligoclonal IgG bands |
|
gold standard for MS dx
|
MRI
|
|
T/F: GBS can cause facial paralysis
|
true
|
|
CSF finding in GBS: high ___ with normal ___
|
protein
cell count |
|
ADEM occurs after ___ (2)
neuropathology is ___ |
infection
vaccination demyelination |
|
charcot-marie-tooth is aka
neuropathology of types 1, 3 and 4 is ___ neuropathology of type 2 is ___ |
hereditary motor and sensory neuropathy
demyelination axonal |
|
5 kinds of generalized seizure
|
tonic-clonic
tonic atonic myoclonic absence |
|
top 2 causes of new onset seizures in non-elderly adult
|
tumor
trauma |
|
___ is always present with peripheral vertigo
|
nystagmus
|
|
nystagmus in peripheral vertigo is always ___
|
horizontal
|
|
nystagmus in central vertigo can be ___ and ___
|
bidirectional
vertical |
|
hearing loss or tinnitus is primarily associated with ___ vertigo
|
peripheral
|
|
typical duration of migraine
|
4--72 hr
|
|
3 proteins released during migraine
|
substance P
CGRP vasoactive peptides |
|
neurocutaneous syndromes are aka ___
4 neurocutaneous syndromes |
Sturge-Weber
tuberous sclerosis neurofibromatosis 1 von Hippel-Lindau |
|
Sturge-Weber has ___ (4)
|
port-wine stain
ipsilateral leptomeningeal angioma mental retardation pheochromocytoma |
|
port-wine stain in Sturge-Weber is located ___ly
|
in V1 dermatomal distribution
|
|
T/F: Sturge-Weber is genetic disorder
|
false: sporadic
|
|
2 histological kinds of growths in tuberous sclerosis
|
hamartoma
hamartoblastoma |
|
tuberous sclerosis growths affect ___ (3)
|
CNS
skin organs (kidneys, heart, lungs) |
|
tuberous sclerosis CNS growths are ___s
|
hamartoma
|
|
facial growths in tuberous sclerosis are called ___ or ___
histologic type of these growths is ___ |
angiofibroma
sebaceous adenoma hamartoma |
|
heart tumor in tuberous sclerosis
|
rhabdomyoma
|
|
kidney tumor in tuberous sclerosis
|
angiomyolipoma
|
|
CNS tumor in tuberous sclerosis
|
subependymal giant cell astrocytoma
|
|
cardiac valve abnormality in tuberous sclerosis
|
mitral regurg
|
|
skin patches in tuberous sclerosis are hyper/hypopigmented
patches are called ___ |
hypo
ash-leaf spots |
|
tuberous sclerosis has shagreen patches, which are ___
|
leathery skin
|
|
tuberous sclerosis is a ___ trait
|
AD
|
|
iris abnormality in neurofibromatosis 1
|
Lisch nodules
|
|
Lisch nodules are pigmented ___s
|
hamartoma
|
|
intracranial tumor in neurofibromatosis 1
|
optic glioma
|
|
abdominal tumor in neurofibromatosis 1
|
pheochromocytoma
|
|
neurofibromatosis 1 is a ___ trait linked to chromosome ___
|
AD
17 |
|
4 kinds of tumor in von Hippel-Lindau
|
cavernous hemangioma
hemangioblastoma renal cell carcinoma pheochromocytoma |
|
von Hippel-Lindau cavernous hemangiomas occur in ___ (3)
|
skin
mucosa organs |
|
RCC in von Hippel-Lindau is ___
|
bilateral
|
|
hemanigoblastomas in von Hippel-Lindau occur in ___ (3)
|
retina
brain stem cerebellum |
|
von Hippel-Lindau is a ___ trait linked to chromosome ___
|
AD
3 |
|
phakomatoses which cause pheochromocytoma
|
Sturge-Weber
neurofibromatosis von Hippel-Lindau |
|
phakomatoses which cause cafe-au-lait spots
|
neurofibromatosis 1
von Hippel-Lindau |
|
4 kinds of primary brain tumors
|
glioma
meningioma neuronal tumors poorly differentiated |
|
3 kinds of glioma
|
astrocytoma
oligodendroglioma ependymoma |
|
3 kinds of astrocytoma
|
well-differentiated
anaplastic glioblastoma |
|
top 3 1' intracranial tumors, age over 15 (IDOOF)
|
glioblastoma/anaplastic astrocytoma
meningioma/nerve sheath Schwannoma |
|
top 2 intracranial tumors, age <15
|
well-diff astrocytoma
medulloblastoma (PNET) |
|
___s are 80% of adult 1' brain tumors. they occur most commonly in ___.
|
astrocytoma
cerebral hemispheres |
|
astrocytomas stain for ___. their malignant potential can be measured with ___ staining, which labels ___.
|
glial fibrillary acidic protein (GFAP)
Ki67 dividing cells |
|
tumors which take up radiocontrast are more/less malignant
|
more
|
|
4 grades of astrocytoma
|
pilocytic
fibrillary diffuse anaplastic glioblastoma |
|
pilocytic astrocytomas occur most commonly in ___. they are benign/malignant and have ___ fibers.
|
cerebellum
benign Rosenthal |
|
fibrillary astrocytoma has high/low Ki67 index
cellularity is high/low and atypia is high/low. |
low
high low |
|
glioblastoma has the features of ___ plus ___ (2)
|
anaplastic astrocytoma
necrosis endothelial/vascular proliferation |
|
necrosis in glioblastoma is surrounded by ___
|
pseudopalisading cells
|
|
endothelial proliferation in glioblastoma is caused by ___ produced by tumor
|
VEGF
|
|
pseudopalisading is caused by release of ___ by ___
|
growth factors
dying cells |
|
2 early mutations in astrocytoma transformation
2 early protein synthesis changes in astrocytoma |
17p-
p53 PDGFR overexpression p14 downregulation |
|
1' glioblastoma happens without ___
|
preexisting low grade astrocytoma
|
|
___ (molecular process) is important in 1' glioblastoma,
___ is important in 2'. |
EGFR overexpression
p53 mutation |
|
oligodendrogliomas occur at age ___ and are located mostly in ___
|
30--50
cerebral hemispheres |
|
4 histopath findings in oligodendroglioma
|
small round nucleus
perinuclear halo ("fried egg") anastomosing capillaries ("chicken wire") calcification |
|
oligodendroglioma has ___ GFAP stain and high/low Ki67 index
|
negative
low |
|
ependymomas in children occur near ___, in adults in ___.
|
4th ventricle
SC |
|
ependymoma cells form ___ or perivascular ___.
|
rosettes
pseudorosettes |
|
ependymoma has ___ GFAP and ___ cytokeratin
|
positive
positive |
|
___ (2) ependymomas have better prognosis.
prognosis is better/worse in adults than children. |
spinal
supratentorial better |
|
medulloblastoma is more common in children/adults. it occurs in ___ of cerebellum.
|
children
vermis |
|
medulloblastoma stains positive for ___ (3).
|
neuron specific enolase
synaptophysin Ki67 |
|
___ rosettes may be present in medulloblastoma. GFAP is usually ___.
|
Homer-Wright
negative |
|
___ is only 1% of intracranial tumors but is the most common in immunosuppressed
|
1' CNS lymphoma
|
|
___ is present in neoplastic ly cells in 1' CNS ly.
|
EBV genome
|
|
prognosis in 1' CNS ly is good/bad
|
bad
|
|
___ spread is common in 1' CNS ly
|
periventricular
|
|
1' CNS ly is usually ___ ly
|
DLBCLy
|
|
1' CNS ly can be detected with ___ stain
|
CD20
|
|
meningiomas arise from ___ cells and are attached to ___
|
arachnoid
dura |
|
the ___ variant of meningioma is flat and causes ___
|
en plaque
hyperostotic rxn |
|
meningiomas are more common in men/women
|
women
|
|
multiple meningiomas are suggestive of ___
|
neurofibromatosis type 2
|
|
most meningiomas are benign/malignant, but tend to ___
|
benign
recur |
|
most adult 1' brain tumors are ___tentorial
|
supra
|
|
most childhood 1' brain tumors are ___tentorial
|
infra
|
|
____ is a tumor which can have spindle cells with whorled pattern and psammomma bodies
|
meningioma
|
|
___ is associated with bilateral acoustic Schwannomas
|
neurofibromatosis 2
|
|
pituitary adenoma is most commonly a ___
|
prolactinoma
|
|
2 tumors associated with 4th ventricle compression
|
medulloblastoma
ependymoma |
|
most common childhood supratentorial primary tumor
|
craniopharyngioma
|
|
craniopharyngiomas are derived from
they commonly exhibit ___ |
rathke's pouch
calcification |
|
hemangioblastomas are most commonly in ___
they are associated with ___ they commonly make ___, which can cause ___ |
cerebellum
von Hippel-Lindau EPO 2' polycythemia |
|
2 kinds of cerebral herniations in terms of dural compartments
|
transfalcine
transtentorial |
|
2 directional kinds of transtentorial herniations
|
horizontal
vertical |
|
horizontal transtentorial herniation causes ___ (radiological sign)
this is associated with ___ |
Kernohan's notch
ipsilateral (?) Babinski |
|
2 kinds of vertical transtentorial herniation
|
central
uncal-parahippocampal |
|
uncal herniation is associated with ipsilateral ___ (2) and contralateral ___
|
CN3 palsy
hemiparesis homonymous hemianopia |
|
ipsilateral hemiparesis in uncal herniation is from ___
|
contralateral Kernohan's notch
(compression of crus cerebri) |
|
contralateral homonymous hemianopia
in uncal herniation is from ___ |
compression of ipsilateral PCA
|
|
caudal displacement of brain stem in uncal herniation can cause ___ hemorrhages
via rupture of ___ |
Duret
paramedian a. |
|
1 heterogenously enhancing brain lesion
|
GBM
|
|
1 uniformly enhancing brain lesions
|
meningioma
|
|
9 ring-enhancing brain lesions
|
mets
abscess glioblastoma infarct contusion AIDS (toxoplasmosis) 1' CNS Ly demyelination resolving hematoma |
|
mets are usually ___ enhancing but are sometimes ___ enhancing
|
ring
uniformly |
|
5 classes of antiglaucoma drugs
|
alpha agonist
beta blocker carbonic anhydrase inhibitor parasympathomimetic prostaglandin |
|
2 main drugs for glaucoma and their families
|
timolol (beta blocker)
pilocarpine (parasympathomimetic) |
|
alpha agonists work for glaucoma by ___ing
the mechanism is ___ |
reducing aqueous humor production
vasoconstriction |
|
___ is an alpha agonist contraindicated in closed angle glaucoma
the reason is ___ |
epinephrine
mydriasis exacerbates outflow obstruction in trabecular meshwork |
|
___ is an alpha agonist which doesn't cause pupillary change
|
brimonidine
|
|
2 non-selective beta blockers for glaucoma
|
timolol
carteolol |
|
1 beta1 selective blocker for glaucoma
|
carteolol
|
|
T/F: beta blockers cause pupillary change
|
false
|
|
carbonic anhydrase inhibitor for glaucoma
mechanism is ___ |
acetazolamide
bicarb ions are required for fluid transport in ciliary body |
|
2 direct PARA-mimetics for glaucoma
|
pilocarpine
carbachol |
|
2 indirect PARA-mimetics for glaucoma
|
physiostigmine
echothiophate |
|
PARA-mimetics work in glaucoma by ___ing
this causes ___ |
inducing miosis
alleviating pressure on canal of Schlemm |
|
prostaglandin for glaucoma
|
latanoprost
|
|
latanoprost is aka ___
it works by ___ing a side effect is ___ |
PGF2alpha
increasing aqueous drainage darkening iris |
|
3 first line drugs for generalized
tonic-clonic (GTC) seizures these drugs are also good for ___ (2) seizures |
phenytoin
carbamazepine valproic acid simple partial complex partial |
|
5 non-first-line drugs for:
GTC, simple partial, and complex partial seizures |
lamotrigine
gabapentin topiramate phenobarbital levetiracetam |
|
phenytoin mechanism
|
Na+ channel inactivation
|
|
carbamazepine mechanism
|
Na+ channel inactivation
|
|
valproic acid mechanism (2)
|
Na+ channel inactivation
GABA_A agonism |
|
lamotrigine mechanism
|
Na+ channel inactivation
|
|
gabapentin mechanism
|
HVA Ca2+ channel inactivation
|
|
topiramate mechanism (2)
|
Na+ channel inactivation
GABA_A agonist |
|
phenobarbital mechanism
|
GABA_A agonist
|
|
2 drugs for simple + complex partial seizures only
|
tiagabine
vagabatrin |
|
vigabatrin mechanism
|
GABA_A agonism
|
|
vagabatrin GABA_A agonism is via ___
|
GABA transaminase inhibition
|
|
tiagabin mechanism
|
GABA_A agonism
|
|
tiagabin GABA_A agonism is via ___
|
GABA reuptake inhibition
|
|
1st-line drug for absence seizures
|
ethosuximide
|
|
ethosuximide mechanism
|
thalamic T-type Ca2+ channel block
|
|
1st line drug for trigeminal neuralgia
|
carbamazepine
|
|
2 non-seizure indications for gabapentin
|
peripheral neuropathy
bipolar disorder |
|
phenobarbital is 1st-line drug for ___ (2 populations)
|
pregnant women
children |
|
in addition to GTC and partial seizures, valproic acid is indicated for ___ (2)
|
absence
myoclonic |
|
1st line drug for acute status epilepticus
|
benzodiazepine
|
|
2 benzodiazepines for status epilepticus
|
diazepam
lorazepam |
|
benzodiazepine mechanism
|
GABA_A agonism
|
|
3 AEDs which cause Stevens-Johnson syndrome
|
carbamazepine
ethosuximide lamotrigine |
|
3 AEDs which induce CYP450
|
phenobarbital
phenytoin carbamazepine |
|
2 AEDs which cause blood disorders
|
carbamazepine
phenytoin |
|
blood disorder caused by carbamazepine
|
agranulocytosis
|
|
blood disorder caused by phenytoin
|
megaloblastic anemia
|
|
2 AEDs which cause ataxia + diplopia
1 AED which causes only ataxia |
carbamazepine
phenytoin gabapentin |
|
3 AEDs which cause fetal malformations
|
carbamazepine
phenytoin valproic acid |
|
3 AEDs which cause endocrine disorders
|
carbamazepine
phenytoin valproic acid |
|
endocrine disorder associated with carbamazepine
|
SIADH
|
|
endocrine disorder associated with phenytoin
|
hirsutism
|
|
endocrine disorder associated with valproic acid
|
weight gain
|
|
AED associated with kidney stones + weight loss
|
topiramate
|
|
AED associated with SLE-like syndrome
|
phenytoin
|
|
phenytoin teratogenesis is aka ___
|
fetal hydantoin syndrome
|
|
phenytoin causes ___ anemia by ___ing
|
megaloblastic
blocking folate absorption |
|
barbiturates increase the ___ of the GABA_A channel
|
opening duration
|
|
___ is an AED associated with hepatotoxicity
|
carbamazepine
|
|
2 AEDs which have additive cardio-respiratory depression with alcohol
|
barbiturate
benzodiazepine |
|
drugs with ___ blood solubility have rapid induction
|
low
|
|
drugs with ___ lipid solubility have rapid induction
|
high
|
|
MAC stands for ___ and is inversely related to ___
|
minimum alveolar concentration
potency |
|
MAC is the concentration at which ___
|
50% of population is anesthetized
|
|
MAC is greatest for ___
|
babies
|
|
N2O has ___ blood solubility and ___ lipid solubililty
|
low
low |
|
induction speed goes with ___
potency goes with ___ |
blood (in)solubility
lipid solubility |
|
halothane has ___ blood solubility and ___ lipid solubility
|
high
high |
|
gas tension in lungs depends on ___ (2)
|
respiratory rate
tidal volume |
|
gas tension in blood depends on ___ aka ___
|
blood/gas partition coeffcient
solubility |
|
gases with increased ___ require more gas to saturate tissue
|
AV concentration gradient
|
|
inhaled anesthetics cause ___ (2) depression, and cerebral ___ (2)
|
myocardial
respiratory increased blood flow decreased metabolic demand |
|
GI effect of inhaled anesthetics
|
nausea/emesis
|
|
SE of halothane
|
hepatotoxicity
|
|
SE of methoxyflurane
|
nephrotoxicity
|
|
SE of enflurane
|
convulsions
|
|
SE of N2O
|
expansion of trapped gas
|
|
thiopental has ___ lipid solubility
induction is fast/slow effect is terminated by ___ |
high
fast redistribution to tissues |
|
thiopental causes ___ cerebral blood flow
|
decreased
|
|
___ is a benzo used for endoscopy
SEs are ___ (3) OD is treated wtih ___ |
midazolam
respiratory depression amnesia hypotension flumazenil |
|
___ is an arylcyclohexylamine
it is a ___ analog mechanism is ___ |
ketamine
PCP NMDA block |
|
ketamine causes ___ cerebral blood flow
|
increased
|
|
propofol is used for ___
it works on ___ |
rapid induction
GABA_A |
|
3 ester local anesthetics
|
procaine
cocaine tetracaine |
|
procaine is aka ___
|
novocaine
|
|
amide local anesthetics have 2 ___s in the name
e.g., ___ |
i's
lidocaine |
|
all the local anesthetics have ___ in their structure
|
3' amine
|
|
3' amine local anesthetics cross membranes as ___
and bind channel as ___ |
uncharged (3')
charged |
|
large/small diameter nerves are blocked first
|
small
|
|
myelinated/unmyelinzted nerves are blocked first
|
myelinated
|
|
size/myelination predominates in speed of block
|
size
|
|
sequence of (4) sensations blocked by local anesthetics
|
pain
temperature touch pressure |
|
all local anesthetics except for ___ are given with vasoconstrictor
|
cocaine
|
|
local anesthetic SE
|
CNS excitation
|
|
bupivacaine SE
|
cardiotoxicity
|
|
cocaine SE
|
arrhythmia
|
|
2 kinds of muscle relaxants
|
depolarizing
nondepolarizing |
|
___ is a depolarizing muscle relaxant
it is broken down by ___ but not ___ |
succinylcholine
butyrylChE AChE |
|
butyrulChE is aka ___
|
pseudoChE
|
|
succinylcholine causes ___ (2)
for this reason it is contraindicated in ___ |
hyperkalemia
hypercalcemia burn patients |
|
during phase 1 of depolarizing muscle block,
membrane is ___ed block is ___ed by ChEI antidote is ___ |
depolarized
potentiated doesn't exist |
|
during phase 2 of depolarizing muscle block,
membrane is ___ed block is ___ed by ChEI antidote is ___ (2) |
(re)polarized
reversed ChEI non-depolarizing blocker |
|
nondepolarizing muscle blockers are called ___ or end in ___ or ___
they are competitive/noncompetitive ACh antagonists |
tubocurarine
curium curonium competitive |
|
competitive muscle block can be reversed by ___ (2)
|
ChEI
depolarizing muscle blocker |
|
post-tetanic potentiation occurs with ___ (2)
|
nondepolarizing block
phase 2 depolarizing block |
|
fasciculations occur with ___
|
depolarizing block
|
|
non-depolarizing block affects __ first and ___ last
___ recovers first |
eyes
diaphragm diaphragm |
|
___ is used for malignant hyperthermia
mechanism is ___ |
dantrolene
prevents release of Ca2+ from SR |
|
PD drug classes
|
Bromocriptine (DA agonists)
Amantadine (DA secretagogue) L-Dopa Selegeline (MAOBIs) Antimuscarinics COMTIs |
|
2 non-ergot DA agonists for PD
|
ropinirole
pramipexole |
|
amantadine SE
|
ataxia
|
|
2 COMTIs
|
entacapone
tolcapone |
|
PD antimuscarinic
these work on ___ but not ___ |
benztropine
tremor bradykinesia |
|
L-dopa SE
|
arrhythmia
|
|
L-dopa is given with ___
this does ___ |
carbidopa
inhibits dopa decarboxylase |
|
long term use of L-dopa causes ___ after administration
and ___ between doses |
dyskinesia
akinesia |
|
2 alzheimer's drugs
|
memantine
donepezil |
|
memantine mechanism
|
NMDA blocker
|
|
memantine prevents ___
|
excitotoxicity
|
|
donepezil mechanism
|
AChEI
|
|
in huntington's, ___ is high and ___ (2) are low
|
DA
GABA ACh |
|
2 amine-depleting drugs for huntington's
|
reserpine
tetrabenazine |
|
anti-DA drug for huntington's
|
haloperidol
|
|
sumatriptan mechanism
|
5-HT1B/1D blocker
|
|
sumatriptan has short/long t1/2
|
short (<2h)
|
|
2 sumatriptan SEs
|
coronary vasospasm
tingling |
|
2 common lumbar disc prolapses
|
L4-5
L5-S1 |
|
pain from L4-5 disc prolapse is over ___ joint, ___, and ___ thigh and leg
|
sacroiliac
hip lateral |
|
numbness from L4-5 disc prolapse is from ___ leg, and ___
|
lateral
1st 3 toes |
|
weakness from L4-5 disc prolapse is for ___
on exam this manifests as ___ (2) |
foot dorsiflexion
difficulty walking on heels foot drop |
|
muscles atrophied from L4-5 disc prolapse are ___
reflex anomalies from L4-5 disc prolapse are ___ |
minimal
minimal |
|
pain from L5-S1 disc prolapse is over ___ joint, ___, and ___ thigh and leg
|
sacroiliac
hip posterolateral |
|
numbness from L5-S1 disc prolapse is from ___ leg, and ___
|
posterior (gastrocnemius)
lateral heel + foot |
|
weakness from L5-S1 disc prolapse is for ___
on exam this manifests as ___ |
platarflexion
difficulty walking on toes |
|
muscles atrophied from L5-S1 disc prolapse are ___
reflex anomalies from L5-S1 disc prolapse are ___ |
gastrocnemius, soleus
ankle jerk |