Usmle-Neuro-First Aid

Front 1

decreased pain and temp sensation over lat. aspects of both arms. where is the lesion

Back 1

syringomyelia

Front 2

penlight in pts right eye produces bilateral pupillary constriction. when moved to the left eye, there is paradoxical dilation.
what is the defect?

Back 2

atrophy of L optic nn

Front 3

decresassed prick sensation on lateral aspect of leg and foot.

deficit in what mm action can also be expected

Back 3

dorsiflexion & eversion of foot (common peronial nn)

Front 4

pt presents w/ tingling over lateral digits of her R hand.
What is the dx

Back 4

carpal tunnel syndrome.
median nn compression

Front 5

decreased plantar flexion and decreased sensation over back fo thigh, calf, and latereal half of foot.
what spinal nn

Back 5

tibial (L4-S3)

Front 6

pt in MVA can't turn head to L & has rightt shoulder droop.
What sx is damaged.

Back 6

R CN XI (inn SCL & trap mm)

Front 7

pt presents w/ one wild flailing arm. where is the lesion?

Back 7

contralateral subthalamic nuccleus (hemiballismus)

Front 8

pt w/ cortical lesion does not know he has a dz. where is the lesion?

Back 8

right paraietal lobe

Front 9

pt cannot protrude tongue toward L side and has a R-sided spastic paralysis. Where is the lesion?

Back 9

L medulla, CN XII

Front 10

teen falls while rollarblading and hurts his elbow. He can't feel the medial part of his palm.
What is the nn & what is the injury.

Back 10

ulnar nn due to broken medial condyle

Front 11

pt presents to ER after falling on arm. X-ray shows midshaft break of the humerus? Which nn & aa are most lkely damaged?

Back 11

radial nn & deep brachial aa (run together

Front 12

pt cannot blink his R eye or seal his lips and has mild ptosis on R side. What is the dx and which nn is affected.

Back 12

bell's palsy; CN VII

Front 13

pt c/o numbness, & tingling sensation. She has wasting of thenar eminence. What is the dx/ What nn is affected?

Back 13

carpel tunnel syndrome (medial nn)

Front 14

stage of sleep where there is variable BP, penile tumescence & variable EEG.

Back 14

REM

Front 15

person demands only the best & most famous doctor in town.
what personality d/o

Back 15

narcissistic personality d/o

Front 16

nurse has episodes of hypoglycemia; blood analysis shows no elevation in C protien. What is the dx.

Back 16

factitious d/o. self scripted insulin

Front 17

woman presents w/ headache, visual disturbance, galactorrhea and amenorrhea
what is the dx

Back 17

prolactinoma

Front 18

pt experiences dizziness & tinnitis. ct shows enlarged internal acoustic meatus. What is the dx

Back 18

schannoma

Front 19

25 y/o female presents w/ sudden uniocular vision loss & slightly slurred speech. She has hx of weekness & parasthesias that have resoved. what is the dx

Back 19

MS

Front 20

10 y/o child "spaces out" in class (e.g., stops talking midsentance & then continues as if nothing happened. During spells there is slight quivering of lips. Dx?

Back 20

absence seizures

Front 21

man on several meds including antidepressants and antihypertensives, has mydriasis and becomes constipated. What is the cause of his symptoms

Back 21

TCA

Front 22

woman on MAO inhibitor has hypertensive crisis after a meal. What did she ingest?

Back 22

tyramine (wine or cheese)

Front 23

This CNS support cell helps maintain the blood-brain barrier. It's cell marker is GFAP

Back 23

astrocyte

Front 24

this CNS support cell makes up the inner lining of the ventricles

Back 24

ependymal cells

Front 25

this CNS support cell is the macrophage of the brain phagocytosing in areas of inflammation or neural damage. Like the macrophage, this cell is mesodermal in origen.

Back 25

microglia.

Front 26

This CNS support cell is responsible for myelin production

Back 26

oligodendroglia

Front 27

This pns support cell is responsible for peripheral myelin production

Back 27

schwann cell

Front 28

All CNS/ PNS support cells (except the microglia which originates from mesoderm)originate from this primary germ cell layer.

Back 28

ectoderm

Front 29

autopsy done on pt w/ HIV shows these support cells transformed into virus filled multinucleated giant cells in CNS

Back 29

microglia

Front 30

these CNS support cells are destroyed in MS

Back 30

oligodendroglia

Front 31

Acoustic neuroma is a neoplasm of this PNS support cell commonly associated with the internal acoustic meatus (CN VII, VIII)

Back 31

schwann cell

Front 32

Give following peripheral nn layers from inner most to outermost :
nn fibers
endoneurium
epineurium
perineurium

Back 32

endoneurium-perineurium-epineurium-nn fibers

Front 33

this peripheral nn layer must be rejoined in microsurgery for limb reattachment

Back 33

perineurium

Front 34

this sensory corpuscle is a small, encapsulated nn ending found in the dermis of palms, soles, and digits of skin. It is involved in light discriminatory touch of glabrous (hairless) skin.

Back 34

meissner's corpuscle

Front 35

this sensory corpuscle is a large, encapsulated nn ending found in deeper layers of skin at ligaments, joint capsules, serous membranes, and mesenteries. It is involved in pressure, coarse touch, vibration, and tension.

Back 35

pacinian corpuscle

Front 36

this sensory corpuscle is a cup-shaped nn ending in dermis of fingertips, hair follicles, hard palate. It is involved in light, crude touch

Back 36

merkel's corpuscle

Front 37

when you hear high frequency sound, this part of the cochlea is responding (narrow & stiff)

Back 37

base

Front 38

when you hear low frequency sound, this part of the cochlea is responding (wide and flexible)

Back 38

apex

Front 39

perilymph in the inner ear is similar to (ECF or ICF)

Back 39

ECF (high Na+)

Front 40

when you hear high frequency sound, this part of the cochlea is responding (narrow & stiff)

Back 40

base

Front 41

endolymph in the inner ear is similar to (ECF or ICF)

Back 41

ICF (K+)

Front 42

Utricle and saccule of the inner ear contain maculae which detect which type of acceleration?

Back 42

linear

Front 43

Semicircular canals of the inner ear contain ampullae which detect which type of acceleration?

Back 43

angular

Front 44

hearing loss in the elderly usually begins with which type of frequency

Back 44

high frequencies

Front 45

blood brain barrier is formed by which 3 structures:

Back 45

1)astrocyte processes
2) basement membrane
3)tight jx b/n nonfenestrated capillary endothelial cells

Front 46

glucose and amino acids cross the blood-brain barrier by which method.

Back 46

carrier mediated transport mechanism

Front 47

what crosses blood brain barrier more redily. water soluble substances or lipid soluble substances?

Back 47

lipid soluble

Front 48

the hypothalamus wears TAN HATS is a mneumonic for the fxns of the hypothalamus?
What does the T stand for (2 chances to get it right.

Back 48

either:
1)Thirst
or
2)Temperature

Front 49

the hypothalamus wears TAN HATS is a mneumonic for the fxns of the hypothalamus?
What does the A stand for (2 chances to get it right.

Back 49

Either
1) Adenohypophysis control
or
2)Autonomic regulation

Front 50

the hypothalamus wears TAN HATS is a mneumonic for the fxns of the hypothalamus?
What does the A stand for (2 chances to get it right.

Back 50

Either
1) Adenohypophysis control
or
2)Autonomic regulation

Front 51

the hypothalamus wears TAN HATS is a mneumonic for the fxns of the hypothalamus?
What does the N stand for

Back 51

Neurohypophysis hormones (synthesized in hypothalamic nucleii)

Front 52

the hypothalamus wears TAN HATS is a mneumonic for the fxns of the hypothalamus?
What does the H stand for

Back 52

Hunger

Front 53

the hypothalamus wears TAN HATS is a mneumonic for the fxns of the hypothalamus?
What does the S stand for?

Back 53

Sexual urges

Front 54

destruction of the lateral nucleus of the hypothalamus results in what type of food intake?

Back 54

anerexia & starvation

Front 55

destruction of the ventromedial nucleus of the hypothalamus results in what type of food intake?

Back 55

hyperphagia and obesity

Front 56

Anterior hypothalamus regulates what division of the ANS.

Back 56

parasympathetic

Front 57

Posterior hypothalamus regulates what division of the ANS.

Back 57

Sypathetic

Front 58

This nucleus controls circadian rhythms.

Back 58

suprachiasmatic nucleus

Front 59

This nucleus controls thirst and water balance

Back 59

supraoptic nucleus

Front 60

This part of the hypothalamus (anterior or posterior) kicks in and regulates heat concervation when cold.

Back 60

posterior hypothalamus

Front 61

This part of the hypothalamus (anterior or posterior) coordinates cooling when hot.

Back 61

anterior hypothalamus

Front 62

When this nucleus of the hypothalmus is destroyed--rage results?

Back 62

septal nucleus

Front 63

The posterior pituitary (neurohypophysis) recieves hypothalamic axonal projections from the supraoptic nucleii and releases what hormone?

Back 63

ADH

Front 64

The posterior pituitary (neurohypophysis) recieves hypothalamic axonal projections from the paraventricular nucleii and releases what hormone?

Back 64

oxytocin

Front 65

this part of the brain is the major relay for ascending sensory informationthat ultimately reaches the cortex?

Back 65

thalamus

Front 66

This geniculate nucleus of the thalamus (lateral or medial) is involved in relaying visual sensory information to the cortex.

Back 66

lateral

Front 67

This geniculate nucleus of the thalamus (lateral or medial) is involved in relaying auditory sensory information to the cortex.

Back 67

medial geniculate nucleus (MGN)

Front 68

This nucleus of the thalamus is involved in relaying BODY sensation information (proprioception, pressure, pain, touch, vibriation) to the cortex via the dorsal columns & the spinothalamic tract.

Back 68

Ventral Posterior Nucleus, Lateral part (VPL)

Front 69

This nucleus of the thalamus is involved in relaying FACIAL sensation information to the cortex via CN V

Back 69

Ventral Posterior nucleus, medial part (VPM)

Front 70

This nucleus of the thalamus is involved in relaying motor information to the cortex.

Back 70

Ventral Anterior/Lateral nucleus (VL)

Front 71

This "system" of the brain is responsible for the 5 Fs. Feeding, Fighting, Feeling, Flight, and Fucking.

Back 71

limbic system

Front 72

This part of the brain is important in voluntary movements and making postural adjustments.

Back 72

basal ganglia

Front 73

Parkinson's dz symptoms are do to decreased imput from this part of the basal gangia.

Back 73

substantia nigra.

Front 74

In Parkinson's dz the symptoms are due to decreased input from the substantia nigra of the basal ganglia. This leads to _______ (increased or decreased) stimulation of the direct pathway and _______ (increased or decreased) inhibition of the indirect pathway

Back 74

decreased
decreased

Front 75

In the basal ganglia, _________ (D1)facilitates movement

Back 75

direct pathway

Front 76

In the basal ganglia, _________ (D2)inhibits movement

Back 76

indirect pathway

Front 77

In the cerebral cortex associative auditoritory fx is associated with which area?

Back 77

Wernicke's area (22)

Front 78

In the cerebral cortex speech motor fx is associated with which area?

Back 78

broca's area

Front 79

Your pt has become recently more and more disorganized. He reports problems concentrating and poor social judgement. What lobe of the brain could be involved.

Back 79

frontal lobe

Front 80

anterior cerebral artery hemarrage could result in sensory motor problems in which location of the body?

Back 80

lower extremity

Front 81

anterior cerebral aa supplies what part of the brain

Back 81

medial surface

Front 82

hemhorrage of the middle cerebral aa would involve what part of the brain.

Back 82

lateral

Front 83

hemhorrage of the middle cerebral aa could involve what pathologies?

Back 83

motor & sensory deficits of teh trunk-arm-face, Broca's and Wernicke's speech areas

Front 84

Anterior communicating artery lesion is the most common circle of Willis aneurism. It may cause this deficit.

Back 84

visual field defect

Front 85

Posterior communicating artery is also a common area of aneurism. It can result in this cranial nn palsy.

Back 85

CN III

Front 86

A stroke in this general part of the circule of wilis can cause general sensory and motor dysfunction and aphasia

Back 86

anterior circle

Front 87

A stroke in this general part of the circle of wilis can cause cranial n deficits (vertigo, visual deficits), coma, cerebellar deficits (ataxia)

Back 87

posterior circle

Front 88

this division of the middle cerebral aa is a common site of stroke. It feeds the internal capsule, caudate, putamen, & globus pallidus

Back 88

lateral striate

Front 89

Cerebral veins drain into the venous sinuses which drain into what?

Back 89

internal jugular vv

Front 90

lateral ventricle drains into the 3rd ventricle via the foramen of _______.

Back 90

monro

Front 91

3rd ventricle drains into the 4th ventricle via the aquaduct of ________

Back 91

sylvius

Front 92

4th ventricle drains into the subarachnoid space via the foramina of ________ (laterally) and the foramina of ________ (medially

Back 92

Luschka
Magendie

Front 93

How many spinal nn are there total?

Back 93

31
8-C
12-T
5-L
5-S
1-coccygeal

Front 94

Vertibral disk herniation usually occurs between what levels_______

Back 94

L5-S1

Front 95

At what levels do you want do a LP

Back 95

L3-L5
(spinal cord extends to lower border of L2; Subarachnoid space extends to lwer border of S2)

Front 96

You perform an LP at the level of L4/L5 (iliac crest levels). List the following sx in the order that you will pierce them?

Ligaments
Arachnoid
Epidural space
Subdural space
skin/superficial fascia
Dural matter
Subarachnoid space CSF

Back 96

skin/superficial fascia
Ligaments
Epidural space
Dural matter
Subdural space
Arachnoid
Subarachnoid space CSF

Front 97

Should you pierce the Pia matter in a lubar puncture?

Back 97

No

Front 98

These columns relay sensation of pressure, vibration, touch, and proprioception to the cerebral cortex.

Back 98

dorsal columns

Front 99

This fasciculus within the dorsal column relays the sensation of pressure, vibration, touch, and proprioception from the upperbody and extremities to the cerebral cortex.

Back 99

fascciculus cuneatus

Front 100

This fasciculus within the dorsal column relays the sensation of pressure, vibration, touch, and proprioception from the lower body and extremities to the cerebral cortex.

Back 100

fasciculus gracilis

Front 101

These tracts relay sensation of pain and temperature up the spinal cord to the cerebral cortex

Back 101

spinothalamic tract

Front 102

These tracts relay motor signals from the brain down teh spinal cord.

Back 102

lateral corticospinal tract

Front 103

what is more lateral in the dorsal columns the fasciculus cuneatus or fasciculs gracilis

Back 103

fasciculus cuneatus

Front 104

Describe the path of a vibratory (or pressure, touch, proproceptive) sensation as after it signals a sensory nn up until its first synapse (must get 3 key points)

Back 104

Sensation enters the DORSAL ROOT GANGLION to ascent the spinal cord IPSILATERALLY in the DORSAL COLUMN.

Front 105

Describe the location of the first synapse of that vibratory (or pressure, touch, proproceptive) sensation (must give nucleus and brain location)

Back 105

NUCLEUS CUNEATUS or GRACILIS in the MEDULLA

Front 106

Describe the 2nd order neuron of that vibratory (or pressure, touch, proproceptive) sensation. (decussation & ascention)

Back 106

decussates in the MEDULLA and ascends CONTRALATERALLY in the MEDIAL LEMNISCUS

Front 107

Describe the 2nd synapse of that vibratory (or pressure, touch, proproceptive) sensation. (Nucleus and brain location)

Back 107

VPL of the THALAMUS

Front 108

Describe the final destination of the 3rd order neuron of that vibratory (or pressure, touch, proproceptive)sensation

Back 108

SENSORY CORTEX

Front 109

Describe the path of an ascending pain (or temperature) sensation after it signals a sensory nn up until its first synapse

Back 109

travels from sensory nn endigns (A-delta and C-fibers)and enters spinal cord ipsilaterally.

Front 110

Describe the first synapse of ascending pain and temperature sensation

Back 110

IPSILATERAL synapse with gray matter in spinal cord.

Front 111

Describe the 2nd order neuron transmission of the ascending pain and temperature sensation. (decussation & ascention)

Back 111

Decussates at the ANTERIOR WHITE COMMISSURE and ascends CONTRALATERAL in the SPINOTHALAMIC TRACT

Front 112

Describe the 2nd synapse of the ascending pain and temp sensation?

Back 112

VPL of thalamus

Front 113

Describe the 3rd order neuron final destination of the ascending pain and temperature sensation.

Back 113

sensory cortex

Front 114

You want to move you're right arm? Describe the 1st order neuron pathway.

Back 114

begin in the LEFT HEMISPHERE PRIMARY MOTOR CORTEX. The UPPER MOTOR NEURONS descends IPSILATERALLY until decussating at CAUDAL MEDULLA (PYRAMIDAL DECUSSATION) and then descend CONTRILATERALLY.

Front 115

You want to move you're right arm? Describe where the 1st synapse occurs.

Back 115

CELL BODY OF THE ANTERIOR HORN (SPINAL CORD)

Front 116

You want to move you're right arm? Describe the 2nd order neuron.

Back 116

LOWER MOTOR NEURON leaves the spinal cord.

Front 117

You want to move you're right arm? Describe where the 2nd synapse occurs.

Back 117

neuromuscular jx

Front 118

Give the brachial plexus dx from the BP damage:
Upper trunk (C5, C6)

Back 118

waiters tip

Front 119

Give the diagnosis from the location of Brachial Plexus damage:
Lower trunk (T1,C8)

Back 119

claw hand

Front 120

Give the diagnosis from the location of Brachial Plexus damage:
Posterior chord (C5-T1)

Back 120

Wrist drop

Front 121

Give the diagnosis from the location of Brachial Plexus damage:
Long Thoracic Nerve

Back 121

Winged scapula

Front 122

Give the diagnosis from the location of Brachial Plexus damage:
Axillary nn

Back 122

Deltoid paralysis

Front 123

Give the diagnosis from the location of Brachial Plexus damage:
Radial nn

Back 123

Sadurday night palsy

Front 124

Give the diagnosis from the location of Brachial Plexus damage:
musculocutaneous nn

Back 124

difficulty flexing elbow, variable sensory loss

Front 125

Give the diagnosis from the location of Brachial Plexus damage:
Median nn

Back 125

decreased thumb fx-Pope's blessing

Front 126

Give the diagnosis from the location of Brachial Plexus damage:
Ulnar branch

Back 126

Intrinsic mm of hand, claw hand

Front 127

What mm protects brachial plexus from injury in the case of the relatively common clavicle fracture

Back 127

subclavius

Front 128

This nn is known as the "great extensor nn" it provides innervation of the Brachioradialis, Extensors or the wrist and fingers, Supinator, and Triceps.

Back 128

Radial nn.

mneu:RAD=BEST
Brachioradialis, Extensors or the wrist and fingers, Supinator, and Triceps.

Front 129

Thenar mm (3)

Hypothenar mm (3)

Back 129

Opponens pollicis, Abuctor pollicis brevis, Flexor pollicis brevis

Opponens digiti minimi, Abductor digiti minimi, Flexor digiti minimi

Both groups perform the same fx: Oppose, Abduct, and Flex (OAF)

Front 130

Clinically important Landmarks:
-Ischial spine?
-2/3 of the way from the umbilicus to the anterior superior Iliiac Spine
-Iliac Crest

Back 130

Pudendal nn block
McBurney's Pt-Appendix
Lumbar puncture

Front 131

Landmark Dermatomes:
Posterior half of the scull "cap"

Back 131

C2

Front 132

Landmark Dermatomes: high turtle neck shirt

Back 132

C3

Front 133

Landmark Dermatomes: low collar shirt

Back 133

C4

Front 134

Landmark Dermatomes: T4

Back 134

nipple

T4 at the "teat pore"

Front 135

Landmark Dermatomes: xyphoid process

Back 135

T7

Front 136

Landmark Dermatomes: Umbilicus

Back 136

T10

T10 at the belly butTEN

Front 137

Landmark Dermatomes: Inguinal ligament

Back 137

L1

L1 is IL

Front 138

Landmark Dermatomes: includes the kneecaps

Back 138

L4

down on L4s (all 4s)

Front 139

Landmark Dermatomes:
erection, and sensation of penile and anal zones

Back 139

S2,3,4

S2,3,4 keeps the penis off the floor

Front 140

Gallbladder pain is referred to the right shoulder via this nn

Back 140

phrenic nn

Front 141

This work in prallel w/ mm fibers. When a mm is stretched it causes the intrafusal to stretch which stimulates the Ia afferent which in turn stimulates the alpha motor neuron which causes a reflex muscle (extrafusal ) contraction

Back 141

muscle spindle

Front 142

these monitor mm lenth. For example help you pick up a heavy suitcase when you didn't know how heavy it was.

Back 142

muscle spindles

Front 143

This senses tension and provides inhibitory feedbach to alpha motor neurons

Back 143

golgi tendon organs

Front 144

These monitor mm tension. For example make you drop a heavy suitcase you've been holding for too long

Back 144

golgi tendon organs

Front 145

CNS stimulates the gamma motor neuron which contracts intrafusal fiber and causees an increased sensitivity of the reflex arc

Back 145

gamma loop

Front 146

Clinical reflexes:
-Achillies:
-Patella:
-Biceps:
-Triceps:

Back 146

S1,2
L3,4
C5,6
C7,8

Front 147

Dorsiflexion of the big toe and fanning of other toes; sign of UMN lesion, but normal reflex in 1st year of life

Back 147

Babinski

Front 148

Primitive Reflexes:
extension of limbs when startled

(normally disappear w/in 1st year. May reemerge following a frontal lobe lesion)

Back 148

moro reflex

Front 149

Primitive Reflexes:
nipple seeking

(normally disappear w/in 1st year. May reemerge following a frontal lobe lesion)

Back 149

rooting reflex

Front 150

Primitive Reflexes:
grasps objects in palm

(normally disappear w/in 1st year. May reemerge following a frontal lobe lesion)

Back 150

palmar reflex

Front 151

Primitive Reflexes:
large toe dorsiflexes w/ plantar stimulation

(normally disappear w/in 1st year. May reemerge following a frontal lobe lesion)

Back 151

babinski reflex

Front 152

CNs that lie medially at brainstem

Back 152

III, VI, XII

mneu: 3(x2)=6(x2)=12

Front 153

Give Cranial nn by Fx: Is it Motor or sensory or Both?
Fx:
smell

Back 153

CNI-olfactory(S)

Front 154

Give Cranial nn by Fx: Is it Motor or sensory or Both?
Fx:
Sight

Back 154

CN II: Optic (S)

Front 155

Give Cranial nn by Fx: Is it Motor or sensory or Both?
Fx:
Eye movement (up(lateral & medial) down (lateral), pupil constriction, accommodation, eyelid opening

Back 155

CN III: Oculomotor (M)

Front 156

Give Cranial nn by Fx: Is it Motor or sensory or Both?
Fx:
Eye movement (down & medial)

Back 156

CN IV: Trochlear (M)

Front 157

Give Cranial nn by Fx: Is it Motor or sensory or Both?
Fx:
Mastication, Facial sensiation

Back 157

CN V: Trigeminal (B)

Front 158

Give Cranial nn by Fx: Is it Motor or sensory or Both?
Fx:
Eye movement (lateral)

Back 158

CN VI: Abducens (M)

Front 159

Give Cranial nn by Fx: Is it Motor or sensory or Both?
Fx:
Facial mvmt, taste from anterior 2/3 of tongue, lacrimation, salivation (submaxillary and sublingual glands, eyelid closing.

Back 159

CN VII: Facial (B)

Front 160

Give Cranial nn by Fx: Is it Motor or sensory or Both?
Fx:
Hearing, balance

Back 160

CN VIII: Vestibulocochlear (S)

Front 161

Give Cranial nn by Fx: Is it Motor or sensory or Both?
Fx:
Taste from post 1/3 of tongue, swallowing, salivation (parotid gland), monitoring carotid body and sinus chemo-and baroreceptors

Back 161

CN IX: Glossopharyngeal (B)

Front 162

Give Cranial nn by Fx: Is it Motor or sensory or Both?
Fx:
Tastte from epiglottic region, swallowing, palate elevaton, talking, throacoabdominal viscera, monitoring aortic arch chemo-and baroreceptors

Back 162

CN X: Vagus (B)

Front 163

Give Cranial nn by Fx: Is it Motor or sensory or Both?
Fx:
Head turning, shoulder shrugging

Back 163

CN XI: Accessory (M)

Front 164

Give Cranial nn by Fx: Is it Motor or sensory or Both?
Fx:
tongue mvmt

Back 164

CN XII: Hypoglossal (M)

Front 165

Cranial nn nucleii located in the Midbrain

Back 165

CN III, IV

Front 166

Cranial nn nucleii located in the Pons

Back 166

CN V-VIII

Front 167

Cranial nn nucleii located in the Medulla

Back 167

IX-XII

Front 168

Cranial nn nucleii located in the Midbrain

Back 168

CN III, IV

Front 169

Cranial nn more lateral in the brainstem tend to be ______; those more medially tend to be _______

Back 169

sensory
motor

Front 170

This vagal nucleii recieves visceral sensory information (e.g., taste baroreceptors, and gut distension) from cranial nn VII, IX, & X

Back 170

Nucleus Solitarius

Front 171

This vagal nucleii is responsible for Motor inervation of the pharynx, larynx and upper esophagus (e.g, swallowing, palate elevation)via CN IX,X,XI.

Back 171

Nucleus aMbiguous

Front 172

This vagal nucleii sends autonomic (parasympathetic) fibers to heart, lungs, and upper GI

Back 172

Dorsal motor nucleus

Front 173

Crandial nn and vessel pathways:
Cribiform plate

Back 173

CN I

Front 174

Crandial nn and vessel pathways:
optic canal

Back 174

CN II, opthalmic artery, central retinal vein

Front 175

Crandial nn and vessel pathways:
Superior orbital fissure

Back 175

(CN III, IV, V1,VI, opthalmic vv)

Front 176

Crandial nn and vessel pathways:
Foramen Rotundum

Back 176

CN V2

Front 177

Crandial nn and vessel pathways:
Foramen Ovale

Back 177

CN V3

Front 178

Crandial nn and vessel pathways:
Foramen spinosum

Back 178

middle meningeal aa

Front 179

Crandial nn and vessel pathways:
Internal auditory meatus

Back 179

CN VII, VIII

Front 180

Crandial nn and vessel pathways:
Jugular foramen

Back 180

CN IX,X,XI, jugular vv

Front 181

Crandial nn and vessel pathways:
Hypoglossal canal

Back 181

CN XII

Front 182

Crandial nn and vessel pathways:
Foramen magnum

Back 182

Spinal roots of CN XI, brainstem, vertebral arteries

Front 183

a collectionof venous sinuses on either side of the pituitary

Back 183

cavernous sinus

Front 184

nn that pass through cavernous sinuses

Back 184

nn that control extaocular mm (CN III, IV, VI) plus V1 & V2

Front 185

pt presents w/ opthalmoplegia, & opthalmic and mandibular sensory loss
what is a possible dx?

Back 185

Cavernous sinus syndrome (e.g., due to mass effect

Front 186

Muscles of mastication:
3 mm that close the jaw

innervated by?

Back 186

Masseter, teMporalis, Medial pterygoid.

inn: V3

mneu: Ms Munch

Front 187

Muscles of mastication:
1 mm opens the jaw

innervated by:

Back 187

Lateral pterygoid.
inn: V3

mneu: Lateral Lowers

Front 188

All mm with the root glossus in their names are innervated by?
Except one exception. What is it and what is the innervation.

Back 188

hypoglossal.
palatoglossus (inn by vagus)

Front 189

All mm with the root palat in their names are innervated by this.
One exception what is it innervated by?

Back 189

vagus


exception: tensor veli palatine (inn by Mandibular branch of CN V)

Front 190

CN IV innervates what mm? What direction would you look?

Back 190

SO--towards your nose

Front 191

CN VI innervates what mm. What direction would you look

Back 191

LR-laterally

Front 192

What reflex? Light in either retina sends a signal via CN III to PRETECTAL nucleii in midbrain that activate bilateral EDINGER-WESTPHAL nucleii;pupls contract bilaterally (consensual reflex)

Back 192

Pupillary light reflex

Front 193

Saying KLM outloud tests what three CNs?

Back 193

K (vagus) palate elevation
L (hypoglossal) tongue
M (facial) lips

Front 194

What waveform?
awake (eyes open), alert, active mental concentration

Back 194

Beta (highest frequency, lowest amplitude)

Front 195

What waveform?
awake (eyes closed)

Back 195

alpha

Front 196

What waveform?
light sleep
What stage of sleep is this? What percentage of total sleep time is this in young adults?

Back 196

Theta
1
5%

Front 197

What waveform?
deeper sleep
What stage of sleep is this? What percentage of total sleep time is this in young adults?

Back 197

Sleep spindles and K complexes
2
45%

Front 198

What waveform?

Deepest sleep; sleepwalking; night terrors, bed wetting

What stage of sleep is this? What percentage of total sleep time is this in young adults?

Back 198

Delta (lowest frequency, hightest amplitude)
3-4
25%

Front 199

What waveform?

dreaming, loss of motor tone, possibly memory procesing fx, erections, increase brain oxygen use

What stage of sleep is this? What percentage of total sleep time is this in young adults?

Back 199

Beta
REM
25%

mneu: At night, BATS Drink Blood

Front 200

What type of sleep is this?
increase variable pulse, rapid eye movements, inceased and variable blood pressure, penile/clitoral tumenescence. Occurs every 90 min; duration increases throughout the night.

Back 200

REM

Front 201

principle neurotransmitter involved in REM sleep

Back 201

Ach

Front 202

REM sleep _______ (increases or decreases) with age

Back 202

decreases

Front 203

neural tube defects are associated with lack of this vitamen intake during pregnancy

Back 203

folic acid

Front 204

neural tube defects are associated with elevated levels of this in amniotic fluid and maternal serum

Back 204

alpha fetoprotein levels

Front 205

This describes failure of bony spinal canal to close, but no structural herniation. Usually seen at lower vertebral levels

Back 205

spinal bifida occulta

Front 206

This describes when the meninges herniate throgh a spinal canal defect

Back 206

meningocele

Front 207

This describes when meninges and spinal cord herniate through spinal canal defects

Back 207

meningiomyelocele

Front 208

Give the area of the brain lesion?

motor (nonfluent/expressive) aphasia with good comprehension

Back 208

broca's area

Front 209

Give the area of the brain lesion?
sensory (fluent/receptive) aphagia with poor comprehension

Back 209

Wernicke's area

Front 210

Give the area of the brain lesion?

conduction aphagia; poor repitition with good comprehension, fluent speech

Back 210

Arcuate fasciculus
(connects Wernicke's to Broca's area

Front 211

Give the area of the brain lesion?

Kluver-Bucy Syndrome (hyperorality, hypersexuality, disinhibited behavior)

Back 211

Amygdala (bilateral)

Front 212

Give the area of the brain lesion?

Personality changes and deficits in concentration, orientation, and judgement; may have reemergence of primitive reflexes

Back 212

frontal lobe

Front 213

Give the area of the brain lesion?

Spacial neglect syndrome (agnosia of the contralateral side of the world)

Back 213

Right parietal lobe

Front 214

Give the area of the brain lesion?

coma

Back 214

reticular activating system

Front 215

Give the area of the brain lesion?

wernicke-korsakoff syndrome

Back 215

mamillary bodies (bilateral)

Front 216

Give the area of the brain lesion?

tremor at rest, chorea, or athetosis

Back 216

basal ganglia

Front 217

Give the area of the brain lesion?

Intention tremor, limb ataxia

Back 217

cerebellar hemisphere

mneu: cerebellar hemispheres are LATERALLY located--affect LATERAL limbs. Vermis is CENTRALLY located-affects CENTRAL body

Front 218

Give the area of the brain lesion?

truncal taxia, dysarthria

Back 218

cerebellar Vermis

mneu: cerebellar hemispheres are LATERALLY located--affect LATERAL limbs. Vermis is CENTRALLY located-affects CENTRAL body

Front 219

Give the area of the brain lesion?

contralateral hemiballismus

Back 219

subthalamic nucleus

Front 220

Chorea--sudden, jerky, purposeless movements are characteristic of a lesion in this part of the brain. Give the classic dz example.

Back 220

Basal ganglia
Huntington's dz

Front 221

Athetosis are slow, writhing movements, especially of the fingers. This is characteristic of a lesion in this part of the brain

Back 221

basal ganglia

Front 222

hemiballismus involves the sudden wild flailing of 1 arm. What kind of lesion does this indicate (& on what side)

Back 222

contralateral subthalamic nucleus

(results in loss of inhibition of thalamus through globus pallidus)

Front 223

Broca's lesion is nonfluent aphagia with intact comprehension it involves this gyrus

Back 223

inferior frontal gyrus

Front 224

Wernicke's aphagia is fluent aphagia with impared comprehension it involves this gyrus

Back 224

superior temporal gyrus

Front 225

most common cause of dementia in the elderly. Associated w/ senile plaques (extracellular, Beta amyloid core) and neuro fibrillary tangles (intracellular, abnormally phosphorylated tau protiein)

Back 225

Alzheimers dz

Front 226

Familial form of alziemers is associeted w/ genes on chromosomes 1, 14, 19 (APOE4 allele), and 21 (p-App gene) is thought to be responsible for this percent of alzheimers cases

Back 226

10%

Front 227

What is the 2nd most common cause of dementia in the elderly

Back 227

multi-infarct dementia

(may cause amyloid angiopathy)

Front 228

pt presents with dementia, aphasia, parkinsonian aspects; associated with intracellular aggregated tau protien and is specific for frontal and temporal lobes.

Back 228

Pick's dz

Front 229

pt presents with chorea and dementia. Autopsy shows atrophy of caudate nucleus (loss of GABAergic neurons).

Back 229

Huntinton's dz

Front 230

Dz associated with chromasome 4--expansion of CAG repeats.

Back 230

Huntinton's dz

mneu: CAG-Caudate loses ACh & GABA.

Front 231

dz associated w/ Lewy bodies and depigmentation of the substantia nigra pars compacta (loss of dopaminergic neurons) Rare cases have been linked to exposure to MPTP, a contaminant in illicit sreet drugs.

Back 231

Parkinson's dz

mneu: TRAP=Tremor (at rest), Rigidity, Akinesia, and Postural instability (you are TRAPped in your body.

Front 232

Dz associated with BOTH LMN & UMN signs, no sensory defect. Also known as Lou Gehrig's dz

Back 232

Amyotrophic lateral Sclerosis (ALS)

Front 233

presents as birth as a "floppy baby", tongue fasciculations; median age of death is 7 months. Associated w/ degeneration of anterior horns. Autosomal-recessive inheritance.

Back 233

Werdnig-Hoffmann dz

Front 234

dz follws infection with poliovirus; LMN signs. Associated with degeneration of anterior horns.

Back 234

Polio

Front 235

Pt presents w malaise, headache, fever, nausea abdominal pain, sore throught. Progreses to signs of LMN lesions--mm weakness & atrophy, fasciculations, fibrillation, & hyporeflexia.
LP of CSF shows lymphocytic pleocytosis w/ slight elevation of protein.
What do you suspect?

Back 235

Poliomyelits

Front 236

this dz is causesd by the poliovirus, which is transmitted by the fecal-oral route. It replicates in the oropharynx and small intestine before spreading through the bloodstream to the CNS where it leads to the destruction of cells in the anterior horn of the spinal cord, leading in turn to LMN destruction.

Back 236

poliomyelitis

Front 237

This dz shows increased prevalence with increased distance from the equator.

Back 237

MS

Front 238

This dz shows periventricular plaques (areas of oligodendrocyte loss and reactive gliosis)with preservation of actions. There is an increase in protein (IgG) in CSF.

Back 238

MS

Front 239

dz associated with a relapsing-remitting course.

Back 239

MS

Front 240

With this dz pts often present w/ optic neuritis (sudden loss of vision) MLF syndrome (internuclear ophtalmoplegia), hemiperesis, hemisensory symptoms, or bladder/bowel incontinence.

Back 240

MS

Front 241

This dz classically presents with scanning speech, intension tremor, and nystagmus. It most often affects women in their 20s and 30s. And is more common in whites. Tx is Beta interferon or immunosuppressant therapy.

Back 241

MS

Front 242

This demyelinating dz is associated with the JC virus and is seen in 2-4% of AIDS pts.

Back 242

Progressive multifocal leukoencephalopathy (PML)

Front 243

This dz is associated with inflammationand demyelination of peripheral nn and motor fibers of the ventral roots (sensory effects are less severe than motor). This results in symmetric ASCENDING mm weakness begining in distal and lower extremities.

LP of CSF shows elevated protein with normal cell count (albuminocytologic dissociation). Elevated protien levels may lead to papilledema.

Pts usually recover completely.

Back 243

Guillian-Barre Syndrome (acute idiopathic polyneuritis)

Front 244

Guillian-Barr has been associated with certain infections including (2)

Back 244

herpesvirus or Campylobacter jejuni

Front 245

seizures involving only one area of the brain

Back 245

partial seizures

Front 246

simple partial seizures

Back 246

1 area of the brain
conciousness intact

Front 247

complex partial seizures

Back 247

1 area of the brain
impaired consciousness

Front 248

generalized seizures

Back 248

diffuse areas of brain

Front 249

generalized siezures involving a blank stare

Back 249

absence (petit mal)

Front 250

generalized siezures involving quick repetitive jerks

Back 250

myoclonic

Front 251

Generalized siezure involving alternating stiffening and movement

Back 251

tonic-clonic

Front 252

Pt hit in the side of the head with a baseball and fracturs his temperal bone. Rupture of the middle meningeal aa results. CT shows a "bioconvex disk" that does not cross suture lines. What is your dz of the Intracranial hemorrhage?

Back 252

epidural hematoma

Front 253

Alcoholic presents to the ER. He fell and hit his head the previous night but thought he was fine until neurological symptoms appeared the next morning. MRI shows a crescent-shaped hemorrhage that crosses suture lines. You suspect a venous bleed. What is your dx of this intracranial hemorrhage?

Back 253

Subdural hematoma

Front 254

Pt complains of "worst headache of their life." You worry it may be a rubture of a berry aneurism. Spinal tap is bloody. What is the d of this intracranial hemorrhage?

Back 254

Subarachnoid hemorrhage

Front 255

This type of aneurism often occurs at the bifurcation in the circule of Willis. The most common site is the bifurcation of the anterior communicating artery. Risk factors include adult polycystic kidney dz, Ehlers-Danlos syndrome, & Marphan's syndrome.

Back 255

Berry aneurysms

Front 256

most _______ (childhood v. adult) tumors are supratentorial, while most ________childhood v. adult) tumors are infratentorial.

Back 256

adult
childhood

Note: 50% of brain tumors are metastases

Front 257

This tumor has an adult peak incidence. It is the most common primary brain tumor and it has a grave prognosis (<1 yr life expectancy). It is found in the cerebral hemisphere and can cross the corpus callosum.
"Pseudopalisading" tumor cells border central areas of necrosis and hemorrhage. Stain astrocytes with GFAP.

Back 257

Glioblastoma multiforme (grade IV astrocytoma)

Front 258

This tumor has an adult peak incidence. It is the second most common primary brain tumor. It most often occurs in the convexities of hemispheres and parasagital region. It arises from arachnoid cells external to the brain. It is usually resectable.

Back 258

Meningioma

Front 259

On pathology this primary brain tumor shows spindle cells concentrically arranged in a whorled pattern and psammoma bodies (laminated calcification) What is it?

Back 259

Meningioma

Front 260

This brain tumor has an adult peak incidence. It is the 3rd most common primary brain tumor. It is of Schwann cell origin and is often localized to the 8th nerve. It is resectable. What is it?

Back 260

Schwannoma

Front 261

Bilateral schwannoma is often found in what condition?

Back 261

neurofibromatosis type 2

Front 262

This primary brain tumor with an adult peak incidence is relatively rare. It is slow growing and most often occurs in the frontal lobes.

Back 262

Oligodendroma

Front 263

On pathology this tumor has "fried egg" cells-round nucleii with clear cytoplasm. They are often calcified.

Back 263

Oligodendroma

Front 264

This priary brain tumor that has an adult peak incidence most commonly comes in a prolactin secreting form. Often it occurs with bilateral hemianopia (due to pressure on optic chiasm)

Back 264

pituitary adenoma

Front 265

This primary brain tumor has a peak incidence in childhood. It is a diffusely infiltrating glioma. It is most often found in the posterior fossa. It is benign and carries a good prognosis.

Back 265

Pilocytic (low grade) astrocytoma)

Front 266

On pathology this primary brain tumor shows Rosenthal fibers (eosinophilic, corkscrew fibers)

Back 266

Pilocytic (low grade )astrocytoma

Front 267

This primary brain tumor that occurs with a peak incidence in children is a highly malignant cerabellar tumor. It is a form of primitive neuroectodermal tumor (PneT). It can compress the 4th ventricle causing hydrocephalus. It is highly radiosensitive.

Back 267

Medulloblastoma

Front 268

On pathology this tumor shows Rosettes or perivascular pseudorosette pattern of cells

Back 268

medulloblastoma

Front 269

This primary brain tumor that occurs with a peak incidence in children is an ependymal cell tumor most commonly found in the 4th ventricle. It can cause hydrocephalus and carries a poor prognosis.

Back 269

ependymoma

Front 270

On pathology this tumor has characteristic perivascular pseudorosettes. Rod shaped blepharoplasts (basal ciliary bodies) found near the nucleus

Back 270

ependymoma

Front 271

This primary brain tumor that occurs with a peak incidence in children is most often cerebeller. It is associated with Von Hippel-Lindau syndrome when found with retinal angiomas. Can produce EPO and lead to secondary polycythemia.

On pathology: Foamy cells and high vascularity are characteristic.

Back 271

Hemangioblastoma

Front 272

This primary brain tumor that occurs with a peak incidence in children is a benign tumor which can be confused with pituitary adenoma (can also cause bitemporal hemianopia). This is the most common childhood supratentorial tumor. It is derived from remnants of Rathke's pouch and calcification is common.

Back 272

Craniopharyngioma

Front 273

Sign of UMN or LMN lesion or both?

Weakness

Back 273

Both

mneu: LOWER MN= everything is LOWERED (less mm mass, less mm tone, less reflexes, downgoing toes. UPPER MN= everything UP (tone, DTRs, toes)

Front 274

Sign of UMN or LMN lesion or both?

Atrophy

Back 274

LMN

mneu: LOWER MN= everything is LOWERED (less mm mass, less mm tone, less reflexes, downgoing toes. UPPER MN= everything UP (tone, DTRs, toes)

Front 275

Sign of UMN or LMN lesion or both?

Fasciculation

Back 275

LMN

mneu: LOWER MN= everything is LOWERED (less mm mass, less mm tone, less reflexes, downgoing toes. UPPER MN= everything UP (tone, DTRs, toes)

Front 276

Sign of UMN or LMN lesion or both?

Increased Reflexes?
Decreased Reflexes?

Back 276

UMN
LMN

mneu: LOWER MN= everything is LOWERED (less mm mass, less mm tone, less reflexes, downgoing toes. UPPER MN= everything UP (tone, DTRs, toes)

Front 277

Sign of UMN or LMN lesion or both?

Increased tone?
Decreased tone?

Back 277

UMN
LMN

mneu: LOWER MN= everything is LOWERED (less mm mass, less mm tone, less reflexes, downgoing toes. UPPER MN= everything UP (tone, DTRs, toes)

Front 278

Sign of UMN or LMN lesion or both?

Babinski?

Back 278

UMN

mneu: LOWER MN= everything is LOWERED (less mm mass, less mm tone, less reflexes, downgoing toes. UPPER MN= everything UP (tone, DTRs, toes)

Front 279

These diseases result in lower motor neuron lesions only. They are due to destruction of the anterior horns and result in flacid paralysis. [pic]

Back 279

Poliomyelitis & Werdinig Hoffman dz

Front 280

This dz effects mostly the white matter of the cervical region. Random and asymmetrical demyelinating lesions are seen. Often pt presents with scanning speech, intention tremor, and nystagmus [pic]

Back 280

MS

Front 281

These diseases result in lower motor neuron lesions only. They are due to destruction of the anterior horns and result in flacid paralysis. [pic]

Back 281

Poliomyelitis & Werdinig Hoffman dz

Front 282

This dz involves combined UMN and LMN deficits with no sensory deficit. Pt often presents with both UMN & LMN neuron signs [pic]

Back 282

ALS

Front 283

When this happpens the only thing spared are the dorsal columns and tract of Lissauer[pic]

Back 283

complete occlusion of ventral artery

Front 284

This results in degeneration of the dorsal roots and dorsal columns. Pt presents with impared proprioception and locomotor ataxia.

Back 284

Tabes dorsalis (tertiary syphilis)

Front 285

This resultswhen the crossing fibers of the corticospinal tract are damaged. Pt presents with bilateral loss of pain and temperature sensation

Back 285

syringomyelia

Front 286

This results in demyelination of dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts. Pt often presents with ataxic gait, hyperreflexia, impared position and vibration sense

Back 286

vit B neuropathy and Friedreich's ataxia

Front 287

This results when the central canal of the spinal cord is enlarged for some reason. The crossing fibers of spinothalamic tract are thus damaged. Pt shows bilateral loss of pain and temperature sensation in upper extremities with preservation of touch sensation.

Back 287

Syringomyelia

Front 288

Syringomyelia often presents with this congenital malformation.

Back 288

Arnold-Chiari malformation

Front 289

Syringomyelia is most common at this spinal level

Back 289

C8-T1

Front 290

This disorder is due to degeneration of the dorsal columns and dorsal roots due to tertiary syphilis. It results in impared proprioception and locomotor ataxia. Pt often presents with Charccot's joints (neuropathy of the joint), Argyll Robertson pupils (reactive to accommidation but not to light), and absensce of DTRs

Back 290

Tabes dorsalis

Front 291

Brown Sequard syndrome is a complete hemisection of the spinal cord. Give the findings.

Back 291

1. Ipsilateral UMN signs(corticospinal tract) below lesion
2) Ipsilateral loss of tactile, vibration, proprioception sense (dorsal column) below lesion
3) Contralateral pain and temperature loss (spinothalamic tract) below the lesion
4) Ipsilateral loss of all sensation at the level of lesion
5) LMN signs at the level of the lesion

*note: if the lesion occurs above T1 the pt will present with Horner's syndrome

Front 292

What are the symptoms of Horner's syndrome?
What spinal levels is it associated with?
What is a common cancer that may result in it?

Back 292

1)Ptosis (droopy eyelid)
2)Anhydrosis (no sweating or flushing of effected side of face
3)Miosis (pupil constriction)

HS is associated with lesion of spinal cord above T1

Pancoast tumor

Front 293

The 3 neuron OCULOSYMPATHETIC PATHWAY projects from 1)hypothalamus to the 2)intermediolateral column of the spinal cord, then to the 3) superior cervical (sympathetic) ganglion, and finally to the 4) pupil, the smooth mm of the eyelids, and the sweat glands of the forehead and face. Interruption of these pathways results in _________

Back 293

Horner's syndrome

Front 294

What nerve was injured?

Pt fractures the shaft of humerus. He presents with "wrist drop" ( extensor carpi radialis longus damage), loss of triceps and brachioradialis reflexes.

Loss of sensation on posterior surface of arm and forearm (posterior brachial cutaneous and posterior antebrachial cutaneous)

Back 294

Radial nn

Front 295

The 3 neuron OCULOSYMPATHETIC PATHWAY projects from 1)hypothalamus to the 2)intermediolateral column of the spinal cord, then to the 3) superior cervical (sympathetic) ganglion, and finally to the 4) pupil, the smooth mm of the eyelids, and the sweat glands of the forehead and face. Interruption of these pathways results in _________

Back 295

Horner's syndrome

Front 296

What nerve was injured?

Pt reports hitting his "funny bone" (medial epicondyle) hard! He now has impared wrist flexion and adduction. He can't adduct his thumb or the 4th and 5th digits resulting in a "claw hand".

He has a loss of sensation over the medial palm and his pinky finger.

Back 296

ulnar

Front 297

What nerve was injured?

pt experiences a break through the surgical neck of the humerus or has an anterior shoulder dislocation. He now has trouble abducting his arm above 30 degrees.

Back 297

Axillary

Front 298

What nerve was injured?

Pt presents with a loss of function of biceps, coracobrachialis, and brachialis muscle. He has no biceps reflex?

Back 298

musculocutaneous

Front 299

This nerve passes through the supinator

Back 299

radial

Front 300

this nerve passes through the pronator teres

Back 300

median

Front 301

this nerve passes through the flexor carpi ulnaris

Back 301

ulnar

Front 302

Child presents with "waiter's tip" appearance: arm hanging to one side (paralysis of abductors), medially rotated (paralysis of lateral rotators), and forarm is pronator (loss of biceps.

What is the dx? What are the nerve roots and what are you concerned about?

Back 302

Erb-Duchenne palsy

traction tear of the upper trunk of the brachial plexis (C5 & C6 roots) often follows blow to shoulder,could be due to trauma during delivery or child abuse.

Front 303

What nerve was injured?

Pt presents with loss of dorsiflexion resulting in "foot drop"

Back 303

Common peroneal nerve (L4-S2)

PED= Peroneal Everts & Dorsiflexes; if injured, foot is dropPED

Front 304

Deep peroneal nn innervates _______ compartment

Superficial peroneal nn innervates _______ compartment

Back 304

anterior

lateral

Front 305

What nn is injured?
pt presents with loss of plantar flexion.

Back 305

Tibial (L4-S3)

TIP=Tibial Inverts & Plantarflexes; if injured, cant stand on TIPtoes.

Front 306

What nn is damaged?
Pt presents with loss of knee extension and deminished pateller reflex.

Back 306

Femoral (L2-L4)

Front 307

What nn is injured?

Pt presents with a loss of hip adduction?

Back 307

Obturator

Front 308

Pt presents with:
1) atrophy of the thenar and hypothenar eminences
2) atrophy of the interosseous mm
3) sensory deficits on the medial side of the forearmand hand
4) disappearance of the radial pulse upon moving the head towards the opposite side

What do you suspect? Discribe this disorder?

Back 308

Thoraci outlet syndrome (Klumpke's palsy)

Compression of subclavian aa and inferior trunk of brachial plexus (C8,T1)

Front 309

In a LMN lesion of CN XII the tongue will deviate _____ (away or towards) the side of the lesion?

Back 309

towards

mneu: lick your wounds

Front 310

In a CN V motor lesion the jaw deviates ______ (towards or away) the side of the lesion

Back 310

towards

Front 311

in a CN X lesion the uvula will deviate _______ (towards or away) of the side of the lesion.

Back 311

away

Front 312

In a unilateral lesion of the cerebellum the pt tends to fall _______ (towards or away) the side of the lesion.

Back 312

towards

Front 313

In a CN XI lesion there is weakness turning head to the side _________ (ipsi or contralateral) to the lesion. There is also a shoulder droop (ipsi or contralateral) to the lesion

Back 313

contralateral
ipsilateral

Front 314

pt presents with paralysis of the lower half his face only. What do you suspect.

Back 314

contralateral UMN lesion
(either of motor cortex or connection between cortex and facial nucleus)

Front 315

pt presents with paralysis of one side of his entire face (upper and lower). What do you suspect?

Back 315

ipsilater LMN lesion of CN VII

Front 316

This disorder is due to a destruction of the facial nucleus itself or it's brancchial efferent fibers (facial nn). It results in ipsilateral facial paralysis with an inability to close the eye of the involved side. It is often idiopathic and there is gradual recovery in most cases

Back 316

Bell's palsy

Front 317

Give some diseases in which Bell's palsy is often seen as a complicaion.

Back 317

Aids, Lyme dz, Sarcoidosis, Tumors, Diabetes

mneu: ALexander BELL with STD: AIDS, Lyme, Sarcoid, Tumors, Diabetes

Front 318

This herniation syndrome can compress the anterior cerebral aa

Back 318

Cingulate herniation under falx cerebri

Front 319

These 3 herniation syndrome can result in coma and death if brain stem is compressed.

Back 319

1)downward transtentoral (central herniation
2) Uncal herniation (Uncus=medial temporal lobe)
3)Cerebellar tonsillar herniation into the foramen magnum

Front 320

In the case of an uncal herniation you may see ipsilateral dilated pupil/ptosis. This is due to what?

Back 320

Stretching of CN III

Front 321

In the case of an uncal herniation you may see contralateral homonymous hemianopia. This is due to what?

Back 321

compression of ipsilateral posterior cerebral aa

Front 322

In the case of an uncal herniation you may see ipsilateral paresis. This is due to what?

Back 322

compression of contralateral crus cerebri (Kernohan's notch)

Front 323

In the case of an uncal herniation you may see Duret hemorrhages (paramedian artery rupture). This is due to

Back 323

caudal displacement of the brain stem

Front 324

Pt can't see at all out of his right eye (right anopia) Where is the lesion?

Back 324

Right optic nn

Front 325

Pts has bilateral temporal visual field defects (bitemporal hemianopia) Where is the lesion?

Back 325

Optic chiasm

Front 326

Pt can't see the left visual field in either eye (Left homonymous hemianopia) Where is the lesion?

Back 326

Right Optic Tract

Front 327

Pt has Left upper quadratic anopsia (cant see up and to the right on both sides) Where is the lesion?

Back 327

Right Temporal Lesion (Meyer's loop)

Front 328

Pt has left lower quandrantic anopia (can't see down and to the left in either eye) Where is the lesion?

Back 328

Right Parietal lesion
(Dorsal optic radiation)

Front 329

Pt has left hemianopia with macular sparing??

Back 329

???visual cortex??

Front 330

this syndrome is seen in many patients with multiple sclerosis. It results in medial rectus palsy on attempted lateral gaze & nystagmus in the abducting eye. Convergence is normal.

Back 330

Internuclear opthalmoplegia (MLF syndrome)

mneu: MLF=MS

Front 331

explain the pathology of Internuclear opthalmoplegia (Medial longitudinal fasciculus [MLF] syndrome)[pic]

Back 331

When looking left, the left nucleus of CN VI fires, which contracts the left lateral rectus and stimulates the contralateral (right) nucleus of CN III via the right MLF to contract the right medial rectus. Lesion in the MLF interrupts this process.

Front 332

give the dz indicated by the following neurotransmitter changes:
↑NE,↓GABA,↓5HT

Back 332

Anxiety

Front 333

give the dz indicated by the following neurotransmitter changes:
↓NE & ↓5HT

Back 333

depression

Front 334

give the dz indicated by the following neurotransmitter changes:
↓ACh

Back 334

Alzheimer's dementia

Front 335

give the dz indicated by the following neurotransmitter changes:
↓GABA,↓ACh

Back 335

Huntington's dz

Front 336

give the dz indicated by the following neurotransmitter changes:
↑Dopamine

Back 336

Schizophrenia

Front 337

give the dz indicated by the following neurotransmitter changes:
↓ Dopamine

Back 337

Parkinson's dz

Front 338

When a person becomes disoriented they generally lose concept of person(their name, who they are), place (where they are), and time. In what order does this loss usually occur?

Back 338

1st-time
2nd-place
last-person

Front 339

what is anosognosia?

Back 339

unawareness that one is ill

Front 340

what is autotopagnosia

Back 340

inability to locate one's own body parts

Front 341

what is depersonalization

Back 341

body seems unreal or dissociated

Front 342

what is ANTEROgrade amnesia?

Back 342

inability to remember things that occurred afte a CNS insult

mneu: antero=after

Front 343

what is RETROgrade amnesia?

Back 343

inability to remember things that occurred before a CNS insult

mneu: retro=before

Front 344

what is substance dependance?

Back 344

maladaptive pattern of substance use defined as 3 or more of the follwing signs in 1 yr:
1)tolerance
2)withrawal
3)substance taken in larger amounts or over longer period of time than desired
4) persistant desire or attempts to cut down
5) significant energy spent obtaining, using, or recovering from substance
6 Important social, occupational, or recreational activities reduced because of substance use
7) continued use in spite of knowing the problems it causes

Front 345

What is substance abuse

Back 345

maladaptive pattern leading to clinically significant imparment or distress. Symptoms have not met criteria for substance dependance. 1 or more of the follwing in 1 yr:
1) recurrent use resulting in failure to fulfill major obligations at work, school, or home
2) recurrent use in physically hazardous situations
3) recurrent substance-related legal problems
4)Continued use in spite of problems caused by use

Front 346

intoxication of this drug results in disinhibition, emotional lability, slurred speech, ataxia, coma, blackouts.

Back 346

alcohol

Front 347

gamma glutamyltransferase (GGT) is a sensitive indicator of this drugs use

Back 347

alcohol

Front 348

withdrawal from this drug results in tremor tachycardia, hypertension, malaise, nausea, seizures, delerium tremens (DTs), tremulousness, agitation, hallucinations

Back 348

alcohol

Front 349

intoxication of this substance results in CNS depression, nausea and vomiting, constipation, pupillary constriction (pinpoint pupils), seizures
*overdose is life threatening

Back 349

opiods

Front 350

withdrawal from this substance results in anxiety, insomnia, anorexia, sweating, dilated pupils, piloerection (goose pimples), fever, rhinorrhea, nausea, stomach cramps, diarrhea ("flulike" symptoms), yawning

Back 350

opiods

Front 351

intoxication of this substance results in psychomotor agitation, impared judgement, pupillary dilation, hypertension, tachycardia, euphoria, prolonged wakefulness and attention, cardiac arrhythmias, delusions, hallucinations, fever

Back 351

amphetamines

Front 352

withdrawal from this substance results in post use "crash", including depression, lethargy, headache, stomach cramps, hunger, hypersomnolence

Back 352

amphetamines

Front 353

intoxication of with this substance results in euphoria, psychomotor agitation, impared judgement, tachycardia, pupillary dilation, hypertension, hallucinations (including tactile), paranoid ideations, angina, sudden cardiac death

Back 353

cocaine

Front 354

withdrawal from this substance results in a post-use "crash", including severe depression and suicidality, hypersomnolence, fatigue, malaise, and severe psychological craving

Back 354

cocaine

Front 355

intoxication with this substance results in belligerence, impulsiveness, fever, psychomotor agitation, vertical and horizontal nystagmus, tachycardia, ataxia, homicidality, psychosis, delirium

Back 355

PCP

Front 356

with this drug recurrence of intoxication symptoms can occur due to reabsorption in the GI tract, resulting in a sudden onset of severe, random, homicidal violence

Back 356

PCP

Front 357

intoxication with this substance can result in marked anxiety or depression, delusions, visual hallucinations, flashbacks, and pupil dilation

Back 357

LSD

Front 358

Intoxication with this substance can result in euphoria, anxiety, paranoid delusions, perception of slowed time, impared judgement, social withdrawal, increased appetite, dry moth, hallucinations

Back 358

Marijuana

Front 359

Intoxication with this drug is dangerous because of its low safety margin. higher doses result in respiratory depression

Back 359

barbituates

Front 360

withdrawal from this substance results in anxiety, seizures, delerium, and life-threatening cardiovascular collapse

Back 360

barbiturates

Front 361

These medications have a greater safety margin than barbituates. Intoxication can result in amnesia, ataxia, somnolence, minor respiratory depression.

Back 361

benzodiazepines

Front 362

these drugs have an additive effect with alcohol

Back 362

benzodiazepines

Front 363

withdrawal from these drugs results in rebound anxiety, seizures, tremor, and insomnia

Back 363

benzodiazepines

Front 364

excessive use of this drug results in restlessness, insomnia, increased diuresis, muscle twitching, and cardiac arrhythmias

Back 364

caffeine

Front 365

withdrawal from this drug results in headache, lethargy, depression, and weight gain

Back 365

caffiene

Front 366

use of this drug results in restlessness, insomnia, anxiety, and arrhythmias-no increased diuresis

Back 366

nicotine

Front 367

withdrawal from this drug results in irritability, headache, anxiety, weight gain, and extreme cravings

Back 367

nicotine

Front 368

use of this drug results in restlessness, insomnia, anxiety, and arrhythmias-no increased diuresis

Back 368

nicotine

Front 369

This dz is charachterized by physiologic tolerance and alcohol dependence with symptoms of withdrawal (tremor, tachycardia, hypertension, malaise, nausea, DTs when intake is interrupted. Pts will show continued drinking despite medical and social contradictions and life disruptions.

Back 369

Alcoholism

Front 370

What is a drug used in treatment of alcoholism

Back 370

disulfiram

Front 371

describe the metabolism and effects of ethenaol

Back 371

image p. 360

Front 372

When do DTs usually appear in alcoholics?

Back 372

2-5D after last drink.

Front 373

In alcoholics in withdrawal what occurs 1st--autonomic system hyperactivity (tachycardia, tremors, anxiety) or psychotic symptoms (hallucinations, delusions)

Back 373

1st-autonomic hyperactivity
2nd-psychotic symptoms

Front 374

How do you treat DTs in alcholics going through withdrawal?

Back 374

benzodiazpenes

Front 375

Long-term alcohol use leads to this involving micronodular cirrhosis with accompaning symptoms of jaundice, hypoalbuminemia, coagulation factor deficiencies, and portal hypertension.

Back 375

alcoholic cirrhosis

Front 376

This syndrome caused by vitamin B1 (thiamine) deficiency, is common in malnourished alcoholics. They classically present with a triad of confusion, opthallmoplegia, and ataxia. This may progress to memory loss, confabulation, and personality change. It is associated with periventricular hemorrhage/necrosis, especially in mamillary bodies.

Back 376

Wernicke-Korsakoff syndrome

Front 377

What is the tx of Wernicke-Korsakoff syndrome

Back 377

IV vitamine B1 (thiamine)

Front 378

this complication of alcoholism consists of longitudinal lacerations at the gastroesophageal junction caused by excessive vomiting. In contrast to esophageal varices it is associated with pain.

Back 378

Mallory-Weiss syndrome

Front 379

Heroine is a schedule __ drug

Back 379

schedule I (not perscribable)

Front 380

addicts of this drug are at increase risk of hepatitis, abscesses, overdose, hemorrhoids, AIDS, and right sided endocarditis.

Back 380

heroine

Front 381

These drugs can competatively inhibit opiods

Back 381

Naloxone (narcan) and naltrexone

Front 382

This long acting oral opiate is used for heroine detoxification or long term maitenance

Back 382

methadone

Front 383

this psychiatric illnesss involves rapid decrease in attention span and level of arousal. Pts show disorganized thinking, have hallucinations, illusions, misperceptions, disturbance in sleep wake cycle, and cognitive disfunction.

The key to diagnosis is its rapid onset and the waxing and waning of level of conciousness.

Back 383

delerium

mneu: deliRIUM=changes in sensoRIUM

Front 384

this is the most common psychiatric illness on medical and surgical floors.

Back 384

delerium

Front 385

delerium is often iatrogenic and reversable. Look at pts meds for ones with this effect.

Back 385

anticholenergic

Front 386

This psychiatric illness ivolves a gradual decrease in cognition--memory deficits, aphasia, apraxia, agnosia, loss of abstract thought, behavior/ personality changes, and impared judgement.

Be sure to differentiate this from delerium. The key to diognosis is the more gradual onset and the fact that pt is alert with no change in his/her level of conciousness.

Back 386

Dementia

mneu: DeMEMtia is characterized by MEMory loss. Commonly irreversable.

Front 387

In elderly pts this disease can often present like dementia.

Back 387

depression

Front 388

DSM Criteria of Major depressive episode

Back 388

characterized by at least 5 of the following for 2 weeks, including either depressed mood or anhedionia:
1) Sleep disturbance
2)↓ Interest
3)Guilt or feelings of worthlessness
4)↓ Energy
5)↓Concentration
6)↕Appetite
7)Psychomotor retardation/agitation
8)Suicidal ideations

mneu: SIG E CAPS

Front 389

Lifetime prevalence of a major depressive episode is _____ for males and _____ for females

Back 389

5-12% - males
10-25% - females

Front 390

This variation on Major depressive disorders invoves 2 or more major depressive episodes with a symptom free interval of 2 months

Back 390

RRECURRENT Major Depressive Disorder

Front 391

This disorder is a milder form of depression that lasts at least 2 years

Back 391

dysthymia

Front 392

Pts with depression typically have the follwing 3 changes in their sleep stages.

Back 392

1)↓ slow wave sleep
2)↓REM latency
3) Early-morning awakening (important screening question

Front 393

Risk factors for suicide completion

Back 393

Sex (male)
Age (teenager or elderly)
Depression
Previous attempt
Etoh (or drug use)
Rational thinking (loss of)
Sickness (≥3 perscriptions)
Organized plan
No spouce (esp if childless)
Social support lacking

mneu: SAD PERSONS

Front 394

ECT is a treatment option when?

Back 394

MDD refractory to other treatment

Front 395

Major adverse effects of ECT

Back 395

anterograde and retrograde amnesia, and confusion

Front 396

T or F: ECT is painful.

Back 396

F

Front 397

This psychiatric disorder is characterized by a period of abnormally and persistantly elevated, expansive, or irritable mood lasting at least one week.

Back 397

Manic episode

Front 398

Describe the DSM criteria for a manic episode.

Back 398

During a manic episode, 3 or more of the follwing are present:
1) Distractibility
2) Irresponsibility
3) Grandiosity
4) Flight of ideas
5)↑Activity
6)↓Sleep
7)Talkativeness

mneu: DIG FAST

Front 399

this psychiatric disturbance is like a manic episode except mood disturbance is not severe enough to cause marked imparement in social and/or occupational functioning or to necessitate hospitalization. There are no psychotic features

Back 399

Hypomanic episode

Front 400

In this disorder pt consciosly fakes or claims to have a disorder in order to attain a specific gain (e.g., avoiding work, obtaining drugs)

Back 400

malingering

Front 401

Drug of choice for bipolar disorder

Back 401

lithium

Front 402

what is cyclothymic disorder?

Back 402

a milder form of bipolar disorder lasting at least 2 years

Front 403

In this disorder the pt conciously creates symptoms in order to assume the "sick role" and to get medical attention.

Back 403

factitious disorder

Front 404

This form of factitious disorder is manifested by a chronic history of multiple hospital admissions and willingness to receive invasive procedures.

Back 404

Munchausen's syndrome

Front 405

This factitious disorder is seen when an illness in the child is caused by the parent. The motivation is unconscious. It is a form of child abuse and must be reported.

Back 405

Muchausen's syndrome by proxy

Front 406

In this psychiatric disorder both illness production and motivation are unconcious drives. These are more common in women and manifest themselves in a variety of ways.

Back 406

Somatoform disorders

Front 407

Type of somatoform disorder in which pt presents with motor or sensory symptoms (e.g., paralysis, pseudoseizure) that suggest neurologic of physical disorder, but tests and physical exam are negative. Onset of symptoms often follow an acute stressor. Pt may seem strangely unconcerned about symptoms

Back 407

Conversion disorder

Front 408

Type of somatoform disorder in which pt presents with prolonged pain that is not explained completely by an illness.

Back 408

Somatoform pain disorder

Front 409

Type of somatoform disorder in which pt presents with preoccupation with and fear of having a serious illness in spite of medical reassurance

Back 409

hypochondriasis

Front 410

Type of somatoform disorder in which pt presents with a variety of complaints in multiple organ sytems with no identifiable underlying physical findings

Back 410

Somatization disorder

Front 411

Type of somatoform disorder in which pt presents with preoccupation with minor or imagined physical flaws. Pts often seek cosmetic surgery

Back 411

Body dysmorhic disorder

Front 412

Type of somatoform disorder in which pt presents with false belief of being pregnant associated with objective physical signs of pregnancy

Back 412

pseudocyesis

Front 413

What type of gain: primary, secondary, tertiary?

What the symmptom does for the patients internal psychic economy

Back 413

primary gain

Front 414

What type of gain: primary, secondary, tertiary?

What the symptom gets the patient (sympathy, attention)

Back 414

secondary gain

Front 415

What type of gain: primary, secondary, tertiary?

What the caretaker gets (like an doctor on an interesting case)

Back 415

tertiary

Front 416

Describe DSM characterization of panic disorder

Back 416

recurrent periods of intense fear and discomfort peaking in 10 minutes with 4 of the following:
Palpitations
Paresthesias
Abdominal distress
Nausa,
Intense fear of dying or losing control
lIght headedness
Chest pain
Chills
Choking
disConnectedness
Sweating
Shaking
Shortness of breath

mneu: PPANIICCCCSSS

note: panic disorder is descrribed in context of occurrence (e.g., panic d/o w/ agoraphobia)

Front 417

This psychiatric disorder involves a specific fear that is excessive or unreasonable. It is cued by presence or anticipation of a specific object or situation. Exposue to this object or situation provokes an anxiety response. Person recognizes the fear is excessive (insight). This fear interfears with normal routine.

Back 417

specific phobia

Front 418

what form of psychotherapy works well for specific phobias

Back 418

systematic desensitation

Front 419

gamophobia

Back 419

fear of marrage

Front 420

algophobia

Back 420

fear of pain

Front 421

acrophobia

Back 421

fear of heights

Front 422

agoraphobia

Back 422

fear of open spaces

Front 423

In this disorder person experiences or witnesses an event that involved actual or threatened death or serious injury. response involves intense fear, helplessness, or horror. The traumatic event is persistently reexperienced as nightmares or flashbacks. The person persistantly avoids stimuli associated with the trauma and experiences persistant symptoms of increased arousal. Disturbance lasts > 1mo and cuases distress or socia/occupation imparent. This disorder often follwos acute stress disorder which lasts up to 2-4 weeks.

Back 423

Post-traumatic stress disorder

Front 424

In this disorder emotional symptoms (anxiety, depression) causing impairment follw an identifiable psychosocial stressor (e.g., divorse, moving). This lasts less than 6 months

Back 424

Adjustment disorder

Front 425

This psychiatric disorder is characterized by uncontrollable anxiety for at least 6 months that is unrelated to a specific person, situation, or event. Sleep disturbance, fatigue, and difficulty concentrating are common.

Back 425

generalized anxiety disorder

Front 426

children with this disorder have severe communication problems and difficulty forming relationships. This disorder is characterized by repetitive behavior, unusual abilities (savants), and usually below-normal intelligence.

Back 426

Autistic disorder

Front 427

This disorder is a milder form of autism involving problems with social relationships and repetitive behavior. These children are of normal intellegence and lack social or cognitive deficits.

Back 427

Asperger disorder

Front 428

This is an X-linked disorder seen only in girls (affected males die in utero). It is characterized by a loss of development and mental reatardation appearing at approximately age 4. There is steriotyped hand-wringing.

Back 428

Rett disorder

Front 429

this disorder is characterized by limited attention span and hyperactivity. Children are emotionally labile, impulsive, and prone to accidents. These children typically have normal intellegence.

Back 429

Attention Deficit Hyperactivity Disorder (ADHD)

Front 430

What is the treatment of ADHD

Back 430

methylphenidate

Front 431

This psychiatric disorder of childhood is characterized by behavior that continually violates social norms. At >18 y/o this disorder is recategorized as antisocial personality disorder.

Back 431

Conduct disorder

Front 432

This psychiatric disorder of childhood is characterized by noncompliance in the absence of criminality.

Back 432

Oppositional defiant disorder.

Front 433

This psychiatric disorder of childhood is characterized by motor/vocal tics and involuntary profanity. Onset is <18 y/o.

Back 433

Tourette's syndrome

Front 434

What is the treatment for Tourette's syndrome

Back 434

haloperidol

Front 435

This psychiatric disorder of childhood is characterized by fear of loss of attachment figure leading to factitious physical complaints to avoid going to school. The common onset is age 7-8.

Back 435

Seperation anxiety disorder.

Front 436

This eating disorder is commonly seen in adolescent girls and coexists with depression. It is characterized by excessive dieting, body image distortion, and increased exercise. Pts often experience severe weight loss, amenorrhea, anemia and eventually electrolyte disturbance.

Back 436

Anerexia nervosa

Front 437

This eating disorder is characterized by binge eating followed by self-induced vomiting or use of laxitives. Body weight is typically normal. Parotitis, enamel erosion, electrolyte disturbances, alkalosis, and dorsal hand calluses are common physical exam/lab findings.

Back 437

Bulimia nervosa

Front 438

Hallucinations v. Illusion v. Delusions

______ are perceptions in the absense of external stimuli

Back 438

Hallucinations

Front 439

Hallucinations v. Illusion v. Delusions

__________ are misinterpretations of actual external stimuli

Back 439

illusions

Front 440

Hallucinations v. Illusion v. Delusions

______ are false beliefs not shared with other members of culture/subculture that are firmly maintained in spite of obvious proof to the contrary

Back 440

Delusions

Front 441

Delusions v. Loose associations

a _____ is a disorder in the CONTENT of the thought (the actual idea)

Back 441

delusion

Front 442

Delusions v. Loose associations

a _____ is a disorder in the FORM of the thought (the way the ideas are tied together)

Back 442

loose association

Front 443

hallucination types:

______ and _____ hallucinations are common in schizophrenia

Back 443

auditory and visual

Front 444

hallucination types:

_____ hallucination often occurs as an aura of a psychomotor siezure

Back 444

olfactory

Front 445

hallucination types:

_____ hallucinations are rare

Back 445

gustatory

Front 446

hallucination types:

_____ hallucinations are common in DTs. Also seen in cocaine abusers ("cocaine bugs")

Back 446

tactile hallucination

Front 447

formication

Back 447

sensation of ants crawling on one's skin

Front 448

by definition hypnagogic hallucinations occur when?

Back 448

going to sleep

mneu: hypnaGOgic hallucination occurs while GOing to sleep

Front 449

by definition hypnopompic hallucinations occur when?

Back 449

while waking from sleep

Front 450

In this disorder a person stops brathing for at least 10 seconds repeatedly during sleep.

It is associated with obesit, loud snoring, systemic/pulmonary hypertension, arrhythmias, and possibly sudden death.

The individual may become chronically tired.

Back 450

sleep apnea

Front 451

In this subcagegory of sleep apnea, the pt shows no respiratory effort

Back 451

central sleep apnea

Front 452

In this subcagegory of sleep apnea, the pt shows respiratory effort against airway obstruction

Back 452

obstructive sleep apnea

Front 453

This diagnosis is categorizecd by disordered sleep-wake cycles. It may include hypnagogic (just before sleep) or hypnopompic (just before waking) hallucinations. The person's sleep episodes start off with REM sleep.

Back 453

narcolepsy

Front 454

This form of narcolepsy involves a loss of all muscle tone follwing a strong emotional stimulus.

Back 454

cataplexy

Front 455

Tx for narcolepsy

Back 455

ampetamines

Front 456

This psychiatric illness is characterized by periods of psychosis and disturbed behavior with adecline in functioning lasting >6months.

Back 456

schizophrenia

Front 457

Give the DSM criterial for schizophrenia.

Back 457

2 or more of the following symptoms (1-4 are positive symptoms)
1)Delusions
2)Hallucinations
3)Disorganized thought
4) Disorganized or catatonic behavior.
5. "negative symptoms"-flat affect, social withdrawal, lack of motivation, lack of speech or thought.

Front 458

What is the most common type of hallucination in schizophrenia

Back 458

auditory

Front 459

in schizophrenia, disorganized thought often takes the form of ______

Back 459

loose associations

Front 460

in the etiology of schizophrenia, what is more important, genetic or enviornmental factors

Back 460

genetic

Front 461

Symptoms of schizophrenia that last 1-6 mo

Back 461

schizophreniform disorder

Front 462

Symptoms of schizophrenia that last <1 mo

Back 462

brief psychotic disorder (usually stress related)

Front 463

Lifetime prevelence of schizophrenia

Back 463

1.5%

Front 464

schizophrenia typically presents earlier in _______ (males or females)

Back 464

males

Front 465

this psychiatric condition involves a combination of schizophrenia and a mood disorder

Back 465

schizoaffective disorder

Front 466

What are the 5 subtypes of schizophrenia

Back 466

1)disorganized
2) catatonic
3)paranoid
4)undifferentiated
5) residual

Front 467

This is an enduring pattern of perceiving, relating to, and thinking about the enviornment and oneself that is exhibited in a wide reange of important social and personal contexts.

Back 467

personality trait

Front 468

This results when personality patterns become inflexible and maladaptive, causing impairment in social or occupational functioning or subjective disress. The person is usually not aware of the problem. These disordered patterns are stable only by early adulthood and not usually diagnosed in children.

Back 468

personality disorders

Front 469

This cluster of personality disorders usually present as "odd" or "eccentric. They cannot develop meaningful social relationships. Give cluster and types.

Back 469

Cluster A "Wierd"
1)Paranoid
2)Schizoid
3) Schizotypal

Front 470

This cluster of personality disorders shows no psychosis but there is a genetic association with schizophrenia.

Back 470

Cluster A "Wierd"
1)Paranoid
2)Schizoid
3) Schizotypal

Front 471

personality disorder characterized by distrust and suspiciousness

Back 471

paranoid personality disorder

Front 472

main defence mechonism exiped by those with paranoid personality disorder

Back 472

projection

Front 473

personality disorder characterized by voluntary social withdrawal and limited emotional expression

Back 473

schizoid

Front 474

personality disorder characterized by interpersonal awkwardness, odd beliefs or magical thinking. Often eccentric in appearance.

Back 474

Schizotypal

Front 475

This cluster of personality disorders is dramatic, emotiona, and eratic.
Give the cluster and the subtypes

Back 475

Cluster B: "Wild"
1)Antisocial
2) Borderline
3) Histrionic
4)Narcissistic

Front 476

This cluster of personality disorders has a genetic associateion with mood disorders and subsance abuse.

Back 476

Cluster B: "Wild"
1)Antisocial
2) Borderline
3) Histrionic
4)Narcissistic

Front 477

personality disorder characterized by disregard and violation of the rights of others, usually manifesting itself in criminality. It affects males > females. Before 18 y/o it is called conduct disorder

Back 477

antisocial personality diosrder

Front 478

personality disorder characterized by unstable mood and interpersonal relationships, impulsiveness, sense of emptiness. Effects females more than males

Back 478

Borderline

Front 479

personality disorder characterized by excessive emotionality, attention seeking, sexually provocative

Back 479

histrionic

Front 480

personality disorder characterized by grandiosity & sense of entitlement. May react to criticism with rage.

Back 480

Narcissistic

Front 481

This cluster of personality disorders is charicterized by anxiety and fear. Give the cluster and the types.

Back 481

Cluster C: "Worried"
1)avoidant
2)obsessive-compulsive
3)dependant

Front 482

This cluster of personality disorders has a genetic association with anxiety diosrders.

Back 482

Cluster C: "Worried"
1)avoidant
2)obsessive-compulsive
3)dependant

Front 483

personality disorder characterized by sensitivity to rejection, socially inhibited, timid, feelings of inadequacy

Back 483

avoidant

Front 484

personality disorder characterized by preocupation with order, perfectionism, and control

Back 484

obsessive-compulsive

Front 485

personality disorder characterized by submissive and clinging behavior. They have an excessive need to be taken care of and low self confidence.

Back 485

dependant

Front 486

This dz is due to a loss of dopaminergic neurons and excess cholinergic activity

Back 486

parkinsonism

Front 487

The treatments for parkinson's dz can be summarized by the mneumonic BALSA. What does this stand for

Back 487

Bromocriptine
Amantadine
Levodopa (w/ carbidopa)
Selegine (&COMT inhibitors)
Antimuscarinics

Front 488

This drug is an erogot alkaloid an a partial dopamine agonist. The strategy behind this drug is to antagonize dopamine receptors.

Back 488

bromocriptine

Front 489

This drug may increase dopamine release.

Back 489

Amantadine

Front 490

This drug is converted to dopamine in the CNS

Back 490

L-dopa/carbidopa

Front 491

This drug is a selective MAO type B ihibitor. The strategy of this Parkensons drug is that it prevents dopamine breakdown.

Back 491

Selegiline

Front 492

This drug is a COMT ihibitor. The strategy of these Parkensons drugs is that it prevents dopamine breakdown.

Back 492

entacapone & tolcapone

Front 493

This drug is an antimuscarinic and thus curbs excess cholinergic activity seen in parkinsons. It improves tremor and rigitity but has little effect on bradykinesia

Back 493

Benzotropine

Front 494

The MOA of this parkinson's drug is that it ↑ levels of dopamine in the brain. Unlike dopamine, this drug can cross the blood-brain barrier and is converted by dopa decarboxylase in the CNS to dopamine

Back 494

L-dopa (levvodopa)/carbidopa

Front 495

What is the most common toxicity of L-dopa

Back 495

arrhthmias from peripheral conversion to dopamine

Front 496

Why is carbidopa given with levodopa.

Back 496

carbidopa is a peripheral decarboxylase inhibitor. It is given with L-dopa inorder to limit the peripheral side effects.

Front 497

Long term use of ______ can lead to the of dyskinesia follwing administraiton, and akinesia between doses.

Back 497

L-dopa

Front 498

This parkinsons drug acts by selectively inhibiting MAO-B, therby ↑ the availabilty of dopamine.

Back 498

Selegine

Front 499

This drug is a 5-HT (1D) agonist. It causes vasoconstriction and is used for acute migrane or cluster headache attacks.

Back 499

Sumatriptan

Front 500

This drug for acute migrane & cluster headache attacks has toxicities that include coronary vasosasm, thereore it is contraindicated in pts with CAD or Prinzmetal's angina

Back 500

Sumatriptan

Front 501

This drug is 1st line for tonic clonic siezures and status epilepticus prophylaxis. It acts by ↑ Na+ channel inactivation

Back 501

phenytoin

Front 502

This drug is first line for tonic clonic siexures and trigeminal neuralgia. It acts by ↑ Na+ channel inactivation.

Back 502

Carbazepine

Front 503

This siezure medication blocks voltage gaited Na+ channels, but has no effect on GABA release

Back 503

Lamotrigine

Front 504

This epilepsy medication acts to ↑ GABA release. It is also used for peripheral neuropathy

Back 504

Gabapentin

Front 505

This epilepsy medication acts to block Na+ channels and ↑ GABA release.

Back 505

topiramate

Front 506

This epilepsy medication acts to ↑ GABA action. It is 1st line in pregnant women & children

Back 506

phenobarbital

Front 507

This epilepsy medication acts to ↑ Na+ channel inactivation & ↑ GABA concentration. It is 1st line for tonic-clonic/ myoclonic seizures and can be used for absence seizures.

Back 507

valproic acid

Front 508

This epilepsy medication is 1st line for absence seizures. It acts by blocking the thalamic T-type Ca++ channesls.

Back 508

ethsuximide

Front 509

This epilepsyy drug acts by ↑ GABA action. It is first line for acute status epilepticus. It is also usd for seizures of eclampsia (however NOT 1st line--which is MgSO4)

Back 509

Benzodiazepines
(diazepam or lorazepam)

Front 510

Give the epilepsy drug associated with the following toxicities:

sedation, tolerance, dependence

Back 510

benzodiazepines

Front 511

Give the epilepsy drug associated with the following toxicities:

Diplopia, ataxia, blood dyscrasias (agranulocytosis, aplastic anemia), liver toicity, teratogenesis, induction of cytochrome P-450.

Back 511

Carbamazepine

Front 512

Give the epilepsy drug associated with the following toxicities:

GI distress, lethargy, headache, uticaria, Stevens-Johnson syndrome

Back 512

Ethosuximide

Front 513

Give the epilepsy drug associated with the following toxicities:

Sedation, tolerance, dependance, induction of cytocrome P-450.

Back 513

Phenobarbital

Front 514

Give the epilepsy drug associated with the following toxicities:

Nystagmus, diplopia, ataxia, sedaton, gingival hyperplasia, hirsuitism, megaloblastic anemia, teratogenesis, SLE-like syndrome, induction of cytocrome P-450.

Back 514

Phenytoin

Front 515

Give the epilepsy drug associated with the following toxicities:

GI distress, rare but fatal hypatotoxicity (measure LFTs), neural tube defects in fetus (spinal bifida), tremor, weight gain.

Back 515

Valproic acid

Front 516

Give the epilepsy drug associated with the following toxicities:

Stevens-Johnson syndrome

Back 516

Lamotrigine

Front 517

Give the epilepsy drug associated with the following toxicities:

Sedation, ataxia

Back 517

Gabapentin

Front 518

Give the epilepsy drug associated with the following toxicities:

Sedation, mental dulling, kidney stones, weight loss

Back 518

Topiramate

Front 519

The mechanism of this drug is blockade of Na+ channels; inhibition of glutamate release from exitatory presynaptic neurons

Back 519

phenytoin

Front 520

This drug is 1st line for tonic clonic siezures and for prophylaxis of status epilepticus. It is also a class IB antiarrhythmic.

Back 520

phenytoin

Front 521

The toxicities of this drug include: nystagmus, ataxia, diplopia, sedation, SLE-like syndrome, induciton of cytocrome P-450. Chronic use produces gingival hyperplasia in children, peripheral neuropathy, hirsutism, megaloblastic anemia (↓B12), and malignant hyperthermia (rare). It is also teratogenic.

Back 521

phenytoin

Front 522

This drug acts by facilitating GABA action by ↑ duration of Cl- channel opening, thus ↓ neuron firing

Back 522

barbituates (phenobarbital, pentobarbital, thiopental, secobarbital)

mneu: BarbiDURATe (increased DURATion)

Front 523

This group of drugs is used as a sedative for anxiety, siezures, insomnia, induction of anesthesia

Back 523

barbituates (phenobarbital, pentobarbital, thiopental, secobarbital)

Front 524

Toxicities of this drug include dependence, additivee CNS depression effects with etoh, respiratory of CV depession (can lead to death. There are also many drug interactions owing to induction of liver microsomal enzymes (cytocrome P-450)

Back 524

barbituates (phenobarbital, pentobarbital, thiopental, secobarbital)

Front 525

this type of drugs is contraindicated in porphyria

Back 525

barbituates (phenobarbital, pentobarbital, thiopental, secobarbital)

Front 526

What do you do if someone ODs on barbituates?

Back 526

symptom management (assist respiration, manage BP)

Front 527

The mechanism of this drug is to facilitate GABA action by ↑ frequency of Cl- channel opening

Back 527

Benzodiazepines (Diazepam, lorazepam, triazolam, temazepam, oxazepam, midazolam, chlordiazepoxide, alprazolam)

mneu: FREnzodiazepenes (increased FREquency)

Front 528

Most benzodiazepines have long half-lives and active metabolites. The short acting ones are what? (3)

Back 528

Triazolam, Oxazepam, Midazolam

mneu: TOM Thumb

Front 529

These drugs are used to treat anxiety, spasticity, status epilepticus, detoxification (esp etoh w/drawl[DTs]), night terrors, & sleep walking.

Back 529

Benzodiazepines (diazepam, lorazepam, triazolam, temazepam, oxazepam, midazolam, chlordiazepoxide, alprazolam)

Front 530

Toxicity of this drug includes dependence, additive CNS depression effects with alcohol. Less risk of respiratory depressiona nd coma than with barbituates.

Back 530

Benzodiazepines (diazepam, lorazepam, triazolam, temazepam, oxazepam, midazolam, chlordiazepoxide, alprazolam)

Front 531

Treat Benzodiazepine overdose with ________

Back 531

Flumazenil (competitive antagonist at GABA receptor)

Front 532

These drugs are used to treat anxiety, spasticity, status epilepticus, detoxification (esp etoh w/drawl[DTs]), night terrors, & sleep walking.

Back 532

Benzodiazepines (diazepam, lorazepam, triazolam, temazepam, oxazepam, midazolam, chlordiazepoxide, alprazolam)

Front 533

phenobarbital, pentobarbital, thiopental, secobarbital are ________

Back 533

barbituates

Front 534

diazepam, lorazepam, triazolam, temazepam, oxazepam, midazolam, chlordiazepoxide, alprazolam are _______ (drug category)

Back 534

Benzodiazepines

Front 535

Thioridazine, haloperidol, fluphenazine, chlorpromazine are all _______ (drug category)

Back 535

Antipsychotics (neuroleptics)

Front 536

This drug acts to block dopamine (D2) receptors

Back 536

antipsychotics (neuroleptics

Front 537

This drug category is used to treat psychosis, acute mania, and tourettes syndrome

Back 537

antipsychotics

Front 538

Toxicies of this group of drugs include extrapyramidal system (EPS side effects)

Back 538

antipsychotics

Front 539

Toxicies of this group of drugs include endocrine side effects (e.g., dopamine receptor antagonism →hyperprolactinemia→gynomastia)

Back 539

antipsychotics

Front 540

Toxicies of this group of drugs include side effects arising from muscarinic block (dry mouth &constipation), alpha receptors (hypotension) and histamine receptors (sedation)

Back 540

antipsychotics

Front 541

This toxicity of antipsychotic involves symptoms that include rigidity, myoglobinuria, autonomic instability, hyperpyrexia.

Back 541

Neuroleptic malignant syndrome

Front 542

How do you treat Neuroleptic malignant syndrome (antipsychotic toxicity)

Back 542

dandrolene and dopamine agonists)

Front 543

This antipsychotic toxicity includes stereotypic oral-facal movements, probably due to dopamine receptor sensitization, which results from long term antipsychotic use.

Back 543

Tarditive dyskinesia

Front 544

Evelution of EPs side effects with antipsychotic use:

Back 544

4 h acute dystonia
4 d akinesia
4 wk akathisia
4 mo tarditive dykinesia
(often reversible)

Front 545

The drugs clozapine, olanzapine, risperidone are of the category _________

Back 545

Atypical antipsychotis

mneu: i'ts not ATYPICAL for OLd CLOsets to RISPER

Front 546

This group of drugs acts by blocking 5-HT2 and dopamine receptors

Back 546

Atypical Antipsychotics

Front 547

These drugs are used in treatment of schizophrenia; they are useful for positive and negative symptoms and they have fewer extrapyramidal and anticholinergic side effects than other antipsychotics.

Back 547

Atypical antipsychotics

Front 548

This atypical antipsychotic is also used for OCD, anxiety disorder, depression, mania, and tourettes syndrome

Back 548

Olanzapine

Front 549

This atypical antipsychotic may cause agranulocytosis and requires weekly WBC monitoring

Back 549

Clozapine

Front 550

The mechanism of this drug is not established. It is possibly related to an inhibition of the phosphoinositol cascade.

Back 550

Lithium

Front 551

This drug is used as a mood stabilizer for bipolar affective disorder. It blocks relapse and acute manic events.

Back 551

Lithium

Front 552

Toxicity of this drug includes tremor, hypothyroidism, polyuria (ADH antagonist causing nephrogenic diabetes insipidus), teratogenesis.
This drug also has a narrow therapeutic window requiring close monitoring of serum levels.

Back 552

lithium

mneu: LMNOP
Lithium side effects:
Movement (tremor)
Nephrogenic dbts insipidus
hypOthyroidism
Pregnancy problems

Front 553

ANTIDEPRESSANTS [image]p.371

Back 553

--

Front 554

The drugs Fluoxetine, sertraline , paroxetine, and citalopram belong to this category of drugs

Back 554

Serotonin-specific reuptake Inhibitors (SSRI)

Front 555

This drug is indicated for endogenous depression, and obsessive compulsive disorder

Back 555

SSRIs

Front 556

This drug boast fewer toxicities than TCAs but has been associated with GI distress, sexual dysfuncion (anorgasmia).

Back 556

SSRIs

Front 557

When used with MAO inhibitors, SSRIs can cause "serotonin syndrome." What three things does this involve.

Back 557

hyperthermia, muscle rigidity, CV collapse

Front 558

The drugs Imipramine, amitriptyline, desipramine, nortriptyline, clomipramine, and doxepin are of this medication category

Back 558

Tricyclic antidepressants

Front 559

These drugs act to block the reuptake of NE and serotonin

Back 559

tricyclic antidepressants

Front 560

These drugs are indicated for major depression that does not respond to SSRIs

Back 560

tricyclic antidepressants

Front 561

This tricyclic antidepressant is indicated for bedwetting

Back 561

imipramine

Front 562

This is the only tricyclic antidepressant indicated for OCD

Back 562

clomipramine

Front 563

The side effects of these drugs include sedation, alpha blocking effects (hypotension), atropine like (anticholinergic) side effects (tachycardia, urinary retention)

Back 563

tricyclic antidepressants

Front 564

Secondary TCAs like ______ have less anticholinergic side effects than do tertiary TCAs like amitriptyline

Back 564

nortriptyline

Front 565

This TCA is the least sedating.

Back 565

desipramine

Front 566

The side effects of these drugs include sedation, alpha blocking effects (hypotension), atropine like (anticholinergic) side effects (tachycardia, urinary retention)

Back 566

tricyclic antidepressants

Front 567

Give the 3 Cs of Tricyclic antidepressant toxicity

Back 567

Convulsions, Coma, Cadiotoxicity (arrhythmias)

also can have respiratory depression & hyperpyrexia?

Front 568

Your elderly pt on TCAs develops confusion and hallucinations. What could this be due to and what is an alternative TCA that could be given?

Back 568

This could be due to the anticholinergic side effects of TCAs. Use nortriptyline.

Front 569

Bupropion, Venlafaxine, Mirtazapine, Maprotiline, Trazodone belong to what drug category

Back 569

heterocyclic antidepressents

mneu: You need BUtane in your VEiNs to MURder for a MAP of AlcaTRAZ

Front 570

These are 2nd and 3rd generation antidepressante with varied and mixed mechanisms of action. They are used to treat major depession.

Back 570

heterocyclic antidepressants

Front 571

This heterocyclic antidepressant is also used for smoking cessation. Its mechanism s not well known. Toxicity includes stimulant effects (tachycardia, insomnia), headache, and siezure in bulimic pts. It does NOT cause sexual side effects.

Back 571

Buproprion

Front 572

This heterocyclic antidepressant is also used in generalized anxiety disorder. It inhibits serotonin, NE, & dopamine reuptake. Toxicity includes stimulant effects, sedation, nausea, constipation and increased BP.

Back 572

Venlafaxine

Front 573

This heterocyclic antidepressant is an alpha2 antagonist (↑ release of NE and serotonin) and a potent 5-HT(2) & 5-HT(3) receptor antagonist. Toxicity includes sedation ↑ appetite, weight gain, and dry mouth.

Back 573

Mirtazapine

Front 574

This heterocyclic antidepressant blocks NE reuptake. Toxicity includes sedation and orthostatic hypotension.

Back 574

Maprotiline

Front 575

This heterocyclic antidepressant acts primarily to inhibit seratonin reuptake. Toxicity includes sedation, nausea, priaprism, and postural hypotension

Back 575

Trazodone

Front 576

The drugs Phenelzine & tranylcypromine are of this catigory

Back 576

Monoamine oxidase Inhibitors (MAOIs)

Front 577

This drug acts by non-selectively inhibiting Monoamine oxidase (MAO)→↑ levels of amine neurotransmitters

Back 577

Monoamine oxidase inhibiters (MAOIs)

Front 578

These drugs are used for atypical depression (i.e., with psychotic or phobic features, anxiety, and hypochondriasis.

Back 578

Monoamine oxidase inhibiters (MAOIs)

Front 579

These drugs can cause a hypertensive crisis with tyramine ingestion (wine & cheese) and merperidine. They also can cause CNS stimulation.

Back 579

Monoamine oxidase inhibiters (MAOIs)

Front 580

These drugs are contraindicated with SSRIs or Beta agonists (to prevent seratonin syndrome)

Back 580

Monoamine oxidase inhibiters (MAOIs)

Front 581

CNS anesthetics must be ______ soluable in order to cross teh blood-brain barrier

Back 581

lipid

Front 582

anesthetics with ↓ solubility in blood have ____ induction and recovery times

Back 582

rapid

Front 583

anesthetics with ↑ solubility in lipids have ______ potency

Back 583

increased

Front 584

relative potency of inhalation anesthetics is indicated by what index

Back 584

Minimal anesthetic concentration

Front 585

Minimal anesthetic concentration is ________ (proportional or inversely proportional) to potency

Back 585

inversely proportional

potency =1/MAC

Front 586

Fill in the blanks regarding general principles of anesthesia.
↑ solubility in ______ =
↑ Potency =1/MAC

Back 586

lipids

Front 587

N2O has low blood and lipid solubility. What is the rate of induction and what is the potency?

Back 587

fast
low

Front 588

Halothane has ↑ lipid and blood solubility, and thus ____ potency and ____ induction

Back 588

high
slow

Front 589

anesthetics with ↓ solubility in blood have ____ induction and recovery times

Back 589

rapid

Front 590

anesthetics with ↑ solubility in lipids have ______ potency

Back 590

increased

Front 591

halothane, enflurane, isoflurane, sevoflurane, methoxyflurane, and nitrous oxide are all this type of anesthetic

Back 591

inhaled anesthetics

Front 592

These drugs result in myocardial & respiratory depression, nausea/emesis, and increased cerebral blood and decreased cerebral metabolic demand.

Back 592

inhaled anesthetics

Front 593

This inhaled anesthetic has a toxicity of hepatotoxicity

Back 593

halothane

Front 594

This inhaled anesthetic has a toxicity of nephrotoxicity

Back 594

methoxyflurane

Front 595

This inhaled anesthetic has a toxicity of seizures.

Back 595

enflurane

Front 596

This is a rare but very dangerous toxicity of inhaled anesthetics

Back 596

malignant hyperthermia

Front 597

This is a barbituate intravenous anesthetic. It is high potency (high lipid solubility). It is used for induction of anesthesia and short surgical procedures. It decreases cerebral blood flow.

Back 597

Thiopental

Front 598

This benzodiazepine given IV is the most common anesthetic used for endoscopy. It may cause severe postoperative respiratory depression, decreased BP, and amnesia.

Back 598

Midazolam

Front 599

You give your pt Midazolam for his endoscopy. Postoperatively he developse hypotension. What drug do you give him?

Back 599

flumazenil

Front 600

Thses PCP analogs given IV act as dissociative anesthetics. They are cardiovascular stimulants. They cause hallucinations and bad dreams. They increase cerebral blood flow.

Back 600

Arylcyclohexamines (Ketamine)

Front 601

These opiates are given IV with other CNS depressants during general anesthesia

Back 601

morphine, fentanyl

Front 602

This IV anesthetic is used for rapid anesthesia induction and short procedures. It has less postoperative nausea than thiopental.

Back 602

Propofol

Front 603

What are the IV anesthetics?

Back 603

Barbituates
Benzodiazepines
Ketamine
Opiates
Propofol

mneu: B.B. King on OPIATES PROPOses FOOLishly

Front 604

This drug is used in the treatment of malignant hyperthermia and neuroleptic malignant syndrome.

Back 604

dantrolene

Front 605

This condition can be caused by the concomitant use of inhalation anesthetics (except N2O) and succinylcholine.

Back 605

Malignant hyperthermiia

Front 606

The drugs procaine, cocaine, tetracaine, lidocaine, mepivacaine, pubivacaine are in this category

Back 606

local anestetics

Front 607

Procaine, cocaine, tetracaine, are considered this type of local anesthetics.

Back 607

esters

Front 608

lidocaine, mepivacaine, pubivacaine are considered this type of local anesthetics.

Back 608

amides

mneu: amIdes all have 2 "I"s in their names

Front 609

This group of drugs acts by blocking Na+ channels in nerves by binding to secific receptors on the inner portion of the channel

Back 609

local anesthetics

Front 610

Your pt has infected tissue that needs to be anesthetized. Do you need more or less local anesthetic?

Back 610

More-infected tissue is acidic and therefore charged. The charged anesthetics will have trouble penetrating the membrane effectively.

Front 611

Give the order of anesthetic nn block regarding diameter of nn and myelination

small melinated autonomic fibers
large myelinated autonomic fibers
small unmyelinated pain fibers

Back 611

small diameter> large diameter
Myelinated>unmyelinated

Overall size factor predominates over myelination factor

small unmyelinated pain fibers> small melinated autonomic fibers>large myelinated autonomic fibers

Front 612

What is the order of loss in sensation upon administration of a local anesthetic.

touch,pain,pressure, temp

Back 612

pain>temp>touch>pressure

Front 613

Local anesthetics are usually given with this to enhance local action--↓bleeding, ↑ anesthesia by ↓ systemic concentration.

Back 613

epinephrine (or another vasoconstrictor)

Front 614

These drugs are used for minor surgical procedures and as spinal anesthesia.

Back 614

local anesthetics

Front 615

You want to give you're pt a local anesthetic but she is allergic to esters. Name an amide you can give her.

Back 615

lidocaine, mepivacaine, bupivancaine

Front 616

a toxicity of this local anesthetic is CV toxicity

Back 616

bupivacaine

Front 617

a toxicity of this local anesthetic is arrhythmias

Back 617

cocaine

Front 618

general side effects of local anesthetics may include?

Back 618

CNS exitation, hypertension, hypotension

Front 619

These drugs are used for muscle paralysis in surgery or mechanical ventilation. They are selective for the motor (v. autonomic) nicotinic receptor

Back 619

neuromuscular blocking drug

Front 620

The depolarizing neuromuscular blocking drug is __________

Back 620

succinylcholine

Front 621

The drugs tubocurarine, atracurium, mivacurium, pancuronium, vecuronium, rapacuronium are of this category of neuromuscular blocking drugs

Back 621

nondepolarizing

Front 622

Nondepolarizing neuromuscular blocking drugs compete with ____ for receptors

Back 622

ACh

Front 623

In order to reverse the blockade of nondepolarizing blocking agents you can use __________

Back 623

any cholinesterase inhibitor:
e.g., neostigmine, edrophonium

Front 624

With depolarizing neuromuscular blocking drugs phase I is known as the ___________ phase

Back 624

prolonged depolarization phase

Front 625

With depolarizing neuromuscular blocking drugs phase I -prolonged depolarization - is potentiated by what?

Back 625

cholinesterase inhibitors

Front 626

With depolarizing neuromuscular blocking drugs phase II is known as the ___________ phase

Back 626

repolarized but blocked phase

Front 627

after initiating paralysis with a depolarizing neuromuscular blocking drugs, is it possible to reverse the effects.

Back 627

During phase II (repolarized but blocked phase) only-- the antidote consists of cholinesterase inhibitors (e.g., neostigmine)