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NPLEX I > Anderson Neuro > Flashcards

Anderson Neuro Flashcards

1
Q

Name the pathology:

Congenital communication between artery and vein, may occur anywhere, often cause chronic HA

A

AVM (arteriovenous malformation)

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2
Q

Name the pathology:

Congenital, anterior middle and posterior communicating arteries (circle of willis), sudden excruciating HA

A

Berry aneurysm

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3
Q

Name the pathology:
Results from diastolic BP over 120, grade 4 retinal changes, confusion/drowsiness/HA/nausea. Complications include rupture and hemorrhage

A

Hypertensive encephalopathy

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4
Q

Which two venous sinuses are often responsible for infections leading encephalitis?

A

Pterygoid plexus and cavernous sinus (drain cellulitis, sinusitis, ear infections)

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5
Q

Name the histology:

Acute necrosis of neurons, change before death of neurons

A

Red neurons

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6
Q

Name the virus related to the cellular inclusion:
Cowdry body
Negri body

A

Herpes

Rabies

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7
Q

Name the CN 1-12

A

Olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, auditory, glossopharyngeal, vagus, spinal accessory, hypoglossal

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8
Q

Which CN stem from midbrain?

A

3-4

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9
Q

Which CN stem from pons?

A

5-8

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10
Q

Which CN stem from medulla?

A

9-12

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11
Q

What is the order of the brain stem top to bottom?

A

Midbrain, pons, medulla, spinal cord

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12
Q

Which CN provides olfaction to the nose? Sensation/pain stimulus?

A

CN I

CN V

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13
Q

What secondary messenger is used in olfaction? In vision?

A

cAMP (most of the brain uses this)

cGMP (unique to vision)

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14
Q

When pupils react to light, what CN is being tested?

A

CN 2 - afferent fibers respond to light

CN 3 - efferent fibers contract sphincter pupillae muscles

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15
Q

Rods vs. Cones

A

Rods: night vision, higher sens, lower activity
Cones: color vision, lower sens, high activity

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16
Q

Describe the flow of aqueous humor in the eye.

A

1) Produced by the ciliary body
2) Flow out to anterior chamber between pupillary sphincter muscle and lense
3) Drain through the trabecular meshwork and out the Canal of Schlemm

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17
Q

Cones and rods face which direction with respect to the retina?

A

They face the pigmented layer, same direction as the light coming in.

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18
Q

What type of visual defect would occur with the following lesions?
Between the optic chiasm and left eye.
In the optic chiasm.
Between the optic chiasm and the lateral geniculate body on the left.

A

Anopsia of the left eye
Lateral (temporal) hemianopsia bilaterally
Right sided hemianopsia bilaterally

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19
Q

Accommodation of lens to near and far vision.

A

Near - ciliary muscle contracted, zonula fibers relaxes, lens rounded, focal length short. (sympathetic)

Far- ciliary muscle relaxed, zonula fibers tense, lens flat, focal length far (parasympathetic)

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20
Q

What muscle does CN4 control and what does it do? CN6?

A

CN4: Sup Oblique - down and out movement of eye

CN6: Lat Rectus m. - lateral eye movement

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21
Q

What are the three divisions of CN V?

A

Opthalmic, maxillary, mandibular

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22
Q

What CN are tested in the “Corneal Blink Reflex”?

A

CN-5: Sensory afferent

CN-7: Motor efferent

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23
Q

What two foramen does CN 7 go through? How does this relate to Bell’s palsy?

A

Stylomastoid foramen and internal acoustic meatus.

Prior to onset of Bell’s palsy - hyperlacrimation and salivation. Proposed mechanism swelling in and around stylomastoid foramen.

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24
Q

What activities is CN 9 responsible for?

A

Swallowing, parotid gland, post 1/3 of tongue (touch/taste)

Post tongue usually sour/bitter

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25
Q

What CN is responsible for touching your tongue to the roof of your mouth?

A

CN 10

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26
Q

What CN provides taste to front 2/3 of tongue? Touch?

A

CN 7 - taste, ant tongue usually salty/sweet

CN 5 - touch

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27
Q

What are the two branches of CN8?

A

Vestibular and cochlear

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28
Q

In pathological nystagmus, what causes horizontal nystagmus? vertical nystagmus?

A

Horizontal - vestibular dz

Vertical - brainstem dz

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29
Q

Na+ rich: perilymph or endolymph

K+ rich: perilymph or endolymph

A

perilymph

endolymph

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30
Q

Lateral geniculate body: vision or hearing

Medial geniculate body: vision or hearing

A

Vision

Hearing

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31
Q

CN 10 actions.

A

Taste around epiglottis, swallowing, lifts palate, larynx (speech), gag reflex, elevates tongue

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32
Q

What two muscles are supplied with efferent CN 11?

A

SCM, trapezius

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33
Q

What CN supplies motor function to tongue?

A

CN 12

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34
Q

Wernicke’s area causes ________ aphasia.

Broca’s area causes ________ aphasia.

A

Sensory - difficulty understanding written/spoken language. Word Salad.

Motor - speech/writing affected, understanding intact
Tongue is broken.

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35
Q

Dorsal horn carries ______ afferents.

Ventral horn carries ______ efferents.

A

Sensory

Motor

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36
Q 
Name the muscle: 
C5
C6 
C7
C8
T1 
L4
L5
A 
Biceps/Deltoid
Brachioradialis
Triceps 
Finger flexors
Interossi
Patellar 
Foot dorsiflex
37
Q

Which nerve fibers are the largest and fastest?

A

A-alpha fibers

38
Q

Which nerve fibers are small and slow and are often a part of the autonomic nervous system?

A

B fibers

39
Q

Which nerve fibers are the slowest and smallest responsible for pain and temperature?

A

C fibers

40
Q

What is the action of the golgi tendon organ?

A

Measures tension and inhibits alpha-motor neurons. Protects against stretch

41
Q

Name the specialized receptor:
Vibration
Movement
Pressure

A

Pacinian
Meissner’s
Merkel

42
Q 
UMN or LMN:
Spastic paralysis and little atrophy
Fibrillation and hyporeflexia 
Positive babinski
Flaccid Paralysis
A

UMN
LMN
UMN
LMN

43
Q

Which nerve system is responsible for pain, thermal, crude touch/sensation, tickle, itch, sexual sensation?

A

Antrolateral - “anything the dorsal does with lower sensitivity”

44
Q

Name the sensory pathway:
Pain/Temp
Conscious proprioception
Light touch

A

Spinothalamic
Fasciculus Cuneatus Gracilis (to Medial Lemniscus)
Spinothalamic and Medial Lemniscus

45
Q

Where do “fast” pain fibers end up? “slow” pain fibers?

A

Somatic sensory areas

Thalamus

46
Q

Where is CSF synthesized?

A

Choroid plexus epithelium

47
Q

Does an UMN or LMN decussate in the spinal cord at the level of action?

A

UMN

48
Q

Which amines are directly excitatory?

A

Glutamate, aspartate

49
Q

Which amines are directly inhibitory

A

GABA, glycine, serine, alanine, cystathionine

50
Q

Which amines are directly inactive?

A

Glutamine, lysine, threonine, leucine.

51
Q

What brain transmitters are considered uppers?

A

Serotonins, Ach, NE, Epi, Dopa, Glycine

52
Q

What brain transmitters are considered downers?

A

GABA, NO, Histamine, Histamine, Neurosteroids, Glycine

53
Q

Is sulfite or sulfate the toxic metabolite?

A

Sulfite (often problem converting in people with sulfite sensitivity)
Requires Molybdenum

54
Q

What vitamins are required for methylation steps?

A

B9 and B12

55
Q

What enzymes creates Ach? What enzyme metabolizes Ach?

A

Choline acetylase

Acetylcholinesterase - most pesticides are inhibitors of this enzyme

56
Q

In the diencephalon, serotonin can be converted to…

A

Melatonin - in the pineal gland, requires B5, B12/B9

57
Q

What are the steps of converting tryptophan to Serotonin?

A

Tryptophan (tryptophan hydroxylase)
5-HTP (requires B6)
Serotonin

58
Q

Circadian periodicity is driven by what what part of the hypothalamus that receives input from the retina?

A

Superchiasmatic nucleus

59
Q

What enzyme converts phenylalanine to tyrosine? What cofactors does it require?

A

Phenyl-Hydroxylase

Cofactors: B3, Fe, Biopterin

60
Q

What enzyme deficiency causes phenylketonuria?

A

Phenyl-Hydroxylase

Normal at birth, develops high levels of phenylalanine through diet leading to retardation.

61
Q

What are three major products of tyrosine?

A

Dopa/NE/Epi, Thyroid Hormone, Melanin

*can also go into Kreb’s cycle

62
Q

What cofactors are required for conversion of NE to Epi (in the periphery)? L-Dopa to Dopamine (in brain)? Tyrosine to L-Dopa (in brain)?

A

SAMe, B12, Folate
B6, B1
B3, Fe, Biopterin

63
Q

What is the main enzymes that metabolize catecholamines?

A

COMT - Catecholomethyltransferase

MAO - Monoamine oxidase

64
Q

What is the most important intermediate in the breakdown of catecholamines?

A

VMA - vanillylmandelic acid
Excreted in urine.

If does not go through VMA, glucuronidation/sulfation in liver.

65
Q

What two amino acids form NO? What is the enzyme?

A

Arginine (donates the NO) and Citrulline

NO synthase

66
Q

What secondary intermediate is associated with NO? What systems does it affect?

A

cGMP

Retina- photoreception
Vascular SM- vasodilation
AMPA- desensitization

67
Q

What enzyme and cofactors are required to convert histidine to histamine?

A

Histidine decarboxylase

B1

68
Q

What are the steps of histamine metabolism? What cofactors are required?

A 
Histamine methyltransferase (requires B12/Folate) 
MAO
Aldehyde dehydrogenase (requires B1)
69
Q

What enzyme is required to convert glutamic acid to GABA?

A

Glutamic acid decarboxylase (requires B1)

70
Q

What are two components of the motor afferent that filter information coming from the motor cortex?

A 
Basal ganglia (nucleus)
Cerebellum
71
Q

Where does pathology in movement disorders often lie?

A

In the filtration: basal ganglia/cerebellum

72
Q

Name the function:
Vestibulocerebellum
Pontocerebellum
Spinocerebellum

A

Balance, eye movement (Romberg’s test)
Planning and initiation of movement
Controls rate, force, range, and direction of movement

73
Q

What two neurotransmitters are used primarily by the basal nucleus?

A

Dopamine (excitatory)

GABA (inhibitory)

74
Q

Pathogenesis of Huntington’s

A

Loss of GABA containing neurons
Genetic, 20-50yo
SSX: choreaform, uncontrolled hyperkinetic movements, dementia

75
Q

Pathogenesis of Parkinson’s

A

Damage to substantia nigra (AI or toxic)

SSX: Festinating (wide, shuffling) gait, cog-wheel rigidity, pill-rolling resting tremor

76
Q

Pathogenesis of ALS

A

Loss of both UMN and LMN.
Autosomal dominance
SSX: muscular atrophy, weakness, hyper-reflexia, mixed presentation, flaccid paralysis.

77
Q

What neuro condition is associated with Tabes Dorsalis?

A

Tertiary Syphilis - spirochetes destroy dorsal roots

Can also cause asymptomatic meningitis

78
Q 
What is the M/C organism in the following age groups: 
0-4wks
4-12wks
3mo-18y
18y-50y
>50y
A

E. Coli, L. monocytogenes, grp B streptococcus
S. pneumoniae, grp B streptococcus, E. coli, L. monocytogenes
N. meningitidis, H. influenzae, S. Pneumoniae
N. meningitidis, S. pneumoniae
S. pneumoniae, N. meningitidis, L. monocytogenes, gm -

79
Q

Children or adults:
Above the tentorium cerebelli
Below the tentorium cerebelli

A

Adults

Children

80
Q

Most aggressive/malignant primary brain tumor in adults.

A

Glioblastoma Multiforme

81
Q

Autoimmune CNS demyelinating disorders.

A

MS

82
Q

Ascending paralysis after viral infection. Peripheral demyelination.

A

Guillain-Barre Syndrome

83
Q

List three dysmyelination disorders (leukodystrophies)

A

Adrenoleukodystrophy
Metachromic leukodystrophy (MC)
Krabbe’s disease

84
Q

What deficiency causes Wernicke-Korsakoff syndrome?

A

B1 - usually due to alcoholism (alcohol dehydrogenase, B1 dependent)

85
Q

What deficiency causes Pellagra?

A

Niacin (B3)

86
Q

What are some SSX of B12 deficiency?

A

Macrocytic anemia, dementia, degeneration of the spinal cord

87
Q

Name the disease: cortical atrophy, neurofibrillary tangles, plaque deposition. MC cause of dementia.

A

Alzheimer’s Disease

88
Q

Name the lysosomal storage disease:
Hexosaminidase A deficiency, death by 4y
Can’t degrade mucopolysaccharides, death by 6-10y
Alpha-glucosidase deficiency - can’t break down glycogen

A

Tay-Sachs Dz
Hurler’s Dz
Pompe’s Dz

89
Q

Name the pathology: Autosomal recessive, toxic levels of copper storage, deposition in liver/brain/eye, Kaiser-Fleisher rings.

A

Wilson’s disease

NPLEX I (12 decks)

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