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Step 1 First Aid: Neurology

Step 1 First Aid: Neurology

by bhs10289, May 2013

Subjects: Neurology

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

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