Term
|
Definition
Deep white matter disease (due to multiple small blood vessel infarcts- HTN, diabetes, hyperlipidemia)
Gait issues (gait pathways pass through here- close to ventricles) |
|
|
Term
|
Definition
| small vessel infarcts affecting pons and basal ganglia |
|
|
Term
| Imaging results in vascular dementia? |
|
Definition
Cortical infarcts
Leukoariosis (white matter disease)
Lacunar infarcts |
|
|
Term
|
Definition
Neurofibrillary tangles w/in neurons
Associated w/ Alzheimers |
|
|
Term
|
Definition
Protein buildup in extracellular space surrounding neurons- affects their communication
Seen in Alzheimers |
|
|
Term
|
Definition
Hippocampal atrophy (responsible for memory loss)
Parietal lobe/cingulate gyrus atrophy (responsible for visuospatial symptoms)
Corpus callosum atrophy (due to parietal lobe atrophy)
PET scan hypometabolism of glucose
Florbetapir- tags beta amyloid- loss of differentiation b/w white and gray matter |
|
|
Term
| What protein are Lewy bodies comprised of? |
|
Definition
|
|
Term
| Why is Parkinsonism associated w/ diffuse Lewy Body dementia? |
|
Definition
| Lewy bodies in substantia nigra of brainstem- major source of dopamine for basal ganglia -> movement disorders |
|
|
Term
|
Definition
Cholinesterase inhibitors
NMDA antagonists- block influx of Ca++ into cell (e.g. memantine) |
|
|
Term
| Tx for vascular dementia? |
|
Definition
| Prevent strokes- antiplatelet (ASA, clopidogrel), statins, BP or glucose control |
|
|
Term
| Why do we avoid neuroleptics in DLBD? |
|
Definition
| Can exacerbate Parkinsonism |
|
|
Term
|
Definition
Cholinesterase inhibitors
(?) Carbidopa/levidopa |
|
|
Term
| Which pathology involves tau and TDP-43 protein? |
|
Definition
| frontotemporal lobe degeneration |
|
|
Term
| Behavioral variant of FTLD- where do tau proteins collect? |
|
Definition
|
|
Term
| Criteria to dx "possible" bvFTD |
|
Definition
At least 3 of the following:
Early (in the disease process) behavioral disinhibition
Early apathy or inertia
Early loss of sympathy or empathy
Early compulsive/ritualistic behavior (new onset)
Late hyper-orality/dietary changes
Executive/generation (coming up w/ a word) deficits, with sparing of memory and visuospatial functions |
|
|
Term
| Average age of presentation with FTD? |
|
Definition
|
|
Term
| Behavioral disinhibition maps where? |
|
Definition
|
|
Term
| Apathy/abulia maps where? |
|
Definition
| Medial portion of frontal lobes |
|
|
Term
| OCD-like behaviors map where? |
|
Definition
|
|
Term
| Hyper-orality maps where? |
|
Definition
|
|
Term
|
Definition
Atrophy of frontal and temporal lobes
PET scan- hypometabolism of glucose in anterior frontal and temporal lobes |
|
|
Term
| 3 key words w/ Parkinson's? |
|
Definition
| Bradykinesia, tremor, rigidity |
|
|
Term
| 3 key words w/ Huntington's? |
|
Definition
| Choreiform movements, psychiatric, dementia |
|
|
Term
| Key psychiatric symptom of HD? |
|
Definition
|
|
Term
|
Definition
| Feeling pain from a non-painful stimulus (e.g. sheet brushing your foot) |
|
|
Term
|
Definition
| a prolonged pain from a painful stimulus like getting poked with a pin that lingers for a long time. |
|
|
Term
| Features of inclusion body myositis? |
|
Definition
MC in males > 50
Can be asymmetric
Attacks quads and forearm flexors first
Vacuolar inclusions on histology |
|
|
Term
|
Definition
| "Climbing up the legs" to get up off the floor |
|
|
Term
| cytoalbuminologic dissociation |
|
Definition
Normal cell count, elevated protein
In csf, associated w/ Guillain Barre |
|
|
Term
|
Definition
| Viral infection - anti ganglioside antibodies - muscle weakness develops over 2 -4 weeks then remits |
|
|
Term
|
Definition
ICU admit
IVIG and plasmapheresis
Monitor respiratory function
Physical therapy |
|
|
Term
|
Definition
|
|
Term
|
Definition
Excess salivation
Associated w/ ALS |
|
|
Term
| El Escorial/Awaji criteria of diagnosing ALS? |
|
Definition
UMN and LMN deficits in 3/4 areas:
Head
Neck and arms
Thoracic
Lumbar (lower back & legs) |
|
|
Term
|
Definition
| Progressive muscular atrophy- purely lower motor neuron form of ALS |
|
|
Term
|
Definition
| Primary lateral sclerosis- purely upper motor neuron form of ALS |
|
|
Term
| Most common gene associated w/ ALS? |
|
Definition
| Chromosome 9 orf (open reading frame) 72 |
|
|
Term
|
Definition
Riluzole- inhibits glutamate release
Edavarone- free radical scavenger |
|
|
Term
| Post-ictal Todd's paralysis? |
|
Definition
| Transient unilateral weakness following a seizure (typically resolves w/in 48 hrs) |
|
|
Term
|
Definition
| An absence of willpower or an inability to act decisively, as a symptom of mental illness |
|
|
Term
| Transcortical motor aphasia |
|
Definition
| Pt not able to say what they want to say, but are able to repeat (lesion higher up than Broca's) |
|
|
Term
| Transcortical sensory aphasia |
|
Definition
| Looks like Wernicke's aphasia but pt is able to repeat (lesion higher up) |
|
|
Term
| Which artery primarily supplies the pons? |
|
Definition
|
|
Term
| Contents of alpha granules of platelets? |
|
Definition
|
|
Term
| Contents of dense granules of platelets? |
|
Definition
| ADP, ATP, Ca++, histamine, serotonin |
|
|
Term
| Where are all procoagulants synthesized? |
|
Definition
|
|
Term
| Where is VWF synthesized? |
|
Definition
| Megakaryocytes & endothelial cells |
|
|
Term
|
Definition
| Converts prothrombin --> thrombin |
|
|
Term
|
Definition
| Converts fibrinogen --> fibrin |
|
|
Term
| Which involves Tissue Factor (TF): extrinsic or intrinsic pathway? |
|
Definition
|
|
Term
|
Definition
| Glipizide, Glimepiride, Glyburide |
|
|
Term
| First line therapy in diabetes management? |
|
Definition
| Biguanides (aka metformin) |
|
|
Term
| MOA of sulfonylureas (like glipizide)? |
|
Definition
| Bind to/close K+ channels on surface of beta cells --> depolarize cell --> influx of Ca++ --> increased fusion of insulin vesicles w/ cell membrane --> increased secretion of insulin |
|
|
Term
|
Definition
| Decreases liver production of glucose, increases peripheral uptake of glucose via GLUT4 transporter |
|
|
Term
|
Definition
| Inhibits Na/K pump in heart cells --> ^ in intracellular Na --> ^ in intracellular Ca++ --> ^ contractility --> improved CHF |
|
|
Term
|
Definition
| Inhibits phosphodiesterase enzymes that break down cAMP --> ^ in cellular cAMP --> blocking platelet aggregation |
|
|
Term
| What is CPP and what should it be? |
|
Definition
| CPP = MAP (mean arterial pressure) - ICP (Intracranial pressure) >/= 70 |
|
|
Term
| How far do we try to reduce SBP in a stroke patient? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Gram stain for S. pnumoniae? |
|
Definition
|
|
Term
| Gram stain for N. meningitidis? |
|
Definition
|
|
Term
| What area of the brain is typically involved in deja vu epileptic auras? |
|
Definition
|
|
Term
| What distinguishes migrainous from epileptic auras? |
|
Definition
Migrainous- several minutes
Epileptic- few seconds |
|
|
Term
| Are epileptic auras usually simple or complex hallucinations? |
|
Definition
| Simple- such as metallic taste, coloured spots, tinnitus, tingling |
|
|
Term
|
Definition
Pork tapeworm
Organism = T. solium |
|
|
Term
| What clinical evidence could indicate history of nocturnal seizures? |
|
Definition
| bed wetting, tongue biting, blood on the pillow, early morning headache, or “hangover” without alcohol |
|
|
Term
| Which is associated w/ seizures: hyper or hypothyroidism? |
|
Definition
|
|
Term
| Factors conferring highest risk of recurrence after first seizure? |
|
Definition
| Nocturnal seizures, prior brain lesion causing the seizure, EEG w/ epileptiform abnormalities (spikes or waves), significant brain imaging abnormality |
|
|
Term
| Rich foci are associated w/ what type of meningitis? |
|
Definition
|
|
Term
|
Definition
| Headache worsens when patient vigorously shakes their head |
|
|
Term
|
Definition
| Pain/hip flexion with flexion of the neck |
|
|
Term
|
Definition
| Pain/resistance to leg extension with hip flexion |
|
|
Term
| What causes petechial rash in meningitis pts? |
|
Definition
| Meningococcemia (due to N. meningitidis) |
|
|
Term
| What two chemicals are secreted by basophils? |
|
Definition
|
|
Term
| Which WBC turns into macrophages in the tissue? |
|
Definition
|
|
Term
| Which are longer-lived: neutrophils or monocytes? |
|
Definition
| Monocytes- able to renew their lisosomes |
|
|
Term
| Horner syndrome is associated w/ what type of headache? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What headache medication class targets serotonin 1d receptors intracranially and on the trigeminal nerve? |
|
Definition
|
|
Term
| What headache med class targets 5HT-1d/1b receptors and is contraindicated in CAD/angina? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| First-line tx of cluster headaches? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Anticonvulsants (depakote, topiramate)
B-blockers (propranolol)
Frovatriptan (menstrually-associated migraine)
Butterbur herbal
Selective calcitonin gene-related peptide antibody (erenumab-aooe) |
|
|
Term
|
Definition
| Competitively inhibits viral DNA polymerase |
|
|
Term
| MC cause of fungal meningitis? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Cause of "pink, lacy" rash in meningitis? |
|
Definition
|
|
Term
| CSF workup in meningitis? |
|
Definition
1) Culture (gold standard)
2)Gram stain
3) Latex agglutination test for antibodies
4) PCR for virus
5) CRP (most likely bacterial) |
|
|
Term
| Prophylaxis for close contacts of N. meningitidis? |
|
Definition
| Rifampin, cipro, ceftriaxone |
|
|
Term
| Drugs that can cause meningitis? |
|
Definition
|
|
Term
| Pathophys of subdural empyema? |
|
Definition
Thrombophlebitis of sinus venous drainage
Osteomyelitis
Neurosurgery |
|
|
Term
| First-line tx for migraine? |
|
Definition
| Triptans (5HT-1b/1d agonists) |
|
|
Term
|
Definition
| acetaminophen, isometheptene and dichloralphenazone |
|
|
Term
|
Definition
| Ergot-derived HA medication (5HT-2b antagonist) |
|
|
Term
| MC nontraumatic cause of SAH? |
|
Definition
|
|
Term
| Temporal arteritis associated w/ what disease state? |
|
Definition
|
|
Term
| Work-up of pt w/ suspected temporal arteritis? |
|
Definition
Start corticosteroids right away
Arterial biopsy gold standard to dx |
|
|
Term
| What is another name for idiopathic intracranial hypertension? |
|
Definition
|
|
Term
| LP findings in pseudotumor cerebri? |
|
Definition
| High opening pressure, normal CSF |
|
|
Term
| Glasgow coma scale findings? |
|
Definition
Normal- 15
Comatose <8
Unresponsive <3 |
|
|
Term
| What is indicated in pinpoint pupils w/o reaction to light? |
|
Definition
|
|
Term
| What is indicated by pinpoint pupils that do react to light? |
|
Definition
|
|
Term
| What causes Wernicke encephalopathy? |
|
Definition
| Thiamine (vit B1) deficiency |
|
|
Term
| What can Wernicke encephalopathy progress to? |
|
Definition
| Korsakoff syndrome (chronic amnesia, confabulation, impaired learning) |
|
|
Term
|
Definition
1) Falls
2) MVA
3) Hitting an object or getting hit |
|
|
Term
|
Definition
2-20 mm Hg
Above 60 damages neurons |
|
|
Term
| Cerebral Perfusion Pressure (CPP)? |
|
Definition
MAP - ICP
Normal 60-80 mm Hg |
|
|
Term
| PE findings consistent w/ basilar skull fracture? |
|
Definition
| Battle's sign, raccoon eyes, CSF leak, hemotympanum |
|
|
Term
|
Definition
| Glabellar reflex (also known as the "glabellar tap sign") is a reflex elicited by repetitive tapping on the forehead. Subjects blink in response to the first several taps. If the blinking persists, this is known as Myerson's sign and is abnormal and a sign of frontal release; it is often seen in people who have Parkinson's disease |
|
|
Term
|
Definition
| the inability to identify an object by active touch of the hands without other sensory input |
|
|
Term
|
Definition
| an impaired ability to perform rapid, alternating movements |
|
|
Term
| What are highest risk factors associated w/ seizure recurrence after unprovoked first seizure? |
|
Definition
1) Prior brain lesion causing the seizure
2) EEG w/ epileptiform abnormalities (spikes or sharp waves)
3) brain imaging abnormality
4) nocturnal seizure |
|
|
Term
| What is the most common type of "first seizure"? |
|
Definition
|
|
Term
|
Definition
| Sudden irregular jerk caused by involuntary muscle activity, involving the trunk or one or more limbs |
|
|
Term
| What distinguishes an epileptic aura? |
|
Definition
Brief- last only a few seconds
Simple sensory- metallic taste, tinnitus, colored spots, tingling (rarely complex hallucinations)
Deja vu/jamais vu- intense feeling of the familiary (associated w/ temporal lobe seizure) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Simple partial motor seizure |
|
Definition
Focal motor seizure w/o loss of consciousness or awareness
Can be clonic, tonic, or dystonic, usually lasts a few seconds |
|
|
Term
| What are the seizures w/ loss of consciousness |
|
Definition
| Absence, complex partial, complex generalized, tonic clonic |
|
|
Term
| What type of seizure used to be called "petit mal"? |
|
Definition
|
|
Term
| What type of seizure typically starts with a cry, then subsequent loss of tone and fall? |
|
Definition
|
|
Term
| Which is more commonly preceded by nausea or sweating: seizure or syncope? |
|
Definition
|
|
Term
|
Definition
| a dangerous condition in which epileptic seizures follow one another without recovery of consciousness between them. |
|
|
Term
| With what disorder is pelvic thrusting associated? |
|
Definition
| Non-epileptic attack disorder |
|
|
Term
| Signs/symptoms of nocturnal seizure? |
|
Definition
| Bed wetting, blood on pillow, "hangover" without drinking |
|
|
Term
| First-line tx of first seizure? |
|
Definition
|
|
Term
| Components and scoring of Glasgow Coma Scale? |
|
Definition
Eye opening, best motor response, best verbal response.
Best score 15, worst 3 |
|
|
Term
| Time window for tPA and mechanical thrombectomy? |
|
Definition
tPA: <4.5 hrs from onset
Thrombectomy: <24 hrs from onset |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What disease is characterized by progressive neuron degeneration with neurons replaced by gliosis? |
|
Definition
|
|
Term
| Intracellular bunina bodies are associated w/ what disorder? |
|
Definition
|
|
Term
| Drug used to tx ALS and its MOA? |
|
Definition
Riluzole
Glutamate blocker |
|
|
Term
| What does dysprosodic mean in regards to speech? |
|
Definition
|
|
Term
| What NIH scale score constitutes severe stroke? |
|
Definition
|
|
Term
| Dipyrimadole MOA and indication? |
|
Definition
Phosphodiesterase inhibitor- blocks uptake and metabolism of adenosine by erythrocytes, platelets and vascular endothelial cells.
Vasodilator/blood thinner to prevent ischemic events |
|
|
Term
| MOA of TPA (tissue plasminogen activator aka alteplase)? |
|
Definition
| Thrombolytic agent: Initiates local fibrinolysis by binding to fibrin in a thrombus and converts entrapped plasminogen to plasmin. |
|
|
Term
| Cerebral Perfusion Pressure (CPP) formula? |
|
Definition
| MAP - ICP (needs to be greater than 70) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Inhibits HMG-CoA reductase, reducing cholesterol synthesis |
|
|
Term
|
Definition
| Irreversibly binds P2Y12 receptors on platelets - inhibits platelet aggregation |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Involuntary spasms, repetitive motions or abnormal voluntary movement |
|
|
Term
| Examples of dopamine antagonists? |
|
Definition
Typical antipsychotics (haloperidol, fluphenazine, chlopromazine)
Atypical (less) (Olanzapine, clozapine, risperidone)
Antiemetics (prochlorperazine, promethazine, metoclopramide) |
|
|
Term
| What chromosome houses the mutation for Huntington's? |
|
Definition
|
|
Term
| What type of tremor is relieved with EtOH ingestion? |
|
Definition
| Essential (benign familial) tremor |
|
|
Term
| What disorder is associated w/ resting tremor/pill rolling? |
|
Definition
|
|
Term
|
Definition
Increased speed while walking
Seen in PD due to postural instability |
|
|
Term
| Examples of COMT inhibitors? |
|
Definition
|
|
Term
| Which of the following presents with decreased DTR: Guillain-Barre or MG? |
|
Definition
|
|
Term
| Gold standard diagnostic test for MS? |
|
Definition
|
|
Term
| MOA of triptans and ergotamines? |
|
Definition
5HT-1B and 1D agonists --> vasoconstriction
Used as abortive tx of migraines |
|
|
Term
| Prophylactic tx of migraines? |
|
Definition
| B-blockers, Ca-channel blockers, TCAs, anticonvulsants, NSAIDs |
|
|
Term
| 1st tx of acute cluster HA? |
|
Definition
|
|
Term
| Prophylaxis for cluster HA? |
|
Definition
|
|
Term
|
Definition
| Carbonic anhydrase inhibitor (acts in the PCT of the nephron) |
|
|
Term
| CT findings in Alzheimers? |
|
Definition
|
|
Term
|
Definition
AchE inhibitors (donepezil, tacrine, rivastigmine, galantamine)
NMDA antagonist (memantine) |
|
|
Term
| What is the MC primary CNS tumor in adults? |
|
Definition
|
|
Term
| What type of astrocytoma is glioblastoma? |
|
Definition
|
|
Term
|
Definition
Abnormal buildup of blood vessels in the skin or internal organs
May secrete EPO --> 2ary polycythemia |
|
|
Term
|
Definition
| a deficit of self-awareness, a condition in which a person with some disability seems unaware of its existence |
|
|
Term
| ABCD2 to assess CVA risk? |
|
Definition
Age > 60
BP > 140/90
Clinical features (speech disturbance, unilateral weakness)
Duration of TIA
Diabetes |
|
|
Term
|
Definition
| Aspirin + dipyridamole or clopidogrel |
|
|
Term
| CT scan in lacunar infarct? |
|
Definition
| Small punched out hypodense lesions |
|
|
Term
|
Definition
|
|
Term
| MC mechanism of epidural hematoma? |
|
Definition
| Temporal bone fracture --> middle meningeal artery hemorrhage |
|
|
Term
|
Definition
| Berry aneurysm (Circle of willis) |
|
|
Term
| MC mechanism of subdural hematoma? |
|
Definition
| Blunt trauma (venous bleed) |
|
|
Term
|
Definition
Think "kermit the frog"
Inability to straighten knee w/ hip flexion |
|
|
Term
|
Definition
| Neck flexion produces hip/knee flexion |
|
|
Term
| MC cause bacterial meningitis in neonates? |
|
Definition
| Group B strep (strep agalactiae) |
|
|
Term
| MC cause of viral meningitis? |
|
Definition
| Enterovirus family (e.g. echovirus, coxsackie) |
|
|
Term
| MC cause of encephalitis? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Tx for tonic clonic seizure? |
|
Definition
| VPA, phenytoin, carbamazepine, lamotrigine |
|
|
Term
| Tx for status epilepticus? |
|
Definition
| Benzos, then phenytoin, then phenobarbital |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Blocks Na channels in CNS |
|
|
Term
|
Definition
| Gingival hyperplasia, SJS, hirsutism |
|
|
Term
|
Definition
| Bind allosterically to GABA receptors to enhance GABAergic inhibition in CNS |
|
|
Term
|
Definition
| Blocks Ca++ channels --> motor cortex depression |
|
|
Term
|
Definition
| Pancreatitis, hepatotoxicity |
|
|
Term
| Which anti epileptic drug (AED) is also used to treat diabetes insipidus and may cause hyponatremia and blood dyscrasias? |
|
Definition
|
|
Term
| Which AED can cause nephrolithiasis? |
|
Definition
|
|
Term
| Which AED can cause osteoporosis? |
|
Definition
|
|
Term
| What class of AEDs is most associated w/ sedation? |
|
Definition
|
|
