CM II ALL Quizlettes

which combination of neurons is most prevalent in CNS?

glutaminergic and Gabanergic

which is a characteristic of muscarinic receptor?

blocked by atropine

which neurotransmitter is principally involved in learning and memory?

glutamic acid

two types of acetylcholine receptors are?

nicotinic and muscarinic

delirium can be differentiated from dementia in that delirium manifests with?

altered level of consciousness

difference between huntington vs. alzheimers, dewy, and parkinson’s?

inheritance is a definite pattern

pt with confusion, inability to perform ADL, walks like drunk, urinary incontinence, he has?

normal pressure hydrocephalus

what should be done when ruling out metabolic causes of dementia?

(all are correct, VDRL - syphilis testing, tsh, glucose, b12 levels)

in the spinothalamic sensory system, where does decussation/crossing over of neuronal axons occur?

spinal cord

at which point could epinephrine be considered the primary “post-ganglionic” neurotransmitter?

adrenal gland

Epinephrine is not a NT, but the adrenal gland can be thought of as a big ganglion, it releases hormones, and remember epinephrine is only released by adrenal gland

the dorsal columns of the spinal cord carry messages to the brain about all of the following except:

• temp*

• proprioception

• discriminatory touch

• vibration

characterized by amyloid plaques and tau protein neurofibrillary tangles (the inclusion bodies)

alzheimer’s dementia

axons in the MAJORITY of corticospinal tract decussate in the:

medulla pyramids

the upper nuclei of facial nerve (CN VII) are innervated by upper motor neurons from:

both the left and right motor cortex on precentral gyrus

receptive aphasia is related to damage in the:

wernicke’s area

motor neurons exiting the nuclei of the cranial nerves in the bulb of the brain innervate muscles located in:

the head and neck

a pt complains of bilateral leg weakness and numbness in her feet. you confirm weakness in lower extremities on exam but deep tendon reflexes are snappy. pinprick sensation absent in feet and ankles, reduced in thighs and hips and doesn't test normal until you reach lower rib cage. can you localize the lesion?

spinal cord (myelopathy)

• sensory problem = spinal cord problem/peripheral nerve problem/cerebral cortex

• “snappy” deep tendon reflexes = UMN

• bilateral leg weakness = central nerve tissue (not peripheral)

someone is having difficulty doing pushups, what reflex would most likely be abnormal on exam?

C7 because triceps responsible for elbow extension

after administering spinal anaesthetic, you start with pinprick touch from ankle up and it isn’t until umbilicus that she says “ouch.” to which spinal level (dermatome) does her sensory blockade most likely respond?

T10

signs of the upper motor neuron include all of the following EXCEPT:

muscle fasiculation

the ones that are UMN = weakness, spasticity, hyperactive reflexes, present babinski reflex

receptive aphasia is caused by lesion in the

temporal lobe

horner’s sydnrome comprises of a tetrad of which physical findings?

ptosis, miosis, enophthalmos, and anhidrosis

34 year old female visits office complaining of neurologic sypmptoms, is on a strict vegan diet for 10 years. what neuro sign would be abnormal in pt?

vibratory sense

patient comes to me with 3 month history of weakness, has trouble standing and supporting weight. tingling sensation of toes, now spread over entire feet and ankles, 4+ patellar and achilles deep tendon reflex which were normal 6 months ago. upper reflexes unchanged. muscle bulk in LE mildly reduced but muscle tone is increased. no muscle fasciculations are noted. can you localize his lesion?

spinal cord (myelopathy)

side effects of l-dopa therapy for parkinson’s dz includes?

• development of on and off phenomena, emotional lability, impulsive/compuslve behavior, hallucinations

  • NOT diminished libido

direct pathway w/ and w/o substantia nigra

stimulates the cortex without substantia nigra, and still stimulates cortex with substantia nigra

indirect pathway w and w/o substantia nigra

restrains the cortex without substantia nigra, with substantia nigra, the dopaminergic ions binds to DA2, you restrain striatum, so less GABA leaves striatum to GPe -> GPe is less inhibited (meaning it’s stronger, it releases GABA-), so it can restrain more on STN -> restrained STN cannot activate GPi -> the GPi cannot restrain the thalamus -> so thalamus is activated!

Without substantia nigra, you will have an inhibition AND excitatory cortex which is what leads to the tremor (in parkinson’s)

which of the following should be done when ruling out metabolic causes of dementia?

all are correct (B12 level, VDRL syphilis testing, thryoid function tests, blood glucose)

how does huntington’s dementia differ fromp karinson’s dementia, lewy body dementia, and alzheimers?

definite pattern of inheritance in huntingtons

which of the following classifications of neuropathy is most commonly found among diabetic pts who have peripheral neuropathy?

axonal polyneuropathy

delirium can be differentiated from dementia in that delirium manifests with?

altered level of consciousness

in what ways is secondary progressive multiple sclerosis different from the primary progressive type?

secondary progressive MS followed a period of relapsing-remitting MS

patient arrives in ER with worsening signs of confusion, inability to perform ADLs, walks like drunk and urinary incontinence

normal pressure hydrocephalus

of the following, which is most likely associated with Lhermitte's phenomenon?

multiple sclerosis

patient diagnosed with MS exhibit which of the following findings on their cerebral spinal fluid?

oligoclonal bands and myelin basic protein

which patient requires at head CT after suffering a concussion?

a pt on meds for a clotting disorder

15 year old youth hockey player is checked, falls, and hits his head on ice, does not lose consciousness, mildly nauseated and confused for 30 minutes, but no other neuro deficit. Glasgow coma scale is 14. what is the diagnosis?

concussion

which of the following is a LAT manifestation (dats to weeks) of concussion?

emotionally lability

which feature primarily distinguishes alzheimers dementia from other forms of dementia?

memory impairment is the core and earliest feature

tension headache DIFFERS from exertional headache in that tension headache?

is not aggravated by physical activity

a patient with alzheimers disease can no longer remember how to use the telephone. this is an example of:

impaired executive function

which item is more typical of a migraine prodrome than of a migraine aura?

yawning

COMT and MAO inhibitors are especially useful in the control of which aspect of parkinson’s disease tx?

on-off phenomenon

what is the main inhibitory NT in the CNS?

GABA

agnosia:

inability to visually recognize objects or people

hyperventilation

causes cerebral-vasal constriction so their brain does not have oxygen → passes out (respiratory alkalosis)

which of the following is autosomal dominant pathology that requires family education and genetic counseling?

huntington’s disease

which is true of meningocele?

no neural tissue is involved in the defect

regarding febrile seizures, which of the following is a false statement?

1. a complex febrile seizure is characterized by a generalized seizure lasting less than 5 minutes

   1. true: 30-40% of first time sufferers will have recurrence, most febrile seizures are tonic-clonic type, children under 12 months of age at first occurrence are at higher risk of recurrence, attendance in daycare is a risk factor for occurrence and recurrence of seizure

82 year old white female has right sided weakness and aphasia, her PMH is significant for HTN, CAD, carotid artery disease, and smoking PPD for 60 years. of the folloiwng choices, which choice increases patient’s risk of ischemic stroke most significantly?

HTN

which is the drug of choice for absence seizures?

zarontin (ethosuximide)

what is a true statement regarding stroke?

cerebral edema reaches its max in 72 hours and takes 2 weeks to subside

image of brain with white spot in the middle

intracerebral hemorrhage

which of the following is not a contraindication for TPA?

age of 80 (not a limitation)

what of the following is not associated with complex febrile seizures?

1. brief postictal phase

   1. It actually has a prolonged complex febrile

what becomes displaced in subfalcine brain herniation?

cingulate gyrus