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Neurology

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resexuwe's version from 2017-07-26 01:16

Neurology

Question Answer
What is the central nervous system?Brain and spinal cord; Oligodendrocytes
What is the peripheral nervous system?Everything else; Schwann cells
What is the autonomic nervous system?Automatic Stuff
What is the somatic nervous system?Moving your muscles
What is the parasympathetic system?Rest-and-Digest → slows stuff down
How does the parasympathetic system behave?“DUMBBLES”; Diarrhea, Urination, Miosis “constrict”, Bradycardia, Bronchoconstrict, Erection “point”, Lacrimation, and Salivation
What is the sympathetic system?Fight-or-Flight → speeds stuff up
How does the sympathetic system behave?Opposite of Parasympathetic; Constriction, Urinary retention, Mydriasis “dilated eyes with fright”, Tachycardia, Bronchodilate, Ejaculation “shoot”, Xerophthalmia (dry eyes), and Xerostomia (dry mouth)
Where is NE synthesized?Locus Cerelues of the PNS
What happens to NE in anxiety and depression?(NE – increase in Anxiety), (NE – decreases in Depression)
Where is Dopamine synthesized ? Ventral Tegmentum and Substania Nigra pars compacta SNc → Dorsal striatum (caudate nucleus and putamen) in the midbrain
What happens to Dopamine in Huntington's, Parkinson's, and Depression?(DA – increases in huntington), (DA – decreases in Parkinson), and (DA – decreases in Depression)
Where is Serotonin synthesized?Raphe Nucleus
What happens to Serotonin in Parkinson's, anxiety, and depression?(5HT – increases in Parkinson's), (5HT – decreases in Anxiety), and (5HT – decreases in Depression)
Where is Acetylcholine Synthesized?Basal nucleus of Meynert
What happens to Ach in Parkinson's, Alzheimer's, and Huntington's?(Ach – increases in Parkinson's), (Ach – decreases in Alzheimer's), and (Ach – decreases in Huntington's)
What does the forebrain or prosencephalon give rise to?Telencephalon → Cerebral Hemispheres, Dienchephalon → Thalamus
What does the midbrain or mesencephalon give rise to?Mesencephalon → Mid-brain
What does the hindbrain or rhombencephalon give rise to?Metencephalon → Pons and Cerebellum, Myelencephalon → Medulla
What is Cushing's triad?HTN, Bradycardia, and Increase ICP
What is Budd-Chiari?Hepatic Vein Obstruction
What is Arnold-Chiari?Foramen magnum obstruction
What is Anencephaly?Notochord did not make contact with brain → only have medulla
What is Encephalocele?Brain tissue herniation
What is Dandy Walker malformation?No cerebellum, distended 4th / lateral ventricles
What is an Arnold-Chiari malformation?Herniation of cerebellum through foremen magnum, Type I – cerebellar tonsils (asymptomatics), Type II – cerebellar vermis/ medulla → (hydrocephalus, syringiomyelia – loss of pain/temp)
What is Spinal bifida occulta?Covered by skin with tuft of hair
What is Spinal bifida aperta?has opening (high AFP)
What is a Meningocele?Sacral pocket with meninges in it
What is a Meningomyelocele?Sacral pocket with meninges and nerve in it
What is Open-angle glaucoma?Overproduction of fluid → Painless ipsilateral dilated pupil, gradual tunnel vision, and optic disc cupping
What is Closed-angle glaucoma?Obstruction of canal of Schlemm → sudden onset, Pain, and Emergency
What are the Watershed areas?Hippocampus, and Splenic flexture
What are the contents of the Cavernous Sinus?CN-III, CN-IV, CN-V(1), CN-V(2), and CN-VI, and postganglionic sympathetic fibers
What bug loves the frontal lobe?Rubella
What bug loves the temporal lobe?HSV
What bug loves the parietal lobe?Toxoplasma
What bug loves the hippocampus?Rabies
What bug loves the posterior fossa?TB
What bug loves the dorsal column-mediated lemniscal (DCML) tract?Treponema
How do migraines present?Aura, photophobia, numbness, tingling, throbbing headache, and nausea
How do tension headaches present?“Band-like” pain starts in posterior neck, worse as day progresses, sleep disturbances
How do cluster headaches present?Rhinorrhea, unilateral orbital pain, suicidal, facial flushing, worse w/ lying down
How does temporal arteritis present?Pain with chewing, blind in one eye
How does trigeminal neuralgia present?Sharp, shooting facial pain
What are the 2 kinds of partial seizures?Simple (pt. Aware), Complex (pt. Not aware)
What are the 3 kinds of generalized seizures?Tonic-Clonic “Grand mal”, Absence “Petit mal”, and Status Epilepticus
How does an epidural hematoma present?Intermittent consciousness, ”Lucid Interval”
How does an epidural hematoma look on CT?Biconvex lens, doesn't crosses suture lines
How does a subdural hematoma present?Headache 4 weeks after trauma, elderly (loose brain)
How does a subdural hematoma look on CT?Crescent moon shape, crosses suture lines, and mid-line shift
How does a subarachnoid hemorrhage present?“Worst headache of my life”, h/o berry aneurysm
What is an Astrocytoma?Rosenthal fibers, #1 in kids w/ occipital involvement
What is an Ependymoma?Rosettes, in 4th ventricle, and hydrocephalus
What is a Craniopharyngioma?Motor oil biopsy, tooth enamel, Rathke's pouch, ADH problem, bitemporal hemianopsia
What is Glioblastoma multiforme?Pseudopalisading, necrosis, “worst prognosis”, intralesional hemorrhage
What is a Hemangioblastoma?Cerebellum, Von-Hipple-Lindau, blood vessels tumor
What is a Meduloblastoma?Pseudorosettes, compresses brain, early morning vomiting
What is a Meningioma?Parasagittal, psammoma bodies, whorling pattern, “best prognosis”
What are the most common places to metastasize to the brain?From Lung, breast, skin; see at white-gray matter junction
What is an Oligodendroglioma?Fried-egg appearance, Nodular Calcification
What is a Pinealoma?Loss of upward gaze, loss of circadian rhythms → Precocious Puberty
What is a Schwannoma?CN8 tumor, Unilateral deafness, aka (acoustic neuroma)
What is Neurofibromatosis?Cafe-au-lait spots (hyperpigmentation) → peripheral nerve tumors, axillary freckle, Type I = “Von-Recklinghausens's” Peripheral (Chr # 17), Optic Glioma, Lisch Nodules, and Scoliosis. Type II = “Acoustic Neuroma”, Central (Chr # 22), Cataracts, and bilateral deafness
What is Sturge-Weber?Port wine stain (big purple spot) on forehead, angioma of retina
What is Tuberous Sclerosis?Ash-leaf spots (hypopigmentation), primary brain tumors, Heart Rhabdomyomas, Renal cell Carcinoma, Shagreen spots (leathery)
Aneurysm in the brain affecting visionAnterior communicating artery compressing optic nerve
Parkinson & AlzhemiersNeurodegenerative disease
Multiple sclerosis affectsOilgodendrocytes (myelin of CNS)
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CARDIOLOGY

Question Answer
How do you calculate SV?EDV-ESV → SV
How do you calculate CO?SV x HR → CO
What is normal CO?5L/minute
How much of this CO goes to the brain, heart, and kidney?20% → 1L minute or 60L an hr
How do you calculate CPP?MAP- ICP → CPP
What organs have resistance in series?Liver, Kidney
What organs have resistance in parallel?All the rest
What organ has the highest A-VO2 difference at rest?Heart
What organ has the highest A-VO2 difference after exercise?Muscle
What organ has the highest A-VO2 difference after meal?Gut
What organ has the highest A-VO2 difference during a test?Brain
What organ has the lowest A-VO2 difference?Kidney
Where does Type A thoracic aortic dissection occur?Ascending aorta(occurs in cystic medial necrosis, syphilis)
Where does Type B thoracic aortic dissection occur?Descending aorta (occurs in trauma, atherosclerosis)
What layers does a true aortic aneurysm occur?Intima, Media, and Adventitia
What layers does a pseudo aortic aneurysm occur?Intima and media
What is pulse pressure?Systolic- Diastolic pressure
What vessel has the thickest layer of smooth muscle?Aorta
What are the top 2 cyanotic conditions in baby?Transposition of Arteries & Tetralogy of Fallot
What vessels have the most smooth muscle?Arterioles
What vessels have the largest cross sectional area?Capillaries
What vessel has the highest compliance?Aorta
What vessels have the highest capacitance?Veins and venules
What are the three causes of HTN?1. Volume, SV 2. Rate, Hr 3. Resistance, TPR
What is your max heart rate?220 – age ( in years)
What is stable angina?Pain with exertion (atherosclerosis)
What is unstable angina?Pain at rest (transient clots)
What is Prinzmetals angina?Intermittent pain (coronary artery spasm)
What is amyloidosis?Stains Congo red, Echo apple green birefringence; deposition of proteins
What is Hemochromatosis?Fe deposit in organs → hyperpigmentation, arthritis, DM
What is Cardiac tamponade?Pressure equalizes in all 4 chambers, quiet precordium, no pulse or BP, kussumaul sign, pulsus paradoxicus (decrease >10mm Hg BP w/ insp)
What is a transudate?An effusion with mostly water. TOO much water – 1. Heart failure 2. Renal failure. NOT ENOUGH PROTEIN – 1. Cirrhosis(cant make protein) 2. Nephrotic syndrome(pee protein out)
What is a exudate?An effusion with protein. TOO much protein – 1. Purulent(bacteria) 2. Hemorrhagic (trauma, cancer, PE) 3. Fibrinous( collagen vascular dz, uremia, TB) 4. Granulomatous (non-bacterial)
What is systole?Squish heart, decrease blood flow to coronary aa, more extraction of O2(Phase 1 Korotkoff)
What is Diastole?Fill heart, increase blood flow to coronary artery, less extraction of O2 (phase 5 Korotkoff)
What are the only arteries w/ deoxygenated blood?Pulmonary Arteries and Umbilical Arteries
What is the difference between a murmur and a bruit?A murmur occurs in the heart, A bruit occurs in blood vessels
What murmur has a Water Hammer pulse?AR (aortic regurgitation)
What murmur has Pulses tardus?AS (aortic stenosis)
What cardiomyopathy has Pulsus alternans?Dilated cardiomyopathy
What disease has Pulsus?Idopathic Hypertrophic Subaortic Stenosis
What murmur has an irregularly irregular pulse?Atrial Fibrillation
What murmur has a regulary irregular pulse?PVC
What sound radiates to the neck?AS / AR
What sounds radiates to the axilla?MR / MS
What sounds radiates to the back?PS
What disease has boot shaped xray?Right ventricle hypertrophy
What disease has a banana shaped xray?Idiopathic hypertrophic subaortic stenosis
What disease has an egg shaped xray?Transposition of great arteries
What disease has a snowman shaped xray?Total Anomalous Pulmonary venous return
What disease has a “3” shaped x ray?Coarctation of Aorta
What is Osler-Weber-Rendu?AVM in lung, gut, CNS-> sequester platelets → telangectasias
What is Bvon Hippel-Linadu?AVM in head, retina → renal cell carcinoma risk
When do valves make noise?When valves close (door shutting make noise)
What valves makes noise during systole?Mitral / Tricuspid
What are the most common causes of Aortic stenosis?1. Aging 2. Dystrophic calcification
What are the most common causes of mitral regurgitation?1.MVP 2. Subacute baterial endocarditis 3. Collagen diseases
What are the most common causes of tricuspid stenosis?1. Rheumatic fever 2. Carcinoid Syndrome
What are the most common causes of tricuspid regurgitation?Acute Endocarditis (S. Aureus secondary to IV drug abuse)
What murmurs occurs during systole?Holosystolic, ejection murmur or click
What are the holosystolic murmurs?Tricuspid regurgitation (TR), Mitral regurgitation (MR), and VSD
What are the systolic ejection murmurs?Aortic stenosis (AS), Pulmonic stanosis (PS), or HCM
What valves make noise during diastole?Aortic and Pulmonic
What are the diastolic murmurs?Blowing and Rumbling
What are the diastolic blowing murmurs?Aortic Regurgitation (AR) or Pulmonary Regurgitation (PR)
What are the diastolic rumbling murmurs?Tricuspid stenosis (TS) or Mitral stenosis (MS)
What are the continuous murmurs?PDA or AVMs
What has a friction rub while breathing?Pleuritis
What has a friction rub when holding breath?Pericarditis
What does a mid-systolic click tell you?Mitral Valve Prolapse
What does an ejection click tell you?A/P stenosis (Aortic/Pulmonic)
What does an opening snap tell you?M/T stenosis (Mitral/Tricuspid)
What does S2 splitting tell you?Normal on inspiration (b/c pulmonic valve closes later)
What does wide S2 splitting tell you?Increase O2, Increase RV volume, or delayed Pulmonic valve opening
What does fixed wide S2 splitting tell you?ASD
What does paradoxical S2 splitting tell you?Aortic Stenosis (AS) or (left bundle branch block)
What do you see in the left sided heart failure?(1) Pulmonary edema, (2) Orthopnea, (3) Paroxysmal nocturnal dyspnea
What do you see in right sided heart failure?(1) Hepatomegaly, (2) Peripheral Edema, (3) Jugular Venous distention
What is cor-pulmonale?Pulmonary HTN → RV failure
What is Eisenmenger's?Pulmonary HTN → reverse (L-R) to (R-L) shunt
What is Transposition of the great arteries?Aorticopulmonary septum did not “spiral”
What is Tetrology of Fallot?(1) Overriding Aorta – Aorta sits on IV spetum over the VSD; pushes on PA, (2) Plmonary Stenosis “Tet Spells”, (3) RV hypertrophy → boot-shaped heart, (4) VSD (L to R shunt)
What is Total Anomalous Pulmonary Venous Return?All pulmonary veins to RA, Snowman X-ray
What is Truncus Arteriosus?Spiral membrane not develop → one A/P trunk, mixed blood
What is Ebstein's Anomaly?Tricuspid Prolapse, Mom's Li increases risk
What can Lithium do to Mom?Nephrogenic Diabetes Insipidus
What is Cinchonism?Hearing Loss, Tinnitus, thrombocytopenia
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