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Neuroscience Exam 3 Diseases and Conditions
Diseases and conditions for Neuroscience Exam 3
142
Medical
Professional
05/01/2011

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Term
Myopia
Definition
difficulty with distant objects
Term
Hyperopia
Definition
difficulty with close objects
Term
Astigmatism
Definition
irregular curvature of eye, difficulty with focus
Term
Presbyopia
Definition
loss of accomodation due to aging
Term
Cataracts
Definition
opacity of lens impairs vision, usually due to aging/diabetes/UV/smoking/infection
Term
Retinal Detachment
Definition
separation of RPE and photoreceptor cell layers, damages rods and cones, usually due to decreased IOP/trauma/vascular disease
Term
Closed-angle glaucoma
Definition
cornea/iris angle closed, no drainage of aqueous humor, acute and painful
Term
Open-angle glaucoma
Definition
dysfunctional drainage, slow onset
Term
Congenital glaucoma
Definition
normal-function drainage, unknown cause
Term
Dry (ischemic) Macular Degeneration
Definition
bruch's membrane thickens, atrophy of RPE, loss of choroidal capillaries
Term
Wet (edema) macular degeneration
Definition
due to neovascularization with leaky fragile vessels/scaring/fibrosis
Term
Papilledema
Definition
increased ICP pushes CSF in meninges against optic n., increasing blind spot with gradual vision loss, venous engorgement/hemorrhage
Term
Most common cause of AMD
Definition
choroidal neovascularization
Term
2nd most common cause of AMD
Definition
geographic atrophy of RPE and photoreceptors
Term
Diabetic Retinopathy
Definition
retinal neovascularization from venules, BM thickens/vascular aletrations/pericyte loss/microaneurysms, nonperfusion leads to hypoxia
Term
Type-2 diabetes
Definition
associated with macular edema of nonproliferative diabetic retinopathy
Term
Type-1 diabetes
Definition
associated with retinal neovascularization in proliferative diabetic retinopathy
Term
Proliferative diabetic retinopathy
Definition
hyperglycemia causes vasoconstriction and edema, pericyte apoptosis and peroxynitrite (ROS) cause endothelial instability, ECM deposition causes TGF-B-mediated BM thickening, PAF causes platelet aggregation and thrombic ischemia, leukocytes with defective actin polymerization obstruct blood flow, increased IGF and PDGF-AB (proangiogenic), decreased PEDF (antiangiogenic)
Term
Retinopathy of prematurity
Definition
hyperoxia for premature infants causes retinal vascular development to stop, neovascularization and retinal detachment, VEGF decreased in hyperoxia (Phase I), VEGF increased in hypoxia (Phase II), decreased IGF from placenta/amniotic fluid due to prematurity
Term
Lesion of right optic n.
Definition
ipsilateral blindness
Term
Lesion of optic chiasm
Definition
bitemporal heteronymous hemianopsia
Term
Lesion of right optic tract
Definition
left homonymous hemianopsia
Term
Lesion of right Meyer's loop
Definition
left superior quadrantanopia of right nasal and left temporal fields
Term
Lesion of right optic radiations in occipital lobe
Definition
left homonymous hemianopia with macular sparing
Term
Lesion of right direct nerves to cuneus
Definition
left inferior quadrantanopia of right nasal and left temporal field with macular sparing
Term
lesion of posterior lobe
Definition
homonymous hemianopsia with macular sparing
Term
Relative Afferent Pupillary Defect (Marcus-Gunn Pupil)
Definition
incomplete afferent lesion rostral to optic chiasm, pupil constricts only during consensual, use swinging-flashlight test to see dilation of affected eye
Term
Parinaud's Syndrome
Definition
compression of pretectal area and superior colliculus, conjugate paralysis of upward gaze, usually due to pineal tumor
Term
Adies pupil
Definition
lesion of ciliary ganglion or postgang. parasymp. fibers (efferent limb), pupil will not constrict to light, normal response to miosis/mydriasis drugs
Term
Argyll-Robertson pupil
Definition
chronic small & irregular pupil, constricts more to accomodation than light, due to bilateral damage to pretectal/E-W nuclei caused by neurosyphilis/MS/diabetes
Term
Most common cause of blindness 20-40 yo
Definition
diabetic retinopathy
Term
Characteristics of background (non-proliferative) DR
Definition
microaneurysms, retinal hemorrhages (flame- nerve fiber, dot/blot-inner plexiform/nuclear layers, boat-pre-retinal layer), hard exudates in outer plexiform layer (lipid-laden macrophages)
Term
Characteristics of proliferative DR
Definition
retinal capillary nonperfusion, neovascularigenesis (VEGF) from retinal venules into inner limiting membrane, proliferation of vitreoretinal interface, contraction causing vitreous hemorrhage and tractional retinal detachment
Term
Most common cause of blindness >50 yo
Definition
Age-related macular degeneration
Term
Characteristics of dry AMD
Definition
drusen, pigmentary changes (RPE atrophy/hypertrophy/hyperplasia), geographyic atrophy of RPE (loss of rods/cones/RPE/choriocapillaris)
Term
Characteristics of Wet AMD
Definition
soft drusen, choroidal neovascularization, sutbretinal neovascularization between retina/RPE and under RPE, fibrosis and disciform macular scar
Term
Most common childhood intraocular tumor
Definition
retinoblastoma
Term
Characteristics of retinoblastoma
Definition
bilateral tumors indicate hereditary factors, unifocal and unilteral (2 somatic mutations) or multifocal and bilateral (1 somatic and 1 germinal mutation), increased chance of femoral osteosarcoma, metastasis/mortality increased with optic nerve involvement or invasion of choroid
Term
Characteristics of choroidal melanoma
Definition
pigment in vitreous chamber blocks light during translumination, callendar classification (mixed-most common, spindle B, spindle A, epithelioid-most deadly), size of tumor most reliable prognosis (<1cm3 or >1cm3)
Term
Causes of painful peripheral neuropathy
Definition
diabetes, alcohol, HIV, post-herpes, medications, toxins, vitamin deficiency, uremia
Term
Guillain-Barre Syndrome
Definition
complement/IgG/Tcells attack myelination, ascending muscle weakness and paresthesia, worsens for days then 80% of patients recover, affects peripheral nerves and spinal nerve roots
Term
Chronic Inflammatory Demyelinating Polyneuropathy
Definition
schwann cell proliferation with onion bulbs, symmetrical weakness, treat with IV Ig
Term
Leprosy
Definition
only non-genetic disease with enlarged peripheral nerves, granulomatous inflammation, M. leprae bacillis in macrophages
Term
Varicella Zoster
Definition
virus in sensory ganglion, follow dermatomal patterns
Term
Charcot-Marie Tooth Disease
Definition
type 1 HMSN, motor symptoms with gradual vib/prop loss, psecavus with hammertoe, enlarged peripheral nerves, mutations in connexin32/MPZ/PMP22
Term
Peripheral Neuropathy from Adult-onset Diabetes
Definition
most common cause of peripheral neuropathy in western world, autonomic/focal/multifocal asymmetric neuropathy, difficult to treat, microangiopathy, hyalination of vessel wall and thinly myelinated fibers, shooting/burning pain with ulcers
Term
Sensorimotor polyneuropathy
Definition
especially found with small-cell lung carcinoma (Hu protein)
Term
Paraneoplastic neuropathy
Definition
plasma cell dyscriasis (increased Ig)
Term
Schwannoma
Definition
benign, forms at side of nerve, compact intertwining fascicles (Antoni A) and loose myxoid stroma (Antoni B), NF2 (merlin) mutation
Term
Neurofibroma
Definition
benign, incorporates axons, NF1 (neurofibromin) mutation, wavy schwann cells, neurofilaments with axons in tumor
Term
Malignant Peripheral Nerve Sheath Tumor
Definition
aggressive, arise after radiation therapy
Term
Neurofibromatosis Type 1
Definition
cafe-au-lait macules, cutaneous neurofibromas, plexiform neurofibromas (can transform to MPNST), Lisch iris nodules
Term
Neurofibromatosis Type 2
Definition
bilateral vestibular schwannomas at CP angle
Term
Traumatic neuroma
Definition
disordered nerve fibers, painful
Term
Thoracic outlet syndrome
Definition
nerve compression at root of neck (scalene mm.), C8&T1 most impinged against ribs, radiating arm pain/numbness, weakness of hand muscles
Term
Erb-Duchenne Palsy
Definition
injury to C5/C6 roots, due to forceful lateral flexion of the neck, weakness of deltoids and biceps brachi, waiter's tip (arm medially rotated/hung at side/adducted/extended, forearm pronated/extended), numbness on lateral arm and forearm
Term
Klumpke palsy
Definition
damage to C8/T1, often damages sympathetic chain (Horner's Syndrome), due to forceful arm abduction, weakness of intrinsic hand muscles and finger flexors/extensors
Term
Long thoracic nerve damage
Definition
damage to C5-C7, weakness of serratus anterior, winged scapula (posterior deviation)
Term
Musculocutaneous nerve injury
Definition
C5-C7, numbness of lateral forearm, partial elbow flexion due to brachioradialis (radial n.), weakness of forearm flexors
Term
Proximal Median nerve injury
Definition
C5-T1, pronator syndrome (hand of benediction), numbness of lateral 3.5 digits, anterior interosseous syndrome (loss of distal phalange flexion, no "ok"), atrophy of forearm flexors and thenar
Term
Distal median nerve injury
Definition
carpal tunnel syndrome (compression in flexor retinaculum), palmar cutaneous br. exits prior to tunnel (no loss of palm sensation), median n. palsy (ape hand)
Term
Radial nerve injury
Definition
due to humeral fracture (proximal) or supinator entrapment (distal), "wrist-drop", sensory loss on dorsum of hand, weakness of wrist extensors
Term
Posterior interosseous syndrome
Definition
wrist drop, no sensory deficits
Term
Ulnar nerve injury
Definition
most common peripheral nerve injury, due to compression of cutibal tunnel or Guyon's canal, numbness of medial 1.5 digits, interosseous m. wasting and loss of flexor digit minimi, "claw hand"
Term
Meralgia Pareshtetica
Definition
compression of femoral and lateral cutaneous n. of thigh, "bikini-brief syndrome", loss of sensatino of thigh and medial leg
Term
Superior Gluteal nerve injury
Definition
weakness of gluteus medius/minimus, loss of hip abduction, positive Trendelenburg sign (drop to contra side when standing on affected leg)
Term
Inferior gluteal nerve injury
Definition
weakness in hip extension, difficulty standing after sitting
Term
Femoral nerve injury
Definition
L2-L4, weakness of hip flexion and leg extension, sensory deficit of anterior thigh and medial leg
Term
Sciatic nerve injury
Definition
L4-S3, weakness in all lower extremity muscles, sensory deficit of lateral leg and all of foot
Term
Common peroneal nerve injury
Definition
L4-S2, foot drop, weakness of dorsiflexion and toe extension, sensory deficits of dorsal surface
Term
Lesion of frontal lobe motor area
Definition
contra hemiparesis (more spastic with more area involvement)
Term
Lesion of frontal premotor area
Definition
apraxia- difficulty performing previously-learned movement
Term
Lesion of frontal eye fields (8)
Definition
irritative-contra conjugate eye deviation
ablative-ipsi conjugate eye deviation
Term
Broca's aphasia
Definition
nonfluent, cannot speak, often depressed
Term
Lesion of prefrontal association areas
Definition
loss of judgment/initiative/insight/social skills
Term
Lesion of parietal primary somatosensory areas (postcentral gyrus 3,1,2)
Definition
contra loss of sensation
Term
Lesion of dominant lobe
Definition
alexia (can't read), agraphia (can't write), anomia (can't name objects), finger agnosia (can't figure which finger), constructive apraxia (can't draw), R/L confusion
Term
Lesion of nondominant lobe
Definition
sensory neglect on opposite side, ignores objects/persons/movement
Term
Lesion of occipital primary visual cortex (17)
Definition
contra homonymous hemianopia
Term
Lesion of occipital visual association areas
Definition
visual agnosia- bilateral difficulty recognizing what is seen
Term
Lesion of Occipital ventral visual association areas (18,19,temporal)
Definition
prosopagnosia-failure to recognize well-known faces
Term
Lesion of temporal primary auditory cortex (41&42)
Definition
bilateral hearing impairment, worse contra
Term
Wernicke's aphasia
Definition
fluent, verbal paraphasias, neologisms
Term
Temporal parahippocampal region
Definition
bilateral ablative-anterograde amnesia (loss after lesion)
irritative-seizures
Term
Lesion of temporal inferolateral regions
Definition
bilateral-retrograde amnesia (loss of before lesion)
Term
Conduction aphasia
Definition
lesion of arcuate fasciculus in dominant hemisphere, speak easily with verbal paraphasias, naming and reading impaired
Term
Global aphasia
Definition
lesion of Broca's and Wernicke's areas, cannot understand or articulate, right hemiplagia/hemianesthesia/homonymous hemianopsia (internal capsule damage)
Term
Lesion of reticular-activating system
Definition
coma and sleep-like state
Term
Lesion of median raphe nuclei
Definition
relative sleeplessness
Term
Narcolepsy
Definition
abrupt onset of 15min of REM sleep, inability to suppress brain areas causing REM, cataplexy (abrupt loss of muscle tone causes falling), sleep paralysis, hypnagogic hallucinations, treat with stimulants and antidepressants
Term
Sleep apnea
Definition
frequent pauses in breathing, obstructive (collapse in airway) or central (suppression of medullary respiratory systems) or mixed, decreased blood O2 and increased blood CO2, arousal hundreds of times per night, treat with continuous-pressure breathing sleep device
Term
Anencephaly
Definition
a-fetoprotein in maternal serum, folate is important, raschischisis (severe spina bifida with open defect over many spinal segments)
Term
Myelomeningocele
Definition
increased risk of meningitis, no latex gloves (can cause allergy)
Term
Arnold-Chiari Malformation (Chiari Type II)
Definition
small posterior fossa, herniation of posterior brain into foramen magnum, elongation of inferior vermis, aqueductal stenosis and obstructive hydrocephalus, subependymal nodules with ventricles (neurons did not migrate from sub-cortical zone)
Term
Dandy-Walker Malformation
Definition
large posterior fossa, cystic dilation of 4th ventricle, no cerebellar vermis
Term
Chiari type I
Definition
only cerebellar tonsils herniate
Term
Cerebral palsy
Definition
10% physician accident/90% static injury in gestation, spasticity/dystonia/ataxia/athetosis(writhing)/paresis, can be caused by hemorrhage or infection
Term
Germinal Matrix Hemorrhage
Definition
most common cause of intraventricular hemorrhage, infarcts in subventricular zone
Term
Periventricular infarcts
Definition
leukomalacia (white matter damage), necrosis, in 3rd trimester
Term
Porencephaly
Definition
necrosis of brain parenchyma, in-utero injury in 2nd trimester
Term
Lissencephaly
Definition
failure of normal sulcation even at leval of thalamus and hypothalamus, thick band of grey matter under surface due to cell bodies not migrating to surface
Term
Miller-Dieker Syndrome
Definition
microcephaly with bitemporal hollowing, deletion of LIS1 at 17p13.3 (haploinsufficiency)
Term
Simple partial seizure
Definition
localized (focal) onset of discharge
Term
Complex partial seizure
Definition
temporal (limbic) epilepsy, loss of consciousness, aura/sensory illusions
Term
Complex partial seizure, secondarily generalized
Definition
partial seizure progresses to generalized seizure
Term
Absence General seizure (petit mal)
Definition
childhood, brief loss of consciousness, freeze or stare
Term
Tonic-clonic generalized seizure (grand mal)
Definition
major convulsions, sudden loss of consciousness, prodrome
Term
Myoclonic generalized seizure
Definition
jerking of muscles of neck and shoulder flexors
Term
Atonic generalized seizure
Definition
loss of postural tone, head sagging, falling
Term
Status epilepticus
Definition
repeated seizures without regaining consciousness, life-threatening medical emergency
Term
Microcephaly
Definition
lissencephaly, agenesis of corpus callosum, sex-linked, trisomy 13/18/5P (cri-du-chat), TEST SERUM GLUCOSE ASAP
Term
Prader-willi
Definition
hypotonia, cryptorchidism, obesity
Term
Smith-Lemli-Opitz
Definition
cryptorchidism, hypospadias, vomiting, seizures
Term
Cornelia de Lange
Definition
anteverted nostrils, carp mouth, micromelia, unibrow
Term
Rubinstein-Taybi
Definition
broad thumb and toes, narrow nose
Term
Congenital microcephaly
Definition
due to toxoplasmosis (diffuse CNS calcifications, CMV (periventricular calcifications), or herpes (temporal lesions)
Term
Toxic exposure microcephaly
Definition
due to radiation, fetal alcohol syndrome, or PKU, CHECK PK IMMEDIATELY AND ONE WEEK AFTER
Term
Complications causing microcephaly
Definition
intrauterine or neonatal hemorrhage/stroke, prematurity, pregnancy-induced hypotension, maternal cocaine use
Term
Migraines
Definition
intermittent and paroxysmal, frequently severe, aura, nausea/vomiting/photphobia/phonophobia/pallor, classic is hemi-cranial, children have bi-temporal
Term
Tension headache
Definition
prolonged and continuous, pressure, occipital-nucal or bitemporal, stress
Term
Organic headache
Definition
night-awakening, early-morning onset vomiting, intracranial lesion until otherwise proven
Term
Febrile seizures
Definition
due to infection or fever-triggered epilepsy, rapidity of body temperature (not height of temperature) increase, risk factors are family history or abnormal neuro exams
Term
Simple febrile seizures
Definition
brief and benign, no treatment, non-focal/non-recurrent in 24h/infrequent (<3 episodes)
Term
Complex febrile seizures
Definition
prolonged and focal, multiple and recurrent (>3 episodes)
Term
Risk factors for suicide
Definition
males (complete), females (attempt), older, white, protestant/jewish, divorce/widowed (especially recent), unemployed, FAMILY HISTORY, PAST HISTORY, isolated, urban, substance abuse, mental illness, chronic medical conditions, falling from high social status, physician/musician/dentist/police/lawyers/insurance
Term
Risk factors for violence
Definition
recent acts, carrying weapons, substance abuse, paranoia, command hallucinations, psychomotor agitation, frontal lobe damage, catatonic excitement, manic episodes, personality disorders, male, 15-24, low socioeconomic status
Term
Schizotypal
Definition
deficits in social/interpersonal relationships, cognitive/perceptual distortions, eccentric behavior or idiosyncratic speech, lack of close friends/confidants, inappropriate/constricted affect, social anxiety
Term
Paranoid
Definition
pervasive distrust/unwarranted suspsiciousness, tendency to misinterpret acts of others, grudges, questions loyalty/fidelity
Term
Schizoid
Definition
detachment from social relationships, indifference and restricted expression, lacks friends/confidants, little pleasure in activities/sex
Term
Borderline
Definition
unstable interpersonal relationships, impulsivity, idealization/devaluation fluctuates, suicidal behavior/threats/thoughts/self-mutilation, instability/lability of affect, feelings of emptiness/anger, dissociation and identity disturbance
Term
Narcissistic
Definition
grandiose sense of self-importance, expects to be recognized as special/superior/unique, arrogant/condescending/haughty
Term
Histrionic
Definition
emotionality and attention-seeking, provocative/seductive/flirtatious, sensitive about aging, physical appearance to draw attention, suggestible/dramatic, believes relationships are more intimate than they really are
Term
Antisocial
Definition
disregard for/violation of rights of others, deceitful/impulsive, unlawful/non-conforming to social norms, reckless/irresponsible/irritable/aggressive
Term
Dependent
Definition
excessive need, submissive/clingy, difficulty with everyday decisions, needs excessive reassurance/advice, difficulty expressing disagreement, toruble initiating/low self-confidence, uncomfortable/helpless when alone
Term
Avoidant
Definition
socially inhibited, inadequacy/hypersensitive to criticism, difficulty with intimate relations, fear of risks/rejection
Term
Obsessive-compulsive
Definition
preoccupied/perfectionistic, excessively devoted to work, overconscientious/inflexible, rigid/stubborn/reluctant/lack spontaneity
Term
Bipolar I
Definition
>1 manic episodes, hypomanic/depression/mixed, M=F
Term
Bipolar II
Definition
>1 major depression and >1 hypomanic episodes, no mania, F>M
Term
Cyclothymic
Definition
alternating hypomania/low-grade depression, no major depressor of mania
Term
Major Depressive Disorder
Definition
SIGECAPS (sleep/interest/guilt/energy/concentration/appetite/psychomotor activity/suicidal thoughts), 2 weeks, mild/moderate/severe with or without psychotic features, F>M, wait until 2 months after death of loved one
Term
Mania
Definition
GREATSAD (grandiosity/RACING THOUGHTS/elevated or irritable mood/activities-goals/talkativeness/sleep need/activities-reckless/distractible, mania is >1 week, hypomanic is >4 days
Term
Serotonin syndrome
Definition
potentially life-threatening, interactions with MAOIs, complicated by St. John's Wort, autonomic/cognitive/motor effects
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