Term
| Which of the following are functions of the limbic system - emotions, control of visceral function, olfaction, or long term memory? |
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Definition
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Term
| The following regions involved in the triangular circuit - amygdala, orbital/medial prefrontal cortex, and mediodorsal nucleus of thalamus, are all involved in what limbic system function? |
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Definition
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Term
| An early model for emotions circuit that involved projection from the mamillary body to the anterior thalamic nucleus, thalamus to cing gyrus, cing gyrus to hippocampus via cingulum, and hippo to the mamillary body via the fornix is called what? |
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Definition
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Term
| What part of the brain is critically involed in emotional responses like learning if something is bad or good, using strong emotions to make memories, and fear from stimuli? |
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Definition
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Term
| The amygdale and hippocampus are underneath what aspect of the gyrus locates in the medial brain? |
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Definition
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Term
| What is the primary cell type in the dentate gyrus and the hippocampus? |
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Definition
| Granule cell, and pyramidal cells |
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Term
| Principal cells throughout the hippocampal circuit use what neurotransmitter? |
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Definition
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Term
| T or F: In the hippocampal circuit, GABA interneurons are located in each region include basket cells. |
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Definition
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Term
| Cholinergic innervation of the hippocampus comes from what nuclei? |
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Definition
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Term
| Which subdivision of the hippocampus is particularly sensitive to ischemic damage? |
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Definition
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Term
| Upon a pathology review of a patient there is hippocampal shrinking, gliosis, CA1/3 cell loss in hilus of dentate gyrus, preservation of granules cells and A2 in dentate gyrus, what is the diagnosis? |
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Definition
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Term
| T or F: neurogenesis occurs in most regions of the brain during adult life, like dentate gyrus and subventricular zone. |
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Definition
| False, new neurons only form in some regions of the brain like those listed, due to stimulation from severe seizures, exercise, SSRI treatment, and an enriched environment. |
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Term
| Neurogenesis is decreased by what factor? |
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Definition
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Term
| Resprouting of axons of damaged neurons may occur and has been demonstrated most clearly in patients with what disease? |
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Definition
| Temporal lobe epilepsy, the mossy fibers of the granule cells occupy the inner part of the molecular cell layer in the dentate gyrus to fill in vacated spots of cells damaged in the hilus and CA3 |
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Term
| The 3 major nuclei divisions of the amygdala are the basolateral, medial and central nuclei, what are their respective functions and connected regions? |
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Definition
| Basolateral - emotion, association cortex (neocortical and Limbic); Medial - olfaction, olfactory cortex/hypothalamus; Central - Visceral Control, Hypothalamus/brainstem |
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Term
| The following three regions are called what collectively - dentate gyrus, hippocampus, subiculum? |
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Definition
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Term
| The dentate gyrus and the hippocampus are both made of 3 cell layers, explain the general cell layout. |
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Definition
| The top layer is called the molecular layer/stratum radiatum, middle layer is the principal cell layer, and the bottome layer is the polymorph/stratum oriens |
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Term
| T or F: the major pathway through the hippocampal formation is as follows - entorhinalcortex projects via perforant path to dentate gyrus, the dentate granule cells send their mossy fibers to the CA3 field, the schaffer axon collateral go from there to CA1, the signal is then sent to subiculum and entorhinal cortex. |
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Definition
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Term
| T or F: the Cornu Ammonis are the divisions of the hippocampus. |
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Definition
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Term
| The excitatory neurotransmitter of the hippocampal pathway is __________. |
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Definition
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Term
| Which neurons are highly depleted in Alzheimers that innervate the hippocampus? |
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Definition
| Cholinergic neurons like the septal nuclei |
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Term
| This enlargement on the medial side of the temporal lobe could compress structures of the brainstem if the region were to herniated through the tentorial notch. |
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Definition
| Uncus, ie. Uncal herniation |
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Term
| The lenticulostriate arteries, deep branches of the MCA, penetrate the brain in what region? |
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Definition
| Anterior perforated substance |
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Term
| The ventral tegmental area is known for being the dopaminergic reward system of the brain, the area within the basal ganglia that receives heavy input from the VTA is …? |
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Definition
| Nucleus Accumbens, which is where the head of the caudate and putamen meet |
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Term
| Name the 5 components of the circle of willis. |
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Definition
| ACA, Ant. comm. Art, Int. Carotid, Post. Comm Art, PCA |
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Term
| What structure is the major efferent pathway for the amygdale? |
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Definition
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Term
| T or F: Because abnormal neurological states may be extrinsically provoked, all seizures are a sign of epilepsy. |
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Definition
| False, epilepsy is an intrinsic condition of the brain. |
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Term
| What do the rhythyms ID’d in an EEG describe? |
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Definition
| The post-synaptic potentials of the pyramidal layer of the cortex. |
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Term
| T or F: consciousness is not an all or none phenomenon. |
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Definition
| True, a deficit in any one of the neuroanatomical structures of the cortex, thalamus, or reticular activating system can produce focal or general deficits. |
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Term
| What is the cause of epilepsy? |
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Definition
| Any cause of cerebral cortex dysfunction: parent with epi, mental retardation, stroke, alzheimers |
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Term
| T or F: more important that commonly occurring features of a seizure is the pattern of features for each individual. |
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Definition
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Term
| If “ictal” means event in an EEG, what does an interictal epileptiform discharge refer to? |
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Definition
| The ictal rhytyms and spikes across an EEG |
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Term
| Name this seizure type: no impairment of mentation, auras, cognitive changes, autonomic changes, involuntary motor action, synesthesias. |
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Definition
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Term
| Name this seizure type: altered mental status, not necessarily loss of consciousness, may/may not have aura, repetitive oral automatisms, amnesia during seizure, duration less than 2 minutes, and followed by confusion/fatigue/headache or focal neuro deficit. |
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Definition
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Term
| Name this seizure type: obvious loss consciousness, may have aura, may follow complex partial, gaze deviation, less than 3 minutes, increased tone and jerks, often injury, followed by confusion/headache/amnesia |
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Definition
| general tonic-clonic seizure |
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Term
| How can you differentiate a generalized seizure versus a secondarily generalized seizure? |
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Definition
| On the EEG, if the seizure starts partially then spreads to a both hemispheres then it is secondary, otherwise it should begin on both sides |
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Term
| The neuronal membrane phenomenon that reflects instability and the occurrence of rapid cell firing is a marker of seizure risk, what is it called? |
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Definition
| Paroxysmal depolarization shift |
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Term
| ID which category of epilepsy each disease is associated with - Benign Rolandic, Temporal Lobe, Childhood Absence, Lennox-Gastaut. |
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Definition
| Idiopathic focal, Symptomatic Focal, Idiopathic general, symptomatic general |
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Term
| Which of the following are appropriate treatments for epilepsy - meds that affect neuronal membrane function, surgical resection, electrical stimulation of the vagus nerve, ketogenic diet to change serum pH. |
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Definition
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Term
| Name this disease: family Hx of epilepsy, cerebral insult before age 5, auras, complex partial seizures, onset mid to late childhood, responds to treatment initially, depression, normal PE, EEG shows spikes, MRI atrophy of hippocampus, unilateral memory deficit. |
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Definition
| Mesial Temporal Lobe Epilepsy |
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Term
| Of the adults with who have epilepsy 70% have partial seizures, what percent have complex partial seizures (usually occurring in the temporal lobe)? |
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Definition
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Term
| What proportion of children with epilepsy have generalized epilepsy? |
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Definition
| 60%, it is frequently genetic |
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Term
| What is the key site to prevent or terminate seizures that anti-epileptic drugs modify? |
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Definition
| Ion channels in the neurons that are activated during a paroxysmal depolarizing shift |
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Term
| Phenytoin, Carbamazepine, and Lamotrigine are all Na+ channel blockers that share what common mechanism of action? |
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Definition
| They bind to the extracellular receptor on the Na+ channel. |
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Term
| Which two drugs block AMPA, Kainate, and Calcium channels? |
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Definition
| Topiramate, and Zonisamide |
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Term
| Which anti-epileptic drug blocks synaptic vesicle protein SV2 and blocks K channels which thereby prevent AP’s and PDS’s? |
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Definition
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Term
| Which of the following drugs act on Cl- channel to prevent APs - Benzos, Phenobarbital, Valproate? |
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Definition
| All of them; first two bind to specific receptors and the last one decreases GABA degradation in the presynaptic terminal |
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Term
| Which of these groups is syncope and which is seizure - 1. urinary incontinence, tongue biting, convulsions; 2. graying of vision, sweating, response to fear/pain, usually standing or sitting. |
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Definition
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Term
| Name this generalized epilepsy: auto dom, carriers have EEG trait w/o clinical signs, onset 12-22, GTC seizures, provoked by EtOH/Sleep loss/strobe light. |
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Definition
| Juvenile myoclonic epilepsy |
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Term
| ID whether each group is either absence generalized epilepsy or complex partial: 1. auras of déjà vu/epigastric rising, staring, minutes of duration, frequent automatisms, EEG shows focal sharp waves or normal, post ictal confusion, rare inheritance; 2. no auras, staring, seconds long, rare automatisms, bilateral 3 sec spike and wave on EEG, no post ictal confusion, auto dom inheritance. |
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Definition
| 1. complex partial, 2. absence |
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Term
| Which of the following is true regarding treatment after a first seizure - early treatment reduces risk of recurrence within two years, early treatment affects long term prognosis, abnormal EEG or MRI increase risk of recurrence? |
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Definition
| First and last are true, long term prognosis is not affected by early treatment |
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Term
| Even though all AEDs cause fetal malformation in at least 6% of births, which of the following two classes of drugs is more teratogenic - 1. Class D - Phenytoin, Valproate, Phenobarbital, Carbamazepine; 2. Class C - Lamotrigine, Gabapentin? |
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Definition
| Class D is more risky; however, Class C causes neural tube defects, ie. Lamo causes cleft lip and Gaba causes urogenital defects |
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Term
| T or F: sudden death in epilepsy tends to affect young people ages 18-40, usually due to cardiac arrythmias or asphyxia. |
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Definition
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Term
| Even though Carbamazepine is the drug of first choice for AED’s, a comparison of it with Levetiracetam showed what? |
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Definition
| That Leve is as effective for INITIAL therapy with a similar side effect profile, although it had greater risk with insomnia and depression |
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Term
| T or F: New AED’s are worse than old AED’s. |
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Definition
| False, New AED’s are equivalent or better |
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Term
| In the SANAD study, which drug proved better for partial seizures by being better tolerated and equiv to carbamazepine for long term? |
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Definition
| Lamotrigine; although the study did show that Lamo, Carba, Topir are better than Gaba for long term remission |
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Term
| In the SANAD study, it showed that which drug should remain the first choice of drug for generalized and unclassified epilepsies? |
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Definition
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Term
| What does the rhomberg and pronator drift test for? |
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Definition
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Term
| T or F: The ability to name objects comes from the occipital-temporal junction. |
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Definition
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Term
| T or F: Lesions in the temporal lobe would cause problems like olfactory hallucinations and perception of GI disturbances. |
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Definition
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Term
| A patient demonstrating a lucid phase between two episodes of unconsciousness is due to what type of hematoma? |
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Definition
| SDH, usually due to severed middle meningeal artery |
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Term
| Name the following syndrome: most common brain stem stroke, contralateral weakness in body, ipsilateral weakness in face, descending fiber prob causing Horner’s, possible ataxia, palatal weakness, and dysphagia. |
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Definition
| Lateral medullary syndrome aka Wallenberg, usually due to posterior inferior cerebellar artery infarct |
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Term
| Name the following syndrome: stroke characterized by oculomotor palsy and contralateral hemiparesis. |
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Definition
| Weber syndrome, due to midbrain infarct causing lesions in corticospinal/bulbar tracts, 3rd nerve |
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