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Systemic Disease > 04. Neuromuscular & Drug Abuse > Flashcards

04. Neuromuscular & Drug Abuse Flashcards

1
Q

What is the most common cause of encephalitis?

A

Viral

-HIV, CMV, polio, HSV, varicella, mumps

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2
Q

What are the other two “important” causes of encephalitis?

A

Rabies

West Nile

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3
Q

What is meningitis?

A

Inflammation of the brain and spinal cord

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4
Q

What is the meningitis triad?

A

Fever
Headache
Stiff neck

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5
Q

Which type of meningitis is self limiting?

A

Viral

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6
Q

What is the most common cause of papilledema?

A

Neoplastic changes

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7
Q

What degenerative diseases may cause papilledema, although it occurs very rarely?

A

Parkinson’s

Alzheimer’s

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8
Q

What are the signs and symptoms of papilledema?

A

Transient visual loss when changing posture
Headache
Diplopia
Nausea/vomiting

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9
Q

What would papilledema cause on a VF?

A

Enlarged blind spot

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10
Q

What is pseudotumor cerebri, or IIH?

A

Increased ICP with papilledema, not caused by a mass

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11
Q

What is the normal ICP for adults and children over 8?

A

60-200 mmH2O

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12
Q

What is the most likely cause of diplopia in IIH?

A

CN6 palsy

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13
Q

What are the symptoms of IIH?

A

AM headaches
Transient vision loss (seconds) - change in posture
Tinnitus
Nausea/vomiting

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14
Q

What meds may cause IIH?

A

Vitamin A
Tetracycline
Oral contraceptives
Nalidixic acid

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15
Q

What are the treatments for IIH?

A

250mg acetazolamide, building to 500mg
Weight loss
Furosemide

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16
Q

What makes myelin in the CNS?

A

Oligodendrocytes

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17
Q

What makes myelin in the PNS?

A

Schwann cells

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18
Q

What is a demyelinating disease of the PNS?

A

Guillain-Barre

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19
Q

What is Uthoff’s sign, and what is it’s associated disease?

A

Body heat increases sypmtoms

MS

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20
Q

What is L’hermitte sign?

A

“Electric shock” on neck flexion

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21
Q

Neuromyelitis optica affect what structures?

A

Eyes and spinal cord

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22
Q

What is the typical type of nystagmus seen in MS?

A

Pendular

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23
Q

What is the inheritance pattern of Charcot-Marie-Tooth?

A

Can be dominant or recessive

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24
Q

What causes CMT?

A

Gene mutation in genes that produce proteins in nerve axons/myelin

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25
CMT affects what type of nerves?
Motor | Sensory
26
What type of reaction is Myasthenia gravis?
Type II
27
What is the MOA of MG?
Autoantibody and cell-mediated destruction of Ach receptors
28
MG is associated with disorders of which gland?
Thymus
29
Who does MG most commonly affect?
Young women | Old men
30
Where are ocular telangiectasias found in cases of ataxia?
Bulbar conj - more prominent with age
31
Sturge-Weber syndrome is caused by abnormal embryogenesis of what 2 things?
Neural crest derived elements | Vascular endothelium
32
What are the 3 signs/symtpms of Sturge-Weber syndrome?
Facial angioma Ipsilateral choroidal hemangioma Congenital glaucoma
33
How many of the 3 signs/symptoms are necessary to diagnose Sturge-Weber syndrome?
2 of the 3
34
Neveus flammeus or port wine stain is seen in what disease?
Sturge-Weber syndrome
35
The facial angioma or port wine stain in Sturge-Weber syndrome typically follows what nerves?
V1 V2 Sometimes V3
36
What is wrong with the CNS cortex in Sturge-Weber syndrome?
Mal-developed or non-functional
37
In Sturge-Weber syndrome, what appearance do Ca deposits in the vessels make on a CT?
Tram Trak appearance
38
In Sturge-Weber, there is a higher risk for glaucoma if what structure is involved?
Upper lid
39
What is the typical fundus presentation in Sturge-Weber?
Tomato-ketchup fundus
40
What retinal changes are often seen in Sturge-Weber?
RP changes that mimic RP
41
How should glaucoma from Sturge-Weber be treated?
Aqueous suppressants
42
What is the inheritance pattern of neurofibromatosis?
Autosomal dominant
43
What is NF type 1?
Peripheral
44
What is NF type 2?
Central
45
What characterizes neurofibromatosis? (NF)
Hamartomas of skin, nervous system, skeleton and viscera
46
What causes NF type 1?
Malformation of the long arm of chromosome 17
47
What is the common cutaneous lesion found in NF1?
Cafe-ou-lait patches (flat, hyperpigmented spots, kind like cow spots)
48
What are the 3 CNS lesions in NF1?
Optic pathway glioma Brainstem glioma Schwanoma
49
What is the congenital skeletal system finding of NF1?
Absence of the greater wing of the sphenoid
50
What are the 4 visceral lesions of NF1?
Pheochromocytoma (adrenals) Rhabdomyosarcoma (head/neck) Wilm's tumor (cancer of kidney) Neurofibrosarcoma
51
What are the "important" ocular findings of NF1?
S sign of lid Thickened corneal nerves (and conj and ciliary nerves) Lisch nodules of iris Choroidal hamartoma
52
What are the "important" optic nerve findings of NF1?
Optic nerve glioma | Juvenile pilocystic astrocytomas
53
What are the common retinal findings in NF1?
Myelinated nerve fibers
54
Which is more common, NF1 or NF2?
NF1
55
NF2 occurs due to an issue with which chromosome?
22
56
NF2 lacks 2 findings that are common in NF1. What are they?
Cutaneous lesions | Lisch nodules of iris
57
What are the typical findings of NF2?
Bilateral acoustic neuromas (from schwann cells)
58
What is the inheritance pattern of NF2?
Autosomal dominant - incomplete penetrance
59
What are the typical ocular findings of NF2?
PSC | ERM
60
Mulberry lesions are large, white lesions with concretions of the retina. They are associated with what condition?
Tuberous sclerosis
61
What are the 3 main signs of Wyburn-Mason Syndrome?
Arterio-venous malformation (AVM) of midbrain AVM of retina Facial nevi of ipsilateral side
62
Wyburn-Mason syndrome has a risk of what with facial/dental surgery?
Massive hemorrhage
63
What antibody panel will show a mosaic pattern when positive for muscular dystrophies?
Dystrophin antibody panel
64
What are the 2 "important" ocular findings in myotonic dystrophy?
Christmas tree cataracts | Pigmentary retinopathy
65
What is the hallmark of myotonic dystrophy>?
Prolonged muscle contractions (myotonia)
66
What is the inheritance pattern of Duchenne dystrophy?
X-linked
67
What is the most common and most severe muscular dystrophy?
Duchenne dystrophy
68
Which muscular dystrophy has a reduced ERG similar to stationary night blindness?
Duchenne dystrophy
69
What genetic test is run to look for Duchenne dystrophy?
Creatine phosphokinase test
70
What genetic test is used to look for Becker muscular dystrophy?
Creatine phosphokinase test
71
When does myotonic dystrophy typically begin?
Adulthood
72
When do Becker and Duchenne begin?
Childhood
73
Which starts later, Becker or Duchenne?
Becker
74
What organism causes endocarditis?
Staph aureus
75
What are the important signs of heroin overdose?
Miosis Flushing Itching Tactile hallucination
76
What is the typical heroin withdrawal sign?
Mydriasis
77
Progressive addiction of anxiolytics leads to what?
Fine lateral gaze nystagmus | Miosis
78
Stimulants are known to cause what 5 conditions?
``` Dilated pupils Orbital cellulitis Orbital wall and nasal septum damage TIA Blue/yellow color vision defects ```
79
Stimulants increase BP, and may cause what ocular signs?
Blurred vision Intraretinal hemes CRAO
80
Methamphetamines are known to cause what 3 major ocular findings?
Amaurosis fugax Retinal vasculitis CRAO
81
PCP commonly causes what type of nystagmus?
Rotary | Vertical
82
Ash-leaf macules are associated with which disease?
Tuberous Sclerousis (Bournevill's syndrome)

Systemic Disease (12 decks)

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