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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
Q

CMT affects what type of nerves?

A

Motor

Sensory

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26
Q

What type of reaction is Myasthenia gravis?

A

Type II

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27
Q

What is the MOA of MG?

A

Autoantibody and cell-mediated destruction of Ach receptors

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28
Q

MG is associated with disorders of which gland?

A

Thymus

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29
Q

Who does MG most commonly affect?

A

Young women

Old men

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30
Q

Where are ocular telangiectasias found in cases of ataxia?

A

Bulbar conj - more prominent with age

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31
Q

Sturge-Weber syndrome is caused by abnormal embryogenesis of what 2 things?

A

Neural crest derived elements

Vascular endothelium

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32
Q

What are the 3 signs/symtpms of Sturge-Weber syndrome?

A

Facial angioma
Ipsilateral choroidal hemangioma
Congenital glaucoma

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33
Q

How many of the 3 signs/symptoms are necessary to diagnose Sturge-Weber syndrome?

A

2 of the 3

34
Q

Neveus flammeus or port wine stain is seen in what disease?

A

Sturge-Weber syndrome

35
Q

The facial angioma or port wine stain in Sturge-Weber syndrome typically follows what nerves?

A

V1
V2
Sometimes V3

36
Q

What is wrong with the CNS cortex in Sturge-Weber syndrome?

A

Mal-developed or non-functional

37
Q

In Sturge-Weber syndrome, what appearance do Ca deposits in the vessels make on a CT?

A

Tram Trak appearance

38
Q

In Sturge-Weber, there is a higher risk for glaucoma if what structure is involved?

A

Upper lid

39
Q

What is the typical fundus presentation in Sturge-Weber?

A

Tomato-ketchup fundus

40
Q

What retinal changes are often seen in Sturge-Weber?

A

RP changes that mimic RP

41
Q

How should glaucoma from Sturge-Weber be treated?

A

Aqueous suppressants

42
Q

What is the inheritance pattern of neurofibromatosis?

A

Autosomal dominant

43
Q

What is NF type 1?

A

Peripheral

44
Q

What is NF type 2?

A

Central

45
Q

What characterizes neurofibromatosis? (NF)

A

Hamartomas of skin, nervous system, skeleton and viscera

46
Q

What causes NF type 1?

A

Malformation of the long arm of chromosome 17

47
Q

What is the common cutaneous lesion found in NF1?

A

Cafe-ou-lait patches (flat, hyperpigmented spots, kind like cow spots)

48
Q

What are the 3 CNS lesions in NF1?

A

Optic pathway glioma
Brainstem glioma
Schwanoma

49
Q

What is the congenital skeletal system finding of NF1?

A

Absence of the greater wing of the sphenoid

50
Q

What are the 4 visceral lesions of NF1?

A

Pheochromocytoma (adrenals)
Rhabdomyosarcoma (head/neck)
Wilm’s tumor (cancer of kidney)
Neurofibrosarcoma

51
Q

What are the “important” ocular findings of NF1?

A

S sign of lid
Thickened corneal nerves (and conj and ciliary nerves)
Lisch nodules of iris
Choroidal hamartoma

52
Q

What are the “important” optic nerve findings of NF1?

A

Optic nerve glioma

Juvenile pilocystic astrocytomas

53
Q

What are the common retinal findings in NF1?

A

Myelinated nerve fibers

54
Q

Which is more common, NF1 or NF2?

A

NF1

55
Q

NF2 occurs due to an issue with which chromosome?

A

22

56
Q

NF2 lacks 2 findings that are common in NF1. What are they?

A

Cutaneous lesions

Lisch nodules of iris

57
Q

What are the typical findings of NF2?

A

Bilateral acoustic neuromas (from schwann cells)

58
Q

What is the inheritance pattern of NF2?

A

Autosomal dominant - incomplete penetrance

59
Q

What are the typical ocular findings of NF2?

A

PSC

ERM

60
Q

Mulberry lesions are large, white lesions with concretions of the retina. They are associated with what condition?

A

Tuberous sclerosis

61
Q

What are the 3 main signs of Wyburn-Mason Syndrome?

A

Arterio-venous malformation (AVM) of midbrain
AVM of retina
Facial nevi of ipsilateral side

62
Q

Wyburn-Mason syndrome has a risk of what with facial/dental surgery?

A

Massive hemorrhage

63
Q

What antibody panel will show a mosaic pattern when positive for muscular dystrophies?

A

Dystrophin antibody panel

64
Q

What are the 2 “important” ocular findings in myotonic dystrophy?

A

Christmas tree cataracts

Pigmentary retinopathy

65
Q

What is the hallmark of myotonic dystrophy>?

A

Prolonged muscle contractions (myotonia)

66
Q

What is the inheritance pattern of Duchenne dystrophy?

A

X-linked

67
Q

What is the most common and most severe muscular dystrophy?

A

Duchenne dystrophy

68
Q

Which muscular dystrophy has a reduced ERG similar to stationary night blindness?

A

Duchenne dystrophy

69
Q

What genetic test is run to look for Duchenne dystrophy?

A

Creatine phosphokinase test

70
Q

What genetic test is used to look for Becker muscular dystrophy?

A

Creatine phosphokinase test

71
Q

When does myotonic dystrophy typically begin?

A

Adulthood

72
Q

When do Becker and Duchenne begin?

A

Childhood

73
Q

Which starts later, Becker or Duchenne?

A

Becker

74
Q

What organism causes endocarditis?

A

Staph aureus

75
Q

What are the important signs of heroin overdose?

A

Miosis
Flushing
Itching
Tactile hallucination

76
Q

What is the typical heroin withdrawal sign?

A

Mydriasis

77
Q

Progressive addiction of anxiolytics leads to what?

A

Fine lateral gaze nystagmus

Miosis

78
Q

Stimulants are known to cause what 5 conditions?

A 
Dilated pupils
Orbital cellulitis
Orbital wall and nasal septum damage
TIA
Blue/yellow color vision defects
79
Q

Stimulants increase BP, and may cause what ocular signs?

A

Blurred vision
Intraretinal hemes
CRAO

80
Q

Methamphetamines are known to cause what 3 major ocular findings?

A

Amaurosis fugax
Retinal vasculitis
CRAO

81
Q

PCP commonly causes what type of nystagmus?

A

Rotary

Vertical

82
Q

Ash-leaf macules are associated with which disease?

A

Tuberous Sclerousis (Bournevill’s syndrome)

Systemic Disease (12 decks)

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