Block 3 Flashcards
nucleus (tractus) solitarius vs dorsal motor nucleus vs paramedian pontine reticular formation vs cerebellopontine angle contains?
CN 7/9/10; can help w/ vomiting -> CN8/9/10 vs CN 10 to send parasymp to heart, lungs, upper GI vs ipsi CN6 nucleus for horiz gaze vs CN5/7/8
CN reflexes: corneal/lac vs jaw jerk vs cough
5.1 -> 7 vs 5.3/masseter; jaw deviates towards lesion vs 10
Gerstmann syndrome
dom parietal cortex/angular gyrus -> agraphia, acalculia, finger agnosia, L/R disorient
Parinaud syndrome affects which part of brain? reticular activating system in midbrain?
dorsal midbrain. dec arousal & wakefulness like coma
restless leg syndrome assoc vs tx. acute dystonia vs regular dystonia tx?
iron defic, CKD vs DA ag -> pramipexole, ropinarole. benzotropine (M3 antag), diphenhydramine vs botulinum
MS dx vs tx
MRI = gold; periventricular white matter lesions space/time, oligoclonal bands, inc igG & myelin basic protein in CSF vs beta IFN, glatiramer, natalizumab, steroids
phys of cerebral edema. explain tramadol
from failed ADP dependent ion transporters. very weak opioid ag & “SNRI” for chronic pain, AE sero syndrome, dec sz threshold
what happens in cavernous sinus thrombosis vs cavernous sinus syndrome vs carotid sinus aneurysm?
proptosis, no CN 4/5.1/5.2/6 (tho this sinus also contains CN3 too) vs dec corneal & maxillary sensation, Horner, ophthalmoplegia, mass effect, carotid-cavernous fistula, infected cavernous sinus thrombosis vs asx or compressed CN6
red nucleus/pons lesion: decorticate vs decerebrate (opisthotonic) posturing
lesion above red nucleus/pons -> flex UE, extend LE vs lesion at or below red nucleus/pons -> extend both U/LE
labs vs tx of Guillain Barre. Charcot Marie Tooth
inc CSF protein, dec/absent DTR, endoneurial inflam vs support, plasma exchange, IVIG. AD CMT1A PMP22 dup -> no protein in periph n or myelin sheath -> foot deform & sensation
Friedrich ataxia
AR frataxin (iron binding protein) GAA on chrm 9 -> no lat corticospinal tract, DRG, spinocerebellar tract -> atax, DM, HCM, hammertoes, kyphoscoliosis
retinitis pigmentosa
genetic degen of retinal pig epith & photoreceptors -> optic disc pallor, bone spicule deposits, retinal vessel atten, nyctalopia, periph vision loss
Alz meds
galantamine, rivastigmine, donezepil +/- memantine; improves cog fxn but not dz process
cauda equina syndrome. what color CSF in subarach hem?
No L2 & below -> no knee & ankle reflexes, incont, saddle anesthesia; d/t hern disc or tumor. bloody or yellow; nimodipine to prevent more spasms; inc risk communic hydroceph
how to tx status epilepticus. causes vs labs for NTDs
acutely w/ IV BZD -> phenytoin for maintenance. carbamez & phenytoin, MTX, GDM vs inc AFP & AchE in amnio
details you forget: central occlusion ASA vs tabes dorsalis
bil pain/temp LE vs Charcot joints, Argylle pupil, no DTRs
gabapentin txs? vigab vs tiagab
fibromyalgia, chronic pain, painful DM nephropathy, VZV postherpetic neuralgia. inhib GABA transaminase vs inhib GABA reuptake
PML
by JCV; reactivated by immunosuppress/HIV -> rapidly progressive. destroy oligo, par/occ, worse w/ ritux & natalizumab
cingulate vs central transtentorial vs uncal transtentorial vs tonsilar hern
ACA, primitive reflex vs ruptured paramedian BA branches -> Duret hem vs early -> ipsi blown pupil, contralat hemiparesis; late -> Kenoch phenom vs HA & cerebellar sxs kinda like Chiari I; coma & death
periph vs central vertigo
by semicirc canal debris/BPPV, Menier -> tx low Na +/- diuretics, vestib neuritis, endolymph pressure; tx w/ antihist/chol/emetic vs by CNS lesion/tumor; diplopia, vertical nystag, skew deviation
