BRAINS! (Neuro) Flashcards
What is the tx of choice for trigeminal neuralgia?
carbamazepine; oxcarbazeine is also used however it is not FDA approved for trigeminal neuralgia
Ketorolac (toradol) is good initial abortive therapy for severe headaches for pts with infrequent migraines. How long should you limit use to?
5 days
Ketorolac is an NSAID, this med has a black box warning for: CV risk, renal risk, GI risk, bleeding risk, hypersensitivity risk and labor/delivery risk
What is Kernig sign?
sign for meningitis
•Kernig sign: supine position, flex hip 90 degrees, inability or reluctance to allow full extension of the knee when the hip is flexed
What is Brudzinski sign?
sign for meningitis
Brudzinski sign: spontaneous flexion of hips during attempted passive flexion of the neck
What are the three branches of the trigeminal nerve?
ophthalmic, maxillary, mandibular
What is normal intracranial pressure?
5-15 mmHg
What is Wernicke’s triad?
Mental confusion, ataxia and ohthalmoplegia
What cells make CSF?
Ependymal cells
What percentage of strokes are ischemic?
80%
By definition, TIA symptoms resolve completely within …. ?
24 hours
This type of aneurysm accounts for 75% of nontraumatic cases of subarachnoid hemorrhage …
Ruptured saccular (berry) aneurysm
What has a triad of: walking problems, incontinence and behavior and dementia problems
normal-pressure hydrocephalus
“wet, wacky and wobbly”
benign essential (familial) tremors often have this inheritance pattern
autosomal dominant
Bell’s palsy involves what nerve?
VII (facial)
pyridostigmine is used to treat what neurological disease?
myasthenia gravis
it’s a cholinesterase inhibitor
what are the most common sources of intracranial metasis (4)?
lungs, breast, GI and kidney
sleep terror and sleepwalking can be treated with?
benzos
78% of spine tumors are located where?
the extradural space
The cornea is heavily innervated by which cranial nerve?
Trigeminal nerve, ophthalmic division V1
Which of the following is not a sign or symptom of increased ICP? A. Headache B. Double vision C. Head tilt D. Unexplained behavior changes E. Fever
E. fever
How would a pt. with a brain tumor (likely) describe their headache?
dull, throbbing exacerbated by bending over and exercise, occurs in the morning, improves with head elevation
Seizures percent in what percentage of pts. With brain tumors?
30%
Homonymous hemianopsia is seen in tumors in what part of the brain?
occipital lobe
Most common clinical feature in guillain barre syndrome is?
Parestheisas (80%), followed by dysautonia (70%), respiratory muscle weakness (30%) and muscle weakness (10%)
Broca’s area is supplied by which cerebral artery?
superior division L MCA
Wernickes’s area supplied by which cerebral artery?
inferior division of the L MCA
Where should LPs be preformed?
at L3/L4 or L4/L5
What medication classes can you prescribe for recurrent migraines (as prophylaxis)?
beta blockers, TCAs, SSRIs, CCBs or anticonvulsants
What is: Difficulty or abnormality in performing voluntary muscle movements
Dyskinesia
What is: Visible twitch of a motor unit?
Fasciculation
What are: Twisting and writhing movements?
Athetosis
What is: area surrounding the dense core of irreversibly damaged cells that has preserved ionic homeostasis and reduced neuronal electrical activity but that is capable of recovery ?
Penumbra
What cell type is mostly destroyed in MS?
Oligodendrocytes- MS is demyelination of CNS tracts
On what chromosome is the gene located that is responsible for amyloid protein?
it’s found on chromosome 21, remember almost all people with Down’s end up developing AD. There have also been links to chromosomes 14 & 19
What is the hallmark of Lambert-Eaton Syndrome?
Muscle weakness – LES is an autoimmune attack against Ca channels this results in a decrease of ACh release and thus muscle weakness
What is the most common neurological disorder?
CVAs
Narcolepsy is associated with abnormalities with _______ sleep.
REM
What is the Miller Fisher test?
An objective gait assessment before and after removal of 30 cc CSF
Shaken babies often have this injury:
Diffuse axonal injury (DAI)
A coma is defined as unarousable unresponsiveness lasting greater than….
60 minutes
an abnormal pattern of breathing characterized by progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing called an apnea is?
cheyne-stokes respirations
Ataxic breathing indicates an injury to the?
Medulla
what is the main spinal nerve root(s) involved with the biceps reflex?
C5, C6
what is the main spinal nerve root(s) involved with the brachioradialis reflex?
C6
what is the main spinal nerve root(s) involved with the triceps reflex?
C7
what is the main spinal nerve root(s) involved with the patellar reflex?
L4
what is the main spinal nerve root(s) involved with the achilles tendon reflex?
S1
You can elicit this sign by holding the patient’s middle finger loosely and flicking the fingernail downward, causing the finger to rebound slightly into extension
Hoffmann’s sign
If the thumb flexes and adducts in response, Hoffmann’s sign is present.
Hoffmann’s sign, or heightened finger flexor reflexes suggest an upper motor neuron lesion affecting the hands.
