BRAINS! (Neuro) Flashcards

1
Q

What is the tx of choice for trigeminal neuralgia?

A

carbamazepine; oxcarbazeine is also used however it is not FDA approved for trigeminal neuralgia

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2
Q

Ketorolac (toradol) is good initial abortive therapy for severe headaches for pts with infrequent migraines. How long should you limit use to?

A

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

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3
Q

What is Kernig sign?

A

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

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4
Q

What is Brudzinski sign?

A

sign for meningitis

Brudzinski sign: spontaneous flexion of hips during attempted passive flexion of the neck

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5
Q

What are the three branches of the trigeminal nerve?

A

ophthalmic, maxillary, mandibular

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6
Q

What is normal intracranial pressure?

A

5-15 mmHg

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7
Q

What is Wernicke’s triad?

A

Mental confusion, ataxia and ohthalmoplegia

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8
Q

What cells make CSF?

A

Ependymal cells

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9
Q

What percentage of strokes are ischemic?

A

80%

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10
Q

By definition, TIA symptoms resolve completely within …. ?

A

24 hours

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11
Q

This type of aneurysm accounts for 75% of nontraumatic cases of subarachnoid hemorrhage …

A

Ruptured saccular (berry) aneurysm

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12
Q

What has a triad of: walking problems, incontinence and behavior and dementia problems

A

normal-pressure hydrocephalus

“wet, wacky and wobbly”

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13
Q

benign essential (familial) tremors often have this inheritance pattern

A

autosomal dominant

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14
Q

Bell’s palsy involves what nerve?

A

VII (facial)

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15
Q

pyridostigmine is used to treat what neurological disease?

A

myasthenia gravis

it’s a cholinesterase inhibitor

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16
Q

what are the most common sources of intracranial metasis (4)?

A

lungs, breast, GI and kidney

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17
Q

sleep terror and sleepwalking can be treated with?

A

benzos

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18
Q

78% of spine tumors are located where?

A

the extradural space

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19
Q

The cornea is heavily innervated by which cranial nerve?

A

Trigeminal nerve, ophthalmic division V1

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20
Q
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
21
Q

How would a pt. with a brain tumor (likely) describe their headache?

A

dull, throbbing exacerbated by bending over and exercise, occurs in the morning, improves with head elevation

22
Q

Seizures percent in what percentage of pts. With brain tumors?

23
Q

Homonymous hemianopsia is seen in tumors in what part of the brain?

A

occipital lobe

24
Q

Most common clinical feature in guillain barre syndrome is?

A

Parestheisas (80%), followed by dysautonia (70%), respiratory muscle weakness (30%) and muscle weakness (10%)

25
Broca's area is supplied by which cerebral artery?
superior division L MCA
26
Wernickes's area supplied by which cerebral artery?
inferior division of the L MCA
27
Where should LPs be preformed?
at L3/L4 or L4/L5
28
What medication classes can you prescribe for recurrent migraines (as prophylaxis)?
beta blockers, TCAs, SSRIs, CCBs or anticonvulsants
29
What is: Difficulty or abnormality in performing voluntary muscle movements
Dyskinesia
30
What is: Visible twitch of a motor unit?
Fasciculation
31
What are: Twisting and writhing movements?
Athetosis
32
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
33
What cell type is mostly destroyed in MS?
Oligodendrocytes- MS is demyelination of CNS tracts
34
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
35
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
36
What is the most common neurological disorder?
CVAs
37
Narcolepsy is associated with abnormalities with _______ sleep.
REM
38
What is the Miller Fisher test?
An objective gait assessment before and after removal of 30 cc CSF
39
Shaken babies often have this injury:
Diffuse axonal injury (DAI)
40
A coma is defined as unarousable unresponsiveness lasting greater than….
60 minutes
41
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
42
Ataxic breathing indicates an injury to the?
Medulla
43
what is the main spinal nerve root(s) involved with the biceps reflex?
C5, C6
44
what is the main spinal nerve root(s) involved with the brachioradialis reflex?
C6
45
what is the main spinal nerve root(s) involved with the triceps reflex?
C7
46
what is the main spinal nerve root(s) involved with the patellar reflex?
L4
47
what is the main spinal nerve root(s) involved with the achilles tendon reflex?
S1
48
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.