ch 5- CNS and PNS Flashcards
what is the leading cause of neurologic disability
ischemic stroke
what are the most important risk factors for stroke
age and hypertension
how is the source of embolic stroke evaluated
echocardiogram, carotid dopplers, ECG/Holter monitoring
what artery is the most common for a stroke and what are the symptoms
Middle cerebral artery- contralateral weakness, sensory loss and hyperreflexia
what should be in the first imaging study ordered when patient may have had a stroke
CT scan without contrast of head
what is the pupillary findings in ICH due to the pons
pinpoint pupils
what is the pupillary findings in ICH due to the thalamus
poorly reactive pupils
what is the pupillary findings in ICH due to the putamen
dilated pupils
what is the term for parkinsonian symptoms + autonomic insufficiency
Shy-Drager syndrome
what are some common medications that have parkinsonian side effects
Neuroleptic drugs (chlorpromazine, haloperidol, perphenazine), metoclopramide, reserpine
what type of dementia has step-wise decline
vascular dementia (multi-infarct dementia)
what is the triad associated with normal-pressure hydrocephalus
dementia, gait disturbance, and urinary incontinence.
what labs and imaging should be ordered when considering dementia
CBC with diff, chemistry panel, thyroid function tests, vitamin B12, folate level, VDRL, HIV screening and CT scan or MRI of head
at what age does multiple sclerosis typically initially present
in a female in their 20s to 30s
what is the test of choice for MS
MRI
what medication can be given to shorten an acute attack in MS
high-dose IV corticosteroids
how is a definitive diagnosis of Guillain-Barre syndrome made
combination of CSF fluid analysis, clinical findings, and nerve conduction velocities
what are the autoantibodies directed against in Myasthenia Gravis
against the nicotinic acetylcholine receptors of the Neuromuscular junction, leading to reduced post-synaptic response to acetylcholine
what are the most common initial symptoms of Myasthenia gravis
ptosis, diplopia, blurred vision
what is the test of choice for Myasthenia Gravis
acetylcholine receptor antibody test
what medications can exacerbate symptoms of Myasthenia Gravis
antibiotics (ahminoglycosides and tetracyclines), beta blockers, anti-arrhythmics (quinidine, procainamide, lidocaine)
how does tuberous sclerosis typically present clinically
cognitive impairment, epilepsy, and skin lesions (including facial angiofibromas, adenoma sebaceous)
what is the key pathological feature of spurge-weber syndrome
presence of capillary angiomatoses of the pia mater
what disorder is classified as bilateral loss of pain and temperature sensation over the shoulders in cape like distribution, preservation of touch, thoracic scoliosis and muscle atrophy of hands
syringomyelia
what are the clinical features of brown-sequard syndrome
contralateral loss of pain and temperature (spinothalamic tract), psilateral hemiparesis (corticospinal tract) and ipsilateral loss of position/vibration (dorsal columns)
what is the triad associated with Meniere’s disease
vertigo, tinnitus, and hearing loss
what is the most common cause of syncope
vasovagal syncope (neurocardiogenic)
what test should be obtained with all patients with syncope
EKG
what lab values should be checked immediately in an unfamiliar, seizing patient
serum calcium, serum sodium, serum glucose or Accu-Chek, BUN
what is the hallmark of ALS
upper and motor neuron signs with progressive muscle weakness
what is the most common cause of aphasia
cerebrovascular disease
what aphasia is described as impaired comprehension of written or spoken language
Wernicke’s aphasia
what aphasia is described as expressive, non-fluent aphasia with good comprehension of words
Broca’s aphasia
what is the drug of choice for treatment of trigeminal neuralgia
carbamazepine
what are the 2 main deficits associated with cerebral cortex lesions
contralateral motor or sensory deficits (depending on what region of the cortex is involved) and aphasia
what clinical findings are common with cerebellar lesions
incoordination, intention tremor, ataxia
what is the key finding with neuromuscular junction lesion
fatiguability
