ch 5- CNS and PNS Flashcards

1
Q

what is the leading cause of neurologic disability

A

ischemic stroke

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2
Q

what are the most important risk factors for stroke

A

age and hypertension

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3
Q

how is the source of embolic stroke evaluated

A

echocardiogram, carotid dopplers, ECG/Holter monitoring

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4
Q

what artery is the most common for a stroke and what are the symptoms

A

Middle cerebral artery- contralateral weakness, sensory loss and hyperreflexia

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5
Q

what should be in the first imaging study ordered when patient may have had a stroke

A

CT scan without contrast of head

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6
Q

what is the pupillary findings in ICH due to the pons

A

pinpoint pupils

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7
Q

what is the pupillary findings in ICH due to the thalamus

A

poorly reactive pupils

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8
Q

what is the pupillary findings in ICH due to the putamen

A

dilated pupils

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9
Q

what is the term for parkinsonian symptoms + autonomic insufficiency

A

Shy-Drager syndrome

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10
Q

what are some common medications that have parkinsonian side effects

A

Neuroleptic drugs (chlorpromazine, haloperidol, perphenazine), metoclopramide, reserpine

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11
Q

what type of dementia has step-wise decline

A

vascular dementia (multi-infarct dementia)

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12
Q

what is the triad associated with normal-pressure hydrocephalus

A

dementia, gait disturbance, and urinary incontinence.

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13
Q

what labs and imaging should be ordered when considering dementia

A

CBC with diff, chemistry panel, thyroid function tests, vitamin B12, folate level, VDRL, HIV screening and CT scan or MRI of head

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14
Q

at what age does multiple sclerosis typically initially present

A

in a female in their 20s to 30s

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15
Q

what is the test of choice for MS

A

MRI

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16
Q

what medication can be given to shorten an acute attack in MS

A

high-dose IV corticosteroids

17
Q

how is a definitive diagnosis of Guillain-Barre syndrome made

A

combination of CSF fluid analysis, clinical findings, and nerve conduction velocities

18
Q

what are the autoantibodies directed against in Myasthenia Gravis

A

against the nicotinic acetylcholine receptors of the Neuromuscular junction, leading to reduced post-synaptic response to acetylcholine

19
Q

what are the most common initial symptoms of Myasthenia gravis

A

ptosis, diplopia, blurred vision

20
Q

what is the test of choice for Myasthenia Gravis

A

acetylcholine receptor antibody test

21
Q

what medications can exacerbate symptoms of Myasthenia Gravis

A

antibiotics (ahminoglycosides and tetracyclines), beta blockers, anti-arrhythmics (quinidine, procainamide, lidocaine)

22
Q

how does tuberous sclerosis typically present clinically

A

cognitive impairment, epilepsy, and skin lesions (including facial angiofibromas, adenoma sebaceous)

23
Q

what is the key pathological feature of spurge-weber syndrome

A

presence of capillary angiomatoses of the pia mater

24
Q

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

A

syringomyelia

25
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)
26
what is the triad associated with Meniere's disease
vertigo, tinnitus, and hearing loss
27
what is the most common cause of syncope
vasovagal syncope (neurocardiogenic)
28
what test should be obtained with all patients with syncope
EKG
29
what lab values should be checked immediately in an unfamiliar, seizing patient
serum calcium, serum sodium, serum glucose or Accu-Chek, BUN
30
what is the hallmark of ALS
upper and motor neuron signs with progressive muscle weakness
31
what is the most common cause of aphasia
cerebrovascular disease
32
what aphasia is described as impaired comprehension of written or spoken language
Wernicke's aphasia
33
what aphasia is described as expressive, non-fluent aphasia with good comprehension of words
Broca's aphasia
34
what is the drug of choice for treatment of trigeminal neuralgia
carbamazepine
35
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
36
what clinical findings are common with cerebellar lesions
incoordination, intention tremor, ataxia
37
what is the key finding with neuromuscular junction lesion
fatiguability