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Neuro Shelf > Clinical signs > Flashcards

Clinical signs Flashcards

1
Q

What is ocular bobbing?

A

conjugate eye movements - rhythmic and directed downward

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2
Q

What type of eye movement is caused by a lesion at the cervicomedullary junction?

A

down-beating nystagmus with both eyes

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3
Q

What does hyperacusis indicate?

A

lesion of the facial nerve, close the brainstem before the stapedius nerve

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4
Q

Young pt with subacute onset morning headaches -> confusion, hemiparesis, and seizure… think what??

A

expanding mass

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5
Q

Headache, obtundation, and vomiting may all be signs of…

A

increased intracranial pressure

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6
Q

What are Hollenhorst plaques?

A

cholesterol and calcific deposits in retinal arterioles

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7
Q

What are the clinical manifestations of Horner Syndrome?

A

ptosis, miosis, anhidrosis

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8
Q

Dydiadochokinesia can be identified with what tests?

A

alternately tapping one side of hand and then the other (coordination tests)
strength/sensation intact

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9
Q

Highly asymmetric dydiadochokinesia may indicate?

A

focal lesion

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10
Q

What is causalgia?

A

severe burning pain due to peripheral nerve injury

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11
Q

What is hypesthesia?

A

decrease in accurate perception of stimuli

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12
Q

What is allodynia?

A

perception of pain with application of nonpainful stimuli

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13
Q

“Claw hand” is seen from injury to what nerve?

A

ulnar nerve

impaired extension of ulnar two digits when trying to extend fingers

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14
Q

Wrist drop is commonly seen in ___ nerve palsy.

A

“Saturday night”
or
radial nerve pressure palsy

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15
Q

What type of migraine (classic or common) is associated with aura of neurologic dysfunction?

A

Classic

most often visual aura

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16
Q

What clinical signs are common in basilar migraines?

A

women
aura - visual
more severe neurologic deficits - visual changes to blindness, irritability into psychosis

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17
Q

Trigeminal neuralgia can often be seen in what chronic condition?

A

MS
basilar artery aneurysms
acoustic schwannomas
posterior fossa meningiomas

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18
Q

What is Tolosa-Hunt syndrome?

A

inflammatory condition –> ophthalmoplegia associated with HA and loss of sensation on forehead

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19
Q

What are common complaints of atypical facial pain?

A

constant, deep, bilateral OR unilateral, limited distribution, responsive to antidepressants

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20
Q

What are symptoms associated with optic neuritis?

A

monocular vision loss, pain with eye movement, “washed-out” color vision

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21
Q

Afferent pupillary defect is found in what diagnosis?

A

Optic neuritis

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22
Q

What is afferent pupillary defect?

A

“swinging flashlight test” = paradoxical pupillary dilation of affected eye with swinging flashlight

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23
Q

Gradual painless peripheral vision loss is a characteristic of what?

A

open-angle glaucoma

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24
Q

Sudden loss of consciousness without prodrome followed by immediate return to baseline after the event is associated with what?

A

cardiogenic syncope

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25
Q

What age is ultrasound of the brain most useful?

A

under 6 mo because widely open anterior fontanelle

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26
Q

What symptoms are associated with Wallenberg syndrome?

A

loss of pain and temp ipsilateral face and contralateral body, ipsilateral bulbar muscle weakness, vertigo/nystagmus, Horner’s syndrome

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27
Q

Sudden loss of vision “curtain falling over the eyes” is called what?

A

amaurosis fugax - atherosclerotic emobli from carotid artery in the retinal artery

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28
Q

Patients with homocystinuria are at increased risk of what neuro complication?

A

thromboembolic events –> cerebrovascular accident

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29
Q

What eye abnormality is seen in patients with homocystinuria?

A

downward lens dislocation

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30
Q

Focal neurologic deficits that gradually worsen over minutes to hours may indicate___.

A

intraparenchymal brain hemorrhage

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31
Q

Neurologic symptoms taht progress in a stuttering fashion may indicate ____.

A

ischemic stroke

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32
Q

Putaminal hemorrhage almost always involves ____.

A

adjacent internal capsule

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33
Q

What is Dejerine-Roussy syndrome? (thalamic pain syndrome)

A

paroxysmal burning pain over affected area exacerbated by light touch (allodynia)

34
Q

Gait dysfunction, truncal ataxia, nystagmus, intention tremor/dysmetria, and impaired dydiadochokinesia are all signs of:

A

cerebellar degeneration

35
Q

What is the most common cause of spontaneous lobar hemorrhage, especially in adults >60yo?

A

amyloid angiopathy - Alzheimer dementia

36
Q

What are manifestations of NF1?

A 
cafe-au-lait spots
clustered freckles
Lisch nodules
Neurofibromas
Optic glioma
37
Q

Idiopathic intracranial hypertension can present with what symptoms?

A

headache worse in the morning or awakens from sleep, +/- blurry vision, nausea, vomiting, etc.

38
Q

What medications worsen IIH?

A

growth hormone, tetracyclines, excessive vitamin A (isotretinoin)

39
Q

What symptoms may accompany absence seizures?

A

simple automatisms –> eyelid fluttering, lip smacking

40
Q

Port wine stain, glaucoma, seizures, intellectual disability, and leptomeningeal capillary-venous malformation are all clinical features of ___

A

Sturge-Weber syndrome

41
Q

Klippel-Trenaunay syndrome is associated with capillary, venous, lymphatic malformations and ___ skin abnormality

A

port wine stain lower extremity

no neurologic abnormalities

42
Q

___ is a neurocutaneous disorder that presents with seizures and intellectual disability.

A

tuberous sclerosis

may also see: retinal hamartomas, ash-leaf spots, angiofibromas, shagreen patches

43
Q

BPPV is due to ____ in the semicircular canals.

A

crystaline deposits - canaliths

44
Q

An acute single episode of vertigo that can last for days following a viral syndrome is called..

A

vestibular neuritis

45
Q

Sudden-onset vertigo that doesn’t go away is most likely due to…

A

brainstem/cerebellar stroke

46
Q

__ is the most common brain tumor in children.

A

pilocytic astrocytoma

47
Q

Supratentorial tumors present with:

A

seizures, weakness, sensory changes

48
Q

Pain, fatigue, and parasthesias of one upper extremity (usually the L) can all be signs of symptomatic ___

A

subclavian steal syndrome or atherosclerosis of the subclavian artery

49
Q

What are the two differences in clinical presentation between Tay Sachs and Niemann-Pick disease?

A

NPD - hepatosplenomegaly and areflexia

TSD - hyperreflexia

50
Q

Febrile seizures are characterized by temperature > ____, lasting ____, in ages ___ to 6 years.

A

100.4 (38)
<15 min
3 mo

51
Q

What percentage of febrile seizures turn into epilepsy?

A

<5%

52
Q

What risk factor has the strongest association with hemorrhagic and ischemic strokes?

A

hypertension

53
Q

What is the “classic triad” of spinal epidural abscess?

A

fever, back pain, neurologic deficits

54
Q

What metabolic disorder is characterized by vomiting, poor weight gain, jaundice, hepatomegaly, convulsions and cataracts?

A

galactosemia

def of galactose-1-phosphate uridyl transferase

55
Q

Name clinical features of SAH.

A

severe HA with onset of neuro symptoms, meningeal irritation, NOT common to have focal deficits

56
Q

___ is common in the first 24 hours after SAH and ____ is common after 3 days.

A

rebleed

vasospasm

57
Q

Dysarthria, limb weakness, loss of deep tendon reflexes, progressive gait and limb ataxia are all clinical findings in what genetic disease?

A

Friedreich ataxia

58
Q

What are non-neurologic signs of Friedreich ataxia?

A

kyphoscoliosis, pes cavus, hypertrophic cardiomyopathy and increased risk of arrhythmia/heart failure

59
Q

It is common to see (unilateral/bilateral) MLF lesions in patients with MS

A

BILATERAL

60
Q

Dementia that first presents with confusion + visual hallucinations and parkinsonian motor symptoms is likely …

A

lewy body dementia

61
Q

Hypertension, bradycardia, and respiratory depression may indicate…

A

brainstem compression

Cushing reflex

62
Q

Cauda equina syndrome or conus medullaris syndrome?

severe radicular pain

A

cauda equina syndrome

63
Q

Cauda equina syndrome or conus medullaris syndrome?

asymmetric motor weakness

A

cauda equina syndrome

64
Q

Cauda equina syndrome or conus medullaris syndrome?

hyperreflexia

A

conus medullaris syndrome

65
Q

Cauda equina syndrome or conus medullaris syndrome?

early-onset bowel and bladder dysfunction

A

conus medullaris syndrome

66
Q

A patient with muscle pain and stiffness in the shoulders over age 65, stiffness in the morning, fatigue, malaise, loss of appetite and depression may have…

A

Polymyalgia rheumatica

“pain in shoulders” is pathomneumonic here

67
Q

Gradual progression of pain in shoulders, upper arms, hips, thighs, with or without swallowing problems may be….

A

Polymyositis

68
Q

Muscle atrophy of the face, shoulder blade, and upper arms is most likely to be …

A

facioscapulohumeral muscular dystrophy

69
Q

Muscle atrophy in the temporal region, sternocleidomastoid, and distal extremity muscles may be what disease?

A

myotonic dystrophy

70
Q

How do you distinguish MDD from dementia in the elderly?

A

Time course - if all of the symptoms come on within 1 month, more likely to be MDD

Also - MDD pts will not even try recall questions, dementia patients will try but answer wrong

71
Q

What is prosopagnosia?

A

inability to recognize faces of familiar people

problem with fusiform gyrus in occipotemporal lobe

72
Q

About 50% of people with giant cell arteritis also have ____.

A

polymyalgia rheumatica

73
Q

What are diagnostic criteria for transverse myelitis?

A

bilateral sensorimotor and autonomic spinal cord dysfunction
clearly defined sensory level
progression between 4hr-21 days after sx onset
exclusion of compression, postradiation, neoplastic, vascular

74
Q

What is Shy-Drager syndrome?

A

Multiple system atrophy

75
Q

Parkinsonism + autonomic dysfunction (orthostatic hypotension) + widespread neurological signs

A

Shy-Drager

aka multiple system atrophy

76
Q

wide-based gait, urinary incontinence, and dementia…

A

Normal pressure hydrocephalus

77
Q

Horizontal nystagmus, ataxia, dysmetria, slurred speech, nausea/vomiting, hyperreflexia… indicate ??

A

phenytoin toxicity

78
Q

Young obese female with headache, normal neuroimaging and elevated CSF opening pressure…

A

pseudotumor cerebri (benign intracranial hypertension)

79
Q

Where is atrophy seen first in patients with Alzheimer disease?

A

temporal lobes

80
Q

REM sleep behavior disorder has a strong association with development of ____

A

alpha-synuclein neurodegenerative disorders

81
Q

Encephalopathy, oculomotor dysfunction (horizontal nystagmus), gait ataxia…

A

Wernicke encephalopatyh

Neuro Shelf (8 decks)

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