Common Neurological Disorders Flashcards
_________ is an important sensory system that informs us when, where, and how severely we are injured.
Pain
___________ may cause secondary headaches in overweight young women. It may present with papilledema and cause vision loss. A lumbar puncture helps to relieve the pain.
Benign intracranial hypertension (or pseudotumor cerebri)
___________ may cause daily progressive headaches. It can be associated with focal findings, seizures, and headaches that are usually worse in the morning.
Brain tumors
__________ are chronic, daily secondary headaches following a head injury. They’re usually associated with depression and poor sleep.
Post-traumatic headaches
___________ is a fairly rare cause of facial pain and headache. It may present with focal sinus tenderness, stuffiness, and fever.
Sinusitis
____________ may cause a headache and facial pain associated with speaking or chewing.
Temporomandibular joint syndrome
___________ has a rapid but gradual onset. It is associated with neck stiffness, photophobia, fever, nausea, and vomiting.
Meningitis
In cases of meningitis, a(n) _________________ should be obtained, followed by treatment with IV antibiotics.
Emergent lumbar puncture
(Viral/Bacterial) meningitis is less severe and usually resolves in a few days.
Viral
What condition is shown in the following image? What abnormalities are shown?
- Hemorrhaged blood outlined in red.
- This is characteristic of a subarachnoid hemorrhage.
(T/F) A recurrent headache is more likely to result in a poor prognosis.
False. Recurrent headaches are less likely to be a serious medical condition.
If a patient presents with a prodrome or aura before severe headaches, it is more likely to be a(n) ____________.
Migraine
A unilateral headache suggests a(n) ____________.
Migraine
A bifrontal or bitemporal headache suggests a(n) _____________.
Tension (muscle-type) headache
Description of a headache as “throbbing” or pulsatile suggests a(n) _____________.
Migraine
A fever accompanying a headache may suggest either ____________ or ____________.
Meningitis or sinusitis
A headache accompanied by nausea, vomiting, and phonophobia suggests a(n) ______________.
Migraine
Rhinorrhea and bloodshot sclera of the eye suggest a(n) ________________.
Cluster headache
A headache accompanied by neck stiffness suggests ____________ or ___________.
Subarachnoid hemorrhage or meningitis
Tenderness of the temple, especially around the area of the temporal artery suggests _________________.
Temporal arteritis
- Jaw claudication - Pain or weakness with chewing
- Scalp tenderness
- Can cause blindness - Requires steroids immediately
A headache accompanied by tenderness over the sinuses suggests ____________.
Sinusitis
_____________ results from inflammation and infection of the meninges. It may stem from a contiguous or hematogenous infection, such as an ear or sinus infection.
Meningitis
Meningitis presents with _____________ sign, or when flexion of the neck causes hip flexion in order to prevent tension on lumbar roots.
Brudzinski‘s sign
Meningitis presents with _____________ sign, or when extension of the knee with the hip flexed causes pain due to tension on lumbar roots.
Kernig‘s sign
In most cases of meningitis, there is a(n) (increase/decrease) of white blood cells, (increase/decrease) of protein, and (high/normal or low) glucose within the CSF.
- Increased WBCs
- Increased protein
- Normal or low glucose
The ankle jerk and plantar reflex are mediated by what spinal nerves?
S1 and S2
The patellar reflex is mediated by what spinal nerves?
L3 and L4
The biceps reflex is mediated by what spinal nerves?
C5 and C6
The triceps reflex is mediated by what spinal nerves?
C7 and C8
What is the useful mnemonic to remember clinical reflexes?
- S1,2 - Buckle my shoe (ankle jerk and plantar reflex)
- L3,4 - Kick down the door (patellar reflex)
- C5,6 - Pick up sticks (biceps reflex)
- C7,8 - Lay them straight (triceps reflex)
___ radiculopathy results in the inability to walk on one’s toes.
S1
___ radiculopathy results in the inability to walk on one’s heels.
L5
(Binocular/Monocular) double vision is experienced when a double image is seen with both eyes open, but goes away when one eye is closed.
Binocular
(Binocular/Monocular) double vision is experienced when a double image is seen with both eyes open and the image persists after one eye is closed.
Monocular
(Binocular/Monocular) double vision is usually due to a problem with ocular alignment.
Binocular
(Binocular/Monocular) double vision is usually due to a local eye disease or refractive error.
Monocular
What systemic diseases can cause double vision?
- Thyroid disease
- Wernicke’s encephalopathy
- Myasthenia gravis
- Ophthalmoplegic migraines
Palsies of what cranial nerves can cause double vision?
- CN III (Oculomotor)
- CN IV (Trochlear)
- CN VI (Abducens)
What are the rules of diplopia?
- The false image is always the outer image.
- The false image always comes from the affected eye.
- Cover each eye to see which generates false image.
Acute or sudden weakness of muscles suggests __________.
Stroke
Chronic or insidious weakness of muscles suggests _________.
Neurodegenerative disease, such as ALS.
Muscle weakness that worsens toward the end of the day suggests ____________.
Myasthenia gravis
Muscle weakness accompanied by muscle wasting and fasciculations, flaccid muscle tone, and hyporeflexia suggests _______________.
Lower motor neuron lesion
Muscle weakness accompanied by spastic muscle tone, hyperreflexia, or a Babinski reflex suggests ________________.
Upper motor neuron lesion
If dysesthesia is accompanied by pain, it usually points to _______________.
Peripheral nerve problems
(T/F) In a case of dysesthesia, you should test all modalities of the patient for sensation, including light touch, pinprick sensations, temperature, vibration, and joint position.
True.
(T/F) In neuropathies, shorter nerves tend to be affected first.
False. Longer nerves tend to be affected first. Symptoms usually appear in the feet and progress upwards over months to years.
In cases of neuropathy, when numbness reaches the knee, the _____________ begin to be affected.
Fingertips
Imaging (usually/rarely) helps localize nerve lesions in cases of neuropathy.
Rarely
One of the most useful tests for diagnosing and determining the extent of neuropathy is a(n) _________________.
Nerve conduction study
______________ is an autoimmune, acute, demyelinating disease of the PNS. It causes destruction of axonal myelin and subsequent slowing and blocking of nerve conduction. Patients often present with weakness, areflexia, and sensory abnormalities such as hyperesthesia. This condition may be preceded by a GI or upper respiratory infection.
Guillain-Barre syndrome
Guillain-Barre presents with (increased/decreased) levels of protein in the CSF, but normal cell populations.
Increased protein
(T/F) Imaging plays an important role in the diagnosis if Guillain-Barre syndrome.
False. Imaging plays no role in the diagnosis of this illness.
A score of __/30 is considered normal on the mini mental exam (MME).
27/30
A stepwise progression of forgetfulness is more likely to be _____________.
Multi-infarct dementia
A sudden or rapid decline in memory may point toward _____________.
Creutzfeldt-Jakob disease (mad cow disease)
The most prominent type of dementia is ________________.
Alzheimer’s disease
A normal response on the swinging-light test is the (dilation/constriction) of the pupil.
Constriction
Periventricular plaques referred to as “Dawson‘s fingers” are very suggestive of ________________.
Multiple Sclerosis
What disease is the patient in the following image most likely to have?
- “Dawson’s fingers” highlighted by arrows.
- This is characteristic of Multiple Sclerosis.
(T/F) The CSF of a patient afflicted with Guillain-Barre syndrome will have oligoclonal bands upon electrophoresis due to intrathecal (inside the spinal cord) IgG synthesis.
False. The CSF of a patient afflicted with Multiple Sclerosis will have these oligoclonal bands.
_______________ is a disease characterized by bradykinesia, resting tremors, cogwheel rigidity (jerky resistance to passive movement of muscles), and postural instability. Its pathology stems from a failure of the substantia nigra to produce the required amounts of dopamine for use in the maintenance of muscle control.
Parkinson’s disease
