Day 12.1 Neuro Flashcards
Most common causes of meningitis in newborns–> 6mo
Gp B Strep
E. coli
Listeria
Most common causes of meningitis in small kids 6mo–> 6yrs
S. pneumonia
N. meningitidis
HiB
Enteroviruses (Echo, Coxsackie- these cause aseptic meningitis, whereas the others cause bacterial)
Most common causes of meningitis in kids-adults 6yr–>60yr
Enteroviruses
S. pneumonia
N. meningitidis
HSV (this also causes temporal lobe encephalitis)
Most common causes of meningitis in 60+ yr elderly?
S. pneumonia
Gram-neg rods
Listeria
What genes are responsible for skeletal devt?
Hox genes
Clinical px of thyroglossal duct cyst?
Midline of neck
Moves when swallowing
Which phase of hepatic metabolism is lost first by geriatric pts?
Phase I
Which phase of hepatic metabolism is mediated by Cytochrome p450?
Phase I
What are the 4 obligate aerobe bacteria?
Nagging pests must breathe: Nocardia Pseudomonas aeruginosa Mycobacterium TB Bacillus spp
Vasculitis w necrotizing granulomas of lung and necrotizing glomerulonephritis
Wegener’s granulomatosis
Vasculitis w necrotizing immune complex inflam of visceral/renal vessels
Polyarteritis nodosa
Vasculitis in a young Asian woman
Takaysu’s
Vasculitis in a young asthmatic
Churgg-Straus
Vasculitis in young children; coronary arteries can be involved
Kawasaki dz
Most common vasculitits
Temporal arteritis
Kids- Henoch-Scholein purpura
Vasculitis a/w HBV infection
Polyarteritis nodosa
Rx to prevent the neurotoxicity of isoniazid
Pyridoxine (Vit B6)
Rx for TCA cardiotoxicity
NaHCO3 to alkalinize the plasma/urine
Rx for Theophylline cardiotoxicity
B-blocker
Where is CN III wrt the arteries in the circle of willis?
Between the PCA and the SCA (superior cerebellar artery).
An aneurysm in PCA or SCA can cause CN III palsy d/t mass effect.
Where does the PICA enter the circle of willis?
Vertebral arteries (PICA = posterior)
Where does the AICA enter the circle of willis?
Basilar arteries (AICA = anterior)
Medial medullary syndrome is the occlusion of which artery?
Anterior Spinal Artery (the one that comes up in the middle of the 2 vertebral arteries)
What are the characteristics of medial medullary syndrome?
Pyramid/corticospinal tract dmg –> Contralateral spastic hemiparesis of lower extremities
Medial lemniscus dmg –> Contralateral tactile and kinesthetic defects (proprioception)
Hypoglossal nucleus/nerve dmg –> tongue deviates toward lesion (ipsilateral paralysis)
What artery is occluded in lateral medullary syndrome (aka Wallenberg’s)?
PICA
Infarct of lateral part of rostral medulla
What are the characteristics of lateral medullary syndrome/Wallenberg’s?
Spinothalamic tract dmg –> Loss of contralateral pain/temp
Trigeminothalamic tract dmg –> loss of pain/temp on ipsilateral face
Nucleus ambiguus- glossopharyngeal and vagus dmg –> hoarseness, difficulty swallowing, loss of gag reflex (ipsilateral)
Descending symp tract dmg –> Ispilateral Horner’s syndrome
Vestibular nuclei dmg –> vertigo, nystagmus, naus/vom
Inferior cerebellar peduncle dmg –> Ipsilateral cerebellar deficits (ataxia, past pointing)
What artery is occluded in lateral inferior pontine syndrome?
AICA (which comes off of basilar artery)
What are the characteristics of lateral inferior pontine syndrome?
Facial nucleus/nerve dmg –> ipsilateral facial paralysis
Solitary nucleus/nerve dmg –> ipsilateral loss of taste from ant 2/3 of tongue
Cochlear nucleus/nerve dmg –> Ipsilateral deafness and tinnitus
Vestibular nucleus/nerve dmg –> Nystagmus, vertigo, naus/vom
Middle and inferior cerebellar peduncle dmg (MCP, ICP) –> ipsilateral limb and gait ataxia
Spinal trigeminal nucleus/nerve dmg –> ipsilateral loss of pain/temp from face
spinothalamic tract dmg –> contralateral pain/temp from body
descending symp tract dmg –> ipsilateral Horner’s syndrome
note: contralateral motor to body and light touch/vib/kinesthetics are fine
