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Neuroscience 2 > Hon Review of All the things > Flashcards

Hon Review of All the things Flashcards

1
Q

what 3 symptoms classically make up meinere’s?

A

tinnitis, vertigo, hearing loss

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2
Q

pts with meinere’s present with? complain of?

A

low frequency hearing loss, fullness in ears, vertigo that comes in spells

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3
Q

vestibular problem with meinere’s?

A

horizontal + rotary nystagmus

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4
Q

what is considered a peripheral cause of vertigo?

A

the labyrinth (PNS starts at spinal cord and goes out)

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5
Q

what does Romberg’s test for?

A

proprioception, posterior columns (peripheral test for dorsal test of dorsal columns)

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6
Q

What age group is diagnosed with Freidrich’s ataxia? COD?

A

young people; cardiomyopathy

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7
Q

what does ataxia look like? how would a pt describe it?

A

disequilibrium, falling, poor balance, hyporeflexic, decreased m. strength

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8
Q

if a pt has a herniation syndrome what may be one of their symptoms?

A

pupil dilate

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9
Q

what kinds of things can be examined on a comatose pt?

A

pupillary light response, extra ocular movements, oculocephalic reflexes, corneal response, can try pain response: pinch nail bed, withdrawal to noxious stimuli, check breathing patterns

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10
Q

where can a lesion occur that would cause coma?

A

both sides of brain involved, brainstem or both, (lesion of bilateral cortex, midbrain/pons/medulla)
not coma causes: hypothalamus, spinal cord, MS lesions, unilateral BG, unilateral thalamus

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11
Q

what does it mean if there is an absent oculocephalic reflex when stimulated with cold on L and intact on R?

A

damage to gaze center in R pons

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12
Q

pt comes into ER after being found down by family members. Pt is sleepy, drowsy, can’t follow commands, eyes deviate to L, babinski found on R, lg L MCA stroke.
Neuro change hours later:
unarousable, L eye down and out, extensor posture, bilateral babinski.
What happened?

A

Uncal herniation L to R

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13
Q

what is common in the presentation of a pt with hepatic coma/encephalopathy?

A

both hemispheres affected, eyes adducted and down, asterictis (hyperextended at wrist, flicking)

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14
Q

cold water into the R ear of a coma pt?

A

normal= conjugately gaze to the R

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15
Q

migraines: more common in? characteristics?

A

in women, unilateral (or bilateral) throbbing/sharp/pressure, N/V, photophobia, phonophobia

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16
Q

What classifies a chronic migraine?

A

15-16days/month, 4+ months, hx of migraine HA,

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17
Q

what can be used to prevent migraine?

A 
beta blockers
Ca channel blocker
AEDs: topiramate, valproic acid
TCAs: amytriptiline, noratriptilline
Botox** FDA approved
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18
Q

which sex more frequently as cluster HA? proven association with? symptoms? prodrome?

A

men; proven association with sleep apnea; periorbital pain, sharp/boring/penetrating pain, 30-90 mins, same time of year, recurring; burring nose/inner canthus ipsilateral side

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19
Q

description of trigeminal neuralgia?

A

unilateral, electric/sharp/shooting, 1+ division of trigeminal n., pain comes in paroxysms in seconds, few seconds and stops on/off thru day

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20
Q

what typically brings on trigeminal neuralgia?

A

chewing, talking, hot/cold liquids/foods

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21
Q

what meds are used to treat trigeminal neuralgia?

A

anticonvulsants: Carbamazepine***, oxcarbamazepine, gabapentin

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22
Q

what is the triad for parkinsons?

A

tremor, bradykinesia, rigidity

23
Q

which symptom of PD first?

A

tremor, unilateral to start

24
Q

what are the other parkinsonisms called?

A

akinetic rigid syndromes

25
Q

what are the symptoms of Progressive Supranuclear Palsy?

A

bradykinesia, rigidity, eyes vertical gaze fail, volitional gaze impaired

26
Q

clinical features of diffuse lewy body dz?

A

psychotic symptoms, visual (small animals/kids)= early feature, autonomic dysfunction, OFTEN FALLING, slow/stiff, festinating gait, MMSE may be normal (not much memory loss)

27
Q

Ad symptoms?

A

early: memory loss, (missed appts, forget where objects are, can’t balance checkbook)
late: kids stealing from them, spouse cheating; mood= intermittent agitation

28
Q

what may imaging reveal for AD?

A

may see generalized atrophy or may be normal for age (blood work will be normal)

29
Q

What should you expect if a pt has intermittent episodes of encephalopathy, unexplained delirium, episodes lasting days?

A

lewy body

30
Q

what would give away vascular dementia?

A

focality

31
Q

what is the triad associated with normal pressure hydrocephalus? which improves with shunt?

A

dementia, gait disturbances, urinary abnormalities; gait improves with shunt

32
Q

which kind of migraine has aura? why more common in women?

A

classic; hormones

33
Q

what are the worrisome symptoms to make us suspect a secondary HA?

A

“worst HA of life,” atypical HA for pt, fever, focal symptom, late onset (>50-55), very rapid onset (secs to mins max intensity)

34
Q

if a pt with a sudden severe HA collapses to ground unconscious and awakes in the ER with some weakness/lethargy what is our diagnosis until proven otherwise?

A

subarachnoid hemorrhage

order bloom work, CT (5-10% not seen on), LP can be done

35
Q

description of wilson’s dz?

A

young person, liver and brain affected, copper metabolism deficiency, brady and hyperkinetic disorder

36
Q

will one test show MS? what are some test results that may further lead you to suspect MS?

A

no; increased IgG synthesis with oligoclonal bands in CSF

37
Q

what kind of dz is MS?

A

dz of young people 20-30s, exacerbations and remissions, dz of CNS: spinal cord and brain

38
Q

what dz will have decrease arm swing?

A

PD

39
Q

what are the dz modifying agents in MS?

A

IFNs, monoclonal antibodies, glaterimur acetate, -timizuab, dimethyl fumurate

40
Q

what do steroids do in MS?

A

decrease the amount of time in exacerbation

41
Q

How is MS diagnosed?

A

by multiple lesion over space and time

42
Q

if a pt presents with optic neuritis and mono phasic lesions what should you think?

A

ADEM (acute disseminated encephalomyelitis); follow these pts closely as this may become MS (MRI 3-6 months)

43
Q

What is the most common reason that someone with controlled epilepsy may have a seizure?

A

missed a medication

44
Q

how many epileptic pts are controlled on first medication?

A

2/3

45
Q

what is the most important thing in determining if a seizure or something else actually occurred?

A

hx with witnesses to event

46
Q

which meds can treat both primary generalized or partial seizures?

A

valproic acid, lamotrigine, zonisamide, levotracetam

47
Q

what are some things that can be confused with stroke?

A

hyper/hypoglycemia, hepatic abnormalities, MIGRAINES*

48
Q

what meds help treat stroke?

A

aspirin, clopidigril, avernox

49
Q

what does a CT of stroke pt look like at 3 hours? 2 days?

A

normal; hypodensity

50
Q

what is the first approach to a pt?

A

ABCs

51
Q

what are cases to tx with warfarin?

A

intermittent A fib, prosthetic valve, MI (EF 10-15%)

52
Q

what are the features of ataxia telangectasia?

A

ataxia
telangectasia- spider veins
and sinopulmonary problems

53
Q

pt comes in following first grand mal seizure. Had head/eye turn (automatism). Pt has had funny feeling in past but no seizure before. What does this tell us?

A

pt likely had partial seizures without generalization; pt had epilepsy

Neuroscience 2 (9 decks)

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