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Neurology_Clinical Medicine > Intro to Neurology > Flashcards

Intro to Neurology Flashcards

1
Q

What grade is a normal reflex

A

2+, Active Response

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2
Q

What is a hemiplegic gait

A

affected leg is held extended and internally rotated, the foot is inverted and plantar flexed and leg moves in circular direction at hip (circumduction)

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3
Q

What is a diplegic gait

A

slow and stiff with legs crossing in front of each other (scissoring)

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4
Q

What type of patient do you normally see a diplegic gait

A

Cerebral Palsy

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5
Q

What is a cerebellar ataxic gait

A

wide based and may be associated with staggering/reeling as in drunkeness

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6
Q

What is a sensory ataxic gait

A

wide based, the feet are slapped onto the floor, and patient may watch his feet

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7
Q

What is a neuropathic (steppage) gait

A

inability to dorsiflex foot, often due to peroneal nerve lesion. Results in exaggerated elevation hip/knee to allow foot to clear floor

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8
Q

What is a dystrophic gait

A

Pelvic muscle weakness produces lordotic/waddling gait (with Trendelenberg tilt)

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9
Q

What is the Parkinsonian (Festinating) gait

A

Flexed posture, starts are slow, steps are small and shuffling, there is reduced arm swing, and involuntary acceleration (festination) may occur

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10
Q

What is a Choreic gait

A

jerky and lurching yet falls are suprisingly rare

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11
Q

What is a Apraxic gait

A

Difficulty initiating walking and may appear to be glued to the floor. Once started, gait is slow and shuffling. However, no difficulty performing leg movements when lying down and not bearing weight

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12
Q

What is an Antalgic gait

A

Favoring one leg over other to avoid pain (limp)

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13
Q

What is the normal color of CSF

A

clear/colorless (champagne colored tap)

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14
Q

Why are there no RBC’s in CSF

A

Because of the blood brain barrier

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15
Q

How do you differentiate glucose levels in viral meningitis vs. bacterial?

A

Viral Meningitis glucose is normal, Bacterial Meningitis it is low (<45 mg/dL)

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16
Q

What WBC predominantly shows in viral meningitis

A

Lymphocytes

17
Q

What WBC predominantly shows in bacterial meningitis

A

Neutraphils

18
Q

What are contraindications for doing an LP

A

-Infection in tissue near puncture site (L4)
-Space occupying lesion, especially brain abscess
-Anticoagulation
-Thrombocytopenia with PLT#<50K
-Complete spinal block
-Non-communicating hydrocephalus

19
Q

What are indications for doing an LP

A

-CNS infection, concern for meningitis
-Suspected SAH
-Unexplained seizures/SE
-Intrathecal chemotherapy/contrast
-Thoraco-abdominal aortic aneurysm repair
-Idiopathic intracranial hypertension (psuedotumor cerebri)

20
Q

What are the labs to diagnose stroke?

A

CBC
Inflammatory markers (ESR/CRP)
Serum glucose
Lipids

21
Q

What is the usefulness of CT in diagnosing neurological conditions

A
  • progressive neurologic disorders
  • focal neuro deficits with suspected lesions
  • elvated ICP
  • patients with suspected stroke/head injuries
22
Q

What imaging modality is better at detecting an acute bleed

A

CT, because it is better at differentiating from other cause (bleed)

23
Q

Indications to order a CT for neurologic conditions

A
  • Stroke
  • Tumor
  • Trauma
  • Dementia
  • SAH
24
Q

What is within the grey matter of the brain?

A

cell bodies

25
Q

What is within the white matter of the brain?

A

nerve fibers

26
Q

Does MRI or CT provide better contrast of white/grey matter?

A

MRI

27
Q

Indications for MRI in neurological disorders?

A
  • Stroke
  • Tumors
  • Trauma
  • Dementia
  • Multiple Sclerosis
  • Infections
  • Seizures
28
Q

Why is MRI useful in diagnosing dementia

A

more sensitive in identifying abnormal white matter signal and associated atrophy

29
Q

Why is MRI useful in diagnosing MS

A

It is possible to detect lesions in cerebral white matter or cervical cord. Can use GAD to distinguish between lesions of different ages. (Identifying lesions are critical to proper diagnosis)

30
Q

Why is MRI useful in diagnosing a brain infection

A

Very sensitive in detecting white matter edema likely attributing to earlier detection of cerebrites/abscess

31
Q

How quickly can DW-MRI Sequencing detect an acute stroke

A

Within an hour of onset with high specificity

32
Q

What is DW-MRI Sequencing used for

A

to discriminate between cytotoxic (strokes) and vasogenic edema (cerebral lesions)

33
Q

What are the indications for a PET scan in neurological disorders

A
  • Medical refractory epilepsy and evaluation for surgery
  • Dementia
  • Grading gliomas
  • Confirmatory evidence of Huntington’s disease
34
Q

Types of Angiography in Neurology

A
  • Formal Cerebral Angiography
  • CT Angiography
  • MR Angiography
35
Q

What are the indications for angiography in neurology

A
  • Acute stoke to evaluate for LVO
  • Intracranial aneurysms/AVM’s/Fistula’s
  • SAH
  • Venous sinus thrombosis
  • Space occupying lesions
36
Q

What are the indications for EMG’s

A

When you suspect diagnosis such as:
- myopathic disorders (especially in inflammatory disorders like polymyositis)
- ALS
- Muscular dystrophies

37
Q

Indications for Evoked Potentials (EP)

A
  • Detection of lesions in MS
  • Evaluating efficacy of treatment in MS
  • Lesion detection in CNS disorders
  • Assessment of trauma/hypoxia
  • Intraoperative monitoring
  • Evaluation of visual/auditory acuity (not first line)
38
Q

What are the types of evoked potentials

A

Visual, Auditory, and Somatosensory

Neurology_Clinical Medicine (13 decks)

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