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MS3 - Neurology > Miscellaneous > Flashcards

Miscellaneous Flashcards

1
Q

Which part of the brain is thought to be involved in essential tremor?

A

Thalamus

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2
Q

What are two treatments for essential tremor?

A
  • Propanol

- Primidone (anti-epileptic med)

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3
Q

Which nerve roots are implicated in Cauda Equina Syndrome?

A

L1-S5

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4
Q

The physical exam finding of “saddle anesthesia” is concerning for what major condition?

A

Cauda Equina Syndrome

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5
Q

What is a major risk factor for rapid fluid resuscitation in the setting of an epidural hematoma?

A

Increased ICP due to rapidly expanding intravascular volume

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6
Q

What is Cushing’s Reflex, and which three symptoms characterize it?

A 
Cushing's Reflex is:
- Hypertension
- Bradycardia
- Respiratory Depression (bradypnea)
which together indicates increased ICP (e.g. uncal herniation, epidural hematoma)
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7
Q

Which nerves are likely to be injured during an uncal herniation?

A
  • CN III (oculomotor - mydriasis) - EARLY FINDING
  • CN IV (trochlear)
  • CN VI (abducens) - LATE FINDING
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8
Q

What are some of the features of tuberous sclerosis?

A
  • Neurologic: seizures, developmental delay, intellectual disability
  • Skin: adenoma sebaceum (reddened facial nodules ina malar distribution), Shagreen patches (leathery patches on trunk), Ash leaf (hypopigmented) patches
  • Retinal lesions
  • Cardiac rhabdomyomas
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9
Q

What are some of the features of Neurofibromatosis (von Recklinghausen Disease)?

A
  • Neurofibromas: soft, flesh-colored lesions attached to peripheral nerves
  • Eight cranial nerve tumors (vestibular schwannomas) - NF2
  • Cutaneous hyperpigmented lesions (café au lait spots) - NF1
  • Meningioma and gliomas
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10
Q

What are some of the differences between NF1 and NF2?

A

NF1

  • More common (90% of all neurofibromatosis cases)
  • More characterized by skin lesions
  • Chromosome 17

vs.

NF2

  • Less common (10% of all neurofibromatosis cases)
  • No skin lesions, but almost ALWAYS cranial nerve lesions (e.g. CN 8)
  • Chromosome 22
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11
Q

What are some of the features of Sturge-Weber syndrome?

A
  • Port-wine stain of the face
  • Seizures (due to leptomeningeal capillary-venous malformations)
  • CNS: homonymous hemianopsia, hemiparesis, intellectual deficits
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12
Q

What are the triad of features of Thiamine (B1) deficiency?

A
  • Encephalopathy
  • Oculomotor dysfunction (nystagmus)
  • Gait ataxia (wide-based gait)
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13
Q

What are 4 common features of Parkinson disease?

A
  • Resting tremor
  • Bradykinesia
  • Cogwheel rigidity
  • Unstable/shuffling gait
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14
Q

How can Bell’s Palsy be distinguished from a stroke?

A

Both may involve the face, but a stroke typically spares the upper face (i.e. can still wrinkle eyebrows) due to the upper part of the face receiving innervation from both cerebral hemispheres.

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15
Q

What is the preferred treatment of Myasthenia Gravis?

A

Pyridostigmine (an acetylcholine esterase inhibitor)

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16
Q

What is the preferred treatment of acute myasthenic crisis?

A

IVIG or Plasmapheresis

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17
Q

What is a leading factor for cerebral palsy?

A

Prematurity

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18
Q

In the setting of head trauma, what symptoms are concerning for epidural hematoma?

A
  • Nausea/vomiting
  • Headache
  • Seizure
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19
Q

What is the most common location of epidural hematomas?

A

Temporoparietal

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20
Q

Which artery is most often implicated in epidural hematomas?

A

Middle meningeal artery

21
Q

Aside from absence seizures, what is another seizure type that may present with automatisms?

A

Complex partial seizures (focal seizures with impaired consciousness)

22
Q

What triad of symptoms are seen in Wernicke’s encephalopathy?

A

Wernicke’s Encephalopathy = Vitamin B1 (Thiamine) Deficiency

  • Encephalopathy
  • Ocular dysfunction
  • Gait ataxia
23
Q

In symptomatic patients with carotid artery stenosis, what percentage meets threshold for carotid endarterctomy?

A

70%+

24
Q

Pure motor (more common) or sensory hemiparesis is most likely indicative of what type of stroke?

A

Lacunar

25
Q

Which part of the brain is implicated in hemi-neglect?

A

The non-dominant (right in right-handed individuals) parietal lobe

26
Q

What type of gait abnormality is observed in the setting of cerebellar degeneration due to chronic alcohol use?

A

Inability to perform tandem gait or heel-to-shin testing

27
Q

Areflexic weakness and loss of pain/temperature sensation in a cape-like distribution is most likely indicative of what condition?

A

Syringomyelia

28
Q

Which vessel(s) is commonly implicated in a subdural hematoma?

A

Rupture of bridging veins

29
Q

In suspected Guillain-Barré syndrome, what is the very first step in management in a stable patient?

A

Serial spirometry (PFTs) to determine lung function and anticipate respiratory compromise/need for respiratory support

30
Q

Why must thiamine be administered before dextrose in the setting of severe malnutrition?

A

Giving dextrose before Thiamine (B1) can precipitate or worsen Wernicke’s encephalopathy. Since B1 is used as a co-enzyme in glucose metabolism, giving glucose products will use up the very small amount of B1 stores available.

31
Q

What is “amaurosis fugax” and what is the most common etiology for this diagnosis?

A

Amaurosis fugax = transient, painless, monocular vision loss, often described as a “curtain descending”

It is most likely due to retinal ischemia due to atherosclerotic emboli originating from the ipsilateral carotid artery

32
Q

What does cerebellar dysfunction, headaches, papilledema and abducens nerve palsy in a young child raise concern for?

A

Posterior fossa tumor

33
Q

What is the most common form of posterior fossa tumor in a child?

A

Medulloblastoma

34
Q

How is status epilepticus defined?

A

Seizure occurring for ≥ 5 minutes or ≥2 seizures back-to-back without return to baseline

35
Q

How is status epilepticus managed?

A
  • Administer IV benzodiazepine (e.g. lorazepam or diazepam)

- Start patient on fosphenytoin (or phenytoin, levetiracetam, or valproate) to prevent recurrence

36
Q

Hemiparesis and hemianesthesia involving an entire side of one body is usually due to intracerebral hemorrhage involving which part of the brain?

A

The basal ganglia (caudate and putamen)

37
Q

A patient presenting with acute onset unilateral muscle weakness without sensory deficits or aphasia, is most likely suffering from what type of stroke?

A

Lacunar (involving the internal capsule)

38
Q

What is one of the biggest risk factors for Lacunar strokes?

A

Chronic hypertension

39
Q

Perioral numbness, metallic taste, and tinnitus are CNS hyperactivity signs of what condition/complication?

A

Local anesthetic systemic toxicity

40
Q

What is a normal LP opening pressure?

A

< 20 cc H2O (< 200 mm H20)

41
Q

What is the most common cause of lobar (e.g. parietal, occipital) hemorrhages?

A

Cerebral amyloid angiopathy

42
Q

What is BPPV?

A

BPPV = Benign paroxysmal positional vertigo. This condition is characterized by brief (< 1min) episodic vertigo that is triggered by changes in head position.

43
Q

What is the most common cause of BPPV?

A

Crystalline debris (canaliths) within the semicircular canals

44
Q

What are three cholinesterase inhibitors used in the management of Alzhiemer’s disease?

A
  • Donepezil
  • Rivastigmine
  • Galamantie
45
Q

A patient presenting with gait disturbances, urinary incontinence, and cognitive impairment, most likely has what diagnosis?

A

Normal Pressure Hydrocephalus (NPH)

  • Weird/Wacky (cognitive impairment)
  • Wet (incontinence)
  • Wobbly (gait)
46
Q

What are some of the immediate and definitive treatments for Normal Pressure Hydrocephalus?

A
  • Immediate: LP

- Definitive: VP shunt

47
Q

A patient presenting with rapidly progressive dementia, myoclonus, and sharp triphasic, synchronous discharges on EEG raises concern for what diagnosis?

A

Prion disease (e.g. Creutzfeldt-Jakob)

48
Q

What is the most common type of pediatric brain tumor?

A

Low-grade astrocytoma

49
Q

Where is the most common site of a pediatric ependymoma?

A

4th ventricle

MS3 - Neurology (1 decks)

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