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neuro 2 Flashcards

1
Q

does essential tremor and tremor of PD have opposite presentations?

A

yes - PD is resting, whereas essential is worse with activity

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2
Q

this reflex is concerning for brainstem compression

A

cushing reflex - hypertension, bradycardia, respiratory depression

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3
Q

*** sensory ataxia, lancinating pains, urinary incontinance, argyll robertson pupils

A

tabes dorsalis of syphilis - give penicillin for tx

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4
Q

fluctuating cognitive impairment, recurrent visual hallucinations, parkinsonism

A

dementia with lewy bodies

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5
Q

*** decreased sensation over 4th and 5th fingers, prolonged leaning on elbows

A

ulnar nerve entrapment at epicondylar groove of the elbow

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6
Q

fasiculations

A

LMN damage

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7
Q

spasticity, bulbar symptoms, exaggerated DTR

A

UMN damage

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8
Q

ALS is a mix of both _____

A

LMN and UMN damage

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9
Q

*** which patients with vertigo should have non contrast CT of head

A

prominent stroke risk factors
new onset HA
neurologic signs/symptoms

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10
Q

eosinophillic intracytoplasmic inclusions

A

Lewy bodies

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11
Q

key differentiation between LBD and PD

A

LBD = early appearance of cognitive fluctuations and dementia; comes LATE with PD

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12
Q

tx of pseudotumor cerebri

A

acetazolamide

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13
Q

tx of trigeminal neuralgia

A

carbamazepine

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14
Q

tx of temporal arteritis

A

glucocorticoids

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15
Q

*** What is the single most POWERFUL risk factor for stroke

A

hypertension

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16
Q

erythema migrans, HA, arthralgias, myalgias

A

burgedorfi, lymes

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17
Q

periodic sharp wave complexes on EEG, 14-3-3 CSF assay, caudate nucleus and putamen, spongiform changes on path, rapid deterioration with dementia and muscle movement

A

CJD

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18
Q

*** old homes, microcytic anemia with basophilic stippling, calcium disodium EDTA

A

chronic lead toxicity

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19
Q

*** what is major cause of death in first 24 hours of SAH presentation?

A

REBLEED

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20
Q

Day 3-10 after SAH, what’s patient at risk for?

A

Vasospasm

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21
Q

*** role of nimodipine in SAH

A

prevent vasospasm

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22
Q

*** bilateral motor function loss, diminished pain and temperature sensation, preserved proprioception, vibratory sensation, light touch

A

anterior cord syndrome - damage to anterior spinary arter

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23
Q

*** painless, rapid, transient monocular vision loss “curtain coming down over visual field”

A

amaurosis fugax - atherosclerotic emoboli from carotid artery

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24
Q

first thing to do with someone who has amaurosis fugax episodes

A

duplex US of the neck

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25
Q

unilateral HA, jaw claudication, fever, fatigue, monocular vision loss

A

think giant cell arteritis - check ESR

26
Q

*** stroke with sudden-onset contralateral sensory loss involving all sensory modalities

A

thalamic stroke

27
Q

stroke in this area is called a “pure sensory stroke”

A

thalamus

28
Q

after a thalamic stroke, can patients develop a burning pain over the affect area, exacerbated by light touch?

A

yes - thalamic pain syndrome

29
Q

stroke with contralateral pure motor or combined sensorimotor deficits

A

internal capsule

30
Q

stroke with ipsilateral oculomotor nerve palsy, ataxia, contralateral hemiparesis

A

midbrain

31
Q

is the internal capsule often involved in stroke to putamen?

A

yes - contralateral hemiparesis, sensory loss, conjugate gaze palsy toward side of the lesion

32
Q

this medication inhibits choroid plexus carbonic anhydrase and is mainstay of pseudotumor cerebri treatment

A

acetazolamide

33
Q

*** lateral medullary infarction, intracranial vertebral artery, sx of nystagmus, vertigo, difficulty sitting upright, loss of pain and temp sensation of ipsilateral face and contralateral trunk, ipsilateral bulbar, dysphagia, hoarseness, diminished gag reflex

A

Wallenberg syndrome

34
Q

lateral mid-pontine lesions

A

motor and sensory fibers of trigeminal nerve

35
Q

Which nerves are typically involved in lateral medullary infarction and lateral mid-pontine lesions

A

lateral medullary = 9 and 10 (dysphagia, hoarseness, diminished gag)
lateral mid-pontine - 5 (weak mastication, diminished jaw jerk reflex, impaired face sensation)

36
Q

contralateral paralysis of the arm and leg and tongue deviation toward the lesion

A

medial medullary syndrome

37
Q

contralateral ataxia and hemiparesis fo the face, trunk and limbs

A

medial mid-pontine infarction

38
Q

*** cortical laminar necrosis

A

hallmark of prolonged seizures, results in persistent deficits and recurrent seizures

39
Q

*** periorbital edema, unable to move the eye, HA, vomiting

A

cavernous sinus thrombosis

40
Q

hemineglect syndrome

A

non-dominant parietal lobe

41
Q

left temporal lobe involvement

A

receptive aphasia

42
Q

frontal cortex lesion

A

hemiparesis

43
Q

occipital lobe damage

A

visual disturbance

44
Q

urinary incontinence/urgency, broad-based shuffling gait, memory/cognitive deficits, decreased CSF absorption by arachnoid granulations

A

normal pressure hydrocephalus - ultimately need VP shunt for tx

45
Q

accumulation of alpha-synuclein within dopaminergic neurons

A

PD

46
Q

charcot-bouchard aneurysm, lenticulostriate arteries, deep intracerebral hemorrhgae (basal ganglia/putamen, cerebllar nucle, thalamus, pons)

A

hypertensive vasculopathy

47
Q

nipple dermatome

A

T4

48
Q

*** corneal sensation

A

CN 5

49
Q

*** CN for swallowing, palate elevation, phonation

A

CN X

50
Q

*** CN that carries visual information and mediates the afferent limb of the pupillary light reflex

A

CN II

51
Q

*** CN for eyelid opening, pupillary constriction, eye movement

A

CN III

52
Q

crohn disease/ileal resection/gastritis, chronic malabsorption, macrocytic anemia, smear with macro-ovalocytes + hypersegmented neutrophils, methylmalonic acid, build-up of homocysteine

A

B12 deficiency

53
Q

suspect this kind of stroke if pt presents initially with focal symptoms which then progress to signs of elevated ICP (vomiting, HA, bradycardia, decreased alertness)

A

hemorrhagic stroke

54
Q

pt with solitary brain metastases and in good function health with stable extracranial disease. tx option?

A

surgical resection - if more than one, whole-brain radiation

55
Q

gait instability, truncal ataxia, difficulty with rapid movements, hypotonia, intention tremor

A

cerebellar dysfunction - common in alcoholics

56
Q

atrophy of frontal lobes

A

frontotemporal dementia

57
Q

atrophy of TEMPORAL lobes

A

alzheimer disease

58
Q

broad flat T waves, U waves, ST depression, PVR, a fib, torsades de pointes, v fib

A

cardiac abnormalities 2/2 hypokalemia <2.5

59
Q

muscle wekaness, fatigue, cramps and cardiac abnormalities

A

think electrolyte abnormalities - potassium!

60
Q

weakness, difficulty chewing, swallowing, coughing, breathing, hyperreflexia, spasticity, fasiculations

A

ALS

IM (17 decks)

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