Neuro Flashcards
What is the dominant sx of Alzheimer’s?
Anterograde amnesia
Most common cause of dementia in adults?
Alzheimer’s
What shows cortical atrophy with neurofibrillary tangles and senile plaques on biopsy?
Alzheimer’s
Loss of recent memory, word finding problems, mood swings, personality changes, issues with drawing and driving see what stage of Alzheimer’s?
Early
Inability to recall information, diminished memory of remote events, behavioral changes, loss of sense of time and place, help with getting dressed and feeling are signs of what stage of Alzheimer’s?
Intermediate
When can definitive dx of Alzheimer’s be done?
Autopsy
What is a medication to treat Alzheimer’s?
Acetylcholinesterase inhibitors Donepezil
Avoid what typed of Meds in Alzheimer’s?
Anti cholinergic , haldol, OTC cold Meds
What is the hallmark sign of cerebral palsy?
Delay in normal milestones
What causes. Cerebral palsy?
Some hypoxic event during fetal growth, treat with therapy
What is Bell’s palsy?
Facial paresis of lower motor neuron of 7 th cranial nerve.
What is a progressive, ascending, symmetric weakness with variable paresthesias?
Giullian-barre syndrome
What is Gillian barre associated with?
Viral, flu vaccine, stress, campylobacter jejuni
What does the EMG show with Gillian barre?
Demyelination
What is the treatment for Gillian barre?
IV immunoglobin, plasma exchange, DO NOT GIVE STEROIDS
What is an autoimmune disease that blocks acetyalcholine receptors?
Myasthenia gravis
What are the common sx of myasthenia gravis?
Diplopia, dysphagia, facial weakness, difficulty swallowing, early stage affects the eye muscles, activity increases weakness.
How to dx myasthenia gravis?
Test for acetylcholine recptor antibodies, or improvement with the Tensilon test. Treat with corticosteroids.
This is a severe unilateral headache with facial issues.
Cluster headache. Common with injection, lacrimination, rhinorrhea, miosis, ele edema. Treat with oxygen or ergotamine.
This is a headache which is unilateral, severe, aggravated by activity, 4-72 hrs and associated with photophobia and nausea and vomiting.
Migraine
when do you give prophylactic treatment for a migraine and what are the options?
If it limits normal activity greater than 3 days a month, severe or has complications. Give propranolol or amitriptyline.
This had a band like pain, bilateral pain, photophobia, nausea, no vomiting, and activity does not change the sx.
Tension headache. Most common caused by stress.
How to treat tension headaches.
Acetaminophen, NSAIDs, amitriptyline
What is an idiopathic increase in intracranial pressure causing headache, visual disturbance and CN 6 palsy?
Pesudotumor cerebri
What is encephalitis and the number one cause?
Infection of brain parenchyma….. Herpes. Other causes are enters iris, EBV, CMV, etc.
Patient t presents to clinic with complaint of fever, stiff neck, nausea, confusion, exaggerated DTR, spastic paralysis ( upper motor neuro n sx). What is the dx?
Encephalitis
He do you treat encephalitis?
Supportive, acyclovir or gancyclovir if needed. NO steroids.
A patient presents to clinic with complaint of headache, nucal rigidity, fever, confusion, seizures, brudzinski or kernig sign. Dx?
Meningitis
CSF with mostly polymorphic neutrophils?
Bacterial meningitis
CSF with high lymphocytes?
Viral meningitis
Bacteria common in meningitis in neonates?
Gram neg bacilli, strep, listeria
Bacteria common in meningitis in kinds up to 15?
H. Flu, n. Meningitidis, s. Pheumonae
Bacteria causes meningitis in adults?
S. Pneumonaie, n. Meningitidis, listeria in over 60
Meningitis empiric treatment for neonates!
Ampicillin + cefotaxime
Meningitis empiric tx for kids/adults?
Cefotaxime + vancomycin
Meningitis emperor tx for elderly?
Cefotaxime + amp + vanc
A patient complains of a sudden headache, severe, altered mental status , vomiting. What do you suspect?
Ruptured cerebral aneurysm.
How do you treat a cerebral aneurysm?
Nimodipine, surgery
How long are the deficits of a CVA?
Over 24 hrs
If deficit is less than 24 hrs?
TIA
Most common site for CVA and sx?
Middle cerebral artery: contra lateral hemiplegia, sensory loss, aphasia
CVA do the internal carotid causes?
Ipsilateral blindness
CVA of the anterior cerebral artery causes?
Upper motor neuron weakness, urinary incontinence,
CVA of the vertebral artery causes?
Vertigo, nausea vomiting, nystagmus
CVA of the basilar artery causes?
Bilateral sensory, paralysis, impaired vision, cranial nerve dysfunction
Where does the lacunar disease stem from and what is a common causes?
Circle of Willis, HTN
Test of choice for suspected CVA?
Non contrast CT
What is an essential tremor?
Involves hand or head, tremor without the rigidity of Parkinson’s. Alcohol improves tremor, treat with propranolol.
What are the manifestations of Huntington’s chorea?
Flicking movement of extremities, lilting gait, facial grimace, ataxia,
What is the dx and treatment. For Huntington’s chorea?
Dx by genetic testing, supportive care only. May give haldol early.
What causes Parkinson’s disease?
Dopamine depletion in the basal ganglia.
Patient has pill rolling tremor, mask like fancies, cog wheel extremities, shuffling gait. Think?
Parkinson’s
Most common treatment for Parkinson’s?
Levodopa or bromocriptine
This neuro disease presents with upper motor neuron sx and lower motor neuron sx. Describe these sx and what disease is it?
ALS or Lou gherigs dz. upper motor neuro.
N sx are spasticity, hyper reflexes, babinski up, and lower motor neuron are muscle atrophy, progressive weakness.
What is the presenting sx of ALS?
Weakness and atrophy in the hands
This is a slow likely autoimmune progressive CNS disease with patches of demyelination in the brain and spinal cord.
Multiple sclerosis
Symptoms of MS?
Blurred vision, sensory abnormalities, weakness. Heat may worsen sx ( hot shower).
What does the MRI of MS show?
Abnormal white matter in brain stem, cerebellum and spinal cord
What is the treatment for MS?
No cure. Corticosteroids is the treatment with possible IV gamma globulins
This seizure is from a single locus in the brain, consciousness is preserved, and had focal motor sx.
Simple partial seizure
This seizure may have. Impaired consciousness, chewing movements or lip smacking.
Complex partial seizure.
This seizure has imparted consciousness with mild components in kids staring is common.
Absence
Seizure with no loss of consciousness but single or multiple myoclonus jerks.
Myoclonic
Sudden loss of consciousness and rigid fall to the ground is classic for this seizure.
Tonic-colonic
Most important test for seizures?
EEG.
This head injury is a transient loss of consciousness followed by complete resolution in 7-10 days.
Concussion
Key to dx a simple concussion?
No focal neurological findings on exam
This is cause d by a rupture of the middle meningeal artery from a skull fracture. CT reveals a lens shaped hematoma.
Epidural hematoma
This is an accumulation of blood in the brain for venous bleeding. CT shows a crescent shaped hematoma
Subdural hematoma
Which hematoma has a brief period of unconsciousness the resolve, the returns again?
Epidural hematoma
What hematoma can cause spinal fluid rhinorrhea?
Epidural
This is the worst headache of life, stiff neck and delirium?
Subarachnoid hemorrhage.
What is the most common brain neoplasm in adults?
Glioblastoma