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Step 2 CK > Neuro > Flashcards

Neuro Flashcards

1
Q

gait with circumduction of one extended leg and flexed elbow and hand

A

hemiplegic gait

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2
Q

gait with wide spaced legs and falling to left

What gait? Where is the lesion?

A

cerebellar gait

lesion on the left (where they are falling)

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3
Q

abduction of legs during gait with tiptoes

A

diplegic - cerebral palsy gait

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4
Q

gait where someone waddles side to side

A

myopathic gait.

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5
Q

gait with high steps due to foot drop

A

neuropathic gait

steppage gait

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6
Q

pronator drift test tests

A

upper motor neuron disease affecting this limb

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7
Q

2 time cutoffs for tPA

A

3 hours IV

6 hours intraarterial

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8
Q

gait w/parkinson’s

A

hypokinetic

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9
Q

muscular dystrophy gait

A

waddling (weak gluteals)

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10
Q

vestibular ataxia gait (describe)

A

minimal head movement staggering w/nystagmus, vertigo

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11
Q

eye differences in thalamus vs pons hemorrhage

pupils and gaze (pons, pupils only)

A

Thalamus, nonreactive meiotic, gaze Towards hemiparesis

Pons, Pinpoint reactive pupils

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12
Q

lobe affected for receptive aphasia

A

L. temporal lobe

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13
Q

lobe affected for L. hemineglect

A

R. parietal lobe

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14
Q

back and leg pain exacerbated by extension, alleviated by flexion

A

spinal stenosis

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15
Q

etiology of DM CN III palsy

A

ischemic

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16
Q

HIV patient w/periventricular ring

EBV virus in CSF

A

primary CNS lymphoma

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17
Q

1st sx of normal pressure hydrocephalus

A

gait disturbance

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18
Q

sequence of 2 complications from subarachnoid hemorrhage

A 
rebleeding = less than 24 hours
vasospasm = days 3-10
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19
Q

15 yo with ataxia, skeletal deformities and cardiomyopathy

A

Friedrich ataxia

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20
Q

MMSE score indicative of dementia

A

less than 24

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21
Q

pt w/central scotoma, afferent pupillary defect, chenges in color perception and acuity, and swollen disc

A

optic neuritis (common in MS)

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22
Q

athetosis

A

slow writhing movement of hands/feet

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23
Q

amantadine MOA and use

A

dopamine agonist

parkinson’s

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24
Q

1st line class in Alzheimers

A

cholinesterase inhibitors

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25
Q

man w/parkinsonism w/orthostasis, or other autonomic signs

A

multi system atrophy (shy-drager syndrome)

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26
Q

1st line drugs in Parkinon’s

class is OK

A

benztropine or trihexyphenidyl

anticholinergics

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27
Q

best initial tx for severe Parkison’s (class is OK)

A

pramipexole and ropinerole

dopamine agonists

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28
Q

adjuvant to stop on/off phenomena of carbidopa/levodopa

A

COMT inhibitors

tolcapone, entacapone

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29
Q

Only drugs to reduce progression of Parkinon’s

A

MAO inhibitors

rasagiline, selegiline

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30
Q

cause of curtain falling down on visual field (amaurosis fougoux)

A

emboli (atherosclerosis)

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31
Q

1st sx in Frontotemporal dementia

A

Personality goes first in Pick Dz (PP)

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32
Q

pathogenesis of vascular dementia

A

suddenly declines due to CVA

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33
Q

test to differentiate coma vs PVD (persistent vegetative state)

A

EEG - normal in coma

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34
Q

brainstem reflex tests (3)

A
  • corneal reflex
  • cold water test
  • doll’s eyes
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35
Q

tumor in a kid with “sun setting sign” (downward gaze)

A

pinealoma

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36
Q

gene defect in marfan’s

A

fibrillin-1

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37
Q

part of the brain atrophied with Wilson’s dz

A

lenticular nucleus

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38
Q

sudden loss of vision, pale retina, dark macula

A

retinal artery occlusion

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39
Q

tx of retinal artery occlusion (3)

A

oxygen
acetazolamide
thrombolytic

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40
Q

loss of vision, with extravasation blood into fundus

A

retinal vein occlusion

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41
Q

mutated proteins in NF1 vs NF2

A 
NF1 = neurofibromin
NF2 = merlin
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42
Q

which one is serious? preseptal cellulitis vs orbital cellulitis

A

orbital cellulitis - and much more likely to have opthalmaplegia

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43
Q

4 midline cranial nerves

A

3,4,6,12

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44
Q

facial droop means ? artery and syndrome

A

AICA’s pooped

lateral pontine syndrome

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45
Q

hypoglossal dysfunction

artery and syndrome

A

ASA

medial medullary syndrome

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46
Q

hoarseness

artery and syndrome

A

PICA

lateral medullary syndrome (Wallenburg)

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47
Q

pronator drift tests for…

A

upper motor neuron lesion

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48
Q

neck hyperextension
weakness of upper extremities
syndrome?

A

central cord syndrome

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49
Q

hallmark sx (2 each) of dominant MCA (left) vs nondominant MCA (right) stroke?

A 
left = aphasia
right = hemineglect or anosognosia
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50
Q

anosognosia

A

lack of awareness of illness

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51
Q

dopamine affects sx of mesolimbic pathway (1) vs tuberoinfundibular pathway (1)

A

mesolimbic: psychosis

tuberoinfundibular = prolactin

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52
Q

eye disorder with distortion of wavy lines

A

macular degeneration

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53
Q

timeline when dyskinesias show up after initiating carbidopa-levidopa therapy

A

after 5 years

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54
Q

lambdoidal suture

A

unites parietal bones with occipital bone

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55
Q

squamosal suture

A

unites squamoid portion of temporal bone with parietal bone

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56
Q

2 types of therapy for essential tremor

1 category, 1 specific drug

A

beta blockers

primidone (anti-seizure)

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57
Q

parkinson drug that alleviates levidopa dyskinesias

A

amantadine

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58
Q

2 antiemetics that can cause drug-induced PD

A

metoclopromide

prochlorperazine (compazine)

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59
Q

T1 vs T2 images

A

WW2

water white on T2 (fat white T1)

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60
Q

4 drugs for tardive dyskinesia

A

tetrabenazine
benzoes
baclofen
vitamin E

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61
Q

wormlike movement of facial muscles, sensed by pt, but difficult for examiner to see

A

facial myokymia

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62
Q

bad MLF side of internuclear ophthalmoplegia exam

A

side that cannot adduct is the side of lesion (eye that is in nystagmus is good).

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63
Q

time cutoff for status epilepticus

A

5 mins

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64
Q

Frequency of awake eeg on posterior with eyes closed

A

Alpha, 8-13 hz

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65
Q

Eeg waveform absence seizure

A

3 hz spike and wave.

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66
Q

absence seizure provoked by

A

hyperventilation

67
Q

toxicity of valproic acid (depakote) (3)

A

tremor
weight gain
hair loss

fat, bald, shaky

68
Q

duration of tx in status epilepticus

A

forever

69
Q

lifetime prevalence seizure

A

10%

70
Q

problem with loading phenytoin

A

arrythmia - needs to be done in ICU (prefer fosphenytoin)

71
Q

best loading drug

A

Keppra (leviteracetam)

72
Q

administering lamotrigine

A

do slowly (over weeks)

73
Q

how long after seizure should someone not drive

A

3 mos (in mn, md can recommend earlier if source, etc)

74
Q

depakote

A

valproic acid

75
Q

when does neural tube close?

A

2 weeks

76
Q

lamotrigine with birth control

A

makes birth control less effective

77
Q

dilantin

A

phenytoin

78
Q

3 nonmedicine options for seizure

A

vagus nerve stimulator
surgery
ketogenic diet

79
Q

status epilepticus that doesn’t resolve with one loading dose of lorazepam

A

phenobarb- induce coma

80
Q

BP cutoff for tPA

A

greater than 185

81
Q

risk of bleeding with tPA if ischemic stroke

A

4%

82
Q

percent of ischemic stroke patients that get better on own

A

25%

83
Q

percent of ischemic stroke patients improved by tPA

A

10%

84
Q

2 side effects of tPA

A

bleeding

angioedema

85
Q

weber test. louder in one ear which means (2)

A

sensorineural (louder in unaffected ear)

conductive (louder in affected ear - consider sticking cotton in ear canal - your voice is louder)

86
Q

exerciser w/ptosis, miosis

A

partial horner syndrome (no anhidrosis)

carotid artery dissection (CN III - levator palpabrae lesion)

87
Q

location of area of brain that is responsible for noncommunicating hydrocephalus

A

aqueduct of sylvius (between 3rd and 4th ventricles)

88
Q

dysdiadochokinesia

A

inability to do rapid alternating movements

89
Q

meningiomas, bilateral acoustic neuromas. Include chromosome #.

A

NF2, chromosome 22

90
Q

NF with skin lesions, include chromosome #

A

NF1, chromosome 17

91
Q

location of corticospinal tracts

A

pyramidal - posterior lateral

92
Q

primary vs secondary progressive MS

A

primary gets worse from the beginning

secondary starts as relapsing, remitting, and then gets worse

93
Q

sensory stroke location

A

thalamus

94
Q

weakness strokes location

A

internal capsule (lacunar)

95
Q

titubation

A

nodding of head or body

96
Q

med to retard ALS

A

riluzole

97
Q

primary lateral sclerosis

A

disease of the corticospinal tracts (without wasting and fasciculations). Goes on to be ALS….

98
Q

Cerebral finding in Sturge-Weber Syndrome

A

leptomeningeal angiomas (meningeal angiomas)

99
Q

nucleus of larynx, IX, X

A

nucleus ambiguus

100
Q

location nucleus ambiguus

A

ventrolateral medulla

101
Q

side effect of the dopamine agonists (besides hallucinations)

A

gambling/hypersexuality

102
Q

entacapone MOA

A

COMT inhibitor

103
Q 
parkinsonism
-unawareness/control of body
abnormal tau proteins
-alien hand syndrome
-cortical myoclonus
A

corticobasal degeneration

104
Q 
parkinsonism
-gait probs
abnormal tau proteins
-upward eye paralysis overcome by head movements
backwoods falls
A

progressive supranuclear palsy

105
Q

parkinsonism

-autonomic dysregulation. passing out, etc. orthostatic hypoT, urinary probs. Not as good a response to meds.

A

multisystem atrophy

106
Q

4 hallmarks of PD

A

TRAP

Tremor
Rigidity
Akinesia bradykinesia
Postural instability

107
Q

2 meds for essential tremor

A

propranolol

primidone

108
Q

med for chorea

A

tetrabenazine

blocks dopa release

109
Q

after infection

chorea

A

sydenham’s chorea

post-strep

110
Q

hereditary ataxia

looks intoxicated. Father or mother has it.

A

cerebellar ataxia

111
Q

supplementation for RLS (or nighttime urges) (2)

A

iron, gabapentin

usually better than dopa agonists

112
Q

etiology of narcolepsy

A

orexin deficiency from lateral hypothalamus

113
Q

3 early signs of parkinson dz

A

REM sleep behavior disorder
anosmia
constipation

114
Q

2 causes optic neuritis

A 
MS
neuromyelitis optic (Devic dz)
115
Q

side effects amiodarone and ethambutol

A

optic neuropathy

116
Q

2 weeks after viral illness or vaccination
MS-like presentation, maybe behavioral changes
no oligoclonal bands.

A

acute disseminated encephalomyelitis (ADEM)

117
Q

epilepsia partialis continua

A

status focal motor seizure

118
Q

2nd line tx absence seizure

A

valproic acid

119
Q

basilar migraine

A

severe!

neuro deficits

120
Q

Wernicke’s with an intact repetition

A

transcortical sensory aphasia

```
sensory = wernike’s w/intact repetition
(motor = broca’s w/intact repetition)
~~~

121
Q

fast phenytoin infusion causes

A

arrythmia

122
Q

timing of ETOH w/d seizure

A

1-2 days (DT’s are 2-4 days)

123
Q

kid with multiple seizure types
mental dysfunction
1-2 hz spike on EEG

A

Lennox-Gastaut Syndrome

124
Q

Lateral optic radiation responsible for which field of vision?

A

upper

125
Q

jacksonian march

A

spread of seizure along homonculus

126
Q

aneurysm
3rd nerve palsy
localization?

A

Posterior communicating artery

127
Q

Triptans contraindicated in this type of migraine

A

w/aura

128
Q

localization of tonic gaze deviation

lobe

A

contralateral frontal lobe

129
Q

aphasia with real but meaningless words. no comprehension. intact repetitions

A

transcortical sensory aphasia
(sensory = wernike’s w/intact repetition)
(motor = broca’s w/intact repetition)

130
Q

rim-enhancing lesions in AIDS patient (2)

A

primary lymphoma

toxoplasma

131
Q

CSF test for primary lymphoma in brain

A

EBV PCR

132
Q

infant w/constipation
ptosis/CN findings
descending weakness/hypotonia/hyporeflexia

A

botulism

133
Q

most common source of brain abscess in AIDS

A

toxoplasma

134
Q

encephalitis in immunocompromised
white matter lesions
inclusion bodies in oligodendrocytes

A

PML

135
Q

complication of normal pressure hydrocephalus shunting operation

A

subdural hematoma

136
Q

language abnormality w/Alzheimer’s

A

transcortical sensory aphasia

137
Q

spastic paresis, and hx of tropical travel

ALS-like

A

HTLV-1

spastic paresis

138
Q

alien hand syndrome in an AIDS pt

A

PML

139
Q

woman with blepharospasm
jaw openings, neck contractions, tongue thrusting

no med hx

A

meige syndrome

140
Q

natlizumab pt (MS) with new sx
multiple foci of white matter abnormalities,
particularly in posterior regions

A

PML

141
Q

type of dz of guillian barre

A

peripheral

142
Q

person w/hx of optic neuritis

transverse myelitis sx onset

A

NMO

143
Q

anti-NMO IgG is antibody against?

A

an aquaporin

144
Q

what is spored in spinal cord stroke

A

dorsal columns (sensation)

145
Q

eye devation in stroke vs seizure

A

L MCA stroke = L gaze

L seizure = R gaze

146
Q

innervation inferior oblique

A

3

147
Q

innervation superior oblique

A

4

148
Q

distinct finding of 3rd nerve palsy in DM

A

no mydriasis

149
Q

artery in cavernous sinus

A

ICA

150
Q

nerves in side of cavernous sinus (5)

specify what is next to ICA

A

3,4,V1,V2

6 is right next to ICA

151
Q

hemiparetic on one side
3rd nerve palsy on other side.
localization?

A

midbrain (ipsilateral to 3 palsy)

152
Q

Horner syndrome

A

ptosis
meiosis
anhydrosis

153
Q

relative afferent pupillary defect AKA

A

marcus gunn pupil

154
Q

bilateral CN palsies

2 common causes

A

sarcoid

lyme

155
Q

pupil accomodation on
3rd nerve palsy?
Holmes-Adie pupil?

A

3rd nerve palsy = absent

Holmes-Adie pupil = present

156
Q

localization of bad ear in BPPV

A

fast beat is away from bad ear.

on dix-hallpike, bad ear is down causing nystagmus

157
Q

75 year old
cranial nerve palsies
segmental demyelination of nerves

A

CIDP

chronic inflammatory demyelinating polyneuropathy

158
Q

location where dorsal columns decuss

A

medulla

159
Q

anti-epileptic drug assoc w/weight loss

A

topiramate

160
Q

inferior and superior MCA branches associated with what aphasias?

A 
superior = wernicke
inferior = broca
161
Q

etiology of parkinsonism in person with severe liver dz

A

manganese toxicity

lack of biliary excretion

162
Q

part of MOA that makes topiramate effective in pseudotumor cerebri

A

carbonic anhydrase activity

163
Q

1 yo, retardation, motor delay, infantile spasm, dysmorphic features

A

miller-dieker lissencephaly

Step 2 CK (12 decks)

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