Neuro Flashcards by Meg Dolohanty

a radiculopathy involving lumbar nerves 2-4 causes what?

creased hip flexion and knee extension

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a non-dermatomal neuropathy that often follows soft tissue injuries or fractures. Presents with limb pain, swelling, reduced ROM, skin changes.

Complex regional pain syndrome

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Tx for complex regional pain syndrome

gabapentin, TCAs, bisphosphnates, steroids

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what may an x-ray show with complex regional pain syndrome

patchy demineralization

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causes of slow onset peripheral neuropathy

DM, uremia, B12 deficiency, HIV

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Hereditary peripheral neuropathy. Early distal muscles weakness/ difficultly running. Loss of reflexes, “stork leg deformity” and hammer toe. WIll have sensory loss. Sleep apnea common

Hereditary Charcot-Marie Tooth

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sponaneous, continuous leg movement at rest. Associated with unpleasent paresthesiasas. Associated with iron def anemia, end stage renal dz, MS, DM

Restless leg syndrome

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Tx for RLS

dopaine agonist (pramipexole, ropinirole)

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what is ramsay hunt syndrome?

zoster + bell’s palsy

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Tx for bell’s palsy

oral steroids, antivirals in severe cases. need artifical tears/ eye ointments at night

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what is the most common cranial neuropathy associated with lyme meningitits

facial nerve plasy (CN VII)

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Pnuemonic for warfarin indications

CHADs(2) CHF, HTN, >75, DM Stroke (2 point), if any are greater than 2= warfarin therapy

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Pneumonic for posterior circulation stroke (VANISH’D)

Vertigo, ataxia, nystamus, intention tremor, slurred speech, hell-shin test, dysdiadochkinesia, broad based gait

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location of brain tumor that presents with kip smakcing, olfactory or gustatotry hallucinations

temporal lobe

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lobe with sensory seizures or sensory loss

parietal lobe

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shape of epidural bleed on CT

biconvex lens shaped appearance

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shape of subdural bleed on CT

crescent-shapped

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tx for subdural hematoma

burr holes or craniotomy

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hallmark of sturge weber syndrome

port wine stain

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type of simple partial motor seizure where there are small jerking movements at the hand or face then spread to other motor areas.

Jacksonian seizure

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first line drug for partial seizures

carbamazepine

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first line drug for absence seizures

ethosuximide

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antiepileptic taht is teratogenic, can result in gum hypertophy.

phenytoin

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antiepileptic that is highly teratogenic and will reduce efficacy of OCPs

sodium valproate

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how do most antiepileptic drugs work?

inhibit sodium channels

tx for status epilepticus

lorazepam IV, IV phenytoin to follow .I f refractory then phenobarbital

hyperkinetic moement disorder that occurs w/ delayed onset after prolonged use of antipsychotic drugs, and meotclopramide

tardive dyskinesia

Tx for guillain-Barre

plasma exhcange, IVIG

LP findings with guillain-barre

elevated CSF protein with normal CSF WBC

Most common infection that proceededs guillain barre

campylobacter jejuni (also CMV, epstein-Barr, HIV)

Signs of autonomic dysfunction with guillain barre

tachycardia, urinary retnteion, loss of sweating, ileus

Tx for myasthenia gravis

pyridostigmine, immunosupressants, thymectomy, acute plasmapharesis and IVIG (short duration)

4 meds that can cause guillain barre

aminoglycoside abx, mag sulfate, penicillamine, interferson alpha

tx for bacterial meningitits

dexamethasone, ceftriaxone, vanco, amipcillin

number of cause of asepctic meningitits

enterovirus

flexion of the hips during attempted passive flexion of the neck

Brudzinskis sign

inability to allow full extension of the knee when hip is flexed at ninety degrees

Kernig's sign

negri bodies are associated with with?

rabies

dementia with fluctuating cognition, recurrent visual hallucinations, and spontaneous motor features of parkinsonism

dementia w/ lewy bodies

dementia with fluctuating cognition, recurrent visual hallucinations, and spontaneous motor features of parkinsonism

dementia w/ lewy bodies

CN palsy that presents with medial turning of affected eye

CN VI (abducens

CN palsy that presents with vertical diploplia

CN IV (trochlear)

Radiating electrical sensation down the spine with neck flexion seen in patients with MS

Lhermitte's phenomenon

Dx test for myasthenia gravis

Edrophonium (Tensilon) test

CSF findings w/ myasthenia gravis

albuminocytologic dissociation

Tx for huntington's chorea

tetrabenazine

reflexive, sustained eye blinking in response to repetitive taping just above the nasal bridge between the eyes. Observed in individuals with parkinsons

Myerson sign

nerve that supplies the 4th and 5th digits

ulnar nerve

injuries to this area cause pain and weakness of the shoulder and sensory problems of the lateral arm

bracial plexus

nerve that supplies the dorsal hand

radial

DOC in trigeminal neuralgia

carbamazepina/ oxcarbazepine

presents with foot drop and lateral paresthesais. Often due to compress of the nerve at the head and neck of the fibula

peroneal nere contusion

presents with pain or paresthesia of the outer aspect of teh thigh

meralgia paresthetica

presents with weakness and wasting of the quadriceps muscles

femoral neuropathy

what will an absence seizures show on EEG

spike and wave activity

what will an absence seizures show on EEG

spike and wave activity

are anticholinergics helpful with bradykinesia in parkinson

No, only helpful with tremor and rigidity

condition with cavitary destruction within the spinal cord resulting in both motor and sensory deficits

syringomyelia

what PE finding supports a diagnosis of mesencephalic lesion

downward conjugate deviation

a lateral conjugate deviation supports a lesion where?

pontine lesion

a lack of doll's eye response indicates a lesion where?

brainstem

long-standing prion disease. manifests with parkinsonian features, dementia, jerking movements

creutzfeldt-jakob syndrome

an occlusion in what artery often results in homonymous hemianopia

middle cerebral artery

what is alexia?

inability to understand written words

alexia is seen in what type of occlusion?

posterior cerebral artery

most common organism isolated in dog or cat bites

pasturella

dopamine agonist that is initial treatment of choice for prolactinoma

cabergoline

what does sciatic nerve impingement cause?

loss of ankle deep tendon reflex, weakness of hamstring muscles, decreased sensation over the lateral calf and heel

what does sciatic nerve impingement cause?

loss of ankle deep tendon reflex, weakness of hamstring muscles, decreased sensation over the lateral calf and heel

weakness of the gastrocnemius muscle (plantar flexion) Is specific for what radiculopathy?

antidote for atropine poisoning

physostigmine

which CN moves eye down and medial

trochlear (IV)

which CN does lateral eye movement

abducens (VI)

constant, generalized HA with possible visual loss. Will have elevated CSF opening pressure.

pseudotumor cerebri (idiopathic intracrnail HTN)

type of partial seizure that often has an aura

complex partial seizure

Tremor that improves with alcohol

essential tremor

what can make an essential tremor worse

stress, lack of sleep, caffeine

tx for essential tremor

beta blockers, primidone

4 cardinal signs of parkinsons

rigidity, bradykinesia, restin tremor postural instability

2 treatments for MS

steroids, interferon-B

impaired attention and cognition, motor hyper or hypoactivity, altered states of arousal

delirium

impaired attention and cognition, motor hyper or hypoactivity, altered states of arousal

delirium

most common cause of bacterial meningitits in adults

strep pneumoniae

if mengitits is caused by listeria (common in immunocomprpomised people) what must be added?

ampicillin

Upper and lower motor neuron dysfuction. Loss of speech, progressive weakness

ALS

what growth can be present in patients with myastehnia gravis?

Thymoma

presents with dry mouth, diploplia, dysphagia, dyarthria, descending weakness

botulism

most common neuroectodermal tumor

astrocytoma

agressive anaplastic type of astrocytoma, enhancing irregular mass, poor prognosis

glioblastoma multiforme

Most common mesodermal trumor, usually benign and slow growing. can cause HA, seizure, focal signs

meningiomas

most common CN tumor

schwannomas

most common brian tumor overall

metastatic tumors

How do MAO-B inhibitors help with parkinsons

inhibit catabolism of dopamine

examples of MAO-B inhibitors

rasagiline, selegiline

examples of MAO-B inhibitors

rasagiline, selegiline

condition associated with AVM

osler-weber-rendu

encephalitits with falccid paralysis + maculopapular rash is due to what?

west nile virus