Neuro Flashcards
a radiculopathy involving lumbar nerves 2-4 causes what?
creased hip flexion and knee extension
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
Tx for complex regional pain syndrome
gabapentin, TCAs, bisphosphnates, steroids
what may an x-ray show with complex regional pain syndrome
patchy demineralization
causes of slow onset peripheral neuropathy
DM, uremia, B12 deficiency, HIV
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
sponaneous, continuous leg movement at rest. Associated with unpleasent paresthesiasas. Associated with iron def anemia, end stage renal dz, MS, DM
Restless leg syndrome
Tx for RLS
dopaine agonist (pramipexole, ropinirole)
what is ramsay hunt syndrome?
zoster + bell’s palsy
Tx for bell’s palsy
oral steroids, antivirals in severe cases. need artifical tears/ eye ointments at night
what is the most common cranial neuropathy associated with lyme meningitits
facial nerve plasy (CN VII)
Pnuemonic for warfarin indications
CHADs(2) CHF, HTN, >75, DM Stroke (2 point), if any are greater than 2= warfarin therapy
Pneumonic for posterior circulation stroke (VANISH’D)
Vertigo, ataxia, nystamus, intention tremor, slurred speech, hell-shin test, dysdiadochkinesia, broad based gait
location of brain tumor that presents with kip smakcing, olfactory or gustatotry hallucinations
temporal lobe
lobe with sensory seizures or sensory loss
parietal lobe
shape of epidural bleed on CT
biconvex lens shaped appearance
shape of subdural bleed on CT
crescent-shapped
tx for subdural hematoma
burr holes or craniotomy
hallmark of sturge weber syndrome
port wine stain
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
first line drug for partial seizures
carbamazepine
first line drug for absence seizures
ethosuximide
antiepileptic taht is teratogenic, can result in gum hypertophy.
phenytoin
antiepileptic that is highly teratogenic and will reduce efficacy of OCPs
sodium valproate
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?
S1
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
