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Neuro Flashcards

1
Q

absence

A

childhood onset and characterized by brief starring spells

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2
Q

myasthenia gravis

A

proximal weakness that extends peripheral with time

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3
Q

concussion

A

traumatic head injury with altered mental status with or without LOC

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4
Q

simple seizure

A

focal neuro deficits with preserved consciousness

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5
Q

complex seizure

A

confusion and bizarre behavior

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6
Q

locked in syndrome is associated with what brain injury

A

bilateral brainstem
Locked-in-syndrome is caused by destructive bilateral brainstem lesions, most commonly ischemic infarction of the ventral pons, leading to quadriplegia, loss of speech/swallow with retained cognition/consciousness. Often the supranuclear ocular motor pathways are spared and patients can still blink and move their eyes

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7
Q

tension

A

most common
band around head
frequent and bilateral
stress, situation, work, etc

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8
Q

migraine

A 
female predominance 
strong association with menstrual cycle
usually unilateral
can be associated with photophobia
classic- w/ aura (scotomas) (vision/smells)
common- w/out aura
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9
Q

cluster headaches

A

middle age men
intense pain around 1 eye
can get tearing (lacrimation, sweating, miosis, ptosis)
occur in clusters
smoking, alcohol, and nitroglycerine can precipitate
tx- O2

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10
Q

medication overuse headache

A

3rd most common HA
can happen w/ OTC meds
take meds everyday
tx stop meds

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11
Q

labrinthitis

A

after viral infection
similar to vestibular neuritis
vestibular neuritis no hearing loss
labrinthitis has hearing loss

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12
Q

1st line tx for HA

A 
dopamine antagonist (droperidol, prochlorperazine (compazine) ,metoclopramide)
also use triptans, nasaids, opioids
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13
Q

most common complication of a fib

A

cerebrovascular event

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14
Q

number 1 cause of disability

A

stroke

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15
Q

middle cerebral artery

A

face and arm

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16
Q

anterior cerebral artery

A

legs

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17
Q

posterior strokes

A

verterbral and basilar artery
brainstem and cerebellum
usually involve cranial nerves
one side of body and opposite side of body
5’ds (dizziness, diplopia, dysarthria (trouble speaking), dysphagia, ataxia)

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18
Q

tx for tia

A

antiplatelet angent (aspirin, and some plavix)
carotid endarectomy for stenosis >70% in 2 weeks
anticoagulation for a fib, or thrombus in LV

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19
Q

subarachnoid hemorrhage

A

most common cause- ruptured aneurysm
thunder clap headache/ worst headache of life
sudden onset w/ maximal pain at onset/different then past HA
syncope
xanthochromia or rbc on lp

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20
Q

workup and tx for subarachnoid hemorrhage

A 
CT scan. If negative then LP
tx- tx pain
decrease BP
seizure prophylaxis
reverse blood thinner
clip or put coil on aneurysm
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21
Q

bells palsy

A 
palsy of CN 7 (facial)
ipsilateral ear pain precedes paralysis
lacrimation/change in taste
can't wrinkle forehead (stroke can)
tx- acyclovir w/or w/out steroids
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22
Q

diabetic polyneuropathy

A

sxs more common in lower extremities
pain, numbness, tingling, burning
usually symmetric. usually polyneuropathy
can get autonomic problems (postural hypotension, arrhythmia, problems in bowel or bladder, sexual dysfunction)
dx- usually clinical but can do nerve conduction studies
tx- control hyperglycemia, pain (gabapentin, tca)
for autonomic problems (compression stocking, midodrine)

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23
Q

Guilian Barre

A 
can occur after flu vaccine 
can occur after campylorbacter jejuni
inflammatory demyelinating polyneuropathy 
lower muscle weakness that ascends
decreased or absent DTR
elevated protein 
can get sensory abnormalities 
LP will show elevated protein
tx- IVIG, plasmapheresis
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24
Q

Myasthenia Gravis

A

improves with rest and gets worse throughout day
CXR to rule out thymoma
associated with hyperthyroid
antibodies against acetylcholine receptor
proximal muscle weakness
dx- edrophonium (tensilon test), serum test for acetylcholine receptor antibodies
tx- pyrodstigmine, neostigmine (cholinesterase inhibitors), immunosuppresants, plasmapheresis, thymectomy

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25
lambert eaton syndrome
opposite of Myasthenia gravis (get better with stimulation) associated w/ small cell lung cancer due to defective release of acetylcholine tx- plasmapheresis, immunosuppressive thearpy
26
complex regional pain syndrome
part of the body feels pain, edema, skin changes, and limited ROM following injury, stroke, or surgery.
27
amyotrophic lateral sclerosis
lou gherig | neurodegenration of neurons in spinal cord and brain that lead to muscle weakness.
28
most common cause of meningitis
viral
29
aseptic meningitis
inflammation of meninges usually caused by nsaids culture and no organisms
30
most common form of meningitis of pregnancy or farm workers (raw milk, eating cheese)
listeria
31
most common meningitis in neonates
group b strep, e coli, listeria (GEL)
32
neonates presentation on meningitis
poor feeding bulging fontaneles irritable lethargic
33
>6 years for meningitis
strep pneumoniae, neiseria menigitdes
34
meningitis
if pt is on abx already (cause tap will be sterile) can send latex agglutination or PCR dx- LP
35
meningitis tx-
3 months including adults- ceftriaxone + vancomycin immunocompromised/alcohol abuse/>50 years- ceftriaxone +vancomycin +ampicillin head trauma/vp shunt/cns surgery- vancomycin + ceftazidime dexamethasone +/-
36
2 months- 6 years
strep pneumo, h flu type b, neiseria menigites
37
waterhouse- friderichsen syndrome
adrenal failure after meningitis
38
encephalitis from HSV
mri temporal lobe
39
csf analysis
bacterial- increased protein, decreased glucose, elevated opening pressure, elevated PMN viral- normal elevated pressure, normal pressure, normal glucose, predominately lymphocytes TB- increased protein, decrease glucose, elevated OP, PREDOMINATELY LYMPHOCYTES traumatic tap can increase protein by rbc (rbc are protein)
40
cerebral abscess
insidious onset FOCAL neurological signs usually pt had bad ear infection, mastoiditis, sinusitis, endocarditis
41
to tell encephalitis from meningtis
encephalitis usually have AMS and possibly seizures/focal neurological signs ct before LP to rule out something that will cause herniation
42
essential tremor
worsens w/ age, stress, caffeine improves w/ alcohol tx- propanolol, primidone
43
parkinson
loss of dopaminergic neurons in substantra nigra antipsychotics can cause TRAP- tremor (resting), rigidity (cogwheel;difficulty moving arm/legs), akinesia(slow moments/bradykinesia), postural instability masked facies, pill rolling, micrographia, shuffling gait, don't swing arms tx- levodopa +carbidopa (carbidopa presents levodopa from being broken down in periphery), selegiline, rasagiline (MAOB), anticholinergics, bromocriptine, surgery- deep brain stimulator SALAD (selegiline, anticholinergic, L dopa, amantadine, dopamine agonist (bromocriptine and pergolide)
44
huntington disease
autosomal dominant degeneration of neurons w/ atrophy in caudate nucleus/ putamen psychotic fxs tx- antipsychotics/antidepressant
45
brain stem stroke
pontine stroke- pinpoint pupils | cerebellar stroke- extensor posturing, lost pupillary reflex
46
uncal herniation
temporal lobe herniates onto brainstem | dilated non reactive ipsilateral pupil
47
central herniation
both sides of brain herniate through tentorium loss of brainstem reflexes decorticate posturing irregular respiration
48
delirium
disturbance of consciousness w/ reduced ability to focus change in cognition fluctuating and develops quickly
49
most common cause of dementia
alzheimers | 2nd- vascular dementia (multiple small strokes)
50
dementia
problem w/ recent memory (usually) | remote memory usually intact (long term)
51
alzheimer
neurofibriliary tangles due to abnormal tau protein amyloid plaques (senile plaques) in hippocampus atrophy (usually temporal lobe) big risk factor is age dx- can check level of tau and amyloid (not usually done)
52
most common guillan barre syndrome
aidp (acute inflammatory demyelinating polyneuropathy)
53
miller Fischer variant
areflexia, opthamoloplegia, ataxia
54
multiple sclerosis
``` optic neuritis (painful unilateral vision loss) pain with EOM LP shows oligoclonal pattern MRI T1- black holes and atrophy T2- UBO (hyperintensities) tx- acute- steroids, plasma exchange chronic- interferon, immunosuppresive sxs fatigue (amantadine) incontinence (oxybutin) spasitisity (baclofen) ```
55
most common MS subtype
relapse remitting
56
abx that precipitate g6pd deficiency
nitrofurantoin and bactrim | also aspirin, nsaids, antimalarial drugs
57
concussion
headache/dizziness irritability, amnesia, insomnia/sleep a lot, slowed rxn time behavioral chagnes usually get better in 10 days can start returning to activities after 24 hours of being asymptomatic return in graded portion w/ each stage lasting 24-48 hrs
58
post concussive syndrome
``` 3 sxs >3 months after concussion headache- most common dizziness fatigue irritability impaired memory insomnia ```
59
cerebral palsy
begins
60
vasovagal syncope
have a couple min of prodrome (nausea, diaphoresis, lightheadedness, graying of vision) usually due to emotional stress or pain different then cardiac which only have 3 second prodrome
61
fixed event thearpy
post orgasm syncope micturition tight shirt collar on carotid sinus autonomic depressor causes orthostatic hypotension
62
how to check for orthostatic hypotension from poor autonomic system
tilt table test- symptoms reproduction or drop in bp, hr
63
partial seizure
focal epileptiform spike simple- preserved consciousness, sterotyped aura w/ eeg complex- impaired consciousness, staring
64
general
altered thalmocortical rhythms absence- brief staring spells, childhood onset myoclonic (arhythmic) clonic (rhythmic), tonic atonic (loss of tone)- happen in patients w/ severe neurologic abnormalities
65
tx for absence seizure
ethosuximide
66
partial seizure tx
carbamazepine, lamotrigine
67
tonic, myoclonic, clonic seizure tx
valproate, lamotrigine, topiramate
68
tourette syndrome
must have both motor and vocal tics for at least a year. can't go longer then 3 months w/out a tic

PANCE (14 decks)

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