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PANCE > Neuro > Flashcards

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
Q

lambert eaton syndrome

A

opposite of Myasthenia gravis (get better with stimulation)
associated w/ small cell lung cancer
due to defective release of acetylcholine
tx- plasmapheresis, immunosuppressive thearpy

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26
Q

complex regional pain syndrome

A

part of the body feels pain, edema, skin changes, and limited ROM following injury, stroke, or surgery.

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27
Q

amyotrophic lateral sclerosis

A

lou gherig

neurodegenration of neurons in spinal cord and brain that lead to muscle weakness.

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28
Q

most common cause of meningitis

A

viral

29
Q

aseptic meningitis

A

inflammation of meninges
usually caused by nsaids
culture and no organisms

30
Q

most common form of meningitis of pregnancy or farm workers (raw milk, eating cheese)

A

listeria

31
Q

most common meningitis in neonates

A

group b strep, e coli, listeria (GEL)

32
Q

neonates presentation on meningitis

A

poor feeding
bulging fontaneles
irritable
lethargic

33
Q

> 6 years for meningitis

A

strep pneumoniae, neiseria menigitdes

34
Q

meningitis

A

if pt is on abx already (cause tap will be sterile) can send latex agglutination or PCR
dx- LP

35
Q

meningitis tx-

A

3 months including adults- ceftriaxone + vancomycin
immunocompromised/alcohol abuse/>50 years- ceftriaxone +vancomycin +ampicillin
head trauma/vp shunt/cns surgery- vancomycin + ceftazidime

dexamethasone +/-

36
Q

2 months- 6 years

A

strep pneumo, h flu type b, neiseria menigites

37
Q

waterhouse- friderichsen syndrome

A

adrenal failure after meningitis

38
Q

encephalitis from HSV

A

mri temporal lobe

39
Q

csf analysis

A

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
Q

cerebral abscess

A

insidious onset
FOCAL neurological signs
usually pt had bad ear infection, mastoiditis, sinusitis, endocarditis

41
Q

to tell encephalitis from meningtis

A

encephalitis usually have AMS and possibly seizures/focal neurological signs

ct before LP to rule out something that will cause herniation

42
Q

essential tremor

A

worsens w/ age, stress, caffeine
improves w/ alcohol
tx- propanolol, primidone

43
Q

parkinson

A

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
Q

huntington disease

A

autosomal dominant
degeneration of neurons w/ atrophy in caudate nucleus/ putamen
psychotic fxs
tx- antipsychotics/antidepressant

45
Q

brain stem stroke

A

pontine stroke- pinpoint pupils

cerebellar stroke- extensor posturing, lost pupillary reflex

46
Q

uncal herniation

A

temporal lobe herniates onto brainstem

dilated non reactive ipsilateral pupil

47
Q

central herniation

A

both sides of brain herniate through tentorium
loss of brainstem reflexes
decorticate posturing
irregular respiration

48
Q

delirium

A

disturbance of consciousness w/ reduced ability to focus
change in cognition
fluctuating and develops quickly

49
Q

most common cause of dementia

A

alzheimers

2nd- vascular dementia (multiple small strokes)

50
Q

dementia

A

problem w/ recent memory (usually)

remote memory usually intact (long term)

51
Q

alzheimer

A

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
Q

most common guillan barre syndrome

A

aidp (acute inflammatory demyelinating polyneuropathy)

53
Q

miller Fischer variant

A

areflexia, opthamoloplegia, ataxia

54
Q

multiple sclerosis

A 
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
Q

most common MS subtype

A

relapse remitting

56
Q

abx that precipitate g6pd deficiency

A

nitrofurantoin and bactrim

also aspirin, nsaids, antimalarial drugs

57
Q

concussion

A

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
Q

post concussive syndrome

A 
3 sxs >3 months after concussion 
headache- most common 
dizziness 
fatigue
irritability
impaired memory
insomnia
59
Q

cerebral palsy

A

begins

60
Q

vasovagal syncope

A

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
Q

fixed event thearpy

A

post orgasm syncope
micturition
tight shirt collar on carotid sinus
autonomic depressor causes orthostatic hypotension

62
Q

how to check for orthostatic hypotension from poor autonomic system

A

tilt table test- symptoms reproduction or drop in bp, hr

63
Q

partial seizure

A

focal epileptiform spike
simple- preserved consciousness, sterotyped aura w/ eeg
complex- impaired consciousness, staring

64
Q

general

A

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
Q

tx for absence seizure

A

ethosuximide

66
Q

partial seizure tx

A

carbamazepine, lamotrigine

67
Q

tonic, myoclonic, clonic seizure tx

A

valproate, lamotrigine, topiramate

68
Q

tourette syndrome

A

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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