Neuro

Question 1

-Dopamine deficiency
-Sx: Difficulty related to slow mov’ts–>rising from seated, up/down stairs, dressing, writing. RESTING TREMOR, bradykinesia, postural instability, shuffling gate, cog wheeling
-Clinical Dx
Tx: Want restore dopamine/Ach balance–>Anticholinergics
-Rx: Levodopa (converts to dopamine), dopamine agonists

Answer 1

Parkinsons

Question 2

• Autoimmune disorder of peripheral nerves–> destruction of Ach receptors on muscle surface
• MC in young women and older men
• Sx: Muscle weakness & fatigue which improves w/ rest. Ptosis, diplopia common
• Dx: can confirm if marked improvement with short acting anti-cholinesterase. Also, EMG, serum assay for Ach receptor antibodies
• Tx: Cholinesterase inhibitor

Answer 2

Myasthenia Gravis

Question 3

• Idopathic why matter axon degeneration 2/2 demyelination
• Can relapse, remit or progressively deteriorate.
• Women>men, 15-45yrs onset
• Sx: Focal weakness, parasethias, blindness, blurry vision, diplopia, balance issues, fatigue (MC SENSORY COMPLAINTS FOLLOWED BY VISION ISSUES)
• Dx: MRI w/ gadolinium (shows white matter plaques). CSF increased IgG
• Tx: Steroids for acute exacerbations. Interferon-beta decreases relapse frequency. Immune suppressing agents

Answer 3

MS

Question 4

• Encephalopathy d/t thiamine (B1) deficiency
• MC seen in alcoholics
• Sx: Confussion, ataxia, nystagmus, peripheral neuropathy
• Dx: B1 levels, response to Tx
• Tx: Thiamine

Answer 4

Wernicke Encephalopathy

Question 5

Follows zoster infx

• Sx: Allodynic pain (out of proportion to touch)
• Tx: Gabapentin, lidocaine patches

Answer 5

Post Herpetic neuralgia

Question 6

-Idiopathic, polyneuropathy p infx, immunizations or spontaneously
-Sx: Symmetrical extremity weakness beg. distally & ascending; decreased DTRs; Sensory deficits, pain, autonomic dysfunction (tachycardia, labile BP, sphincter issues, etc)
Dx: CMG
TX: Plasmaphoresis, IVIg

Answer 6

Guillain-Barre

Question 7

• Rapidly progressing muscle degeneration.
• Usually fatal by 15yrs. d/t defect on x-chromo
• Sx: Onset 1-5yrs, central muscle joint weakness progressing outward
• Dx: Bx
• Tx: Prenisone

Answer 7

Muscular dystrophy

Question 8

Necrosis of upper and lower Motor neurons–>progressive motor degeneration, retained sensation

• Sx: loss of ability to initiate and control motor mov’ts, muscle atrophy, eventually resp. dysfunction
• Dx: EMG
• Tx: Riluzole (glutamate blocker)

Answer 8

Amyotrophic lateral sclerosis (ALS)

Question 9

-Increased ICP mimics tumor
-Idiopathic etiology. Maybe d/t long term steroids
-Sx: HA (worse on straining), visual disturbances
-LP shows increased pressure, imaging neg.
Tx: Acetazolamide

Answer 9

Pseudotumor Cerebri

Question 10

Most common type of brain tumor and MC source of mets to brain.

Answer 10

Gliomas

Lung, breast, kidney, GI