Neuro Flashcards
anterior cord syndrome
associated with ____ fractures
infarct of anterior spinal a., ant 2/3 spinal cord affected
loss of
motor (gray and lcst)
pain and temp (acst, astt, lstt)
preservation of
position and vibratory sensation
associated with burst fracture of vertebra, eg jumping from building landing on feet
hemiballismus
what is it
what causes it
unilateral chorea of proximal muscles
vascular disease of contralateral STN subthamic nucleus
tetrabenazine moa
- | VMAT2
dec monoamine uptake and signaling
(dopamine serotonin e ne h)
reserpine moa
depletes peripheral catecholamines, dec sns, vasodilation and sedation
what is chorea
what are 2 etiologies?
rapid irregular unpredictable involuntary muscle jerks
caudate and putamen cell losses
dopaminergic agonists
akathisia
colloquial synonymn
restlessness
postural tremor
tremor w holding position against gravity, eg holding arms outstretched
2 adjectives for tremor
rhythmic oscillatory
3 most common bugs in brain abscess
strep v
staph a
gnrs
so empiric tx ceftri vanc metro
empiric tx brain abscess
ceftri strep v
vanc staph a
metro gnrs
typical ct finding in hsv encephalitis
hypodense lesion in parietal lobe
when is pt at risk for nocardia brain abdcess
cd4 v100/mm3
tf
rhizopus causes brain abscesses
f
mucormycosis can spread from sinuses thru bone to brain but is highly destructive and necrotizing not abscess forming usually
tf
cerebral toxoplasmosis typically causes single ring enhancing lesion
f
multiple usually
when is pt at risk for toxoplasmosis
cd4 v100
tf
cd4 v100 is risk for toxo and nocardia both
t
single brain abscess usually results from
direct extension of sinusitis otitis media dental infection
central cord syndrome
hyperextension inj in eld w preexisting c-spine degenerative change – selective cst and lstt damage, maybe stt. ue motor weakness more than le as ue mn more midline, maybe some pain and temp loss from stt
brown sequard syndrome
hemisection of soinal cord eg from penetrating injury
below lesion
ipsi weakness spasticity vib and prop loss
contra pain temp loss
tf
cerebral contusion produces fnd’s
both
can oroduce fnd’s, but also ams and risk of seizure from edema
posterior cord syndrome
vib and prop loss and maybe weakness paresthesias urinary incontinence retention
eg from ms or vertebral a dissection
spondylosis
degeneration of spinal column from any cause, most commonly oa osteoarthritis
diff in pres of wilsons in kid/adolescent vs adult
kid/ado typically liver – asymp transaminitis to fulminant liver failure
adults typ neuropsych from tremor rigidity to depression catatonia paranoia
confirm dx of suspected wilsons
low ceruloplasmin v20
confirm w urine cu excretion
and slit lamp to look for kayser fleischer rings
how to look for keyser fleischer rings in wilsons
slit lamp test
what causes the neurological sympx of wilsons
cu dep in basal ganglia
at what age does hemochromatosis typ present
after age 40
another name for mallory body
mallory hyaline
tf
mallory body = mallory hyaline, same thing
t
what do mallory bodies suggest
alcoholic hepatitis
OR
wilsons
tf
mallory bodies on liver biopsy are associated w wilsons
t mallory bodies assoc w alc hepatitis OR wilsons
liver bx in a1-antitrypsin deficiency
pas + , diastase resistant granules in hepatocytes
pas + , diastase resistant granules in hepatocytes on liver bx suggests
a1-antitrypsin deficiency
4 precipitators of myasthenic crisis
infection sx
pregnancy child birth
tapering immunosuppressants
meds like aminoglycs an bb’s