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MS3 > Neuro 6 > Flashcards

Neuro 6 Flashcards

1
Q

Define apraxia and what part of the brain causes it

A

o Inability to carry out a learned motor task despite preservation of the primary functions need to carry out the task, such as comprehension, motor ability, sensation, and coordination
o Caused by lesions in the frontal or parietal lobes of the dominant hemisphere – cortical lesion

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2
Q

Describe agnosia and what part of the brain causes it

A

o Inability to recognize objects despite preservation of the basic sensory modalities being used
o Caused by lesions in the sensory associated areas of the brain – processing areas that lie next to the primary sensory areas – cortical lesion

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3
Q

4 components of Gerstmann syndrome

A

♣ 1. Agraphia (inability to write)
♣ 2. Acalculia (inability to calculate)
♣ 3. Finger agnosia (inability to distinguish fingers)
♣ 4. Left-right disorientation

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4
Q

Part of the brain affected in Gerstmann syndrome

A

o Damage to dominant parietal cortex

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5
Q

Part of the brain affected in hemispatial neglect

A

o Damage to non-dominant frontal or parietal cortex (usually R-sided)
o Will cause neglect to contralateral (L) side

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6
Q

Describe tests that should be done in a patient with dementia

A

♣ Hematologic screening including ESR
♣ Vitamin B12 and Folate
♣ Calcium
♣ LFTs, including ammonia
♣ Electrolytes
♣ Serum urea nitrogen and creatinine levels
♣ Infection workup: Syphilis, HIV, TB, etc.
♣ Thyroid function tests
♣ EEG – look for seizuers
♣ CT or MRI – structural abnormalities (tumor, hematoma, hydrocephalus)
♣ Brain biopsy – CJD, HIV, CNS vasculitis

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7
Q

Presentation of Lewy body dementia

A

Early onset dementia with visual hallucinations followed by Parkinsonian features

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8
Q

Clinical findings of Progressive Supranuclear Palsy (PSP)

A
  • Supranuclear ocular palsy (failure of vertical gaze), dysarthria, dysphagia, extrapyramidal rigidity, gait ataxia, dementia
  • Earliest signs are falls and gait abnormality
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9
Q

Which parts of the brain are affected by PSP

A

• Atrophy of dorsal midbrain, globus pallidus, and subthalamic nucleus
o Hummingbird sign

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10
Q

Presentation of Huntingtons

A

Chorea, dementia, personality and behavioral changes

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11
Q

Part of the brain affected in Huntingtons

A

Caudate and putamen

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12
Q

Presentation of frontotemporal dementia

A
  • Early = Behavior/personality changes (frontal lobe) and/or aphasia (temporal lobe)
  • Late = Dementia
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13
Q

Presentation of CJD

A

• Rapidly progressive dementia + ataxia + startle myoclonus

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14
Q

What will be seen on EED in CJD

A

• Periodic sharp waves on EEG

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15
Q

What will be seen in CSF in CJD

A

Presence of protein 14-3-3

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16
Q

Ddx for neurological causes of facial pain

A

Trigeminal neuralgia
Postherpetic neuralgia
Giant cell arteritis
Cluster HA

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17
Q

Definition of dystonia

A

Sustained muscle contraction (e.g. torticollis)

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18
Q

What is hemiballismus and what part of the brain is it caused by

A

Unilateral violent arm flinging

Caused by damage to the contralateral subthalamic nucleus

19
Q

Where do hypertensive hemorrhages usually occur in the brain

A

Lacunar stroke = basal ganglia, cerebellum, thalamus, pons

20
Q

Presentation of myasthenic crisis

A
  • Increased generalized and oropharyngeal weakness

* Respiratory insufficiency/dyspnea

21
Q

Tx of myasthenic crisis

A
  • Intubation for deteriorating respiratory status

* Plasmaphoresis or IVIC and corticosteroids

22
Q

Presentation of Wilson disease

A

♣ Copper accumulation leads to:
• Kayser-Fleisher rings copper deposition in the cornea
• Liver disease
• Neurologic manifestations (behavioral changes, dementia, chorea, parkinsonian symptoms)

23
Q

Diagnosis of Wilson disease

A
  • Low ceruloplasmin

* Increased urinary copper excretion

24
Q

Describe EEG features of sleep cycle

A

BATS Dream Big

Awake (eyes open) = beta
Awake (eyes closed) = alpha
N1 = theta
N2 = K spindle fibers
N3 = delta
REM = beta
25
Q

What lab value should always be gotten in patients with restless leg syndrome

A

Ferritin - RLS is often associated with iron deficiency

26
Q

Tx of RLS

A

Dopamine agonists - Ropinirole and Pramipexole

27
Q

Lab value used to diagnose narcolepsy

A

CSF with low hypocretin

28
Q

Tx of narcolepsy

A

Modafinil

29
Q

Cause of Myasthenia gravis

A

Autoantibodies against ACh receptor

30
Q

What is the triad of sx in MS

A

♣ Charcot triad of symptoms - SIN:
• Scanning speech
• Intention tremor, Incontinence, Internuclear ophthalmoplegia
• Nystagmus

31
Q

Describe potential sensory or motor sx associated with MS

A

♣ Sensory symptoms (numbness and paresthesia)
♣ Motor symptoms (paraparesis and spasticity)
♣ Bowel/bladder dysfunction

32
Q

Tx of choice for agitation in the elderly

A

Haloperidol

33
Q

What part of the brain do complex partial seizures usually arise from

A

Temporal or frontal lobe

34
Q

Most common cause of seizures in:

  • Children
  • Young adults
  • Elderly
A

Children = fever

Young adults = head injury and alcohol

Elderly = stroke

35
Q

What type of seizure can be triggered by hyperventilation

A

Absence

36
Q

Brand name and major side effects of phenytoin

A

Dilantin

Gingival hyperplasia, ataxia, osteoporosis, diplopia, hirsutism, teratogenic = cleft palate, SJS

37
Q

Brand name and major side effects of Carbamazepine

A

Tegretol

Hyponatremia, agranulocytosis, diplopia, ataxia, NTD, SJS

38
Q

Brand name and major side effects of Valproic acid

A

Depakote

NTD, hepatotoxicity, pancreatitis, weight gain, GI sx, tremor

39
Q

MOA and side effects of Gabapentin

A

Bind and block voltage-gated Ca2+ channels

Ataxia, sedation

40
Q

Brand name and side effects of Lamotrigine

A

Lamictal

Rash, SJS, diplopia

41
Q

Brand name and side effects of Topiramate

A

Topamax

Fatigue, weight loss, kidney stones, glaucoma, confusion (DOPAmax)

42
Q

Brand name and side effects of Levetiracetam

A

Keppra

Fatigue, anxiety/agitation

43
Q

What is the order of meds given to treat status epilepticus

A

Lorazepam (Ativan)
Phenytoin
Phenobarbital

44
Q

What disorder is associated with central scotoma, washed out colors, afferent pupillary defect, monocular vision loss, pain with eye movement

A

Optic neuritis

MS3 (88 decks)

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