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Mistakes > Neuro > Flashcards

Neuro Flashcards

1
Q

What are the characteristic features of NF1?

A 
Cafe-au-lait spots
Macrocephaly
Feeding problems
Short stature
Learning disabilities

Later, they develop:
Fibromas
Neurofibromas
Other tumors

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2
Q

What are the characteristic features of NF2?

A

Bilateral acoustic neuromas

Cataracts

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3
Q

What is Alteplase?

A

IV Thrombolytic

Give within 3.5 - 4 hours of stroke symptom onset

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4
Q

A patient is on ASA therapy and has a stroke anyway. What do you give them?

A

ASA

+

Dipyridamole or Clopidogrel

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5
Q

CGG’ trinucleotide repeat expansions are associated with

A

Fragile X Syndrome

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6
Q 
Syndrome:
ADHD features
Autism-like features
Speech delay
Motor delay

Head abnormalities
Macroorchidism

A

Fragile X Syndrome

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7
Q

Arachnodactyly

A

Long slender fingers

Most commonly found in Marfan Syndrome

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8
Q

Marfan Syndrome

A 
Tall
Thin
Ectopia Lentis
Pectus Carinatum
Aortic Root Dilation
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9
Q

Internuclear Ophthalmoplegia

A

Affected eye can’t adduct
Contralateral eye abducts with nystagmus
Accommodation intact

From damage to MLF
If bilateral, it is likely MS

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10
Q

Bilateral MLF Lesions

A

Bilateral Internuclear ophthalmoplegia

Classically seen in MS

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11
Q

Unilateral MLF Lesion

A

Unilateral internuclear ophthalmoplegia

Lacunar stroke in pontine artery distribution

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12
Q

Damaged Edinger-Westphal Nucleus

A

Interrupted Preganglionic Parasympathetic outflow to the eye

Ipsilateral fixed dilated pupil nonreactive to light or accommodation

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13
Q

Common complication in premature and underweight neonates

A

Interventricular hemorrhage
Blood in subarachnoid space impairs arachnoid villi from absorbing CSF
Leads to communicating hydrocephalus

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14
Q

2 Components of Occulomotor Nerve

A

Inner Somatic Fibers - Levator, EOMs

Superficial Parasympathetic Fibers - Iris Sphincter, Ciliary Muscles

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15
Q

Ischemic CN III Injury

A

Inner somatic fibers are further from blood supply
Ptosis + Down-and-Out
Preserved pupillary response (this is compromised in compressive neuropathy)

(Microvascular complication from diabetes)

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16
Q

What age is normal for breath holding spells?

A

6 months to 2 years

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17
Q

Management of breath holding spells

A

Reassurance - Does not affect development

Some will stop by age 5
Some will develop vasovagal syncope later in life

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18
Q

Hypertensive hemorrhagic stroke affects which arteries?

A

Small penetrating arteries

Like a lacunar stroke

19
Q

Sudden focal neurologic deficits that gradually worsen over minutes to hours

A

Intraparenchymal brain hemorrhage

Occur during routine activity
Precipitated by exertion
Progresses to headache, vomiting, seizures (if lobar) and AMS

20
Q

Stroke where symptoms are maximal at onset

A

Embolic Stroke

Also true of subarachnoid hemorrhage

21
Q

Stroke where symptoms progress in a stuttering fashion

A

Ischemic stroke

22
Q

Most frequent locations for hypertensive hemorrhagic stroke

A

Basal Ganglia
Cerebellar Nuclei
Thalamus
Pons

23
Q

Putaminal Hemorrhage

A

Almost always involves adjacent Internal Capsule

Contralateral hemiparesis
Contralateral hemianesthesia
Conjugate gaze deviation (toward side of lesion)

24
Q

Cerebellar Hemorrhage

A

Occipital Headache
Nausea/Vomiting
Dizziness
Ataxia/Dysmetria

No hemiparesis

25
Q

Difference between thrombotic/embolic MCA stroke & Putaminal Hemorrhage

A

Both give you contralateral hemiparesis and conjugate gaze towards the lesion

Headache & sudden neuro deficits that gradually worsen indicate hemorrhage

26
Q

Medial medullary syndrome

A

Branch occlusion of Vertebral Artery or ASA

Contralateral arm & leg paralysis (Lateral Corticospinal)
Contralateral loss of position sense (Dorsal Column)
Tongue deviation towards lesion (Hypoglossal)

27
Q

Midbrain Ischemic Stroke

A

Ipsilateral occulomotor nerve palsy
Ataxia (Superior cerebellar peduncle)
Contralateral hemiparesis (Basis pedunculi)

28
Q

Bilateral Pontine Hemorrhage

A 
Coma (Reticular Activating System)
Total paralysis (Corticospinal & corticobulbar)
Pinpoint Pupils (Descending sympathetics)
29
Q

Type B Adverse Drug Reaction

A

Unexpected, dose-independent pharmacologic effect

Stevens-Johnson Syndrome (Lamotrigine)
Neuroleptic Malignant Syndrome (Antipsychotics)

30
Q

Type A Adverse Drug Reaction

A

Dose-dependent

Respiratory depression (Opioids)

31
Q

Treatment for Neuroleptic Malignant Syndrome

A

Cessation of offending agent

Dantrolene

32
Q

Serotonin Syndrome

A

AMS
Autonomic instability
Neuromuscular excitability (tremor, hyperreflexia, myoclonus)

33
Q

Brainstem ischemic strokes

A

Crossed Signs

Ipsilateral cranial nerve deficit
Contralateral hemiplegia

34
Q

NPH Classic Triad

A 
Cognitive Dysfunction
Gait difficulty (Wide-based)
Urinary Incontinance
35
Q

Spinal Cord Infarct

A

Abrupt Symptoms

Weakness (may progress)
Loss of pain & temp (ASA Infarct)
Autonomic Dysfunction

36
Q

Naproxen vs. Ibuprofen

A

Naproxen has a longer duration

Better for patients who require more frequent dosing

37
Q

Topical Capsaicin

A

Used for mild to moderate neuropathic pain

Postherpetic neuralgia

38
Q

Medications most commonly leading to torticollis

A

Typical Antipsychotics
Metoclopramide
Prochlorperazine

39
Q

Hemiballismus

A

Unilateral, violent arm flinging

Caused by damage to contralateral STN

Tends to be self-limited

40
Q

Headache - Warning Signs that indicate early imaging

A

Neuro Findings: Seizure, consciousness changes, specific deficits
Difference from prior headaches: Change in frequency, intensity, characteristics
Other: New at age >40, sudden onset, trauma, present on awakening

41
Q

Patient is in myasthenic crisis and has to be intubated

A

Hold cholinesterase inhibitors (reduce excess airway secretions)

IVIG or Plasmapheresis (preferred) + Corticosteroids
Consider mycophenolate or azathioprine if steroids don’t work

42
Q

Brain CT/MRI - Butterfly appearance with central necrosis

A

Glioblastoma multiforme

43
Q

Brain CT/MRI - Heterogenous & Serpiginous contrast enhancement

A

High-grade astrocytoma

44
Q

LP - Elevated CSF protein, normal white count

A

Guillain Barré

Mistakes (8 decks)

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