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Neuro Flashcards

1
Q

Wernicke’s Encephalopathy

A

Alcoholism, severe malnutrition, hyperemesis gravidarum.
Thiamine deficiency
Features: Encephalopathy, horizontal nystagmus (abducens), ataxic gait

Tx IV thiamine and then glucose

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2
Q

Normal Pressure Hydrocephalus

A

Wet, Wacky, Wobbly. Normal opening pressure. Ventriculomegaly out of proportion to cerebral atrophy.
Mostly idiopathic but can be secondary to neurologic insult.

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3
Q

GBS

A

Motor and reflex deficits, paresthesias

Tx: IvIG or plasmapharesis

Once patient is stabilized and is in no resp distress, spirometry should be done to assess lung function.

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4
Q

Freidrich Ataxia

A

Slurring of speech and gain instability in adolescents.
MRI: Medulla and dorsal column
Absent DTRs, scoliosis, cardiac hypertrophy, Diabetes mellitus
Mean survival 30-40
Death due to cardiac arrhythmia or CHF

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5
Q

Akathisia

A

Restless feeling brought on by certain medications (metoclopramide/other dopamine antagonists)
tx: BB, Benzos, Benztropine

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6
Q

Tardive Dyskinesia

A

lip smacking, writhing, choreoathetoid movements that occur after prolonged exposure to dopamine antagonists.

Pathophys: increased D2 receptors and sensitivity
Tx: Valbenazine

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7
Q

Acute Dystonia

A

Sudden sustained contraction of the neck, mouth, and or eyes.
Tx: Benadryl, Benztropine

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8
Q

Charcot-Marie-Tooth

A

Hereditary lower extremity weakness, foot drop, and eventual tremor.

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9
Q

Myasthenia Gravis

A

Upon diagnosis they should receive a chest CT to determine if they have a thymoma. Removal of this may improve symptoms long term.

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10
Q

Pronator drift is sensitive/specific for ________ and ________ problems.

A

Upper Motor Neuron and Pyramidal Tract

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11
Q

INH Polyneuropathy

A

Isoniazid can cause a deficiency in B6 (Pyridoxine) causing it to be renally excreted. Stocking glove distribution numbness and tingling that may progress to loss of vibratory sense, proprioception, pain, and temp.

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12
Q

Acute MS exacerbation

A

If there are disabling symptoms: IV methylprednisolone, if refractory then plasmapheresis.

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13
Q

Delayed Sleep Wake Phase Disorder

A

Circadian rhythm disorder characterized by inability to fall asleep at traditional times and excessive daytime sleepiness.

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14
Q

Advanced Sleep Wake Phase Disorder

A

Circadian rhythm disorder characterized by inability to stay awake in the evening and inability to fall asleep in the morning.

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15
Q

Anterior Spinal Cord Syndrome

A

Bilateral Hemiparesis (Lateral cortical spinal tract), Diminished bilateral pain and temp (Lateral spinothalamic)

Intact proprioception, light touch, and vibration (Dorsal columns)

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16
Q

Brown Sequard Syndrome

A

Hemisection of the spinal cord

Loss of:
Contralateral pain & temp (Lateral spinothalamic(docusate one level below the injury))
Ipsilateral motor (Lateral corticospinal)
Ipsilateral proprioception, light tough, and vibration (Dorsal Column)

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17
Q

Athetosis

A

Writhing, uncontrollable movements that are commonly seen in cerebral palsy

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18
Q

Pure Sensory Stroke location

A

Thalamus (VPL & VPM nuclei)

  • one type of lacunar stroke
  • Atherothrombotic etiology
  • Several weeks later may develop thalamic pain syndrome
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19
Q

Pure Motor Stroke location

A

Internal capsule, although some internal capsule strokes will have both motor and sensory symptoms.

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20
Q

Tabes dorsalis

A

Late neurosyphilis. Sensory ataxia, lancinating pains, neurogenic bladder, Argyll Robertson pupils.

Tx: Penicllin

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21
Q

Pineal Gland Mass

A

Limited upward gaze, upward eyelid retraction, pupils not reactive to light, obstructive hydrocephalus.

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22
Q

Metastasis to the CNS

A

circumscribed lesions at grey-white matter junction. 30% symptomatic. Lung cancer and melanoma are the most common.

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23
Q

Alcohol-Induced Cerebellar Degeneration

A

10+ years of alcohol abuse causing degeneration of Purkinje fibers in the cerebellar vermis. Leads to truncal ataxia and wide gait. Peripheral coordination generally remains intact.

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24
Q

Achilles Tendon Reflex

A

Often decreases as we age, may be absent in elderly.

25
Q

Blepharospasm

A

Bilaterally spasm of the eyelids usually in response to stimuli such as a bright light. May also happen in the jaw and tongue, when combined it is called Meige Syndrome. Usually idiopathic but can be associated with Parkinsons or antipsychotics.

Tx: avoid stimuli, if the problem persists can do botulinum toxin.

26
Q

Trigeminal Neuralgia Tx

A

Carbamazepine

27
Q

Syringomyelia

A

Formation of a syrinx within the spinal cord. Usually associated with Arnold-Chiari I, but can also present after meningitis, tumors, inflammatory processes, and trauma.

Loss of pain and temp

28
Q

Pseudotumor cerebri/Idiopathic Intracranial Htn

A 
Overweight women
Signs of ICP (papilledema)
Impaired CSF reabsorption by arachnoid villi.
Tx: Wt loss and acetazolamide
Risks: Blindness
29
Q

Meniere’s Dz

A

Elevated endolymphatic pressure
Patients present with episodic vertigo, sensorineural hearing loss, and low-frequency tinnitus.
Tx: decrease Na, caffeine, nicotine, and alcohol. Diuretics can help long term. Antihistamines and antiemetics can help with acute symptoms.

30
Q

Transtentorial/Uncal Herniation

A

ipsilateral hemiparesis, compression of CNIII (Down, out, and dilated), contralateral homonymous hemianopia, altered level of consciousness.

31
Q

Erb Duchenne Palsy

A

C5 C6 injury
“Waiters tip” Extended elbow, pronated forearm, flexed wrist and fingers.
Intact grasp reflex

32
Q

Klumpke Palsy

A

C8 T1 injury
“Claw hand” extended wrist, extended MCP, flex PIPs and DIPs, absent grasp reflex
Horner syndrome

33
Q

High 14-3-3 CSF Titer

A

CJD

34
Q

Diabetic Ophthalmoplegia

A

Ischemia to CNIII, the inner fibers which control the eyelid levators and EOMs are more susceptible, which usually means preserved pupillary responses.

35
Q

Anticholinesterases used for dementia

A

Rivastigmine, donepezil, galantamine

36
Q

Amantadine

A

Parkinsons

37
Q

Causes of pediatric stroke

A

Sickle cell, cardiac abnormalities, meningitis, vasculitis

38
Q

Status epilepticus

A

more than 5 minutes of continuous seizure or two or more seizures where the patient does not regain consciousness in between.

39
Q

Post traumatic neuromas

A

After transection of nerves in surgery or injury, increased proliferation of unmyelinated nerves causes pain with pressure on the site.

40
Q

Subdural hematoma

A

Crescent on CT

Tearing of bridging veins

41
Q

Subarachnoid hemorrhage

A

Bleed between arachnoid and pia mater on CT
Rupture of aneurysm
Thunderclap headache

42
Q

Epidural hematoma

A

MMA rupture usually

Biconvex on CT

43
Q

Morton Neuroma

A

Running injury, compression of digital nerves in foot results in a false neuroma. Usually between 3rd and 4th digits. Clicking sound when toes are squeezed together.

44
Q

REM sleep behavior disorder

A

Patient enacts dreams. They remember the dream. Able to be awoken. More common in older men

45
Q

Bilateral enhancement of the globus pallidus on MRI

A

Hypoxic brain injury

46
Q

Heat stroke vs dehydration

A

Heat stroke temp >104 and altered mental status

47
Q

New brain mass in adult

A

Brain mets are the most common new brain mass, usually multiple, well-circumscribed lesions.

Gliomas are the most common primary brain mass in adults. Usually a single, irregularly shaped mass.

48
Q

Most common brain tumor in adults and prognosis

A

Astrocytoma (glioma) prognosis depends on degree of anaplasia

49
Q

Mild Cognitive Impairment

A

No interference in activities of daily living

50
Q

Critical illness polyneuropathy

A

Sepsis-related damage to peripheral nerves. LMN signs only.

51
Q

Cavernous sinus thrombosis

A

Usually due to cellulitis or sinusitis that enters the venous circulation.
Intracranial HTN leading to headache, facial edema, nausea, ocular palsy, and vomiting.

52
Q

Rapid Eye Movement Sleep Behavior Disorder

A

Enacting dreams, muscle atonia, men over 50

Strong association with alpha-synuclein diseases (Parkisons)

53
Q

Central cord syndrome

A

Hyperextension injury, damage to corticospinal and lateral spinothalamic tracts. Weakness, diminished pain, and diminished temp in the upper extremities.

54
Q

Pediatric brain tumors

A

Pilocytic astrocytoma > Medulloblastoma

55
Q

Pilocytic astrocytoma

A

The most common brain tumor in children. Generally occurs in the cerebellar hemispheres where it affects coordination. Commonly impinge the 4th ventricle and cause symptoms of ICP.

56
Q

Medulloblastoma

A

The second most common brain tumor in children. Found at the cerebellar vermis. Causes truncal and gait ataxia.

57
Q

Narcolepsy somnography findings

A

Decreased REM latency

58
Q

Lambert Eaton Syndrome

A

Antibodies to presynaptic voltage-gated calcium channels. Proximal muscle weakness, significantly diminished reflexes, and autonomic dysfunction. Muscle strength is recovered with use.
Associated with small cell lung cancer

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