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Hippos > Neuro > Flashcards

Neuro Flashcards

1
Q

What eye movement is limited with a CN IV palsy?

A

Cannot converge eyes

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2
Q

What is the classic complaint of a patient with a CN IV palsy?

A
  • Cannot read a book

- Trouble walking down stairs

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3
Q

Why is CN VI considered a false localizing sign?

A

Increased ICP can cause a palsy, rather than an anatomically specific lesion

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4
Q

What are the CNs that are associated with the midbrain?

A

1, 2, 3, 4

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5
Q

What are the CNs that are associated with the pons?

A

5, 6, 7, 8

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6
Q

What are the CNs that are associated with the medulla?

A

9, 10, 11, 12

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7
Q

What is the presentation of a patient that has a stroke in the pons?

A

Locked in with pinpoint pupils

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8
Q

What are the three major areas of bleeding in the brain?

A
  • Deep nuclei
  • Pons
  • Cerebellum
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9
Q

Where is the most common location for a intracranial artery aneurysm?

A

Anterior communicating artery

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10
Q

What is difference in the appearance of a traumatic vs spontaneous subarachnoid hemorrhage on CT scan?

A

Spontaneous will be blood diffusely throughout the brain, whereas a traumatic will be localized to area of trauma.

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11
Q

When is xanthochromia reliably present on LP for diagnosing SAH?

A

12 hours

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12
Q

What is the CCB used to treat SAH?

A

nimodipine–specifically for brain vasculature, and only given orally

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13
Q

What type of fluids should NEVER be given to stroke patients? Why?

A

Hypotonic fluids, since this will worsen any cerebral edema.

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14
Q

Why should all patients with a stroke be reversed on their anticoagulation (even those with mechanical valves)?

A

Risk of bleeding very high in ischemic area

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15
Q

What is the major difference between lacunar strokes vs cortical strokes?

A

Lacunar have either motor or sensory, whereas cortical strokes have both.

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16
Q

What are the tests that all patients with TIAs need to help prevent future strokes?

A
  • PFO/ECHO study
  • EKG/holter for a-fib
  • Carotid dopplers
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17
Q

How does the presentation of a venous sinus thrombosis differ from a stroke?

A

Venous clots can cause bilateral symptoms

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18
Q

What is the “delta sign” on a non-contrast head CT that is diagnostic of venous sinus thrombosis?

A

Bright white appearance (clot) in the posterior confluence of sinuses

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19
Q

What is the treatment for a carotid artery dissection?

A

AC

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20
Q

What is the scoring system for predicting a stroke following a TIA?

A

ABCD2 scoring system

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21
Q

What is the role of steroids in the treatment of meningitis?

A

Should be given before abx are given

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22
Q

What are the four indications to obtain a head CT prior to performing an LP?

A

Old
Immunocompromised
AMS
Focal neuro findings

23
Q

What are the three major abx given to adult meningitis pts?

A

Ceftriaxone
Vanco
Ampicillin

24
Q

Why can you not give infants less than 1 month old ceftriaxone? What can you give instead?

A
  • Can cause kernicterus

- Cefotaxime

25
Q

What are the major viruses that cause aseptic meningitis (4)

A
  • Enterovirus
  • West nile
  • HSV2
  • VZV
26
Q

Where does TB infect the brain, typically? Why?

A

Brainstem since this is the highest oxygenated area

27
Q

What can clinically differentiate TB meningitis from other bacterial meningitis? What treatment benefits TB meningitis the most outside of abx?

A
  • CN s/sx

- Steroids early

28
Q

India ink stain = ?

A

Cryptococcal meningitis

29
Q

What is the most common cause of a mass lesion in AIDS pts?

A

Toxoplasmosis

30
Q

What blood test is pretty sensitive for CNS spinal cord infections?

A

ESR

31
Q

What is the myotome level for the: biceps?

A

C5

32
Q

What is the myotome level for the: Triceps?

A

C7

33
Q

What is the myotome level for the: Quads?

A

L4

34
Q

What is the myotome level for the: ankle?

A

S1

35
Q

What is the myotome level for the: abdominal muscles

A

T8-T12

36
Q

What is the myotome level for the: cremaster

A

L1-L2

37
Q

What is the myotome level for the: anus

A

S2-S4

38
Q

How many CCs of urinary retention is supportive of diagnosing cauda equina?

A

100-150 cc

39
Q

Is having bilateral symptoms more or less specific for cauda equina?

A

More, since it has to be higher than a peripheral nerve root

40
Q

What are the symptoms of syringomyelia?

A

Loss of pain/temp in hands

41
Q

Why are chiari malformations associated with recurrent headaches?

A

Tonsillar “herniation” blocks CSF flow intermittently

42
Q

What are the two major infections that precipitate Guillain barre syndrome?

A

Mycoplasma pneumonia and campylobacter diarrhea

43
Q

What is the treatment for Guillain barre?

A

Plasmapheresis

44
Q

What is the difference between tick paralysis and Guillain barre syndrome?

A

GBS has sensory deficits, whereas tick paralysis does not

45
Q

What are the three major cause of ptosis?

A

Horner’s syndrome
Third nerve palsy
Myasthenia Gravis

46
Q

Which muscles are primarily affected with myasthenia gravis: proximal or distal?

A

Proximal

47
Q

What is the diagnostic test for myasthenia gravis?

A

Edrophonium test or ice pack test

48
Q

What are the major risks of edrophonium?

A

Cardiac arrhythmias and heart blocks

49
Q

How do you differentiate between myasthenia gravis and lambert-eaton syndrome?

A

Myasthenia gravis gets worse with repetitive action, whereas Lambert-Eaton syndrome gets worse

50
Q

What is Lambert-Eaton syndrome associated with?

A

Cancer (it’s a paraneoplastic syndrome)

51
Q

Who is usually affected with acute periodic paralysis?

A

Young men with thyroid disorders

52
Q

Why must you be careful with replacing potassium in patients with acute periodic paralysis?

A

Not a problem of total body loss, rather of maldistribution. Thus you may overshoot potassium if giving too much

53
Q

What is the pharmacologic long term treatment for acute periodic paralysis?

A

Beta blockers

Hippos (23 decks)

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