Neuro Flashcards
Besides a traumatic tap, what condition is often associated with red blood cells in the cerebrospinal fluid on lumbar puncture?
HSV encephalitis
Bilateral lateral rectus palsy is often seen with what vascular condition?
Cavernous sinus thrombosis
Blood pressure greater than or equal to what value is a contraindication for t-PA therapy in patients with ischemic stroke?
Systolic blood pressure greater than185mmHg or Diastolic blood pressure greater than 110mmHg
An obese individual with headaches is found to have a high opening pressure during lumbar pressure. What Is the best medication for this pt’s likely condition?
Acetazolamide (Carbonic anhydrase inhibitor)
Name four commonly prescribed medications that can cause aseptic meningitis.
TMP-SMX (Trimethoprim-Sulfamethoxazole), IVIG (Immunoglobulin),NSAIDS, Carbamazepine
Patient is found to have left homonymous quadrantanopia. Where is the lesion?
Right optic radiation
What are the MRI T1 (increased/decreased)and T2 (increased/decreased) signal changes seen in patients with multiple sclerosis?
Decreased T1 and Increased T2
Optic chiasm compression will lead to what eye abnormality?
Bitemporal hemianopsia
What area of the brain is affected with the diagnosis featuring bradykinesia, cogwheel rigidity, postural instability and resting tremor?
Substantia nigra (likely diagnosis is Parkinson’s disease)
Rapid fire txt: Tonic-clonic seizures
Levetiracetam, phenytoin, valproate, carbamazepine
Rapid fire txt: Trigeminal neuralgia (tic douloureux)
Carbamazepine
Atrophy of the mammillary bodies associated w/what dz?
Wernicke encephalopathy (thiamine deficiency causing ataxia, ophthalmoplegia, and confusion)
Guillain Barre Syndrome tx?
Rx: IVIG and Plasmapheresis
Don’t confuse GBS w/what dz that has descending paralysis?
Botulism
Rapid fire txt: Absence seizures
Ethosuximide (treatment)
Rapid fire assoc: Yellowish CSF
Xanthochromia (eg, due to subarachnoid hemorrhage)
Rapid fire txt: Malignant hyperthermia
Dantrolene
Rapid fire txt: Migraine
Abortive therapies (eg, sumatriptan, NSAIDs); prophylaxis (eg, propranolol, topiramate, CCBs, amitriptyline)
Rapid fire txt: Temporal arteritis
High-dose steroids
Rapid fire assoc:Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick disease: progressive dementia, changes in personality)
Rapid fire assoc: Protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
Rapid fire assoc:Eosinophilic cytoplasmic inclusion in neuron
Lewy body (Parkinson disease and Lewy body dementia)
Rapid fire assoc:Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
Negri bodies of rabies
Rapid fire assoc:Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer disease)
Rapid fire assoc: Degeneration of dorsal column fibers
Tabes dorsalis (3º syphilis), subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)
Rapid fire assoc:Depigmentation of neurons in substantia nigra
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
Rapid fire assoc: Bloody or yellow (xanthochromia) tap on lumbar puncture
Subarachnoid hemorrhage
Toe extension/fanning upon plantar scrape
Babinski sign (UMN lesion)
Unilateral facial drooping involving forehead
LMN facial nerve (CN VII) palsy; UMN lesions spare the forehead
Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia
Multiple sclerosis
Ptosis, miosis, anhidrosis
Horner syndrome (sympathetic chain lesion)
Pupil accommodates but doesn’t react
Neurosyphilis (Argyll Robertson pupil)
Rapidly progressive limb weakness that ascends following GI/upper respiratory infection
Guillain-Barré syndrome (acute inflammatory demyelinating polyradiculopathy subtype)
Resting tremor, rigidity, akinesia, postural instability, shuffling gait
Parkinson disease (loss of dopaminergic neurons in substantia nigra pars compacta)
Chorea, dementia, caudate degeneration
Huntington disease (autosomal dominant CAG repeat expansion)
Conjugate horizontal gaze palsy, horizontal diplopia
Internuclear ophthalmoplegia (damage to MLF, may be unilateral or bilateral)
Lucid interval after traumatic brain injury
Epidural hematoma (middle meningeal artery rupture)
What is the triad of symptoms you would expect in a patient with normal pressure hydrocephalus (NPH)?
Ataxia (wide based gait), dementia,and urinary incontinence (Wet, wobbly, wacky)
Bilateral acoustic schwannomas dx?
Neurofibromatosis type 2
Which class of medication is used to prevent vasospasm in patients with subarachnoid hemorrhage?
Calcium channel blockers (eg.nimodipine, nifedipine)
What is POUND criteria for migraine?
Pulsatile quality, one day duration, unilateral, nausea or vomiting, disabling intensity
Persistent vertigo, limb ataxia, bidirectional nystagmus, symptoms greater than 72 hours suggest what diagnosis?
cerebellar stroke
Highly aggressive cancer. Pts p/w seizures, n/v, headache, rapid neuro decline. What’s the dx?
Glioblastoma multiforme
Scattered ovoid shaped, periventricular white matter lesions on MRI suggest what diagnosis?
Multiple sclerosis
What diagnosis is suggested by foot or wrist drop as well as pain, nausea, loss of reflexes?
Mononeuritis multiplex