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neuro Flashcards

1
Q

cold calorics

A

intact- eyes deviate with cold toward the water, then nystagmus away back to middle - if brainstem is hurt then it wont deviate to the side at all, if cortex hurt it will deviate and wont come back

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2
Q

bilateral intranuclear opthalmoplegia (cant look at nose )

A

MS - lesion in MLF

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3
Q

when does CT scan sens dec in SAH

A

after 12 hours

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4
Q

steroids in meningitis?

A

steroids first then abx in seriously ill with WBC >1000 did better

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5
Q

when to CT before LP

A

age 60, HIV, CNS dz, sz, abnormal neuro

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6
Q

0-1 month meninigitis abx and bugs

A

listeria, e coli, gbs - ampt and gent (or 3rd gen cef but not ceftriaxone bc of jaundice )

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7
Q

meninigits VP shunt

A

staph epi staph aureus

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8
Q

LP positive for cells but negative gram stain

A

HSV encephalitis

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9
Q

unilateral vision loss, painful, papilledema, pain with eye movements

A

optic neuritis- MS - might have bilaterael ION- cant look at nose

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10
Q

LP of MS

A

ncrease protein, IGG, oligoclonal bnds- lots of protein

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11
Q

rapid progressive extreity weakness, limb paralysis after exercise, Low K

A

acute periodic paralysis, asian male, K shifted into cells after exercise, assn hypo K ***thyrotoxicosis- AD - avoid high carb diet

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12
Q

muscle weakness, fatiguability with diplopia, ptosis

A

MG classicaly starts in face, wake up in AM ok, worse during the day, worse during counting

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13
Q

autoab vs ach receptors

A

MG, assn thyoma

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14
Q

tensilon (edrophonium) test

A

tensilon test- blocks ACHi- ach sticks around longer , patient gets better - side effect brady/sycope

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15
Q

tx MG

A

physostigmine/neostigmine

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16
Q

exacerbations of MG causes

A

either exacerbation- or overtreatment - comes in cholingeric BBBB sludge

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17
Q

hx Ca, decreased DTR, calcium channels- failure to release Ach from terminal presynaptic axons of motor neurons

A

Lambert EAton- weakness improves with use

18
Q

tx lambert eaton

A

remove tumor, plamapheresis

19
Q

ach release blocked at NMJ

A

botulism- motor and autonomic fxn

20
Q

causes of botulism

A

foodborne, wound, infant

21
Q

diplopia, dysphagia, ptosis, descneding flaccid paralysis, antiAch sxs- drymouth, dilated pupils, normal sensation

A

botulism

22
Q

floppy baby, constipation, feeble cry

A

botulism

23
Q

tx botulsims

A

antitoxin, debride wound, high dose pcn

24
Q

reversible, rapidly ascending paralysis, no paresthesias

A

tick paralysis - no paresthesias diff from GBS

25
Q

upper and lower motor neurons- m wasting, fascuclartions, weakess, spasticitys

A

ALS

26
Q

expanding central cavity in spinal cord- usually cervical

A

syngomyelia- weakness in arms

27
Q

patient with poor motor function in hand, loss of pain and tep- vibration and position preserved

A

synringomyelia, central cord- IO wasting, assn Chiari cerebella defect- MRI

28
Q

contralateral motor and sensory, CN defects

A

cortical- cerebral

29
Q

cranial n one side and cortocispinal tract other side-

A

crossed- brainstem

30
Q

stroke with coma, miosis, gze paresis, rsp

A

pontine

31
Q

stroke numb and weak in opposite leg

A

ACA

32
Q

stroke contralateral arms and face paralysis, sensory, asphaia (dominant left) or neglect (nontominat right), homonoymous hemianipsia

A

MCA

33
Q

stroke with contralateral homonymous hemoanipsia

A

PCA

34
Q

locked in syndrome

A

CPM and pons stroke from basilar A occlusion- only have vertical eye mvmt left

35
Q

pure motor stroke

A

pons, IC (lacunar)

36
Q

pure sensory stroke

A

thalamus (lacunar)

37
Q

myopathy weakness vs perinheeral neuropathy

A

myopathy is proximal, peurpheral neuropathy is distal

38
Q

buring pain and hyperalgeisa after injury

A

CRPS (RSD) blocks, gabapentin

39
Q

lead pipe rigidity, elevated CPK, fever, encephalopathy, change in vitals

A

NMS- IVF benzos, consider dantrolene - usually early after start of antipsychotics

40
Q

altered mental, fever, BP and tachy, irritabiility, myoclonus and twitching

A

serotonin syndrome tx IVF, benzos, serotonin blockers like chlorpromazine or cyproheptadine

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