Neuro Flashcards
Is a stroke an upper or lower motor neuron lesion
Upper
Is a brain/spinal cord injury an upper or lower motor neuron lesion
Upper
Is Guillain Barre an upper or lower motor neuron lesion
Lower
Is cerebral palsy an upper or lower motor neuron lesion
Upper
Is botulism an upper or lower motor neuron lesion
Lower
Is cauda equina an upper or lower motor neuron lesion
Lower
Is polio an upper or lower motor neuron lesion
Lower
Is MS an upper or lower motor neuron lesion
Upper
Is bell palsy an upper or lower motor neuron lesion
Lower
What kind of paralysis does an UMN lesion cause
What are reflexes
Spastic (hypertonia)
Increased DTR
What kind of paralysis does a LMN lesion cause
What are reflexes
Flaccid (hypotonia)
Decreased DTR
Which type of motor neuron lesion will have fasiculations
Lower
Describe what happens with the Babinski reflex for upper and lower MN lesions
Upper: upward
Lower: downward
Which motor neuron lesion causes muscle atrophy
Lower
Pt has contralateral sensory/motor loss / hemiparesis greater in the face and arm
Gaze preference to ipsilateral side
Which artery
Middle cerebral artery
Wernickes v Brocas: superior MCA or inferior MCA
Brocas = superior Wernickes = inferior
Are wernickes/ brocas left side or right side dominant
L side dominant
Pt with contralateral sensory/motor loss / hemiparesis in leg/foot with abnormal gait
Normal face and speech
Personality changes
May have incontinence
Which artery
Anterior cerebral artery
Pt with visual hallucinations
ipsilateral CN deficits and contralateral muscle weakness - “contralateral homonymous hemianopsia “
May have vertigo, nystagmus, diplopia
Posterior infarction
(Posterior cerebral artery
Basilar artery
Vertebral artery)
Pt with hemiparesis, hemiplegia, clumsiness. CT shows small punched out hypodense areas
Lacunar infarct
Which ischemic stroke do you treat with aspirin instead of TPA
Lacunar infarct
Convex lens shaped bleed
Between skull and dura
Doesn’t cross suture lines
Us. Temporal
Epidural hematoma
Concave crescent shaped bleed
Between dura and arachnoid
Can cross suture lines
Subdural hematoma
If you suspect intracerebral hemorrhage, what can’t you do as a dx test
LP - risk herniation
MC meningitis bug age <1 month
GBS (strep agalactiae)
MC meningitis bug age 1mo - 18y
N meningitidis
MC meningitis age 18-50
S pneumo
How do you treat meningitis age 1mo - 50 y
Ceftriaxone + vancomycin
Describe the CSF findings for bacterial meningitis Opening pressure Protein Glucose WBC
Opening pressure - high
Protein - high
Glucose - low*
WBC - high* with neutrophils and PMNs
Describe the CSF findings for viral meningitis Opening pressure Protein Glucose WBC
Opening pressure - normal or high
Protein - low to normal
Glucose - normal**
WBC - mild high with lymphocytes
MC bug in viral meningitis
Enteroviruses (echovirus, coxsackie)
MC cause of encephalitis
HSV1
What is the s/s difference between meningitis and encephalitis
Encephalitis has abnormal cerebral function eg sensory/motor, speech/movement
Seizure
Brief impairment of consciousness
Brief staring episodes
No postictal phase
Generalized
Absence (petit mal)
Seizure
Loss of consciousness with rigidity and arrest of respirations
Repetitive rhythmic jerking for 2-3 minutes
Flaccid coma/sleep
Generalized
Tonic-clonic (grand mal)
Seizure
No LOC
Sudden, brief, sporadic involuntary twitching
Generalized
Myoclonus
Seizure
Sudden loss of postural tone “drop attack”
Generalized
Atonic
Seizure
There is impaired consciousness
Lip smacking, picking, patting, coordinated motor movement
Partial (focal)
Complex partial
Seizure
Consciousness maintained fully
Focal sensory, autonomic, or motor symptoms
“Todd’s paralysis” lasting up to 24 hours
Partial (focal)
Simple partial
What level is increased in seizures that helps to differentiate from pseudoseizure
Prolactin
TOC for absence seizures
Ethosuxamide
Glutamate is increased with what disease
Alzheimers
Glutamate is decreased with what disease
PKU
GABA is increased with what disease
NONE
GABA is decreased with what disease
UMN lesions
Huntington’s
Ach is increased with what disease
Parkinsons
Dopamine is increased with what disease
Schizophrenia
Dopamine is decreased with what disease
Parkinson’s
NMS