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first aid 2015 Teresa > NEURO: first aid 485-489 > Flashcards

NEURO: first aid 485-489 Flashcards

1
Q

Why do you see optic neuritis in MS?

A

CN II is only nerve myelinated by oligodendrocytes

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2
Q

what is marcus Gunn pupils?

A

someone explain?

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3
Q

MS more common in what type of population?

A

whites living far from equator

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4
Q

What type of bowel incontinence is seen in MS?

A

Urge

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5
Q

What type of hypersensitivity is MS?

A

4

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6
Q

charcot triad of MS?

A

SIN

  • Scanning speech
  • Intention tremor (also Incontinence and Internuclear ophthalmoplegia
  • Nystagmus
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7
Q

woman in 20 with sudden loss of vision and it’s relapsing and remitting course

A

MS

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8
Q

Diagnostic test for MS

A

Oligoclonal bands

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9
Q

Gold standard for MS and what do you see

A

MRI and periventricular plaques (areas of oligodendrocyte loss and reactive gliosis)

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10
Q

Bonus: Reactive gliosis by what cells

A

astrocytes

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11
Q

MS: multiple white matter lesions separated in time and space mean?

A

anyone?

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12
Q

DMARDS for MS

A

IFNB and natalizumab

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13
Q

what is natalizumab?

A

against integrin4

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14
Q

Whats the treatment of acute flares of MS

A

IV steriods

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15
Q

list Muscarinic antagonist to treat neurogenic bladder

A

oxybutynin

Tolterodine

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16
Q

What do you use for Spasticity in MS

A

Baclofen (GABAb agonist)

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17
Q

where do you see albuminocytologic dissociation?

A

Guillain Barre

Increased CSF protein with normal cell count

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18
Q

GB associated infections

A

Associated with infections (eg, Campylobacter

jejuni, viral)

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19
Q

can you use steriod in GB?

A

“Respiratory support is critical until recovery.
Additional treatment: plasmapheresis, IV
immunoglobulins. No role for steroids.”

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20
Q

Patient comes to you with Ptosis, “down and out” gaze and normal pupillary light reflexes. What is the most common cause of this type of nerve injury?

A

Vascular disease

eg. DM

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21
Q

What is the function of parasympathetic out of CN 3

A

pupillary light reflex

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22
Q

What type of aneurysm AND herniation that can affect sympathetic fibers of CN3?

A

Posterior communicating artery aneurysm

Uncal herniation

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23
Q

If you have CN IV damage, what are the symptoms?

A

SO4
Function of SO
1. trouble going downstairs ( SO depresses and abduct)
2. Head tilt towards the side of the lesion (So intort, now no SO –> you extort –> so may present with compensatory head tilt in the opposite direction)

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24
Q

What will happen to L CN VI palsy when you tell that patient to look L?

A

L eye will not look L

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25
Q

What happen to the R eye in Right CN IV palsy with L gaze?

A

R eye looks upward = R hypertropia

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26
Q

List the causes of R anopia?

A

Optic neuritis, central retinal A occlusion

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27
Q

Tunnel vision, what lesions?

A

Pituitary lesion

Optic chiasm

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28
Q

Patient has L parietal lesion because of MCA infract, what type of visual field defect would he have?

A

Calcarine fissure –> R lower quadrantic anopia

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29
Q

Meyer loop

  1. which lobe
  2. what vision defect
  3. what blood supply
A
  1. temporal
  2. upper quadrantic anopia
  3. MCA
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30
Q

you lesion the optic tract, what visual defect?

A

Homnoymous hemianopia

** optic tract is in occipital lobe and supplied by MCA

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31
Q

What else can cause Homnoymous hemianopia?

A

LGB complete lesion

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32
Q

Macula –> bilateral projection to occiput. What does it mean?

A

I don’t know too, anyone?

33
Q

Meyer loop is responsible for what part of retina? and what vision loss?

A

inferior –> Pie in the sky ( upper quadrantic anopia)

34
Q

Meyer loop loops around?

A

Inferior horn of lateral ventricle

35
Q

What goes through internal capsule?

A

Dorsal optic radiation

36
Q

Patient has R MLF lesioned, what are the symptoms?

A

When eye looks L, R eye cannot look L ( Right MR is not working)

37
Q

Convergence normal or abnormal?
1. MLF
2. CN 3 lesion
Explain why?

A
  1. MLF is normal

2. CN 3 is not

38
Q

Bilateral INO seen in

A

MS

39
Q

What eye gets nystagmus in R-MLF lesion in L gaze?

A

L

Explanation: Abducting eye gets nystagmus (CN VI overfires to stimulate CN III)

40
Q

When you say this patient has R INO, it means what?

A

R eye paralyzed

41
Q

Senile plaques and tau, which one is intracellular and which one is extracelluar

A

plaques is extra

tau is intra

42
Q

to determine the degree of dimentia, what do you look for?

A

number of tangles

43
Q

What decreases the risk of Alzheimer? What increases?

A

ApoE2 decrease

ApoE4 increases

44
Q

Early onset dimentia by down why?

A

chr 21 has APP gene on it

45
Q

what are presenilin 1 and 2?

A

gene that increases risk of early onset

46
Q

where do you see spherical tau and what do you stain with

A

Pick, silver

47
Q

Patient with change in personality which type of dimentia

A

Pick (FT dimentia)

48
Q

Paitent with visual hallucinations followed by parkinsonian features

A

Lewy

49
Q

How do you DDx Lewy body dimentia and Parkinson patient with dimentia?

A

Lewy is early onset

50
Q

Dimentia with myoclonus

A

Creutzfeldt-Jakob (rapid!)

51
Q

What are prions?

A

PrPc—> PrPsc sheet which are Bpleated sheet reisstant to proteases

52
Q

where do you see 14/3/3 protein

A

CJ

53
Q

Where do you see Hirano bodies in hippocampal

A

Alzheimer

54
Q

Name 2 infections and 2 vaccinations that can cause acute disseminated (postinfectious) encephalomyelitis

A
  1. measles or VZV

2. rabies, small pox

55
Q

Demyelinating disease with Pes cavus and foot drop

A

Charcot-marie-tooth, AD

56
Q

Krabbe what enzyme deificiency

A

Galactocerebrosidase

57
Q

Glucocerebrosidase deficiency

A

Gaucher

58
Q

Metachromatic leukodystrophy enzyme deficiency?

A

Arylsulfatase A

59
Q

JC virus can cause what type of demyelinating diease?

A

Progressive multifocal leukoencephalopathy

60
Q

PML also seen in 2-4% of what patient

A

AIDS

61
Q

Patient with MS, we give this antibody-drug and she suddenly develops Dementia, weakness, sensory loss, and every possible CNS symptoms, what drug did you give her?

A

Natalizumab –> PML

62
Q

Patient with follicular lymphoma, we give this antibody-drug and she suddenly develops Dementia, weakness, sensory loss, and every possible CNS symptoms, what drug did you give her?

A

Rituximab CD20-

63
Q

explain adrenoleukodystrophy and how do they die?

A

X linked, males
very long chain FA cannot be broke down –> built up in CNS, adrenal gland, testes
die with adrenal crisis

64
Q

What is partial seizures?

A

it’s focal seizure, single area

65
Q

Generalized?

A

diffuse

66
Q

Whats the origin of partial seizures?

A

medial temporal lobe

67
Q

what’s simple partial?

A

simple = consciousness intact

complex is not

68
Q

causes of simple partial can be? (4)

A

motor, sensory, autonomic, pyschic

69
Q

the one with no postictal confusion

A

absence

70
Q

the one with repetitive jerks

A

myoclonic

71
Q

metabolic disorders of myoclonus?

A

renal and liver

72
Q

what’s grand-mal seizures?

A

tonic-clonic (stiff and move)

73
Q

atonic is mistaken for what?

A

fainting

74
Q

febrile seizures are epilepsy? T or F?

A

F

75
Q

Define status epilepticus

A

continous or recurring seizures that may result in brain injury (duration is >10-30 min)

76
Q

causes of seizures by age

children? MCC

A

genetic, infection, trauma, congenital, metabolic

77
Q

Adults causes of seizures

A

tumor, trauma, stroke, infection

78
Q

elderly

A

stroke, tumor, trauma, metabolic, infection

first aid 2015 Teresa (9 decks)

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