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VM749 Clin Sci III > Neuro Part 2 > Flashcards

Neuro Part 2 Flashcards

1
Q

hypogastric n innervates _____ on _____ & _____ on ____

A

beta receptors
detrusor m

alpha receptors
internal urethral sphincter

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2
Q

pudendal n innervates ____ on _____

A

ACh receptors
external urethral sphincter

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3
Q

pelvic n innervates ____ on _____

A

ACh receptors
detrusor m

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4
Q

LMN bladder

A

flaccid bladder, hypotonic

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5
Q

UMN bladder

A

hypertonic, firm, hard to express

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6
Q

UMN dysfunction treatment

A
  1. alpha-anatagonists - Phenoxybenzamine or Prazosin
  2. striated m relaxants - Diazepam (valium)
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7
Q

LMN dysfunction treatment

A
  1. parasympathomimetics - Bethanechol
  2. PPA/estrogen
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8
Q

sequelae to bladder dysfunction

A
  1. UTI, cystitis
  2. urine scald
  3. bladder atony (prolonged distension > 24-48 hr)
  4. bladder rupture
  5. urine overflow
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9
Q

what does autonomic dysfunction of the bladder lead to

A

loss of nerve function but intact central integration = stranguria, dysuria, large residual volume

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10
Q

most common causes of multifocal CNS disease

A

infectious, inflam, neoplastic

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11
Q

meningoenceohalitis of unknown origin (MUO)
breed predispositon?
thought to be etiology?
treatment?

A

middle aged pugs, toys and terriers
immune mediated
prenisolone + anticonvulsants

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12
Q

younger dogs with severe neck pain acutely, no neurological deficits

A

steroid responsive meningitis arteritis (SRMA)

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13
Q

SRMA treatment

A

4-6 months slowly tapering steroids

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14
Q

most common differential for older dogs with multifocal CNS disease

A

neoplasia - lymphoma

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15
Q

FIP
etiology?
neuro signs seen with ____ form
most common cause of ____ in cats
age?
treatment?

A

feline coronavirus
dry form
hydrocephalus
> 2 yr
Remdesivir

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16
Q

what is the most likely infectious cause of multifocal CNS disease in the dog

A

Neospora meningoencephalomyelitis

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17
Q

Neospora meningoencephalomyelitis
diagnostic?
treatment?

A

MRI (cerebellum hyperintensity), CSF, Ab titers, CK/AST elevations
clindamycin/TMPS + pyrimethamine

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18
Q

rabies clinical signs

A

acute CN deficits
ascending LMN paresis
non-suppurate polioencephalomyeliti and craniospinal neuritis

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19
Q

canine distemper bimodal onset
dog < 1 yr =
dog > 1 yr =

A

< 1 yr = gray matter, forebrain signs

> 1 yr = white matter, brainstem, cerebellum and spinal cord

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20
Q

canine distemper
diagnostic?
treatment?

A

titers - IgM, IgG
CSF IgG distinguishes recent vx from true infection
steroids

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21
Q

diffuse and bilateral symmetrical is indicative of what?

A

intoxication

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22
Q

primary brain injury occurs _____ and causes _____

A

time of incident
direct mechanical injury

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23
Q

secondary brain injury occurs ____ and causes ____

A

minutes-days after
biochemical changes

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24
Q

cerebral swelling can continue to worsen for up to ____ hours post trauma then will stabilize and begin to resolve overtime

A

72 hours

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25
Q

what is the Cushing’s reflex/response

A

bradycardia < 60bpm in the face of hypertension >250mmHg due to increased ICP

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26
Q

how can you stabilize a patient/provide supportive care with head trauma

A

elevate head/neck/shoulders 30-45 degrees
avoid jugular compression

27
Q

how would you treat a head trauma patient with hypovolemic shock

A

fluid resuscitation

28
Q

O2 therapy to conscious patient? unconscious patient?

A

nasal cannula or O2 catheter

intubation + ventilation

29
Q

contraindications of mannitol

A

hypovolemia
electrolyte abnormalities

don’t use if not hemodynamically stable

30
Q

what drugs can you give for head trauma and increased ICP

A

mannitol or hypertonic saline
furosemide
analgesia
NEVER STEROIDS

31
Q

best indicator for prognosis of head trauma patient

A

MGCS – trend in the first 48 hours is more valuable than an isolated neurologic evaluation
>8 associated with 50% survival

32
Q

peripheral vestibular system

A

CN VIII

33
Q

central vestibular system

A

vestibular nuclei
spinal cord
extraocular nuclei
cerebellum

34
Q

most common causes of peripheral vestibular disease

A
  1. otitis media/interna
  2. old dog/geriatric/idiopathic vestibular disease
35
Q

what is paradoxical vestibular disease

A

vestibular disease + cerebellar involvement

36
Q

what is the one sign that can differentiate central vestibular disease from paradoxical vestibular disease

A

postural reaction deficits will always be on the same side of lesion

37
Q

feline cerebellar hypoplasia
onset?
progression?
cause?

A

from birth
static
inutero infection with feline panleukopenia virus

38
Q

common signs of cerebellar ataxia

A

truncal sway
wide base stance
dysmetria
intention tremor

39
Q

cerebellar abiotrophy
breed predispositon?
onset?
progression?

A

kerry blue terrier, gordon setters, rough-coated collies, arabian horses
normal at birth, onset 2-36 months
progressive/gradual

40
Q

infarction
onset?
progression?
causes?

A

peracute < 24hf
static/improved
kidney, CV dz, infection, coagulopathy

41
Q

corticosteroid-responsive tremor syndrome (CRTS)
cause?
onset?
treatment?

A

“white shaker dog syndrome”
thought to be autoimmune, worsens with exercise, stress, excitement, disappears during sleep seen at rest
acute onset-intention tremor of head/limbs/body
prednisolone or diazepam

42
Q

acute generalized ddx for neuromuscular diseases

A

polyradiculoneuritis
myasthenia gravis
botulism
tick paralysis
polymyositis immune mediated/infectious

43
Q

chronic progressive ddx for neuromuscular diseases

A

myasthenia gravis
polymyositis inflam/infectious

44
Q

localized neuromuscular diseases ddx

A

traumatic
facial paresis/paralysis
spinal n hypertrophic neuritis
brachial plexus
trigeminal n

45
Q

gold standard diagnostic test for myasthenia gravis

A

AChR Ab test

46
Q

flaccid paralysis ddx

A

acute polyradiculoneuritis
botulism
tick paralysis

47
Q

west highland white terrier or jack russel with ascending flaccid tetraparesis and dysphonia but retains tail wag

A

acute polyradiculoneuritis

48
Q

acute polyradiculoneuritis 4 causes

A
  1. idiopathic, post vx or contact with racoon
  2. immune-mediated
  3. campylobacter and raw feed
  4. bengal cats
49
Q

acute polyradiculoneuritis diagnostic

A

F waves or CSF analysis (albuminocytological dissociation)

50
Q

Botulism
cause?
clinical signs

A

contaminated feed with C. botulinum
junctionopathy, dysautonomia and concurrent GI signs

51
Q

Neospora caninum clinical signs and treatment

A

radiculoneuritis and myositis
- arthrogryposis
clindamycin / TMPS + Pyrimethamine and physical therapy

52
Q

masticatory muscle myositis
cause?
clinical signs?
treatment?

A

auto-Ab to 2M myosin isoform
bilateral masticatory muscle atrophy, trismus
prednisolone, PT

53
Q

immune-mediated polymyositis
cause?
breeds?
treatment?

A

immune-mediated
large breeds
prednisolone + analgesia

54
Q

tetanus
pathogenesis/MOA
clinical signs

A

contaminated wound, tetanospasmin, binds irreversibly preventing GABA and glycine, and causes prolonged contraction

sawhorse stance, hypersensitivity, risus sardonicus, trismus/lockjaw

55
Q

idiopathic facial n paralysis
unilateral or bilateral?
ddx?
treatment?
prognosis?

A

unilateral
hypothyroidism, otitis media/interna, trauma, neoplasia, polyneuropathy
artificial tears
should resolve 6-8 weeks

56
Q

idiopathic trigeminal neuropathy
unilateral or bilateral?
clinical signs?
treatment?
prognosis?

A

bilateral inflammation
dropped jaw
PT or tape muzzle
resolves ~3wks

57
Q

what is the most common cause of inability to close the mouth

A

idiopathic trigeminal neuropathy

58
Q

DDX for unilateral trigeminal lesions?

A

trigeminal nerve sheath tumor

59
Q

neuromyopathy ddx

A

ischemic neuropathy
hypokalemic neuropathy

60
Q

chronic neuropathy ddx

A

diabetes
hypothyroidism

61
Q

common causes of ischemic neuropathy in the cat? dog?

A

feline aortic thromboembolism due to cardiomyopathy
dogs - renal disease

62
Q

hypokalemic neuropathy 3 causes

A

reduced intake
renal failure, hyperthyroid
burmese cat

63
Q

if a cat has cervical ventroflexion and muscle weakness, what would you consider on the ddx

A

hypokalemic neuropathy

VM749 Clin Sci III (11 decks)

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