neuro- pretest Flashcards
multi infarct and hemosiderin
amyloid angiopathy
wallenberg stroke syndrome (lateral medullary)
ipsi: ataxia, horners, loss f facial pain and temp, impaired corneal reflex (effects CNV)
contra: pain and temp of limbs and trunk
dysphagia and dysphonia
nucleus ambiguus
contains motor of CN IX, X –> dysphagia
lamictal vs keppra in inpatient setting?
keppra! Lamictal takes a looooong time to become therapuetic
sturge weber (encephalofacial angiomatosis)
port wine stain over upper dist of V1 and leptomeningeal angioma
alcohol withdrawal timelines:
- sz
- DTs
sz- 24 hours
DTs- 2-4 days
Lennox-Gestaut syndrome
epilepsy: 1-2Hz spikes
- mental dysfunction
- multiple seizure types
- hx of infantile spasms
olfactory hallucinations auras come from…..
mesial temporal lobe
most common complication of temporal lobectomy
right superior quadrantanopsia
most common cause of intractable complex partial seizures in adults
mesial temporal sclerosis
-80% sz freedom with temporalectomy
treatment for West syndrome (recurrent infantile febrile sz)
ACTH?
why would you choose valproate in absence sz?
ethosuximide causes GI distress
also if they also have generalized tonic clonic sz
jacksonian march: general or focal?
begins focal, usually becomes general
benign juvenile myoclonic epilepsy
often see myoclonic sz
myoclonus occurs when pt is awake!!
no taste after head trauma?
(aguesia)
avulsion of olfactory rootlets –> anosmia is common after brain injury
managment of spinal cord trauma patient coming into ED
high dose IV methylpred
you see a ring enhancing lesion on CT in a patient with known HIV. What do you do next?
LP CSF for EBV PCR –> specific for CNS lymphomoa
JC virus leads to….
PML (progressive multifocal leukoencephalopathy
how does rabies access CNS?
retrograde axoplasmic flow
upward herniation
transtentorial –> crosses tentorium cerebelli
downward herniation
transforaminal –> crosses foramen magnum
cerebellr ataxia signs in someone with breast lump, ovarian, or lung cancer found?
paraneoplastic cerebellar degeneration –> deg of purkinje fibers, assoc with anti-yo antibodies
enzymatic abnormabilty of tay sachs?
hexosaminidase A
cherry red spots
visual field cut in B12 deficiency?
centrocecal scotoma
language disturbance in alzheimers
transcoritcal sensory loss
- repition intact
- lack understanding of complex language
caudate shapes what ventricle?
lateral
tremor in parkinsons is……
asymmetric
Lewy bodies are intracyctoplasmic or intranuclear inclusions?
CYTOPLASM
speech defect in parkinsons
hypophonia –> progressively inaudible. think of as similar to handwriting
hepatolentricular dz
WILSONS
atrophy of putamen and globus pallidus
bladder issue in MS?
spastic bladder (UMN)
good contractility, but poor distensibility–> leads to spasticity
usu have urge incont
uthoff phenomenon
demylinating sx that get worse in the heat
leber optic atrophy
mitochondrial DNA mutations
looks like optic neuritis but blind spot extends into central field of vision
fragile X phenotype in men vs women
Repeat?
women- about half have mild retardation but generally normal
men- hyperextensible joints, prominent thumbs
CGG (chin, giant gonads)
friedrichs ataxia repeats?
phenoytpe?
GAA (ataxic GAAit)
cerebellar signs
hypertrophic cardiomyopathy!! (cause of death)
myotonic dystrophy repeats
CTG (cataracts, toupe, gone gonads)
arrythmias
neimann pick
Sphingomyelinase
cherry red spots on macula
progressive neuro degeneration
(no man picks his nose with his sphinger)
antibiotic proph for n. meningitis
rifampin
transient global amnesia
1-24h only!!
general anterograde amenesia
resolves spontanesously
a risk of acute angle closure glauc? tx?
mydriasis (drug induced, dark room)
- pilocarpine to inc angle, acetazolamide to dec aq humor production
- beta blocker drops
NO ATROPINE OR EPI
NO BP LOWERING
characteristics of cavernous sinus thrombosis
- palsy of 3,4,5i ii, 6
- proptosis
- most common from spread of infection
presentation of polymyositis
proximal muscle weakness –> difficulty climbing stiars, brushing hair
dysphagia
(cervical) spondylytic myelopathy
inter or extramedullary compression of mass that causes LMN signs at level of lesion and UMN signs below level of lesion (wide based gait, absent babinski)
- impaired sensatin
- impaired bowel/bladder
sx of uncal hernation
ipsilateral CNIII palsy with contralat
INO
weak adduction of the AFFECTED EYE
