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neurology shelf > Neuro quick facts > Flashcards

Neuro quick facts Flashcards

1
Q

6-12 Hx tremor? 10-12Hz tremor? 3-6Hz tremor?

A

Benign essential tremor, physiologically enhanced tremor (caffeine or hyperthyroid), Parkinsons dz

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2
Q

where is the atrophy in huntingtons dz

A

caudate&raquo_space;> putamen

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3
Q

40y/o w/ personality change and later develops dementia, dysarthria and chorea

A

huntingtons

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4
Q

how does the juvenile form of huntingtons present?

A

westphal variant is like parkinsons (hypo kinetic)

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5
Q

what causes dystonia at rest starting in the leg with no other neuro findings

A

brain lesion (secondary dystonia)

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6
Q

what gene is expanded in spinocerebellar ataxia

A

ataxin gene

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7
Q

What is seen in Spinocerebellar ataxia 1, 2, 3, 6, 7

A

1: pyramidal signs
2: dementia
3: parkinsonism and lid retraction (big eyes) [aka mach ado joseph dz (impaired temperature discrimination in all limbs)]
6: very late onset
7: infantile onset

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8
Q

if tardive dyskinesia occurs when a patient is on metoclopramide what do you switch to in order to continue DA reduction

A

Reserpine + tetrabenzine

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9
Q

what are 3 risk factors that increase the risk of permanent dyskinesia

A

old age, female, co-existing brain damage

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10
Q

if there is a cervical vertebral fracture above C3 what causes respiratory difficulties

A

phrenic nerve paralysis

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11
Q

if someone is <9y/o and has quadriparesis what must be ordered

A

MRI

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12
Q

What is it very important to do if you suspect an epidural hematoma but the CT is normal and then there is change in mental status

A

Re-do CT

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13
Q

what is the MC neurobehavioral disorder in hospitals

A

delirium

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14
Q

what is the pathophys of Subarachnoid hemorrhage becoming delirium

A

SAH –> secondary SIADH –> delutional hyponatremia –> delirium

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15
Q

what constitutes concussion grades

A

1: no loss of consciousness and all symptoms resolve 15 mins
3: any loss of consciousness

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16
Q

what is post-concussive syndrome

A

iritability + change in intellectual fxn in 4 wks after w/ resolution boy 3 mo

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17
Q

what are the criteria to get a CT with a concussion

A

if persistent HA, emesis, >60y/o, on drugs or alcohol, anterograde amnesia, seizure, injury above clavicle

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18
Q

what is the MCC of hemorrhagic stroke

A

uncontrolled HTN

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19
Q

how do you evaluate strokes

A

BEC (blood, EKG, CT)

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20
Q

What are the grades for SAH 1-5

A

1/2: no focal signs

3: mild focal signs
4: hemiparesis
5: comatose

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21
Q

what is MCC of SAH coming from ant comm a.

A

ADPKD

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22
Q

what is MCC of SAH presentation from Post comm a.

A

CN 3 paralysis

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23
Q

what 3 conditions predispose you to spontaneous dissection

A

marfans, ehlers danlos, and fibromuscular dysplasia

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24
Q

what is the severe form of AVM and what happens

A

Moyamoya; causes secondary occlusion of the CoW

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25
Q

what do you call an stroke of unknown etiology and what usually causes it

A

cryptogenic stroke; usually secondary to patent foramen ovale

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26
Q

define a seizure

A

abnormal neuronal activity

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27
Q

what are 4 things that lower seizure threshold

A

EtOH, Rx, too little sleep, menstrual cycle

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28
Q

what is the difference btw a simple and complex seizure

A

with a simple seizure you maintain consciousness

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29
Q

what are the 2 types of partial seizures and the 5 types of generalized seizures

A

Partial: simple and complex
Generalized: tonic, myoclonic, tonic-clonic, absence, atonic

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30
Q

what drug do you use for a partial seizure

A

carbamazepine

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31
Q

what drug do you use for a complex seizure

A

topiramate

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32
Q

what is the MC seizure in adults w/ epilepsy

A

Complex partial seizure

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33
Q

3 Hz spike and wave

A

absence seizure

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34
Q

how do you precipitate an absence seizure

A

hyperventilation

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35
Q

what test do you use to evaluate syncope

A

tilt-table test (+ if they pass out or if BP drops 20 systolic)

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36
Q

what are 2 things that can cause syncope

A

dec CO and arrythmias

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37
Q

how do you confirm pseudoseizures

A

continuous 24 Hr EEG w/ video; previous hx of trauma/traumatic experience

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38
Q

what is the difference btw a classic and a common migraine

A

classic has aura; common does not

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39
Q

what is the presentation/progression of a migraine

A

trigger -> prodrome -> +/-aura -> migraine HA +/- associated symptoms

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40
Q

unilateral periorbital thorbbing headache

A

migraine

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41
Q

what is given as a migraine abortive drug and what is given for prophylaxis

A

Abortive: triptan (5HT-agonist)
prophylaxis: topomax

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42
Q

hat band headache

A

tension HA

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43
Q

intense pain behind ears going toward temples

A

occiptial neuralgia (secondary inflammation of greater occipital nerves)

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44
Q

what do you give for occipital neuralgia

A

steroid + anesthetic injection at greater occipital nerve exit point

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45
Q

progressive impaired memory and one other cognitive fxn w/o change in consciousness that alters daily living or quality of life

A

dementia

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46
Q

what neurotransmitter changes are seen with Alzheimers

A

decrease in Ach from destruction of nucleus basal is of meynert

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47
Q

what is the progression of alzheimers in the brain

A

hippocampus degeneration early –> parietotemporal cortex follows –> frontal cortex last

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48
Q

what is pseudo dementia

A

a severe form of depression where pts answer with “i don’t know”

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49
Q

what are lewy bodies made of

A

alpha synuclien

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50
Q

syndrome of sensory loss and spastic paresis; loss of dorsal columns and lateral CST; hallucinations

A

B12 def

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51
Q

what is seen on labs with b12 def

A

low b12, high homocysteine and MMA

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52
Q

what is the pathophys of optic neuritis

A

possibly secondary AI + demyelinating dz of optic nerve

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53
Q

what is uhthoffs phenomenon

A

in MS where heat causes worsening of demyelinating dz

54
Q

what is the tx for optic neuritis

A

IV steroids (give IFN-b1 if they have MS)

55
Q

focal demyelination in MS causes plaques that are made of what?

A

lymphocytes/macrophages, IgG/M complement, and dying oligodendroglia

56
Q

what is the order of subtypes of MS from worst to best prognosis

A

primary progressive, secondary progressive, relapsing remitting, and benign

57
Q

how do you dx MS

A

it is a clinical dx

58
Q

what is seen on T2 MRI with MS pts

A

dawson’s fingers (periventricular /corpus callusum lesions)

59
Q

What drugs are given for MS

A

IFNb1, IV steroids, mitoxantrone (antineoplastic used to reduce worsening MS)

60
Q

pt w/ MS and encephalitis w/o fever

A

Acute disseminated encephalomyelitis

61
Q

what is the pathophys of Acute disseminated encephalomyelitis

A

AI acute uniphasic demyelinating dz of the CNS associated w/ post viral / vaccine illness

62
Q

what is the mechanism of perivascular demyelination of ADEM

A

T cell mediated

63
Q

what would you see with ADEM

A

perivenular demyelination

64
Q

what percent of ADEM pts develop MS

A

25%

65
Q

what do you call incomplete leg extension secondary to blood irritating lumbosacral roots causing decreased hamstring fxn and what is it a sign of

A

kernigs sign; meningitis

66
Q

what do you call neck flexion causing involuntary leg/hip flexion and what is it a sign of

A

brudzinski sign; meningitis

67
Q

baby and honey

A

infantile botulism

68
Q

what does botulism cause in the presynaptic cell

A

cleaves v+t snares preventing neurotransmitter release

69
Q

what do you evaluate for with infantile botulism

A

respiratory depression

70
Q

myelin pallor on MRI

A

HIV associated dementia

71
Q

first dec concentration, then personality change, then ataxia, then dementia

A

HIV associated dementia

72
Q

rapidly progressing dementia

A

CJD

73
Q

spongiform encephalopathy

A

CJD

74
Q

change in muscular coordination leading to myoclonus and rapidly progressing dementia

A

CJD

75
Q

pulvinar hockey stick on MRI

A

CJD

76
Q

what would cause tabes dorsal is to present much faster

A

concurrent HIV infection

77
Q

what causes tabes dorsalis

A

neurosyphilis (t. pallidum)

78
Q

lancinating pain and sensory ataxia, CN change, impotence/bowel-bladder problems, and hyporeflexia

A

Classical tabes dorsalis

79
Q

infant and cats

A

toxoplasmosis

80
Q

what are 3 ways to get toxoplasmosis

A

ingestion of meat w/ cysts, ingestion of water w/ cat feces, vertical transmission

81
Q

chorioretinitis, intracranial calcivications, and hydrocephalus in an HIV pt

A

Toxoplasmosis

82
Q

what do you use to tx toxo

A

pyrimethamine, sulfadiaine; bactrim prophylaxis if CD4<200

83
Q

non reactive pupil, normal CT, and frontal headache that does not improve w/ tylenol; pupil constricts w/ pilocarpine

A

holmes adie pupil

84
Q

where is the lesion in a holmes aide pupil

A

after the ciliary ganglion

85
Q

graying out vision

A

inc ICP (pseudotumor cerebri)

86
Q

how do you treat pseudotumor

A

high vol LP, acetazolamide, VP shunt

87
Q

herpes in the ear w/ hearing loss but no damage to tympanic membrane

A

ramsay hunt syndrome

88
Q

what kind of hearing loss occurs in ramsay hunt syndrome

A

sensorineural

89
Q

what is the MCC of CNVII palsy

A

idiopathic (bells palsy)

90
Q

85% of MG pts have what condition

A

thymic hyperplasia

91
Q

anti MuSK Ab

A

MG

92
Q

what do you give for MG

A

pyridostigmine and plasmaphoresis

93
Q

what is it important to evaluate for during Myasthenic crisis

A

FVC (respiratory fxn)

94
Q

what causes BPPV

A

otoliths (Ca-stones) in posterior semicircular cancal

95
Q

what is the difference btw menieres dz and BPPV

A

menieres dz has hearingloss

96
Q

what 2 dz have high protein w/ normal cell count on CSF and what is that called

A

CIDP/AIDP; albuminocytologic dissociation

97
Q

GBS will show what on babinski test

A

negative because UMN and CST are unaffected

98
Q

double vision, droopy eyes, dilated pupils, droopy face, dry mouth, dysphagia what does this pt have

A

botulism

99
Q

what is the triad for miller fischer

A

ataxia, opthalmoplegia and areflexia

100
Q

anti-GQ1b Ab

A

Miller fisher (GBS)

101
Q

pts with dermatomyositis have inc risk for what

A

ovarian cancer

102
Q

heliotrope rash and gotron papules

A

dermatomyositis

103
Q

anti-Jo-1 Ab

A

dermatomyositis

104
Q

increased CD4 cells in a perivascular pattern on biopsy

A

dermatomyositis

105
Q

what percent of ALS is hereditary and what is the other part

A

10% hereditary; 90% sporadic

106
Q

what is the MC mutation in hereditary ALS

A

SOD

107
Q

what is the standard treatment for ALS

A

riluzole

108
Q

what constitutes the clinical diagnosis of ALS

A

UMN+LMN signs in 3 separate regions

109
Q

tinel sign and phalen sign; what are they and what do they tell you

A

Tinel sign: symptoms of pain by tapping wrist
Phalen sign: pain w/in 1 min of hands back to back
tells you carpal tunnel syndrome

110
Q

carpal tunnel syndrome is a neuropathy of what nerve

A

Median nerve

111
Q

what is the clinical presentation of Carpal tunnel

A

pain at night (feel swollen) must shake hands when wake up

112
Q

common peroneal nerve comes from what root(s)

A

L4-5

113
Q

steppage gait is seen with which neuropathy

A

common peroneal palsy

114
Q

what are 4 seizures seen btw 3yr-20yr/o

A

benign rolandic, absence, JME, febrile

115
Q

what seizures are seen btw 6mo-6yr

A

febrile seizures

116
Q

all idiopathic seizure disorders resolve spontaneously except which one

A

JME

117
Q

what percent of kids w/ a simple febrile seizure are at risk for epilepsy

A

2-4%

118
Q

proximal muscle weakness, + gower sign, and toe walking

A

duchenes muscular dystrophy

119
Q

what labs should you order if you suspect DMD and what would it show

A

CK (inc 5x normal)

120
Q

what is the MCC of death in DMD

A

respiratory dz

121
Q

what are the diagnostic criteria of tourettes

A

at least 1 motor and 1 phonetic tic that lasts for 1 yr

122
Q

what are 2 disorders associated w/ tourettes

A

OCD, ADHD

123
Q

nocturnal episode involving face/speech and inc salivation w/ loss of consciousness and FHx

A

benign rolandic epilepsy

124
Q

when is it ok to treat for benign rolandic epilepsy

A

if they have 3+ seizures

125
Q

baby w/ agyria and pachgyria, epicentral fold dysmorphism

A

miller dieker syndrome

126
Q

what is the MC tumor in the CP angle

A

acoustic neuroma (schwannoma)

127
Q

what are the MC places of primary tumors that metastasize to the brain

A

Lung> breast> skin> colon> kidney

128
Q

floppy baby

A

werdnig hoffman dz

129
Q

positive for increased SMN1 gene

A

werdnig hoffman dz; causes fewer motor neurons

130
Q

a baby w/ werdnig hoffmans dz would have shown what in utero?

A

decreased movement and polyhydramnios

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