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CPD III > Neuro Quiz #2 > Flashcards

Neuro Quiz #2 Flashcards

1
Q

What would be outcome of lesion in Wernickes area?

A

Pt can speak but doesn’t make any sense

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2
Q

Spinal cord white matter

A

ascending and descending pathways

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3
Q

spinal cord grey matter

A

neuronal cell bodies and synapses

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4
Q

What are sx of upper motor neuron damage?

A

spasm, fine movements, positive babinksy

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5
Q

sx of lower motor neuron damage?

A

decreased tone, atrophy of muscle, can’t grip, decreased reflexes

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6
Q

Disorders of basal ganglia

A

parkinsonism:
chorea: sudden jerky, purposeless movements
motor issues

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7
Q

parkinsonism

A

rigidity, slowness, resting tremor

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8
Q

Chorea

A

sudden, jerky, purposeless movements

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9
Q

athetosis

A

slow, writhing, snakelike of one arm

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10
Q

hemibalismus

A

sudden, wild flail-like movements of one are

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11
Q

Neuro history in HEENT system. Important questions

A

HA (rule out stroke, meningitis)
visual changes
dizziness

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12
Q

Neuro hx questiosn

A 
tremor
weakness or sensory loss
LOC
dysphagia
motor dysfunction
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13
Q

Mental Status Exam FOGS

A

Family Story of Memory Loss
Orientation
General information
Spelling

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14
Q

compare dementia and delerium

A

dementia: worse at night, slowly gets worse, no change in consciousness
delerium: changes in consciousness, comes on suddenly

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15
Q

Basic labs for neuro disorders

A

CBC, CMP, TSH, bedside glucose
celiac
heavy metal testing

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16
Q

Imaging and further workup for neuro

A

MRI, CT

lumbar puncture

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17
Q

What is 3rd most common cause of death and most common cause of neuro disability?

A

Stroke

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18
Q

sx of anterior supply stroke

A

unilateral sx

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19
Q

posterior supply stroke sx

A

unilateral or bilateral sx and affets consciousness

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20
Q

sx of stroke

A

numbness, weakness, paralysis of contralateral limbs and face
aphasa

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21
Q

sx of stroke

A 
numbness, weakness, paralysis of contralateral limbs and face
aphasia
confusion
visual disturbances 
dizziness or loss of balance
HA
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22
Q

What is the most common type of stroke?

A

ischemic

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23
Q

types of ischmic stroke

A

thrombosis (most common)
Emboli
lacunar (small vessels)
TIA (mini)

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24
Q

FAST acronym for stroke

A

Face asymmetrical drooping
Arm drop: pronator drift
Speech difficulties
Timing when did they notice onset

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25
Q

FAST acronym for stroke

A

Face asymmetrical drooping
Arm drop: pronator drift
Speech difficulties
Timing when did they notice onset

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26
Q

sx of hemorrhagic stroke

A

ha
nausea
impairment of consciousness

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27
Q

compare dementia and delerium

A

dementia: worse at night, slowly gets worse, no change in attention or consciousness until very severe.
delirium: worse at night, changes in consciousness and attention, comes on suddenly, usually reversible

28
Q

sx of intracerebral hemorrhagic stroke

A

ha
nausea
impairment of consciousness

29
Q

sx of subarachnoid hemorrhage

A

sudden severe ha with LOC

severe neurologic deficits

30
Q

What is the most common cause of cognitive impairment?

A

delirium and dementia

31
Q

What does dementia effect

A

memory

32
Q

What does delirium effect?

A

attention

33
Q

What does delirium effect?

A

attention

34
Q

What is typical cause of delirium?

A

acute illness or toxicity

35
Q

sx of delirium

A 
difficulty focusing
fluctuating consciousness
confusion
change in personality
disoriented
hallucinations
36
Q

Required for Dx of delirium?

A
  • acute change in cognition that fluctuates during the day
  • inattention (dif focusing)
  • plus one of the following:
    - disturbance of consciousness
    - altered level of consciousness
37
Q

I WATCH DEATH acronym for etiology of deliruim

A

Infectious: encephalitis, meningitis, UTI
Withdrawal: alcohol, barbituates, benzo
Acute metabolic disorder: electrolyte imbalance, hepatic or renal failure
Trauma: head injury or postoperative
CNS pathology: stroke, hem, tumor, seizure, parkinsons
Hypoxia: anemia, cardiac failure
Deficiency: B12 folate, other vitamin
Endocrinopathies: thyroid
Acute vascular
Toxins, substance use, medication
Heavy metals

38
Q

What typically causes dementia?

A

anatomic changes in brain due to primary disease of brain or other causes

39
Q

Most common diseases of brain that cause dementia?

A 
Alzheimers
Vascular dementia
Lewy Body Dementia 
Parkinsons Dementia
HIV associated den
Frontotemporal dem
40
Q

sx of dementia

A

short-term memory loss first
impairs cognition globally
gradual onset
personality and behavioral disturbances

41
Q

Dx of dementia

A

history and mental status exam
physical exam with complete neuro
labs: TSH, B12, CBC, LFT, HIV
CT or MRI

42
Q

What does dx of dementia require

A
  • cognitive or behavioral sx interfere with ability to function at work or do usual daily activities
  • sx represent decline from previous levels of functioning
  • sx not explained by delirium or major psychiatric disorder
  • And more than 2 of the following:
    - language dysfunction, amnesia, reasoning, changes in personality
43
Q

Pathophysiology of Alzheimers Disease

A

progressive cognitive deterioration caused by b-amyloid deposits and neurofibrillary tangles in cerebral cortex and subcortical gray matter

44
Q

What causes b-amyloid to form?

A

amyloid precursor protein (APP) encoded from chromosome 21

- presenilin 1 and presenilin 2 contribute to APP

45
Q

What causes b-amyloid to form?

A

amyloid precursor protein (APP) encoded from chromosome 21

- presenilin 1 and presenilin 2 contribute to APP

46
Q

Neurofibrillary tangles

A
  • number directly related to severity of dementia
  • formed intercellularly with protein tau
  • acetylcholine
47
Q

risk factors for alzeimers

A

age
family hx
ApoE genotype
trisomy 21

48
Q

risk factors for alzeimers

A

age
family hx
ApoE genotype
trisomy 21

49
Q

dx of alzeimers

A
  • dementia documented by MSE
  • deficits in more than 2 areas of cognition
  • gradual onset
  • no disturbance of consciousness
  • onset after 40 or 65
  • no systemic brain disorders
50
Q

Vascular Dementia

A

2nd most common dementia of elderly
cognitive deterioration due to diffuse focal cerebral infarction related to CVD
- stroke hx

51
Q

sx of vascular dementia

A
  • exaggeration of DTRs
  • babinski
  • gait abnormalities
  • weakness of extremeties
52
Q

Lewy Body Dementia

A

cellular inclusions called Lewy bodies in cytoplasm or cortical neurons

53
Q

Parkinsons Disease Dementia

A

movement disorder but dementia can form later in the disease and it is from Lewy bodies in substantial nigra

54
Q

Parkinsons Disease Dementia

A

movement disorder but dementia can form later in the disease and it is from Lewy bodies in substantial nigra

55
Q

sx of Lewy Body Dementia

A 
cognitive and extrapyramidal sx begin within 1 year of each other (unlike Parkinsons)
  - tremor late
 - rigidity of axial muscles
 - deficits tend to be symmetric
fluctuating cognitive function
visual hallucinations
sleep disorders
56
Q

Parkinsons sx

A

cognitive sx don’t begin until 10-15 years after motor sx

psychiatric sx less common than lewy body

57
Q

Parkinsons sx

A

cognitive sx don’t begin until 10-15 years after motor sx

psychiatric sx less common than lewy body

58
Q

neck pain radiating to forehead, severe headache, nausea, vomitting, kernig and brudzinksi sign. what is dx?

A

subarachnoid hemorrhagic stroke

59
Q

What is dx tool for hem stroke?

A

lumbar puncture

reveals bleeding in subarachnoid space.

60
Q

compare and contrast lewy body dementia and parkinsons dementia

A

Lewy body: hallucinations, cognitive disturbances.

Parkinsons: motor problems first, then cognitive (10-15 years later), no hallucinations

61
Q

How do you dx Parkinsons dementia?

A

definitive dx requires autopsy samples of brain tissue

62
Q

HIV associated dementia

A

chronic cognitive deterioration due to brain infection by HIV
- occurs in younger people

63
Q

Frontotemporal dementia

A

spradic, hereditary disorders that affect frontal and temporal lobes

  • 55-65 yo pt
  • pick cells
64
Q

sx frontotemporal dementia?

A

personality, behavior, language

less memory

65
Q

Normal pressure hydrocephalus sx

A

gait disturbance/magnetic gait, urinary incontinence, dementia, enlarged brain ventricles, elevated CSF pressure

CPD III (7 decks)

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