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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
FAST acronym for stroke
Face asymmetrical drooping Arm drop: pronator drift Speech difficulties Timing when did they notice onset
26
sx of hemorrhagic stroke
ha nausea impairment of consciousness
27
compare dementia and delerium
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
sx of intracerebral hemorrhagic stroke
ha nausea impairment of consciousness
29
sx of subarachnoid hemorrhage
sudden severe ha with LOC | severe neurologic deficits
30
What is the most common cause of cognitive impairment?
delirium and dementia
31
What does dementia effect
memory
32
What does delirium effect?
attention
33
What does delirium effect?
attention
34
What is typical cause of delirium?
acute illness or toxicity
35
sx of delirium
``` difficulty focusing fluctuating consciousness confusion change in personality disoriented hallucinations ```
36
Required for Dx of delirium?
- 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
I WATCH DEATH acronym for etiology of deliruim
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
What typically causes dementia?
anatomic changes in brain due to primary disease of brain or other causes
39
Most common diseases of brain that cause dementia?
``` Alzheimers Vascular dementia Lewy Body Dementia Parkinsons Dementia HIV associated den Frontotemporal dem ```
40
sx of dementia
short-term memory loss first impairs cognition globally gradual onset personality and behavioral disturbances
41
Dx of dementia
history and mental status exam physical exam with complete neuro labs: TSH, B12, CBC, LFT, HIV CT or MRI
42
What does dx of dementia require
- 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
Pathophysiology of Alzheimers Disease
progressive cognitive deterioration caused by b-amyloid deposits and neurofibrillary tangles in cerebral cortex and subcortical gray matter
44
What causes b-amyloid to form?
amyloid precursor protein (APP) encoded from chromosome 21 | - presenilin 1 and presenilin 2 contribute to APP
45
What causes b-amyloid to form?
amyloid precursor protein (APP) encoded from chromosome 21 | - presenilin 1 and presenilin 2 contribute to APP
46
Neurofibrillary tangles
- number directly related to severity of dementia - formed intercellularly with protein tau - acetylcholine
47
risk factors for alzeimers
age family hx ApoE genotype trisomy 21
48
risk factors for alzeimers
age family hx ApoE genotype trisomy 21
49
dx of alzeimers
- 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
Vascular Dementia
2nd most common dementia of elderly cognitive deterioration due to diffuse focal cerebral infarction related to CVD - stroke hx
51
sx of vascular dementia
- exaggeration of DTRs - babinski - gait abnormalities - weakness of extremeties
52
Lewy Body Dementia
cellular inclusions called Lewy bodies in cytoplasm or cortical neurons
53
Parkinsons Disease Dementia
movement disorder but dementia can form later in the disease and it is from Lewy bodies in substantial nigra
54
Parkinsons Disease Dementia
movement disorder but dementia can form later in the disease and it is from Lewy bodies in substantial nigra
55
sx of Lewy Body Dementia
``` 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
Parkinsons sx
cognitive sx don't begin until 10-15 years after motor sx | psychiatric sx less common than lewy body
57
Parkinsons sx
cognitive sx don't begin until 10-15 years after motor sx | psychiatric sx less common than lewy body
58
neck pain radiating to forehead, severe headache, nausea, vomitting, kernig and brudzinksi sign. what is dx?
subarachnoid hemorrhagic stroke
59
What is dx tool for hem stroke?
lumbar puncture | reveals bleeding in subarachnoid space.
60
compare and contrast lewy body dementia and parkinsons dementia
Lewy body: hallucinations, cognitive disturbances. | Parkinsons: motor problems first, then cognitive (10-15 years later), no hallucinations
61
How do you dx Parkinsons dementia?
definitive dx requires autopsy samples of brain tissue
62
HIV associated dementia
chronic cognitive deterioration due to brain infection by HIV - occurs in younger people
63
Frontotemporal dementia
spradic, hereditary disorders that affect frontal and temporal lobes - 55-65 yo pt - pick cells
64
sx frontotemporal dementia?
personality, behavior, language | less memory
65
Normal pressure hydrocephalus sx
gait disturbance/magnetic gait, urinary incontinence, dementia, enlarged brain ventricles, elevated CSF pressure

CPD III (7 decks)

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