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Antibiotics > neuro uworld > Flashcards

neuro uworld Flashcards

1
Q

contralateral hemiparesis, homonymous hemianopia, gaze palsy, hemisensory loss

A

basal ganglia hemorrhage

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2
Q

facial weakness, ataxia, nystagmus, occipital headache, neck stiffness

A

cerebellar hemorrhage

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3
Q

contralateral hemiparesis, hemisensory loss, nonreactive miotic pupils, upgaze palsy, eyes deviate towards hemiparesis

A

thalamic hemorrhage

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4
Q

contralateral hemiparesis only

A

frontal lobe hemorrhage

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5
Q

contralateral sensory loss only

A

parietal lobe hemorrhage

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6
Q

homonymous hemianopsia

A

occipital lobe hemorrhage

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7
Q

eyes deviate away from hemiparesis and high occurrence of seizures

A

cerebral hemorrhage

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8
Q

deep coma, total paralysis, pinpoint reactive pupils

A

pontine hemorrhage

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9
Q

patient is jogging on treadmill and then start having headache, vomiting, seizures, and AMS

A

intraparenchymal brain hemorrhage

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10
Q

where do hypeternsive hemorrhage typically occur

A

small penetrating arteries that are also responsible for lacunar strokes. These are mostly in the basal ganglia, cerebella nuclei, thalamus, or pons.

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11
Q

what does a putaminal hemorrhage affect

A

it leads to anesthesia of the side and contralateral hemiparesis- due to the disruption of the corticospinal and somatosensory fibers in the posterior limb with conjugate deviation of the eyes to the side of the lesion

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12
Q

who typically has lobar hemorrahge

A

adults over 60 due to amyloid antipathy. Hemorrhage is often recurrent and involves the occipital lobe and hmonymous hemianopsia whereas partial can cause contralateral hemisensory loss

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13
Q

conditions associated with Wernickes encephalopathy and what is deficient

A

chronic alcoholism, malnutrition, hyperemesis gravidarum- thiamine deficiency.

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14
Q

encephalopathy, horizontal nystagmus, bilarteral abducens palsy, postural and gait ataxia

A

werknicke encephalopathy

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15
Q

treatment for werknickes

A

IV thiamine

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16
Q

risk factors for brain abscess

A

otitis media, mastoiditits, frontal or ethmoid sinusitis, dnetal infection, bacteremia from other sites of infection, cyanotic heart disase

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17
Q

what is the distribution of brain accesses in bacteria from heart disease (cyanotic )

A

multiple abscesses along the distribution of middle cerebral artery at the grey-white matter junction.

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18
Q

why does deogeorge cause seizures and what is the other associated problem

A

they can have hypocalcemia leading to tetany and seizures from hypocalcemia. they also have cyanotic heart disease that risk hematogenous spread of infection into the brain because the blood bypasses the lungs were it can be cleaned. Also, they have poor brain perfusion from chronic hyperemia, metabolic acidosis, and increased blood viscosity from secondary polycythemia.

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19
Q

what is the classic triad of brain abscesses

A

fevere, severe headaches in the morning or nocturnal, focal neurologic changes.

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20
Q

what is the typical length of absence seizures

A

length is <20 seconds and lack of response to vocal or tactile stimulation there are also automatisms like eye fluttering or lip smacking, but there are not more complex events in the motor.

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21
Q

what is the typical EEG and treatment of absence seizures

A

they are 3 hz spike and wave discharge patterns during the episodes. treatment is ethosuxamide

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22
Q

diplopia, bitemporal hemianopsia, vision loss, headache, hormonal deficiencies- what is this

A

sellar mass

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23
Q

what is the most common seller mass

A

pituitary adenoma of which the most common is prolactinoma

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24
Q

what is the typical age ranges for craniopharyngiomas and tell me about the tumor

A

50% are under 20 and the rest are 55-65. These grow gradually over a period of years and cause slow progression of symptoms. Can lead to bitemporal blindness. Confirm it with a MRI or CT, and treatment is surgery and radiotherapy.

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25
Q

headache, hearing loss, vertigo, tinnitus, balance problems- what is the tumors and where are they

A

acoustic neuromas and meningiomas

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26
Q

tumor causes worsening headache, visual abnormalities, focal motor weakness, and cognitive defects

A

glioblastoma multiforme

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27
Q

what part of vision is knocked out by temporal lobe stroke

A

homoynmous superior quadrantanopsia

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28
Q

when does cerebellar degeneration typically occur

A

it occurs after ten years of heavy alcohol use and is due to the degeneration of the pukinje cells of the cerebellar ermis

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29
Q

what symptoms occur with cerebellar degeneration

A

truncal coordination decreases and slowly progressive wide-based gait and postural instability.

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30
Q

what are the physical exam findings for cerebellar degeneration

A

inability to tandem walk and abnormal heel-knee-shin testing with relatively preserved limb coordination so normal finger-nose testing. Cognitive function is preserved

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31
Q

gait dysfunction, extremity weakness, vibratory, propioceptive abnormalities with upper and lower motor nueron problems

A

spondylotic myelopathy

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32
Q

ataxia, symmetric paresthesia, and loss of vibration and proprioception sensation

A

B12 deficiency

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33
Q

attention difficulties, concentration, memory and executive function, difficulty completing the testing and put forth poor effort- why is the dementia occurring

A

pseudo dementia from major depression- use an SSRI.

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34
Q

what is the most common pediatric brain tumor

A

low grade astrocytoma like pilocytic astrocytoma

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35
Q

what are the symptoms of supratentorial tumors

A

increased ICP and seizures, morning headaches, papiledema, vomiting, macrocephaly

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36
Q

what are the symptoms of posterior fossa tumors

A

increased ICP, ataxia, clumsymorning headaches, papiledema, vomiting, macrocephaly

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37
Q

what are the symptoms of brainstem tumors

A

ataxia, clumsy, cranial nerve palsies

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38
Q

what are the symptoms of spinal cord tumors

A

back pain, weakness, and abnormal gait

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39
Q

ependymomas

A

glial cell tumors that arise from the ependymal cells of the ventricles and spinal cord. They are most often in the 4th ventricle posterior fosaa leading to hydrocephalus

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40
Q

medulloblastoma

A

second most common pediatric tumor- infratentorial tumor that arise from the cerebellar vermis that vomiting, headaches, and ataxia

41
Q

neuroblastomas

A

sympathetic ganglion cell tumors that are usually abdominal masses but can spread to the brain

42
Q

dementia: early, insidious short term memory loss, language deficits, spatial disorientation, later personality changes

A

AD

43
Q

dementia: stepwise decline, early executive dysfunction, cerebral infarction and or deep white matter changes on neuroimaging

A

vascualr dementia

44
Q

dementia: personality changes, apathy, disinhibition, compulsive behavior, atrophy

A

frontotemporal

45
Q

dementia: visual hallucinations, spontenous PD, fluctuating congintion

A

dementia with levy body

46
Q

dementia: ataxia, urinary incontience, dilated ventricles

A

NPH

47
Q

dementia: behavior, rapid progressive, myoclonus and seizures

A

prions

48
Q

typical exam findings with vascular dementia

A

hemiparesis, pronator drift, romberg sign

49
Q

what neurological condition do you not give steroids for

A

GBS

50
Q

symmetric muscle weakness, decreased reflexes, paresthesias, autonomic dysfunction, respiratory compromise previous illness

A

GBS

51
Q

treatment of GBS and the CSF findings

A

increased protein but normal counts- five plea or IVIG

52
Q

what is used to treat ALS

A

riluzole

53
Q

what do you treat warfarin associated intracerebral hemorrhage

A

need to reverse the anticoagulation- vitamin K and protehromin concentrate which can do this or FFP

54
Q

what can cause warfarin associated intracerebral hemorrhage

A

a lot of drugs like cold medications like acetoaminophen and phenylephrine can alter the metabolism of warfarin leading to supratherapuetic levels of warfarin leading to lots of bleeding

55
Q

progressive proximal muscle weakness and atrophy without pain or tenderness- lower extremity muscles are more involved- what myopathy is this

A

glucocorticoid induced= ESR and CK are normal

56
Q

muscle pain, stiffness in the shoulders and pelvic girdle, tenderness with decreased range of motion at shoulder, neck and hip, responds rapidly to glucocorticoids- what myopathy is this

A

polymyalgia rheumatica- increased ESR

57
Q

muscle pain, tenderness and proximal muscle weakness, skin rash, inflammatory arthritis- what myopathy is this

A

inflammatroy myopathy- increased ESR and CK

58
Q

prominent muscle pain and tenderness with or without weakness sometimes rhabdo- what myopathy is this

A

statin induced myopathy- increased CK

59
Q

muscle pain, cramps and weakness involving the proximal muscles, delayed tendon reflexes and myxedema, occasional rhabdo, hypothyroidism- what myopathy is this

A

hypothyroid- increased CK

60
Q

medication with stroke within 3.5-4 hours

A

alteplase

61
Q

medication with stroke with no prior anti plate therapy

A

aspirin

62
Q

medication with stroke on asa

A

asa plus dipyrimidole or clopidogrel

63
Q

medication with stroke on asa and intracranial large artery atherosclepris

A

asa plus clopidogrel

64
Q

medication with evidence of afib

A

warfarin, dabigatran, rivaroxaban

65
Q

early signs of AD

A

anterograde memory loss, immediate recall affected but distant memories are preserved, lost in own neighborhood, difficulty finding words, cognitive impairment with progressive decline

66
Q

late findings of AD

A

neuropsychiatric hallucinations and wandering, dyspraxia difficulty performing learned motor tasks, lack of insight regarding deficits, non cognitive neurologic deficits like pyramidal and extrapyramidal motor, myoclonus, seizures, urinary incontinence

67
Q

fluctuating and fatigable proximal muscle weakness that is worse later in the day, and ptosis and diplopia, dysphagia, dysarthria, respiratory compromise

A

MG

68
Q

what is the order of testing in MG

A

tensilon, ice pack, CT scan, acetylcholine receptor antibodies

69
Q

risk factors of IIH

A

overweight, fertile, tetracyclines and retoninons

70
Q

IIH symptoms

A

headache, vision loss, tints that is pulsaltile, diplopia, papilladema peripheral visal field defect, VI palsy

71
Q

dx for IIH

A

MRI or MRV, LP with >250 mm opening pressure

72
Q

tx for IIH

A

stop the offending medication, weight loss, acetazolamide

73
Q

carotid dissection symtpoms

A

hemiparesis, facial droop, aphasia, neck pain, thunderclap headache, and ischemic stroke

74
Q

pure motor stroke is in

A

internal high capsule

75
Q

pure sensory strokes

A

thalamic stroke

76
Q

albuminocytologic dissociation

A

GBS

77
Q

14-3-3 protein in CSF

A

prion disease

78
Q

vasovagal or neural meidated syncope

A

trggers: prolonged standing or motional distress, painful stimuli, prodrome of nausea, warmth, diaphresis

79
Q

sitational syncope

A

cought, micturition, defecation

80
Q

orthostatic syncope

A

postural changes in heart rate and blood pressure after standing suddenly

81
Q

syncope with exertion or during exercise

A

aortic stenosis, HCM, anamolous cornary arteries,

82
Q

gneral sense of warmth with syncope

A

neurocardiac syncope

83
Q

levadopa carbidopa side effects

A

somnolense, confusion, hallucinations- in elderly- dyskinesia

84
Q

trihexaphenidyl or benztropine side effects

A

dry mouth, blurred vision, constipation, nausea, urinary retention

85
Q

side effect of aporophine, bromicriptine, pramipexole or ropinerole- side effects

A

somnolience, hypotension, confusuon, hallucinations

86
Q

capone side effects

A

dyskinesia, hallucination, confusion, nausea, orthostatic hypotension

87
Q

selegiline side effects

A

insomnia and confusion in the elderly

88
Q

neurologic complication of thoracic AA repatir

A

anterior cord syndrome

89
Q

what tracks are affected in anterior cord syndrome

A

spinothalamic and corticospinal tracks.

90
Q

what arteries are knocked out in the TAA repair

A

artery of ademkawitz and the radicular arteries

91
Q

what are the symptoms of anterior cord syndrome

A

flaccid paralysis and loss of pain and temperature below the injury. Static UMN develops over time. Autonomic can be from intermediolateral cord.

92
Q

what is perserved with anterior cord syndrome

A

the vibration and proprioception is preserved

93
Q

bells palsy face

A

inability to raise eyebrow and close eye, and droop of mouth. Decreased tearing, hyeracusis and loss of taste over the anterior 2/3 of the tongue

94
Q

stroke face

A

the forehead is spared

95
Q

headache that becomes intolerable, vomiting, papilladema, and binocular palsy, periorbital edema, hypesthesia, and rapidly can become intolerable- what is it, imaging performed for it, and treatment

A

it is cavernous sinus thrombosis, and there needs to be antibiotics, can use an MRI for it

96
Q

what nerves run through the cavernous sinus

A

II, IV< V, VI

97
Q

sparse, nonfluent speech, some comprehension, impaired reputation, and right hemiparsis

A

broca aphasia- dom frontal

98
Q

fluent, columinous, lack of meaning, diminished comprehension, impaired repititon, and right superior field defect

A

wernicke dom temporal

99
Q

fluent with phonemic erors, preserved comprehension, poor reputation, no associated features

A

dom partieel lobe conduction aphasia from the myers loop involvement

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