Neurological Flashcards
1
Q
GCS categories
A
Eye opening, Verbal, Motor
2
Q
GCS, 4 5 6
A
4 eyes, 5 words, 6 motions
3
Q
Pronator drift, one hand pronates
A
Suspect UMN
4
Q
Pronator drift test, one arm drifts up
A
Suspect cerebellar disease
5
Q
MSE categories: ASMA TPTC CIJ
A
Appearance, behaviour, clothing, speech, mood, affect
Thought process, thought content
Cognition, insight, judgement
6
Q
APGAR
A
Appearance, pulse, grimace w stim, activity (tone), resp effort
7
Q
Pupillary light reflex branches
A
Afferent CNII sensory, CNIII motor
8
Q
Weber conductive hearing loss
A
Hear it in bad ear
9
Q
Weber sensorineural hearing loss
A
Hear it in good ear
10
Q
Rinne test, SNHL
A
Bone conduction better than air conduction since the issue is at the level of the nerve
11
Q
Diffuse thyroid enlargement
A
Graves, hashimotos, endemic goiter
12
Q
Single thyroid node DDx
A
Cyst, benign tumour, malignancy
13
Q
Multinodal goiter thyroid
A
Iodine deficiency
14
Q
Firm thyroid
A
Hashimotos, malignancy, benign, malignant
15
Q
Tender thyroid on palpation
A
Thyroiditis
16
Q
Continuous bruit over thyroid
A
Hyperthyroidism
17
Q
Space we LP between is
A
L3 and L4
18
Q
Normal opening pressure CSF
A
8-10 cm
19
Q
Normal WBC in CSF
A
Less than 4
20
Q
Normal protein in CSF
A
<0.4 g/L
21
Q
Glucose in CSF
A
> 60% of serum glucose
22
Q
Things you need to ask about specifically in a psych interview
A
Hallucinations, delusions, suicide, homocide
23
Q
Motor exam NS
A
bulk, symmetry, tone, fasciculations, power (5)
24
Q
DDx seizure in an infant
A
CNS bleeding, infection, structural abnormalities, metabolic disorder, electrolyte abnormalities, genetic syndromes, epilepsy, febrile
25
Signs of a basilar skull fracture
Battles sign (ecchymosis behind ear), raccoon eyes, hematotympanum, CSF leaking from nose or ears
26
Manifestations of alcoholic cerebellar degeneration
Develops over weeks to months, wide based gait, incoordination in legs, cognition intact, truncal ataxia, and nystagmus
27
Alcoholic cerebellar degeneration occurs due to degeneration of
Purkinje cells (cerebellar vermis)
28
Pendular knee reflex is due to
Muscle hypotonia
29
Positive babinski suggests
Upper motoneuron disease
30
Bradykinesia is a hallmark of
Parkinsons
31
DTRs in parkinsons
Typucally normal
32
Clasp knife phenomenon is seen in patients with hypertonia that is due to disease of the
Pyramidal tract
33
Diagnosing DVT
Doppler, duplex ultrasonography
34
Treating upper limb DVT
3 months anticoagulation
35
Untreated strabismus can lead to
Amblyopia
36
Exam findings in strabismus
Asymmetric corneal light reflexes and asymmetric red reflexes that are more intense in the deviated eye
37
First step in evaluation of strabismus is
A dilated fundoscopic exam to assess for secondary causes, particularly retinoblastoma
38
Visual evoked potential testing may be performed for
Optic neuritis
39
What would the EEG look like for psychogenic non epileptic seizures
No excessive neuronal activity
40
Causes of seizures
Neuro/anatomic causes, metabolic/physiologic causes, epilepsy, PNES
41
What causes a TIA?
Transient neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia without acute infarction
42
What is the significance of a TIA?
The individual is at risk for stroke
43
EEG during a seizure
Abnormal excessive hypersynchronous activity in the brain
44
What area of the brain do seizures typically occur
The cerebral cortex
45
To be diagnosed with epilepsy, one must have
2 unprovoked seizures, 24 hrs apart, or one unprovoked with high probability of further seizures, or a diagnosis of epilepsy syndrome by genetics
46
Provoked seizures may be due to
Metabolic derangement, substance use/withdrawal, acute neurological disorders
47
What percent of the population has an unprovoked seizure in their lifetime?
5%
48
Types of seizures
Focal, generalized, unknown onset
49
Generalized seizure types
Motor - tonic/clonic or other
| Non motor - absence
50
Focal seizures are located in
One cerebral hemisphere
51
Myoclonic is
Sudden, brief, single or multiple irregular contractions
52
Clonic means
Jerking (regularly repetitive longer contractions)
53
Tonic means
Abnormally sustained posture lasting seconds to minutes
54
Versive during seizure means
Forced eye deviation, head/neck turning
55
Negative motor phenomenon that can occur during seizure
Atonic, negative myoclonus
56
Atonic during seizure means
Sudden loss of muscle tone which can involve the head, trunk, jaw, limb
57
Negative myoclonus means
Sudden brief loss of tone in a muscle
58
What is an automatism
Involuntary complex, repetitive, coordinated motor activity during seizure
59
Localization related seizures are often due to
Structural lesion - tumour, stroke, infection
60
Temporal lobe epilepsy often related to sclerosis of the
Hippocampus
61
Jacksonian march
Occurs in a frontal lobe seizure, motor involvement moves from one limb to another as the seizure activity moves across the cortex
62
What is absence seizures
Brief episodes of loss of awareness due to sudden generalized seizure
63
Average absence seizure lasts
15 seconds
64
First step during seizure
ABCs, time it
65
Status epilepticus is defined as a seizure lasting
Longer than 5 minutes
66
After 5 mins of seizing and checking ABCs, whats the next move?
Benzos, phenytoin, phenobarbital
67
Muscular back pain should be treated using
NSAIDs and exercise
68
Muscular back pain should resolve by
4 weeks
69
Investigating suspected MSK back pain that wont go away
XRAY MRI
70
Treating cord compression
Dexamethasone
71
Alarm symptoms lower back pain
Bowel/bladder sx, saddle anesthesia, new functional neurological diseases, rapid progression
72
Osteophyte in back treatment
Surgery
73
Spinal stenosis signs
Pseudo claudication, positional changes
74
Treatment for spinal stenosis
Laminectomy
75
Diagnosing spinal pathology
1st xray, best MRI
76
Spinal compression due to osteoporosis classical story
Older patient who falls on coccyx, vertebral step off, pinpoint tenderness
77
EEG of comotose patient
Depressed
78
4 cranial reflexes in neurology
Corneal, cold water, calorics, dolls eyes
79
Workup for possible reversible causes of dementia
BMP, B12, depression, MRI, TSH, T4, LFT, CT
80
Delirium course of illness
Waxes and wanes
81
Pathophysiology of Alzheimer’s
Plaques and tangles
82
CT of Alzheimer’s pt brain may shoe
Diffuse atrophy
83
Treatment for Alzheimer’s
Support, family education, tacrine donepezil
84
Treatment for creutzfelt Jacobs disease
Supportive
85
Lewy body dementia symptoms
Parkinsonian, dementia, visual hallucinations
86
Three W’s of normal pressure hydrocephalus (NPH)
Wet, wobbly, weight
87
Diagnosing normal pressure hydrocephalus
CT shows hydrocephalus, patient improves with LP
88
NPH treatment
VP shunt
89
Vascular dementia pathophys
CVA
90
CT for vascular dementia
Previous infarcts
91
Spinning and unsteady dizziness is called
Vertigo
92
Central causes for vertigo
Within the brain
93
Peripheral causes of vertigo have accompanying
Tinnitus and hearing loss
94
Posterior fossa causes for vertigo (6)
MS, stroke, tumour, abscess, migraines, seizure
95
BPPV pathophys
Otolith movement
96
Diagnosing BPPV
Dix hallpike maneuver
97
Treating bppv
Epley maneuver
98
Labyrinthitis and vestibular neuritis pathophys
Post viral infection, vertigo lasting 1-10 mins with hearing loss, nausea, vomiting
99
Treatment for labyrinthitis and vestibular neuritis
Steroids, meclizine
100
Meniere disease symptoms
Hearing loss, tinnitus, vertigo, severe sx 30min-1hr long
101
Treating meniere disease (3)
1. Salt restrict, 2. diuresis (thiazide), 3. meclizine
102
What is meclizine
An antihistamine used to treat motion sickness and dizziness
103
Headache red flags
Fever, FND, older than 50, thunderclap, progressive, nausea and vomiting
104
Tension headache path
Muscular, radiates to neck
105
Treating tension headaches (2).
NSAIDs, acetominophe
106
Cluster headache path
Vascular
107
Sx specific to cluster headache
Asymptomatic for months then 8-10 a day, unilateral with eye pain and Horners
108
Treating (2) and prophylaxis (1) for cluster headaches
O2 & triptans acutely, verapamril for prophylaxis
109
Migraine path
Vasculature
110
Migraine sx
Unilateral, debilitating, photo/phonophobia, nausea and vomiting, aura, trigger, sleep helps, feeling hungover the next day
111
Treating migraines
Triptans, ergot, NSAIDs
112
Migraine prophylaxis
Propranolol, topiratmate
113
Seizure DDx “VITAMINS”
Vascular, infarct, trauma, autoimmune, metabolic, ingestion/withdrawal, neoplasm, sych
114
Treating atonic or myoclonic seizures
Valproate
115
Treating absence seizures
Ethosuximide
116
Trigeminal neuralgia presents with
Lance like face pain
117
Signs that its a real seizure
LOC, jerking, bowel/bladder incontinence, tongue biting, post ital state
118
Testing after seizure
EEG, CT/MRI, vitamins
119
Med cascade for seizing patient
Phenytoin, midazolam, propofol, phenobarbital
120
Ischemic strokes may be 1 of 2 types
Thrombotic or embolic
121
Risk of thrombotic stroke increases with
Hypertension, diabetes, smokin, obestity, family hx, age
122
Hemorrhagic strokes occur secondary to
Intracerebral hemorrhage and subarachnoid hemmorhage
123
Stroke affecting ACA will lead to issues with
Feet and legs
124
Stroke affecting MCA will affect
Hands, arms, face, speech (the typical idea)
125
stroke of the PCA will affect
Vision
126
Basilar and vertebral stroke will cause
Syncope
127
Meds for suspected stroke
ASA statins
128
Labs during suspected stroke
A1C, TSH, LIPID, CMP, CBC
129
Essential tremor occurs
With movement
130
Intention tremor occurs
With movement
131
Pathophys of parkinsons
Loss of dopamine producing substantia nigra
132
Symptoms of Parkinson’s
Bradykinesia, cogwheel rigidity, resting tremor, gait/postural instability
133
Treating parkinsons in younger population
Dopa agonists
134
Treating parkinsons older than 70 (3)
Lavodopa, carbidopa, COMT-1, MAOB1
135
Intention tremor occurs due to
Cerebellar dysfunction
136
Huntington’s pathophys
Anticipation of a trinucleotide repeat
137
Patho of essential tremor
Familial
138
Treating an essential tremor
Propranolol
139
Treating an intention tremor
None
140
Chorea in Huntington’s
Purposeless ballistic movements
141
Treating Huntington’s
Not possible
142
Multiple sclerosis pathophysiology
Autoimmune demyelination
143
Patient in MS is usually
20-40, female, any neurological sx occuring in different times/space, optic neuritis
144
Diagnosing MS
MRI for periventricular white matter
| Dis and dit
145
Treating MS flare
Steroids
146
Treating MS chronically
IFN, glatiramer, fingolimod
147
Treating MS urinary retention
Bethanechol
148
Treating MS urinary incontincec
Amytriptyline
149
Treating MS spasms
Baclofen
150
Treating neuropathic pain in MS
Gabapentin
151
CSF in a patient with guillian barre syndrome shows
Lots of protein, few cells
152
Treating Gullian barre
IVIG plasmapheresis, never steroids
153
Hallmark of ALS
UMN and LMN
154
Diagnosing ALS requires what kind of testing?
EMG
155
Treatment for ALS
Supportive riluzole
156
Pathophysiology of myasthenia gravis
Autoimmune attach of Ach receptor
157
Myasthenia gravis sx
Fatiguable weakness, eyes drooping, swallowing problems, worse at night
158
Diagnosing myasthenia gravis
Look at Abs vs ACH-R, EMG, CT for thymoma
159
Treating myasthenia gravis
Increase ACH via cholinesterase 1, decrease autoimmune response with steroids
160
Treating MG crisis
IVIG plasmaphoresis, thymectomy
161
Most common cause of dementia
Alzheimer’s disease
162
Early findings in Alzheimer’s
Anterograde memory loss, visuospatial issues, language difficulties, cognitive impairment with progressive decline
163
How is Parkinson’s disease diagnosed?
Clinically by physical exam
164
What accumulates in Parkinson’s disease patietns?
Accumulation of alpha-synuclein within the neurons of the substantia nigra
165
3 cardinal signs of Parkinson’s disease
Rest tremor, rigidity, bradykinesia
166
Most common presenting sign of Parkinson’s disease
Asymmetric rest tremor in the distal part of an upper extremity
167
Lhermitte’s sign
Electric shock sensation down the spine with forward Flexion of the next
168
Cervical spondylotic myelopathy generally presents with
Progressive neck pain, gait disturbances, lower motoneuron signs in the upper extremities, and upper motoneuron signs in the lower extremities
169
UMN signs
Increased reflexes, spasticity
170
LMN signs
Weakness, diminished reflexes
171
Preferred treatment for PTSD is
CBT, SSRI, SNRI
172
Primary and secondary presentation of retinoblastoma is
Leukocoria, estropia (due to central vision loss)
173
Optic nerve cupping is indicative of what disease
Glaucoma
174
How can you confirm the presence of a retinal mass seen on dilated fundoscopic examination?
MRI of the brain and orbits
175
What tests can you do for strabismus?
Cover and uncover, dilated pupil fundoscopy
176
Tremor of PD characteristics
Occurs during rest and improves with activity, often the first manifestation of parkinsons
177
What type of drug is trihexyphenidyl?
An anticholinergic
178
Trihexyphenidyl is typically used in what patients
Young patients with tremor dominant Parkinson’s disease
179
First line treatment for essential tremor is
Beta blocker - propranolol
180
Cessation of exercise resulting in sudden decrease in venous return to the heart
Exercise associated postural hypotension
181
Management of exercise associated postural hypotension
Trendelenburg positioning, oral hydration, patients remain alert with normal mental status
182
When would you consider carotid endarterectomy?
Symptomatic patients with high grade carotid stenosis (70-99%)
183
Profound hemineglect is usually due to a lesion impacting the
Non dominant parietal lobe responsible for spatial organization
184
Vestibular schwannoma present as
SN hearing loss and imbalance
185
Bilateral hereditary schwannomas are often associated with what condition
Neurofibromatosis type II
186
Sensations carried by the posterior column
Proprioception and vibration
187
Sensations carried by the lateral spinothalamic tract
Pain and temperature
188
What is the risk of status epilepticus?
Permanent brain injury due to excitatory cytotoxicity
189
What brain changes occur secondary to status epilepticus
Cortical laminar necrosis
190
Classic triad for pheochromeocytoma
Episodic headache, sweating, and tachycardia
191
Diagnosing pheochromocytoma
Urine or plasma metanephrine levels, then confirmatory abdominal imagine
192
How long does GBS typically last?
Reaches a nadir at 4 weeks before improving
193
Treating pain in GBS
Gabapentin, NSAIDS, opioids, morphine if severe
194
Treating GBS
Immunotherapy with IVIG or plasma exchange PLEX
195
Pheochromeocytoma triad
Episodic headaches, sweating, and tachycardia
196
Screening for pheochromeocytoma
Plasma metanephrines
197
Ramsay hunt syndrome aka
Herpes zoster oticus
198
Ear pain, face weakness, and vesicular rash in external auditory canal is suspicious for
Ramsay hunt syndrome
199
Treating Ramsay hunt syndrome
Corticosteroids and antivirals
200
Motor signs of stroke with a clean CT and a sense of cortical signs, seizure, or mental status changes
Lacunar stroke
201
Traumatic rupture of bridging veins in the brain result in
Subdural hematoma
202
Carotid artery dissection may cause what kind of stroke?
Ischemic due to thromboembolism or hypoperfusion
203
Alterations in consciousness, fluctuating cognition, visual hallucinations, Parkinsonism, early compromise of executive functions characterize
Lewy body dementia
204
What type of hearing loss does otosclerosis cause?
Conductive
205
How does tympanic membrane fibrosis present?
Asymptomatic, incidental finding on ear exam
206
Mechanism of injury in noise exposure hearing loss
Sensorineural hearing loss due to irreversible death of hair cells in cochlea
207
Clear, unilateral rhinorhea that increases at times of relatively increased ICP is suspicious for
Cerebrospinal fluid rhinorrhea
208
Evaluation of CSF rhinorrhea
Test for CSF specific proteins, imaging with intrathecal contrast, endoscopy with intrathecal fluorescein dye
209
Management of CSF rhinorrhea
Bed rest, lumbar drain placement, surgical repair
210
Inflammation at the eyelid margin, most prominent at opening of meibomian glands. Burning or itching of lids, with discharge and foreign body sensation in eye.
Blepharitis
211
97% of the population has which side of the brain dominant?
Left
212
Dominant hemisphere brain functions (3)
1. Language. 2. Praxis (skilled motor formulation) 3. Attention to the other side of the world
213
Non dominant hemisphere of brain functions (5)
1. Prosody 2. Visuospatial skills 3. Emotional significance 4. Music perception 5. Attention to both sides of the world
214
A lesion to the primary motor cortex will cause weakness to which side?
Contralateral side
215
A lesion to which area of the brain can cause: poor planning, judgement, problem solving, disinhibition, a motivational syndrome, and urinary incontinence?
Prefrontal cortex
216
A lesion to which area of the brain causes non fluency aphasia?
Broca’s area
217
A lesion to which area of the brain can cause impaired comprehension of language?
Wernicke’s area
218
Kluver Bucy Syndrome of hyperorality, emotional blunting, hyposexuality, blunting of response to fear and aggression caused by a lesion to which area?
Prototypical limbic system disorder
219
Lesion of unilateral primary visual cortex causes
Contralateral hemianopia
220
Lower visual field travels through which brain lobe?
Lower visual field through parietal lobe
221
Upper visual field travels through which brain lobe?
Upper visual field travels through temporal lobe
222
Akinetopsia is impaired
Motion sensation
223
The tract which is the ascending sensory system, pain and temperature
Spinothalamic tract
224
The spinothalamic tract has its decussation in
The spinal cord
225
A lesion after the decussation of the spinothalamic tract causes
Contralateral loss of pain and temperature sensation
226
Ascending sensory system responsible for proprioception and vibration
The dorsal column/medial lemniscus
227
Decussation of the dorsal column is in
Superior medulla
228
The descending motor system tract
The corticospinal tract
229
The corticospinal tract decussation is in
The medulla, pyramidal decussation
230
Fasciculation and atrophy are characteristic of which lesion, UMN or LMN?
LMN, lower motoneuron injury
231
Lower motoneurons connect
The spinal cord to the muscle
232
VPL & VPM sensory nuclei transmit what kind of information?
Somatosensory
233
Lateral geniculate sensory nuclei transmits
Visual information from optic tracts to occipital cortex
234
Medical geniculate nucleus transmits
Auditory information from brainstem to temporal cortex
235
Limbic nuclei transmit (2)
Memory and emotions
236
Thalamus receives input from (2)
Cerebellum, basal ganglia
237
Which level does the spinal cord end at?
L2
238
3 clinical features of meningeal inflammation
1. Nuchal rigidity, 2. Kernig’s sign, 3. Brudzinski’s sign
239
Puncture site for LP
L4-5
240
3 contraindications to lumbar puncture
1. Risk of bleeding 2. Infection over area 3. Risk of brain herniation (increased ICP
241
3 signs of increased ICP in adults
Headache, CN palsy (esp CN6), papilledema
242
Cloudy to milky CSF on LP can be indicative of
Bacterial meningitis
243
Most likely Etiology for viral meningitis
Enteroviruses
244
5 most likely bacterial causes for meningitis
S. Pneumoniae, N. meningitidis, L. Monocytogenes., H. influenzae, Group B Strep
245
Etiology of chronic meningitis (3)
Tuberculosis, fungi, parasites
246
Management of intracranial hemorrhage (3)
Lower BP, reverse anticoagulation, consult neurology
247
80% of hypotonia is (central or peripheral)
Central
248
Genetic disease with progressive loss of anterior horn cells in the spinal cord and motor nuclei in cranial nerves
Spinal muscle atrophy
249
Genetic testing for spinal muscle atrophy
SMN1 gene
250
Babies born to mothers with myasthenia gravis can have
Transient neonatal MG with complete recovery by 3-8 weeks
251
Acid maltase deficiency causes
Pompe’s disease
252
Magnesium sulphate, given during <32 weeks premature labour is thought to decrease the risk of fetal
Cerebral palsy
253
1st line treatment of a persistent seizure
Benzos - lorazepam, midazolam, diazepam
254
Herniation which can cause ipsilateral CNIII palsy (blown pupil), and contralateral hemiplegia
Uncal herniation, lateral transtentorial. Can be due to a temporal lobe mass.
255
Herniation type that can cause coma, bilaterally small pupils, abnormal posturing, caudal loss of brainstem reflexes
Central transtentorial herniation. Due to diffuse cerebral edema and inferior displacement of the diencephalon
256
Herniation type causing coma, contralateral weakness, strange leg posturing, +/- ACA stroke
Subfalcine herniation. Due to frontal/parietal mass pushing the cingulate gyrus under falx.
257
Herniation causing medullary dysfunction, leading to coma and abnormal positioning
Cerebellar herniation
258
Head injury with transient confusion, LOC <30s, seizures following, irritability, lethargy, vomiting following
Concussion
259
Hematoma resulting from the disruption of the MMA due to skull fracture
Epidural hematoma
260
Brain bleeding due to torn bridging vein or contused brain
Acute subdural hematoma
261
Most common cause of compressive lesion in spinal cord extradural space
Neoplasms
262
TB of the spine is called
Pott’s disease
263
Contralateral loss of pain and temperature sensation, ipsilateral loss of position and vibration plus weakness
Hemi-cord “brown sequard” syndrome (lateral cord compression)
264
5th day fits, also known as
Benign neonatal seizures
265
Prognosis for benign familial neonatal seizures
Resolve within 6m, normal development but 10% risk of epilepsy
266
Seizure with fever >38’C in a child aged 6m to 5yr
Febrile seizures
267
Triad of epileptic spasms, hypsarrythmia on EEG, neurodevelopmental arrest or regression in an infant
West syndrome
268
Prognosis for west syndrome
Poor - death, drug resistant epilepsy, motor delay, severe neurocognitive delay
269
Rolandic seizures (unilateral focal sensorimotor, parasthesia on one side of mouth followed by dysarthria/gagging, jerking of face and drooling, usual preservation of conciousness), predominantly nocturnal, in children
Benign epilepsy of childhood with Centro temporal strikes (BECTS)
270
Adolescent epilepsy syndrome with three seizure types, predominantly within 60 mins of awakening and triggered by sleep deprivation, alcohol, flashing lights
Juvenile myoclonic epilepsy
271
First step when a parent has concern about their baby’s language development is
Audiogram
272
Allowable occupational noise exposure
80dB for 8 hrs
273
Cisplatin, Gentamycin, loop diuretics, ASA, erythromycin, quinine all have what side effect in common?
Ototoxicity
274
What ear components are required for cochlear implants to be effective?
Require a cochlea and CNVIII (vestibularcochlear nerve)
275
CIWA is a tool used to assess for
Alcohol withdrawal and threshold for treatment
276
Tobacco use disorder 3 main treatment options
1. Nicotine replacement therapy, 2. Bupropion (Wellbutrin), 3. Varenicline (Champix)
277
When is opioid withdrawal life threatening?
During pregnancy (to fetus) due to high risk of miscarriage
278
Opioid antagonist used in opioid use disorder
Naltrexone
279
Opioid agonist used in opioid substance use disorder treatment
Methadone
280
Partial agonist at mu receptor, antagonist at kappa-opioid receptor
Buprenorphine
281
Cocaine, amphetamines, methylphenidate, bath salts, are all
Stimulants
282
What effect do stimulants have on pupils?
Dilation
283
Increased ICP resulting in dilation of the cerebral ventricles with accumulation of CSF
Hydrocephalus
284
CSF is produced in the
Choroid plexus
285
Cushings triad
Hypertension, bradycardia, irregular respirations
286
Sunsetting sign, light-near dissociation, convergence retraction nystagmus, and lid retraction in a child is a late stage presentation of
Perinaud syndrome (dorsal midbrain syndrome) - hydrocephalus
287
Most common cause of cerebral palsy in preterm infants is
Periventricular leukomalacia
288
Three main types of cerebral palsy
Spastic, dyskinetic, ataxic
289
Signs of mass effect in the brain. (3)
1. Headache (worse in morning), 2. Nausea/vomiting, 3. Papilledema
290
HEADACHe mnemonic for headache red flags
```
Headache worst ever or different
Exertion triggered
Age >50
Despite treatment it persists
Acute onset
CNS findings
HIV/Immunocompromised
fEver/BSx
```
291
What kind of imaging to screen for a mass lesion?
CT scan
292
Part of the brain responsible for releasing dopamine
Substantia nigra pars compacta
293
TRAP mnemonic for Parkinsonism
Tremor
Rigidity
Akinesia/Bradykinesia
Posture and Gait change
294
To diagnose parkinsons the MD needs 2 signs
Slowness, and tremor at rest OR rigidity
295
Parkinsonism with stooped neck early, autonomic failure, ataxia, pyramidal, and poor med response
Multiple system atrophy
296
Parkinsonism with wide open eyes, neck rigidity, poor down gaze, falls, pharyngeal dysfunction, early dementia, no tremor
Progressive supranuclear palsy
297
Asymmetric Parkinsonism with grasp reflex, apraxia, stimulus sensitive myoclonus, alien hand, and dementia
Cortical basal degeneration
298
Disease with symptom onset 30-50YO, motor symptoms of chorea, dystonia, tics, cognitive impairment, and neuropsychiatric fx
Huntington disease
299
Hemiballism is due to an infarct in the
subthalamic nucleus
