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Clerkship Prep > Neurological > Flashcards

Neurological Flashcards

1
Q

GCS categories

A

Eye opening, Verbal, Motor

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2
Q

GCS, 4 5 6

A

4 eyes, 5 words, 6 motions

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3
Q

Pronator drift, one hand pronates

A

Suspect UMN

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4
Q

Pronator drift test, one arm drifts up

A

Suspect cerebellar disease

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5
Q

MSE categories: ASMA TPTC CIJ

A

Appearance, behaviour, clothing, speech, mood, affect
Thought process, thought content
Cognition, insight, judgement

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6
Q

APGAR

A

Appearance, pulse, grimace w stim, activity (tone), resp effort

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7
Q

Pupillary light reflex branches

A

Afferent CNII sensory, CNIII motor

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8
Q

Weber conductive hearing loss

A

Hear it in bad ear

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9
Q

Weber sensorineural hearing loss

A

Hear it in good ear

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10
Q

Rinne test, SNHL

A

Bone conduction better than air conduction since the issue is at the level of the nerve

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11
Q

Diffuse thyroid enlargement

A

Graves, hashimotos, endemic goiter

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12
Q

Single thyroid node DDx

A

Cyst, benign tumour, malignancy

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13
Q

Multinodal goiter thyroid

A

Iodine deficiency

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14
Q

Firm thyroid

A

Hashimotos, malignancy, benign, malignant

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15
Q

Tender thyroid on palpation

A

Thyroiditis

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16
Q

Continuous bruit over thyroid

A

Hyperthyroidism

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17
Q

Space we LP between is

A

L3 and L4

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18
Q

Normal opening pressure CSF

A

8-10 cm

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19
Q

Normal WBC in CSF

A

Less than 4

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20
Q

Normal protein in CSF

A

<0.4 g/L

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21
Q

Glucose in CSF

A

> 60% of serum glucose

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22
Q

Things you need to ask about specifically in a psych interview

A

Hallucinations, delusions, suicide, homocide

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23
Q

Motor exam NS

A

bulk, symmetry, tone, fasciculations, power (5)

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24
Q

DDx seizure in an infant

A

CNS bleeding, infection, structural abnormalities, metabolic disorder, electrolyte abnormalities, genetic syndromes, epilepsy, febrile

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25
Q

Signs of a basilar skull fracture

A

Battles sign (ecchymosis behind ear), raccoon eyes, hematotympanum, CSF leaking from nose or ears

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26
Q

Manifestations of alcoholic cerebellar degeneration

A

Develops over weeks to months, wide based gait, incoordination in legs, cognition intact, truncal ataxia, and nystagmus

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27
Q

Alcoholic cerebellar degeneration occurs due to degeneration of

A

Purkinje cells (cerebellar vermis)

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28
Q

Pendular knee reflex is due to

A

Muscle hypotonia

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29
Q

Positive babinski suggests

A

Upper motoneuron disease

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30
Q

Bradykinesia is a hallmark of

A

Parkinsons

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31
Q

DTRs in parkinsons

A

Typucally normal

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32
Q

Clasp knife phenomenon is seen in patients with hypertonia that is due to disease of the

A

Pyramidal tract

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33
Q

Diagnosing DVT

A

Doppler, duplex ultrasonography

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34
Q

Treating upper limb DVT

A

3 months anticoagulation

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35
Q

Untreated strabismus can lead to

A

Amblyopia

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36
Q

Exam findings in strabismus

A

Asymmetric corneal light reflexes and asymmetric red reflexes that are more intense in the deviated eye

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37
Q

First step in evaluation of strabismus is

A

A dilated fundoscopic exam to assess for secondary causes, particularly retinoblastoma

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38
Q

Visual evoked potential testing may be performed for

A

Optic neuritis

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39
Q

What would the EEG look like for psychogenic non epileptic seizures

A

No excessive neuronal activity

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40
Q

Causes of seizures

A

Neuro/anatomic causes, metabolic/physiologic causes, epilepsy, PNES

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41
Q

What causes a TIA?

A

Transient neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia without acute infarction

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42
Q

What is the significance of a TIA?

A

The individual is at risk for stroke

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43
Q

EEG during a seizure

A

Abnormal excessive hypersynchronous activity in the brain

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44
Q

What area of the brain do seizures typically occur

A

The cerebral cortex

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45
Q

To be diagnosed with epilepsy, one must have

A

2 unprovoked seizures, 24 hrs apart, or one unprovoked with high probability of further seizures, or a diagnosis of epilepsy syndrome by genetics

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46
Q

Provoked seizures may be due to

A

Metabolic derangement, substance use/withdrawal, acute neurological disorders

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47
Q

What percent of the population has an unprovoked seizure in their lifetime?

A

5%

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48
Q

Types of seizures

A

Focal, generalized, unknown onset

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49
Q

Generalized seizure types

A

Motor - tonic/clonic or other

Non motor - absence

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50
Q

Focal seizures are located in

A

One cerebral hemisphere

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51
Q

Myoclonic is

A

Sudden, brief, single or multiple irregular contractions

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52
Q

Clonic means

A

Jerking (regularly repetitive longer contractions)

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53
Q

Tonic means

A

Abnormally sustained posture lasting seconds to minutes

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54
Q

Versive during seizure means

A

Forced eye deviation, head/neck turning

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55
Q

Negative motor phenomenon that can occur during seizure

A

Atonic, negative myoclonus

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56
Q

Atonic during seizure means

A

Sudden loss of muscle tone which can involve the head, trunk, jaw, limb

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57
Q

Negative myoclonus means

A

Sudden brief loss of tone in a muscle

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58
Q

What is an automatism

A

Involuntary complex, repetitive, coordinated motor activity during seizure

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59
Q

Localization related seizures are often due to

A

Structural lesion - tumour, stroke, infection

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60
Q

Temporal lobe epilepsy often related to sclerosis of the

A

Hippocampus

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61
Q

Jacksonian march

A

Occurs in a frontal lobe seizure, motor involvement moves from one limb to another as the seizure activity moves across the cortex

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62
Q

What is absence seizures

A

Brief episodes of loss of awareness due to sudden generalized seizure

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63
Q

Average absence seizure lasts

A

15 seconds

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64
Q

First step during seizure

A

ABCs, time it

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65
Q

Status epilepticus is defined as a seizure lasting

A

Longer than 5 minutes

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66
Q

After 5 mins of seizing and checking ABCs, whats the next move?

A

Benzos, phenytoin, phenobarbital

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67
Q

Muscular back pain should be treated using

A

NSAIDs and exercise

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68
Q

Muscular back pain should resolve by

A

4 weeks

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69
Q

Investigating suspected MSK back pain that wont go away

A

XRAY MRI

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70
Q

Treating cord compression

A

Dexamethasone

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71
Q

Alarm symptoms lower back pain

A

Bowel/bladder sx, saddle anesthesia, new functional neurological diseases, rapid progression

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72
Q

Osteophyte in back treatment

A

Surgery

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73
Q

Spinal stenosis signs

A

Pseudo claudication, positional changes

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74
Q

Treatment for spinal stenosis

A

Laminectomy

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75
Q

Diagnosing spinal pathology

A

1st xray, best MRI

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76
Q

Spinal compression due to osteoporosis classical story

A

Older patient who falls on coccyx, vertebral step off, pinpoint tenderness

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77
Q

EEG of comotose patient

A

Depressed

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78
Q

4 cranial reflexes in neurology

A

Corneal, cold water, calorics, dolls eyes

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79
Q

Workup for possible reversible causes of dementia

A

BMP, B12, depression, MRI, TSH, T4, LFT, CT

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80
Q

Delirium course of illness

A

Waxes and wanes

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81
Q

Pathophysiology of Alzheimer’s

A

Plaques and tangles

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82
Q

CT of Alzheimer’s pt brain may shoe

A

Diffuse atrophy

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83
Q

Treatment for Alzheimer’s

A

Support, family education, tacrine donepezil

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84
Q

Treatment for creutzfelt Jacobs disease

A

Supportive

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85
Q

Lewy body dementia symptoms

A

Parkinsonian, dementia, visual hallucinations

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86
Q

Three W’s of normal pressure hydrocephalus (NPH)

A

Wet, wobbly, weight

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87
Q

Diagnosing normal pressure hydrocephalus

A

CT shows hydrocephalus, patient improves with LP

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88
Q

NPH treatment

A

VP shunt

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89
Q

Vascular dementia pathophys

A

CVA

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90
Q

CT for vascular dementia

A

Previous infarcts

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91
Q

Spinning and unsteady dizziness is called

A

Vertigo

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92
Q

Central causes for vertigo

A

Within the brain

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93
Q

Peripheral causes of vertigo have accompanying

A

Tinnitus and hearing loss

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94
Q

Posterior fossa causes for vertigo (6)

A

MS, stroke, tumour, abscess, migraines, seizure

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95
Q

BPPV pathophys

A

Otolith movement

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96
Q

Diagnosing BPPV

A

Dix hallpike maneuver

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97
Q

Treating bppv

A

Epley maneuver

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98
Q

Labyrinthitis and vestibular neuritis pathophys

A

Post viral infection, vertigo lasting 1-10 mins with hearing loss, nausea, vomiting

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99
Q

Treatment for labyrinthitis and vestibular neuritis

A

Steroids, meclizine

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100
Q

Meniere disease symptoms

A

Hearing loss, tinnitus, vertigo, severe sx 30min-1hr long

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101
Q

Treating meniere disease (3)

A
  1. Salt restrict, 2. diuresis (thiazide), 3. meclizine
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102
Q

What is meclizine

A

An antihistamine used to treat motion sickness and dizziness

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103
Q

Headache red flags

A

Fever, FND, older than 50, thunderclap, progressive, nausea and vomiting

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104
Q

Tension headache path

A

Muscular, radiates to neck

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105
Q

Treating tension headaches (2).

A

NSAIDs, acetominophe

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106
Q

Cluster headache path

A

Vascular

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107
Q

Sx specific to cluster headache

A

Asymptomatic for months then 8-10 a day, unilateral with eye pain and Horners

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108
Q

Treating (2) and prophylaxis (1) for cluster headaches

A

O2 & triptans acutely, verapamril for prophylaxis

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109
Q

Migraine path

A

Vasculature

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110
Q

Migraine sx

A

Unilateral, debilitating, photo/phonophobia, nausea and vomiting, aura, trigger, sleep helps, feeling hungover the next day

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111
Q

Treating migraines

A

Triptans, ergot, NSAIDs

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112
Q

Migraine prophylaxis

A

Propranolol, topiratmate

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113
Q

Seizure DDx “VITAMINS”

A

Vascular, infarct, trauma, autoimmune, metabolic, ingestion/withdrawal, neoplasm, sych

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114
Q

Treating atonic or myoclonic seizures

A

Valproate

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115
Q

Treating absence seizures

A

Ethosuximide

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116
Q

Trigeminal neuralgia presents with

A

Lance like face pain

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117
Q

Signs that its a real seizure

A

LOC, jerking, bowel/bladder incontinence, tongue biting, post ital state

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118
Q

Testing after seizure

A

EEG, CT/MRI, vitamins

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119
Q

Med cascade for seizing patient

A

Phenytoin, midazolam, propofol, phenobarbital

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120
Q

Ischemic strokes may be 1 of 2 types

A

Thrombotic or embolic

121
Q

Risk of thrombotic stroke increases with

A

Hypertension, diabetes, smokin, obestity, family hx, age

122
Q

Hemorrhagic strokes occur secondary to

A

Intracerebral hemorrhage and subarachnoid hemmorhage

123
Q

Stroke affecting ACA will lead to issues with

A

Feet and legs

124
Q

Stroke affecting MCA will affect

A

Hands, arms, face, speech (the typical idea)

125
Q

stroke of the PCA will affect

A

Vision

126
Q

Basilar and vertebral stroke will cause

A

Syncope

127
Q

Meds for suspected stroke

A

ASA statins

128
Q

Labs during suspected stroke

A

A1C, TSH, LIPID, CMP, CBC

129
Q

Essential tremor occurs

A

With movement

130
Q

Intention tremor occurs

A

With movement

131
Q

Pathophys of parkinsons

A

Loss of dopamine producing substantia nigra

132
Q

Symptoms of Parkinson’s

A

Bradykinesia, cogwheel rigidity, resting tremor, gait/postural instability

133
Q

Treating parkinsons in younger population

A

Dopa agonists

134
Q

Treating parkinsons older than 70 (3)

A

Lavodopa, carbidopa, COMT-1, MAOB1

135
Q

Intention tremor occurs due to

A

Cerebellar dysfunction

136
Q

Huntington’s pathophys

A

Anticipation of a trinucleotide repeat

137
Q

Patho of essential tremor

A

Familial

138
Q

Treating an essential tremor

A

Propranolol

139
Q

Treating an intention tremor

A

None

140
Q

Chorea in Huntington’s

A

Purposeless ballistic movements

141
Q

Treating Huntington’s

A

Not possible

142
Q

Multiple sclerosis pathophysiology

A

Autoimmune demyelination

143
Q

Patient in MS is usually

A

20-40, female, any neurological sx occuring in different times/space, optic neuritis

144
Q

Diagnosing MS

A

MRI for periventricular white matter

Dis and dit

145
Q

Treating MS flare

A

Steroids

146
Q

Treating MS chronically

A

IFN, glatiramer, fingolimod

147
Q

Treating MS urinary retention

A

Bethanechol

148
Q

Treating MS urinary incontincec

A

Amytriptyline

149
Q

Treating MS spasms

A

Baclofen

150
Q

Treating neuropathic pain in MS

A

Gabapentin

151
Q

CSF in a patient with guillian barre syndrome shows

A

Lots of protein, few cells

152
Q

Treating Gullian barre

A

IVIG plasmapheresis, never steroids

153
Q

Hallmark of ALS

A

UMN and LMN

154
Q

Diagnosing ALS requires what kind of testing?

A

EMG

155
Q

Treatment for ALS

A

Supportive riluzole

156
Q

Pathophysiology of myasthenia gravis

A

Autoimmune attach of Ach receptor

157
Q

Myasthenia gravis sx

A

Fatiguable weakness, eyes drooping, swallowing problems, worse at night

158
Q

Diagnosing myasthenia gravis

A

Look at Abs vs ACH-R, EMG, CT for thymoma

159
Q

Treating myasthenia gravis

A

Increase ACH via cholinesterase 1, decrease autoimmune response with steroids

160
Q

Treating MG crisis

A

IVIG plasmaphoresis, thymectomy

161
Q

Most common cause of dementia

A

Alzheimer’s disease

162
Q

Early findings in Alzheimer’s

A

Anterograde memory loss, visuospatial issues, language difficulties, cognitive impairment with progressive decline

163
Q

How is Parkinson’s disease diagnosed?

A

Clinically by physical exam

164
Q

What accumulates in Parkinson’s disease patietns?

A

Accumulation of alpha-synuclein within the neurons of the substantia nigra

165
Q

3 cardinal signs of Parkinson’s disease

A

Rest tremor, rigidity, bradykinesia

166
Q

Most common presenting sign of Parkinson’s disease

A

Asymmetric rest tremor in the distal part of an upper extremity

167
Q

Lhermitte’s sign

A

Electric shock sensation down the spine with forward Flexion of the next

168
Q

Cervical spondylotic myelopathy generally presents with

A

Progressive neck pain, gait disturbances, lower motoneuron signs in the upper extremities, and upper motoneuron signs in the lower extremities

169
Q

UMN signs

A

Increased reflexes, spasticity

170
Q

LMN signs

A

Weakness, diminished reflexes

171
Q

Preferred treatment for PTSD is

A

CBT, SSRI, SNRI

172
Q

Primary and secondary presentation of retinoblastoma is

A

Leukocoria, estropia (due to central vision loss)

173
Q

Optic nerve cupping is indicative of what disease

A

Glaucoma

174
Q

How can you confirm the presence of a retinal mass seen on dilated fundoscopic examination?

A

MRI of the brain and orbits

175
Q

What tests can you do for strabismus?

A

Cover and uncover, dilated pupil fundoscopy

176
Q

Tremor of PD characteristics

A

Occurs during rest and improves with activity, often the first manifestation of parkinsons

177
Q

What type of drug is trihexyphenidyl?

A

An anticholinergic

178
Q

Trihexyphenidyl is typically used in what patients

A

Young patients with tremor dominant Parkinson’s disease

179
Q

First line treatment for essential tremor is

A

Beta blocker - propranolol

180
Q

Cessation of exercise resulting in sudden decrease in venous return to the heart

A

Exercise associated postural hypotension

181
Q

Management of exercise associated postural hypotension

A

Trendelenburg positioning, oral hydration, patients remain alert with normal mental status

182
Q

When would you consider carotid endarterectomy?

A

Symptomatic patients with high grade carotid stenosis (70-99%)

183
Q

Profound hemineglect is usually due to a lesion impacting the

A

Non dominant parietal lobe responsible for spatial organization

184
Q

Vestibular schwannoma present as

A

SN hearing loss and imbalance

185
Q

Bilateral hereditary schwannomas are often associated with what condition

A

Neurofibromatosis type II

186
Q

Sensations carried by the posterior column

A

Proprioception and vibration

187
Q

Sensations carried by the lateral spinothalamic tract

A

Pain and temperature

188
Q

What is the risk of status epilepticus?

A

Permanent brain injury due to excitatory cytotoxicity

189
Q

What brain changes occur secondary to status epilepticus

A

Cortical laminar necrosis

190
Q

Classic triad for pheochromeocytoma

A

Episodic headache, sweating, and tachycardia

191
Q

Diagnosing pheochromocytoma

A

Urine or plasma metanephrine levels, then confirmatory abdominal imagine

192
Q

How long does GBS typically last?

A

Reaches a nadir at 4 weeks before improving

193
Q

Treating pain in GBS

A

Gabapentin, NSAIDS, opioids, morphine if severe

194
Q

Treating GBS

A

Immunotherapy with IVIG or plasma exchange PLEX

195
Q

Pheochromeocytoma triad

A

Episodic headaches, sweating, and tachycardia

196
Q

Screening for pheochromeocytoma

A

Plasma metanephrines

197
Q

Ramsay hunt syndrome aka

A

Herpes zoster oticus

198
Q

Ear pain, face weakness, and vesicular rash in external auditory canal is suspicious for

A

Ramsay hunt syndrome

199
Q

Treating Ramsay hunt syndrome

A

Corticosteroids and antivirals

200
Q

Motor signs of stroke with a clean CT and a sense of cortical signs, seizure, or mental status changes

A

Lacunar stroke

201
Q

Traumatic rupture of bridging veins in the brain result in

A

Subdural hematoma

202
Q

Carotid artery dissection may cause what kind of stroke?

A

Ischemic due to thromboembolism or hypoperfusion

203
Q

Alterations in consciousness, fluctuating cognition, visual hallucinations, Parkinsonism, early compromise of executive functions characterize

A

Lewy body dementia

204
Q

What type of hearing loss does otosclerosis cause?

A

Conductive

205
Q

How does tympanic membrane fibrosis present?

A

Asymptomatic, incidental finding on ear exam

206
Q

Mechanism of injury in noise exposure hearing loss

A

Sensorineural hearing loss due to irreversible death of hair cells in cochlea

207
Q

Clear, unilateral rhinorhea that increases at times of relatively increased ICP is suspicious for

A

Cerebrospinal fluid rhinorrhea

208
Q

Evaluation of CSF rhinorrhea

A

Test for CSF specific proteins, imaging with intrathecal contrast, endoscopy with intrathecal fluorescein dye

209
Q

Management of CSF rhinorrhea

A

Bed rest, lumbar drain placement, surgical repair

210
Q

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.

A

Blepharitis

211
Q

97% of the population has which side of the brain dominant?

A

Left

212
Q

Dominant hemisphere brain functions (3)

A
  1. Language. 2. Praxis (skilled motor formulation) 3. Attention to the other side of the world
213
Q

Non dominant hemisphere of brain functions (5)

A
  1. Prosody 2. Visuospatial skills 3. Emotional significance 4. Music perception 5. Attention to both sides of the world
214
Q

A lesion to the primary motor cortex will cause weakness to which side?

A

Contralateral side

215
Q

A lesion to which area of the brain can cause: poor planning, judgement, problem solving, disinhibition, a motivational syndrome, and urinary incontinence?

A

Prefrontal cortex

216
Q

A lesion to which area of the brain causes non fluency aphasia?

A

Broca’s area

217
Q

A lesion to which area of the brain can cause impaired comprehension of language?

A

Wernicke’s area

218
Q

Kluver Bucy Syndrome of hyperorality, emotional blunting, hyposexuality, blunting of response to fear and aggression caused by a lesion to which area?

A

Prototypical limbic system disorder

219
Q

Lesion of unilateral primary visual cortex causes

A

Contralateral hemianopia

220
Q

Lower visual field travels through which brain lobe?

A

Lower visual field through parietal lobe

221
Q

Upper visual field travels through which brain lobe?

A

Upper visual field travels through temporal lobe

222
Q

Akinetopsia is impaired

A

Motion sensation

223
Q

The tract which is the ascending sensory system, pain and temperature

A

Spinothalamic tract

224
Q

The spinothalamic tract has its decussation in

A

The spinal cord

225
Q

A lesion after the decussation of the spinothalamic tract causes

A

Contralateral loss of pain and temperature sensation

226
Q

Ascending sensory system responsible for proprioception and vibration

A

The dorsal column/medial lemniscus

227
Q

Decussation of the dorsal column is in

A

Superior medulla

228
Q

The descending motor system tract

A

The corticospinal tract

229
Q

The corticospinal tract decussation is in

A

The medulla, pyramidal decussation

230
Q

Fasciculation and atrophy are characteristic of which lesion, UMN or LMN?

A

LMN, lower motoneuron injury

231
Q

Lower motoneurons connect

A

The spinal cord to the muscle

232
Q

VPL & VPM sensory nuclei transmit what kind of information?

A

Somatosensory

233
Q

Lateral geniculate sensory nuclei transmits

A

Visual information from optic tracts to occipital cortex

234
Q

Medical geniculate nucleus transmits

A

Auditory information from brainstem to temporal cortex

235
Q

Limbic nuclei transmit (2)

A

Memory and emotions

236
Q

Thalamus receives input from (2)

A

Cerebellum, basal ganglia

237
Q

Which level does the spinal cord end at?

A

L2

238
Q

3 clinical features of meningeal inflammation

A
  1. Nuchal rigidity, 2. Kernig’s sign, 3. Brudzinski’s sign
239
Q

Puncture site for LP

A

L4-5

240
Q

3 contraindications to lumbar puncture

A
  1. Risk of bleeding 2. Infection over area 3. Risk of brain herniation (increased ICP
241
Q

3 signs of increased ICP in adults

A

Headache, CN palsy (esp CN6), papilledema

242
Q

Cloudy to milky CSF on LP can be indicative of

A

Bacterial meningitis

243
Q

Most likely Etiology for viral meningitis

A

Enteroviruses

244
Q

5 most likely bacterial causes for meningitis

A

S. Pneumoniae, N. meningitidis, L. Monocytogenes., H. influenzae, Group B Strep

245
Q

Etiology of chronic meningitis (3)

A

Tuberculosis, fungi, parasites

246
Q

Management of intracranial hemorrhage (3)

A

Lower BP, reverse anticoagulation, consult neurology

247
Q

80% of hypotonia is (central or peripheral)

A

Central

248
Q

Genetic disease with progressive loss of anterior horn cells in the spinal cord and motor nuclei in cranial nerves

A

Spinal muscle atrophy

249
Q

Genetic testing for spinal muscle atrophy

A

SMN1 gene

250
Q

Babies born to mothers with myasthenia gravis can have

A

Transient neonatal MG with complete recovery by 3-8 weeks

251
Q

Acid maltase deficiency causes

A

Pompe’s disease

252
Q

Magnesium sulphate, given during <32 weeks premature labour is thought to decrease the risk of fetal

A

Cerebral palsy

253
Q

1st line treatment of a persistent seizure

A

Benzos - lorazepam, midazolam, diazepam

254
Q

Herniation which can cause ipsilateral CNIII palsy (blown pupil), and contralateral hemiplegia

A

Uncal herniation, lateral transtentorial. Can be due to a temporal lobe mass.

255
Q

Herniation type that can cause coma, bilaterally small pupils, abnormal posturing, caudal loss of brainstem reflexes

A

Central transtentorial herniation. Due to diffuse cerebral edema and inferior displacement of the diencephalon

256
Q

Herniation type causing coma, contralateral weakness, strange leg posturing, +/- ACA stroke

A

Subfalcine herniation. Due to frontal/parietal mass pushing the cingulate gyrus under falx.

257
Q

Herniation causing medullary dysfunction, leading to coma and abnormal positioning

A

Cerebellar herniation

258
Q

Head injury with transient confusion, LOC <30s, seizures following, irritability, lethargy, vomiting following

A

Concussion

259
Q

Hematoma resulting from the disruption of the MMA due to skull fracture

A

Epidural hematoma

260
Q

Brain bleeding due to torn bridging vein or contused brain

A

Acute subdural hematoma

261
Q

Most common cause of compressive lesion in spinal cord extradural space

A

Neoplasms

262
Q

TB of the spine is called

A

Pott’s disease

263
Q

Contralateral loss of pain and temperature sensation, ipsilateral loss of position and vibration plus weakness

A

Hemi-cord “brown sequard” syndrome (lateral cord compression)

264
Q

5th day fits, also known as

A

Benign neonatal seizures

265
Q

Prognosis for benign familial neonatal seizures

A

Resolve within 6m, normal development but 10% risk of epilepsy

266
Q

Seizure with fever >38’C in a child aged 6m to 5yr

A

Febrile seizures

267
Q

Triad of epileptic spasms, hypsarrythmia on EEG, neurodevelopmental arrest or regression in an infant

A

West syndrome

268
Q

Prognosis for west syndrome

A

Poor - death, drug resistant epilepsy, motor delay, severe neurocognitive delay

269
Q

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

A

Benign epilepsy of childhood with Centro temporal strikes (BECTS)

270
Q

Adolescent epilepsy syndrome with three seizure types, predominantly within 60 mins of awakening and triggered by sleep deprivation, alcohol, flashing lights

A

Juvenile myoclonic epilepsy

271
Q

First step when a parent has concern about their baby’s language development is

A

Audiogram

272
Q

Allowable occupational noise exposure

A

80dB for 8 hrs

273
Q

Cisplatin, Gentamycin, loop diuretics, ASA, erythromycin, quinine all have what side effect in common?

A

Ototoxicity

274
Q

What ear components are required for cochlear implants to be effective?

A

Require a cochlea and CNVIII (vestibularcochlear nerve)

275
Q

CIWA is a tool used to assess for

A

Alcohol withdrawal and threshold for treatment

276
Q

Tobacco use disorder 3 main treatment options

A
  1. Nicotine replacement therapy, 2. Bupropion (Wellbutrin), 3. Varenicline (Champix)
277
Q

When is opioid withdrawal life threatening?

A

During pregnancy (to fetus) due to high risk of miscarriage

278
Q

Opioid antagonist used in opioid use disorder

A

Naltrexone

279
Q

Opioid agonist used in opioid substance use disorder treatment

A

Methadone

280
Q

Partial agonist at mu receptor, antagonist at kappa-opioid receptor

A

Buprenorphine

281
Q

Cocaine, amphetamines, methylphenidate, bath salts, are all

A

Stimulants

282
Q

What effect do stimulants have on pupils?

A

Dilation

283
Q

Increased ICP resulting in dilation of the cerebral ventricles with accumulation of CSF

A

Hydrocephalus

284
Q

CSF is produced in the

A

Choroid plexus

285
Q

Cushings triad

A

Hypertension, bradycardia, irregular respirations

286
Q

Sunsetting sign, light-near dissociation, convergence retraction nystagmus, and lid retraction in a child is a late stage presentation of

A

Perinaud syndrome (dorsal midbrain syndrome) - hydrocephalus

287
Q

Most common cause of cerebral palsy in preterm infants is

A

Periventricular leukomalacia

288
Q

Three main types of cerebral palsy

A

Spastic, dyskinetic, ataxic

289
Q

Signs of mass effect in the brain. (3)

A
  1. Headache (worse in morning), 2. Nausea/vomiting, 3. Papilledema
290
Q

HEADACHe mnemonic for headache red flags

A 
Headache worst ever or different 
Exertion triggered 
Age >50
Despite treatment it persists 
Acute onset 
CNS findings 
HIV/Immunocompromised 
fEver/BSx
291
Q

What kind of imaging to screen for a mass lesion?

A

CT scan

292
Q

Part of the brain responsible for releasing dopamine

A

Substantia nigra pars compacta

293
Q

TRAP mnemonic for Parkinsonism

A

Tremor
Rigidity
Akinesia/Bradykinesia
Posture and Gait change

294
Q

To diagnose parkinsons the MD needs 2 signs

A

Slowness, and tremor at rest OR rigidity

295
Q

Parkinsonism with stooped neck early, autonomic failure, ataxia, pyramidal, and poor med response

A

Multiple system atrophy

296
Q

Parkinsonism with wide open eyes, neck rigidity, poor down gaze, falls, pharyngeal dysfunction, early dementia, no tremor

A

Progressive supranuclear palsy

297
Q

Asymmetric Parkinsonism with grasp reflex, apraxia, stimulus sensitive myoclonus, alien hand, and dementia

A

Cortical basal degeneration

298
Q

Disease with symptom onset 30-50YO, motor symptoms of chorea, dystonia, tics, cognitive impairment, and neuropsychiatric fx

A

Huntington disease

299
Q

Hemiballism is due to an infarct in the

A

subthalamic nucleus

Clerkship Prep (34 decks)

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