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First Aid > Neurologie > Flashcards

Neurologie Flashcards

1
Q

contrindication of TPA in stroke(11)

A

systolic BP>185 and diastolic >110
prior intracranial hemorrage
stroke or head trauma within the last 3 months
recent MI
current anticoagulation with INR>1,7 or prolonged PTT
platelet count< 100000
major surgery in 14 days
GI or unrinary bleeding in the past 21 days
seizures present at the onset of the stroke
blood glucose< 50 or> 400
age < 18

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2
Q

clue for SAH

A

worst headache of my life

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3
Q

complication of berry aneurism in eye

A

CN 3 palsy with pupil involvement

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4
Q

3 common cerebral aneurisms

A

ACA 30%
PSA 25%
MCA 20 %

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5
Q

Apres combien de tempa you can have mental changes in epidural hematoma(2)

A

within minutes to hours

classic lucid interval

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6
Q

Apres combien de tempa you can have mental changes in sub dural hematoma

A

within days to weeks

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7
Q

quid of blown pupil

A

fixed and dilated pupil

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8
Q

disease with blown pupil

A

epidural hematoma

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9
Q

CT for epidural hematoma

A

biconvex lens shaped

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10
Q

recent onset of headaches next step

A

immediate work up

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11
Q

most common type of headache in adults

A

tension headaches

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12
Q

causes of seizure in infant(4)

A

perinatal injury
infection
metabolic
congenital

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13
Q

causes of seizure in children 2-10 ans(4)

A

idiopathic
infection
trauma
febrile seizure

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14
Q

causes of seizure in adolescent(4)

A

idiopathic
trauma
drug withdrawal
AVD

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15
Q

cause of seizure in adult 18-35 ans(3)

A

trauma
alcohol
brain tumor

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16
Q

5 A for dementia

A 
aphasia
apraxia
agnosia
amnesia
abstract thought disturbance
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17
Q

cause of seizures in adult > 35 ans(4)

A

stroke
metabolic disorder
alcoholism
brain tumor

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18
Q

triad of MS(3)

A

scanning speech
intranuclear ophtalmoplegia
nystagmus

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19
Q

physiologic condition associated with decreased frequence of MS episode

A

pregnancy

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20
Q

CSF protein level in GBS

A

> 55 mg/dl

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21
Q

5 A for GBS

A 
acute inflammatory demyelinatingpolyradiculopathy
ascending paralysis
autonomic neuropathy
arrythmias
albuminocytologic dissociation
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22
Q

most common CNS tumor

A

metastatic

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23
Q

most common CNS tumor in adult(2)

A

glioblastoma

meningioma

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24
Q

most common CNS tumor in children(2)

A

meduloblastoma

astrocytoma

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25
Q

localisation of brain tumor in kids

A

1/3 supratentorial

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26
Q

localisation of brain tumor in adults

A

2/3 supratentorial

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27
Q

other name of neurofibromatosis type 1

A

von recklinghausen disease

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28
Q

association of NF2

A

acoustic neuroma

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29
Q

genetic problem in NF 2

A

chromosome 22

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30
Q

quid of Lysh nodules in NF1

A

pigmented iris hamarthoma

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31
Q

criteria for NF 1(5)

A 
six cafe au lait spots
freckling in axillary or inguinal area
optic glioma
2 lish nodules
first degree relative with NF 1
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32
Q

triad for wernicke encephalopathy(3)

A

encephalopathy
ophtalmoplegia
ataxia

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33
Q

classic patient with b1 deficiency(5)

A 
alcoholics
hyperemesis
dyalisis
starvation
 aids
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34
Q

what can elicited wernicke encephalopathy

A

large dose of glucose administration

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35
Q

quid of ophtalmoplegia in Wernicke encephalopathy(3)

A

nystagmus
lateral rectus palsy
conjugate gaze palsy

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36
Q

risk factor for dementia(4)

A

age
positive family history
head trauma
down syndrome

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37
Q

mutation associated with the most severe form of NF2(2)

A

nonsense

frame shift mutation

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38
Q

quid of same sense mutation (2)

A

silent mutation

not severe

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39
Q

clue for normal pressure hydrocephalus(3)

A

gait disturbance
dementia’
urinary incontinence

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40
Q

PL in normal pressure hydrocephalus

A

normal opening pressure

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41
Q

MRI of NPH

A

enlarged ventricle

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42
Q

MRI of PML

A

multiple non enhancing lesions

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43
Q

CT of alzheimer

A

diffuse cortical atrophy greater in temproal and parietal lobe

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44
Q

side effect of trihexyphenidil

A

anticholinergic effect

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45
Q

quid of anticholinergic effect(7)

A 
dry skin
dry mouth
constipation
urinary retention
flushing
visison changes
confusion
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46
Q

disease associated with vascular dementia

A

stroke

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47
Q

CSF analysis in herpes encephalitis(3)

A

lymphocytosis pleiocytosis
high erythrocytes
high protein

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48
Q

symptomatic hypokaliemie

A

< 2,5 meq/l

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49
Q

EKG of hypokaliemia(3)

A

U waves
flat and broad T waves
premature ventricular beats

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50
Q

initial imaging in the setting of unprovoked seizure

A

CT of head without contrast

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51
Q

Dx of epidural abcess

A

MRI with gadolinium

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52
Q

types of stroke(4)

A

ischemic thrombotic
ischemic embolic
intra cerebral hemorrage
spontaneous sub arachnoid hemorrage

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53
Q

treatment of of myasthenie gravis crisis(2)

A

endotracheal intubation

withdrawal of anticholinesterase inhibitor

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54
Q

site of lesion for myasthenie gravis

A

neuromuscular

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55
Q

criteria to declare brai death in the setting of mechanical ventilation(2)

A

absent cranial nerves reflexes
fixed and dilated pupils
no spontaneous breath
agreement of 2 physicians

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56
Q

quid of glioblastome multiforme(2)

A

astrocytoma de grade 4 or

high grade astrocytoma

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57
Q

CT for glioblastoma multiforme

A

butterfly appearance

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58
Q

early symptom in normal pressure hydrocephalus

A

gait impairment

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59
Q

differenciate NPH from alzheimer(2)

A

in NPH first symptom gait impairment

in alzheimer gait impairment comes later

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60
Q

pill rolling tremor

A

parkinson disease

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61
Q

CT for high grade astrocytoma

A

heterogenous and serpiginous contrast enhancement

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62
Q

predisposing factor for delirium(5)

A 
dementia
parkinson
prior stroke
advanced age
sensory impairement
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63
Q

precipitating factors for delirium(6)

A 
drugs
infections
electrolyte disturbances
metabolic derangements
systemic illness
central nervous system necrosis
64
Q

drugs percipitating delirium(5)

A 
narcotics
sedatives
antihistamines
muscles relaxers
polypharmacy
65
Q

infections precipitating delirium(3)

A

pneumonia
IGU
meningitidis

66
Q

electrolytes disturbances precipitating delirium(2)

A

hyponatremia

hypercalcemia

67
Q

metabolic disturbances precipitating delirium(3)

A

volume depletion
B 12 deficiency
hyperglycemia

68
Q

systemic disturbances precipitating delirium(3)

A

CHF
hepatic failure
Malignancy

69
Q

CNS disturbances precipitating delirium(3)

A

seizures
head injury
subdural hematoma

70
Q

quid of delirium(3)

A

confusion
desorientation
reduced or fluctuate level of consciousness

71
Q

Symptom accompany delirium(3)

A

agitation
anxiety
hallucination

72
Q

only abnormality in CSF analysis in GBS

A

increased protein

73
Q

other appelation peripheral facial paralysis

A

Bell’s palsy

74
Q

other symptom of bell’s palsy(3)

A

decreased tearing
hyperacusis
loss of taste sensation over the 2/3 ant of the tongue

75
Q

most common cause of subdural hematoma

A

blunt trauma

76
Q

finding in CSF in MS

A

oligoclonal bands

77
Q

quid of conus medularis

A

spinal cord termination

78
Q

what cauda equina syndrome will give

A

lower motor neuron

79
Q

finding in cauda equina syndrome(6)

A 
usually unilateral
radicular pain
asymetric muscular weakness
hypo or areflexia
late onset of bowel and bladder dysfunction
saddle hypo or anesthesia
80
Q

finding in conus medullaris syndrome(5)

A 
sudden onset of severe back pain
perianal hypo/ oranesthesia
symetric motor weakness
hyperreflexia
early onset of bowel or bladder dysfunction
81
Q

rx of conus medullaris syndrome(3)

A

MRI
IV glucocorticoids
neurosurgical evaluation

82
Q

quid of cauda equina syndrome

A

lumbo sacral nerve roots from cauda equina

83
Q

what consequence will have a lesion in cauda equina syndrome

A

lower motor neurone

84
Q

what consequence will have in conus medullaris syndome

A

both upper and lower motor neuron

85
Q

sensory role in cauda equina

A

saddle area

86
Q

motor role in cauda equina

A

control of sphincter anal and uretral

parasympathetic to bladder and lower bowel

87
Q

congenital foot drop

A

charcot marie tooth disease

88
Q

first rx of NPH

A

large volume of lumbar puncture

89
Q

failure in large volume lumbar puncture in NPH

A

ventriculoperitoneal shunt

90
Q

symptom for Cauda equina syndrome(4)

A

weakness of both legs
numbness from buttocks to feet
loss of rectal tone
retention d’urine

91
Q

retention d’urine in USMLE

A

foley catheter ramene 800 CC d’urine

92
Q

next step in in cauda equina syndrome(2)

A

MRI

surgical in emergency

93
Q

clue for ACA stroke(2)

A

controlateral motor and sensory deficits

more pronounced in the lower limbs than the upper

94
Q

bloof supply of the brain(2)

A

ant circulation

post circulation

95
Q

quid of anterior circulation of the brain

A

internal carotid arteries

and its branches

96
Q

brain branches of carotid arteries(2)

A

ACA

MCA

97
Q

Post circulation of the brain

A

paired of vertebral arteries

forms basilar artery

98
Q

origin of post cerebral arteries

A

from basilar arteries

99
Q

med used in thrombotic stroke(2)

A

TPA

tissue plasminogen activator

100
Q

example of TPA

A

alteplase

101
Q

cause of lacunar strokes(2)

A

microatheroma

lipohyalinosis of the small penetrating arteries of the brain

102
Q

risk factor for lacunar infarct(2)

A

HTA

diabetes

103
Q

most common site of lacunar infarct

A

post internal capsule

104
Q

lacunar stroke type(2)

A

thrombi

not embolic

105
Q

conduction aphasia(2)

A

fluent spontaneous speech but phonemic errors

comprehension relatively preserved

106
Q

repetition in wernicke and broca

A

impaired

107
Q

repetition in conduction aphasia

A

very poor

108
Q

associated features with broca

A

right hemiparesis

109
Q

associated features with wernicke

A

right superior visual field defect

110
Q

associated features with CONDUCTION APHASIA

A

none

111
Q

clue for broca

A

broken speech

112
Q

artery in broca

A

MCA

113
Q

complication of subarachnoid hemorrage

A

hyponatremia

114
Q

clue for lacunar infarct(3)(post limb interbnal capsule)

A

unilaterla motor impairment
no sensory or cortical deficits
no visual field defect

115
Q

clue for MCA

A 
controlateral somato sensory
motor weakness in face arm and legs
conjugate eye deviation toward side of the infarct
aphasia
hemineglect syndrome
116
Q

aphasia in MCA occlusion

A

dominant sphere atteint

117
Q

hemineglect syndrome in MCA occlusion

A

non dominant sphere

118
Q

ACA occlusion(6)

A 
controlateral somato sensory 
motor weakness predominat in lower extremities
abulia
dyspraxia
urinary incontinence
emotionnal disturbances
119
Q

quid of abulia

A

lack of will and initiation

120
Q

vertebro basilar system occlusion(3)

A

alternate syndrome with controlateral hemiplegia
ipsilateral cranial nerve involvement
possible ataxia

121
Q

best tool to confirm parkinsonism

A

physical exam

122
Q

torticolis in USMLE(2)

A

periodic involuntary head turning

hypertrophied STERNO CLEIDO MASTOID muscle

123
Q

synonym of torticolis

A

focal dystonia

124
Q

acute agitation in elderly and demented people(2)

A

antipsychotics

no benzodiazepines

125
Q

risk in status epilepticus

A

cortical laminar necrosis

126
Q

quid of status epilepticus

A

seizures for more than 5 mn

127
Q

consequence of cortical laminar necrosis

A

persistent neurologic deficits

recurrent seizures

128
Q

ischemic stroke on CT

A

hypodense area

129
Q

hemorragic stroke on CT

A

hyperdense area

130
Q

broad based shuffling gait

A

NPH

131
Q

cause of NPH in USMLE

A

decreased CSF absorption

132
Q

physiopatho of amaurosis fugax

A

cholestrerol emboli from plaques in carotid artery

133
Q

next step after dx myasthenia gravis and why(2)

A

chest CT

look for thymoma

134
Q

most common cause of of hemorragic intraparenchymal(2)

A

uncontrolled HTA

amyloid angioplasty

135
Q

most common site of hTA bleeding(2)

A

basal ganglia

specially in putamen

136
Q

stroke with no prior antiplatelet rx

A

aspirin

137
Q

stroke on aspirin ,rx

A

aspirin plus dypiridamole or clopidogrel

138
Q

stroke on aspirin plus large intracranial artery atherosclerosis

A

aspirin plus clopidogrel

139
Q

stroke with AFIB ,management

A

long term anticoagulation

140
Q

memory loss ,constipation and weight gain

A

hypothyroidism

141
Q

gait in parkinsonism(2)

A

hypokinetic

shuffling gait

142
Q

quid of shuffling gait

A

patient is chasing his center of gravity

143
Q

problem in parkinson

A

underactivity of dopaminergic neuron in substantia nigra

144
Q

clue for parkinson (extra)

A

fixed facial expression

resistance to passive flexion

145
Q

cause of CN 3 neuropathy

A

nerve ischemia

146
Q

target in pharmacotherapy restless leg syndrome

A

dopamine

147
Q

firs line rx of restless leg syndrome

A

dopamine agonist

148
Q

second line rx of restless leg syndrome

A

gabapentin

149
Q

quid of gabapentin

A

alpha 2 delta calcium channel ligands

150
Q

cause of RLS

A 
iron deficiency anemia
uremia
diabetes mellitus
MS
parkinson
pregnancy
drugs
151
Q

drugs causing RLS(2)

A

antidepressants

metochlopramide

152
Q

rx of intermittent mild symptom of RLS(3)

A

iron supplementation
supportive measures
avoid aggravating factors

153
Q

supportive measures in RLS(3)

A

leg masssage
heating
exercice

154
Q

aggravating factor in mild intermittent RLS(2)

A

sleep deprivation

medications

155
Q

when to give medication in RLS

A

persistent moderate to severe form

First Aid (19 decks)

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