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VM749 Clin Sci III > Neurology > Flashcards

Neurology Flashcards

1
Q

UMN functions

A

initiate voluntary movement
maintain tone (posture)
inhibit extensor mm (moderate activity)

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2
Q

LMN functions

A

link between CNS & effector muscles
direct innervation of effector mm

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3
Q

efferent motor tracks

A

brain to muscles
movement

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4
Q

afferent motor tracks

A

muscles to brain
coordination

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5
Q

what happens when something goes wrong with the motor tracts?

A

weakness, paresis or plegia

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6
Q

what happens when something goes wrong with the sensory tracts?

A

ataxia (reduced coordination)

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7
Q

when can you see both weakness and ataxia together? lesion in the ____

A

UMN spinal cord region

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8
Q

UMN signs

A

Paresis or paralysis of innervated muscles
↑ stride length
Normal to ↑ reflexes “hyperreflexia”
none/mild muscle atrophy, occurs slowly due to “disuse atrophy”
Normal to hypertonic/spastic muscle tone

+ standing/walking on dorsum of foot or dragging/scruffing foot “nail wear”

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9
Q

LMN signs

A

Paresis or paralysis of innervated muscles
↓ stride length
↓ to absent reflexes “hyporeflexia”
Severe, rapid muscle atrophy (5-7 days) “denervation atrophy”
hypotonic/atonia/flaccid muscle tone

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10
Q

paresis localizes to LMN and paralysis localizes to UMN

true or false

A

false

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11
Q

intention tremor
no proprioceptive deficits & paresis
wide based stance
irregular foot placement
dysmetria (hypermetria or hypometria)
ipsilateral absent menace

A

Cerebellar Ataxia

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12
Q

asymmetric gait
head tilt, circling
spontaneous nystagmus
proprioceptive deficits & paresis

A

Vestibular Ataxia

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13
Q

proprioceptive deficits & paresis
knuckling
long overreaching “solider marching”
UMN hypermetria

A

General Proprioceptive Ataxia
(caudal brainstem and spinal cord lesion)

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14
Q

Indications of multifocal lesions

A

LMN signs in both limbs

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15
Q

what part of the brain does proprioception

A

cerebellum & brainstem

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16
Q

what part of the brain does gait

A

brainstem & cerebrum

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17
Q

schiff sherington posture
lesion?
signs?

A

T3-L3 lesion - no prognostic significance
PL flexed, TL extended

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18
Q

forebrain lesion clinical signs

A

behavior change
contralateral blindness
ipsilateral head turn, body turn, circling, head press, pacing
deficits in contralateral limbs
contralateral facial hypoalgesia
seizures

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19
Q

what is the imaging modality of choice for the brain

A

MRI

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20
Q

CSF analysis contraindications

A

in absence of MRI
increased ICP
coagulopathy
cerebellomedullary cistern contraindicated with chiari-like malformation, AA instability or cervical trauma

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21
Q

cat ddx for forebrain disease of infectious origin

A

toxoplasma gondii
FIV
FeLV
FCov

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22
Q

CSF max volume

A

1ml/5kg

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23
Q

SRMA does NOT result in forebrain disease but may cause CSF abnormalities

true/false

A

true – results in neutrophillic, mononuclear or mixed pleocytosis

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24
Q

function of an EEG

A

assess forebrain activity
identifies seizures activity

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25
Q

DDX for forebrain diseases in older animals

A

intracranial neoplasia (most common is meningioma)
canine cognitive dysfunction (degenerative)

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26
Q

Slowly progressive, confusion, anxiety, loss of sleep-wake cycle, decreased pet-owner interaction
> 8 yr old dog
females & smaller breeds more common

disease?

A

canine cognitive dysfunction

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27
Q

treatment for intracranial neoplasia

A

prenisolone

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28
Q

treatment for canine cognitive dysfunction

A

MCT Diet, omega3, carnitoids, vitamin E & A
Selegiline
cognitive enrichment
levetiracetam

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29
Q

what are the DDX for any aged animal with forebrain disease due to metabolic dysfunction?

A

hypernatremia (>170-175)
hyponatremia (<125)

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30
Q

chronic hypernatremia treatment

A

corrected slowly 48-72 hrs
not faster than 0.5 mEq/L/hr
half or normal saline then 5% dextrose

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31
Q

acute hypernatremia treatment

A

5% dextrose

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32
Q

acute hyponatremia treatment

A

correct quick with normal saline

33
Q

chronic hyponatremia treatment

what is the risk of rapid correction?

A

corrected slowly 48-72 hrs
normal saline
not faster than 0..5 mEq/L/hr
risk of central myelinolysis with rapid correction

34
Q

younger animal DDX for forebrain diseases

A

hepatic encephalopathy
hypoglycemia
hydrocephalus

35
Q

treatment for hepatic encephalopathy

A

IV fluids, enemas, lactulose, diet
antibiotics (metronidazole or potentiated amoxicillin)
Levetiracetam

36
Q

small breed, toy breed or brachycephaic dog with domed shape head and fontanelles, obtundation, behavior abnormalities, difficulty training, decreased vision, circling and pacing

disease?

A

hydrocephalus

37
Q

hydrocephalus diagnostic modality of choice & treatment

A

MRI

glucocorticoids
furosemide
omeprazole
acetazolamide
surgery

38
Q

type of seizure:
sustained increase in muscle contraction followed by repetitive involuntary muscle contractions at a frequency of 2-3 seconds

A

tonic-clonic (most common)

39
Q

type of seizure:
sudden brief involuntary contraction of a muscle or group of muscles

A

myoclonic

40
Q

type of seizure:
sustained increase in muscle contraction lasting a few seconds-minutes

A

tonic

41
Q

type of seizure:
regular repetitive myoclonus, involving the same muscle groups, freq 2-3 sec

A

clonic

42
Q

type of seizure:
sudden loss of muscle tone

A

atonic

43
Q

what are 3 forms of focal seizure

A

motor
autonomic
behavioral

44
Q

idiopathic head tremor syndrome is found in what breeds

A

dobermans
english bull dogs
boxers

45
Q

episodic falling due to paroxysmal hypertonicity is found in what breed

A

calvalier king charles spaniels

46
Q

paroxysmal gluten sensitive dyskinesia (canine epileptoid cramping) is found in what breed

A

border terrier

47
Q

causes of reactive seizures

A

metabolic or toxic

48
Q

causes of structural epilepsy

A

inflammatory, neoplastic, traumatic

49
Q

causes of idiopathic epilepsy

A

genetics
- diagnosis of exclusion
- dogs 6 mo - 6 yr

50
Q

most common cause of reactive seizures in cats

A

hypoglycemia, hepatic encephalopathy and intoxication

51
Q

most common cause of structural epilepsy in cats

A

hippocampal necrosis

52
Q

criteria for starting treatment for seizures

A

structural epilepsy or reactive seizures
status epilepticus or cluster seizures
2+ seizures in 6 month period
post-ictal signs are severe or last longer than 24 hours

53
Q

type of seizure:
seizure lasting > 5 min or >2 seizures without full recovery of consciousness

A

status epilepticus

54
Q

type of seizure:
2 or more seizures within 24 hours

A

cluster seizures

55
Q

only antiepileptic that is FDA approved in dogs? cats?

A

primidone

none in cats

56
Q

phenobarbital
MOA:
steady state reached:
metabolism:

A

increased inhibitory effect of GABA
2-3 weeks
induces cytochrome P450 (contraindicated in dogs with hepatic dysfunction)

57
Q

Potassium Bromide (KBr)
MOA:
steady state reached:
contraindications:

A

competes with Cl transporter, inhibits Na, membrane hyperpolarization
12 weeks
not used in cats due to eosinophillic bronchitis
must be given along consistent diet
don’t use in patients with kidney disease

58
Q

Levetiracetam (keppra)
MOA:
indications:

A

unknown
AED of choice in PSS/liver disease

59
Q

Zonisamide
MOA:
metabolism:
dose:

A

blocks propagation of epileptic discharges
metabolized by liver, use in dogs and cats
dose increased when used with phenobarbital

60
Q

treatment for stopping seizures immediately

A

diazepam per rectum
midazolam intranasal

61
Q

treatment if the patient is still seizing

A

phenobarbital then levetiracetam

62
Q

treatment for breakthrough seizures

A

infusion of diazepam, midazolam, propofol

63
Q

after 30 min of sustained seizure activity (prolonged status epilepticus) what drug do you use

A

NMDA receptor antagonists
= Ketamine + dexmedetomidine

64
Q

Hansen type I IVDD

A

chondroid degeneration
nucleus pulposus extrusion
young/middle aged chondrodystrophic breeds (dachunds)
acute, painful

65
Q

Hansen type II IVDD

A

fibroid degeneration
annulus fibrosus protrusion
older large breed (GSD)
chronic, painful

66
Q

gold standard diagnostic for IVDD

A

MRI

67
Q

treatment for IVDD

A

crate rest 4-8 weeks
medical management (pain)
surgery recurrent/persistent pain or unresp to conservative therapy

68
Q

young, middle aged, active dog that is acutely (hours) painful, non-progressive clinical signs

A

fibrocartilaginous embolism (FCE)

69
Q

DDX for a FCE

A

acute non compressive nucleus pulposus etrusion (ANNPE)
type I IVDD

70
Q

young-middle aged, medium-giant breed dogs that have severe pain (spinal hyperesthesia), fever, inappetance, decreased mentation and reluctance to move

A

diskospondylitis

71
Q

diskospondylitis diagnosis and treatment

A

radiographs (at 3 weeks) or MRI (right away)
cephalosporins

72
Q

> 7 yr old german shepherd, boxer or corgi with insidious onset, slowly progressive, non-painful T3-L3 signs

A

degenerative myelopathy

73
Q

middle aged-older german shepherd with DJD at L7-S2

A

lumbosacral syndrome
- bony proliferation = stenosis + type II disc protrusion

74
Q

lumbosacral syndrome treatment

A

dorsal laminectomy
conservation therapy

75
Q

2 types of caudal cervical spondylomyelopathy “wobbelers”?

A
  1. young great danes and mastiffs - degeneration/thickening of articular processes, dorsolateral compression
  2. older dobermans - hypertrophy of articular processes, dorsal and ventral compression
76
Q

what breeds are predisposed to atlantoaxial instability and what are the 2 causes

A

toy breeds, < 1 yr
1. congenital malformation of C2
2. trauma of dens

76
Q
A
76
Q
A

VM749 Clin Sci III (15 decks)

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