Neurology Flashcards
Myasthenia Gravis: Who does this affect? How does this affect muscles? There are 3 categories of sxs. How do they present? What is seen in a lab for this disease? Treatment?
Young woman and older men.
Ocular:Ptosis and diplopia.
Causes generalized muscle weakness and fatigability.
Bulbar(relates to medulla; affecting CN VII-XII): dysarthria(motor speech d/o), dysphagia(difficulty swallowing), fatigable chewing.
Proximal limb weakness.
Acetylcholine receptor antibodies.
Tx with pyridostigmine.
What is Guillian-Barre Syndrome? What is the MC precipitation? How do you describe the muscle weakness? What do you need to monitor? Tx?
Idiopathic polyneuropathy.
campylobacter jejuni(GI illness causing D).
Other causes are minor infections, immunizations, surgery.
Symmetric LE weakness that begins distally and ascends.
Monitor respiratory status: diaphragmatic weakness.
Plasmapheresis, IV immunoglobulins, PT/OT/Speech
Brainstem Hemorrhage:
Eye signs with a Pontine hemorrhage?
Eye signs with a Cerebellar hemorrhage?
Pontine = pinpoint pupils. Cerebellar = lost pupillary reflex.
What are partial szs?
What is a simple seizure?
What is a complex seizure?
Partial seizures are focal.
The simple type is conscious and may have aura.
The complex type has automatisms(lip smacking, picking at clothes, fumbling)impaired consciousness and staring
What is an Absence sz?
What is the tx?
Staring spell, starts in childhood.
Treat with ethosuximide or valproic acid
What is the Locked-In Syndrome?
What area of the brain does it damage?
A stroke damages part of the brainstem(pons).
The body is paralyzed and most of the facial muscles, but consciousness remains and ability to perform certain eye movements is preserved.
Targets myelinated axons in the CNS–plaques in 2 areas: spinal cord (cervical) and optic nerve.
Intraneuclear opthalmoplegia.
Name disease.
MS
How do you treat Gillian-Barre Syndrome?
Monitor respiratory status–diaphragmatic weakness;
Plasmapheresis;
IV immunoglobulins
PT
Huntington Disease:
Characteristics?
CT findings?
Autosomal dominant: trinucleotide repeat
Progressive chorea and dementia.
Cerebral atrophy.
What nerve root is damaged with inability to maintain plantar flexion of the foot and asymmetric ankle jerk reflex.
S1
What does the L5 control?
Foot and big toe dorsiflexion.
Seizure where the person is conscious. It can be motor, sensory or autonomic and may exhibit tonic-clonic activity of a limb or a transient altered sensory perception that may spread to entire side of body.
Simple Seizure (focal)
What is the diagnostic finding for MS?
What is the treatment of choice for MS spasticity?
Oligoclonal bands and myelin basic protein found in CSF.
Baclofen
What is this condition in an 80 year old: abnormal wide shuffling gait, dementia and urinary incontinence?
Normal Pressure Hydrocephalus.
This can be reversed with treatment.
What do you Not see in Alzheimer’s?
Abnormal gait and urinary incontinence.
What are some symptoms of Parkinson’s?
What is the abnormality in the brain that causes this?
What diagnostic finding is associated with this?
Brady kinesia, wide based shuffling gait, resting tremor and rigidity.(You do not see urinary incontinence, weakness and Deep tendon reflexes are normal)
Dopamine depletion.
Intracellular Lewy Bodies.
What is the fist line monotherapy for partial seizures?
Carbamazepine.
When a patient has the presentation of a subarachnoid hemorrhage and the CT is negative, then what is considered a diagnostic finding?
How is the HA described?
Lumbar Puncture showing RBCs in the CSF.
Worst HA of my life, thunderclap HA
What is the treatment for restless legs syndrome?
Dopamine agonist
What is the treatment for Parkinson’s?
Anticholinergic medication
What serum antibodies are present in Myasthenia Gravis?
Acetylcholine Receptor Antibodies.
What does CN VII supply?
What does CN V supply?
A motor nerve to the face(Facial nerve) responsible for: close eyes, frown, wrinkle forehead, smile.
Trigeminal: motor and sensory function in the face. Test by closing jaw against resistance or moving chin from side to side.
What are the primary features of Parkinson’s?
What are not features?
Resting tremor, rigidity, postural instability, bradykinesia.
No weakness and deep tendon reflexes are normal
What is the MCC of a non traumatic subarachnoid hemorrhage?
Berry cerebral aneurysm.
