Neurology Flashcards
How does cranial nerve XII deficit present?
Weakness on the ipsilateral side and protrusion of the tongue toward the affected side - CN XII = Hypoglossal nerve
How does cranial nerve XI deficit present?
Weakness with turning of head - CN XI = Spinal accessory nerve
How does cranial nerve X deficit present?
Focal: Aphonia dysphagia dysarthria - Systemic: (cardiac and GI most affected) - CN X = Vagus nerve
How does cranial nerve IX deficit present?
Dysphagia and dysarthria - CN IX = Glossopharyngeal nerve
How does cranial nerve VIII deficit present?
Positional vertigo - Tinnitus - Rarely hearing loss - CN VIII = Vestibulocochlear nerve
How does cranial nerve VII deficit present?
Complete or partial paralysis of the face - CN VII = Facial nerve
How does cranial nerve VI deficit present?
Medial turning of affected eye - CN VI = Abducens nerve
How does cranial nerve V deficit present?
Anesthesia of the forehead - Corneal drying - Decreased salivation - CN V = Trigeminal nerve
How does cranial nerve IV deficit present?
Vertical diplopia - CN IV = Trochlear nerve
How does cranial nerve III deficit present?
Outward and downward deviation of the eye - Ptosis of the eyelid - Dilation of the ipsilateral pupil in complete palsy -CN III - Oculomotor nerve
How does cranial nerve II deficit present?
Partial or complete blindness - CN II = Optic nerve
How does cranial nerve I deficit present?
Loss of smell - CN I = Olfactory nerve
Medication added to cholinesterase inhibitors in the treatment of Alzheimer’s?
Memantine
First line class of drugs used to treat Alzheimer
cholinesterase inhibitors
Beta amyloid plaques and neurofibrillary tangles?
Alzheimer’s findings on autopsy
Most common form of dementia?
Alzheimer’s disease
Slowly progressive impairment of memory reasoning and orientation?
Dementia
Common causes of delirium?
Medical illness - Sun downing - Substance intoxication or withdrawal - Sepsis
Short term/temporary confusion or altered mental state?
Delirium
Acute meningitis associated with a purpuric rash?
Meningococcal meningitis (N. Meningiditus)
Most common cause of Reye Syndrome?
Salicylates (e.g. aspirin Pepto Bismol etc.)
Rapidly progressive encephalopathy with hepatic dysfunction?
Reye Syndrome
In what disorder are negri bodies found in neurons?
Rabies
What are the most common symptoms of encephalitis?
Fever - Headache - Nausea - Vomiting - Altered mental status
Most common severe complication of measles?
Encephalitis
Viral meningitis is associated with predominance of what cell in the CSF?
Lymphocytes (Note: bacterial meningitis has neutrophils)
Name the sign: Inability to allow full extension of knee when hip is flexed 90 degrees.
Kernig’s sign
Name the sign: Flexion of hips on passive neck flexion.
Brudzinski’s sign
What disorder are fever, headache, neck stiffness with initially normal brain function most concerning for?
Meningitis
Treatment for Cerebral Palsy?
Speech physical and occupational therapy - Aspiration precautions - Anti-spasmodics
Non-progressive disorder characterized by spastic rigidity and slow writhing movements?
Cerebral Palsy
Treatment of acute exacerbations of MS?
Glucocorticoids
What ophthalmology disorder is seen frequently in patients with multiple sclerosis (MS)?
Optic Neuritis
Most common demyelinating disorder mainly in women age 20-50?
Multiple Sclerosis
Radiating electrical sensation down the spine with neck flexion seen in patients with multiple sclerosis?
Lhermitte’s phenomenon
Patients with Myasthenia Gravis have antibodies to what?
Acetylcholine receptors
Treatment for Myasthenia Gravis?
Pyridostigmine
Diagnostic test for Myasthenia Gravis?
Edrophonium (Tensilon) test
Proximal to distal motor weakness?
Myasthenia Gravis
Treatment for Guillain-Barre?
Intravenous immunoglobulins - Plasma exchange
Typical cerebral spinal fluid findings with Guillain-Barre?
Albuminocytologic dissociation
Most common organism causing Guillain-Barre?
Campylobacter jejuni
Ascending symmetrical paralysis/weakness with absent or decreased deep tendon reflexes?
Guillain-Barre Syndrome
Treatment for chorea + psychosis?
Haloperidol olanzapine or risperidone
Treatment for Huntington’s chorea?
Tetrabenazine
Mode of inheritance for Huntington’s?
Autosomal dominant
Inherited neurodegenerative disorder characterized by chorea?
Huntington’s
Rapid involuntary irregular jerking motion of the hands face and feet?
Chorea
What disorder has bradykinesia pill rolling tremor masked facies and cogwheel rigidity?
Parkinson’s
Preferred initial treatment for Parkinson’s after age 65?
Levodopa + carbidopa
Causes of intention tremors?
Multiple sclerosis - Brain trauma - Cerebellar disease
Tremor that increases in severity as it reaches its target?
Intention tremor
Treatment for essential tremors?
Propanolol and primidone
Tremor with movement but no tremor at rest?
Essential tremor
Tremor associated with caffeine intake anxiety and lithium therapy?
Physiologic tremor
Preferred first line treatment for Parkinson’s prior to age 65?
Dopamine agonists (bromocriptine - pramipexole - ropinirole)
What disorder has a resting tremor which goes away with movement?
Parkinson’s
When can an athlete return to play after one concussion?
After 1 week with no symptoms
When can an athlete return to play if they have suffered 2 or more concussions in one year?
The following season
Headaches irritability loss of memory or concentration after a concussion?
Post Concussive Syndrome
Concussions are characterized by what Glasgow Coma Score 30 min after injury?
13-15
Mild traumatic brain injury due to contact or acceleration/deceleration injury?
Concussion
Medical treatment for complex seizures?
Phenytoin
Medical treatment for partial seizures?
Carbamazepine or lamotrigine
Pathophysiology of vasovagal (neurocardiac syncope)?
Bradycardia - Vasodilation
Medical treatment for status epilepticus?
IV lorazepam may follow with IV phenytoin
Single nonstop seizure lasting longer than 5 minutes or frequent seizures without a return to baseline?
Status Epilepticus
Seizure in which body is stiff and rigid followed by limb jerking then a post ictal phase?
Tonic-Clonic Seizures
Medical treatment for absence seizures?
Ethosuximide or valproic acid
Seizure common in children in which patient is conscious but not aware (staring)?
Seizure common in children in which patient is conscious but not aware (staring)?
Seizure limited to part of one hemisphere with impaired consciousness?
Complex partial seizure
Seizure limited to part of one hemisphere with consciousness fully maintained?
Simple partial seizure
Acute medical treatment for increased intracranial pressure (ICP)?
Head elevation - Hyperventilation - Osmotic diuresis (mannitol)
Appearance of a subdural hematoma on a CT scan?
Crescent shaped
Vessels involved in a subdural hematoma?
Bridging veins
Most common cause of subdural hematoma?
Head trauma
Appearance of an epidural hematoma on a CT scan?
Lens-shaped
Most common artery affected in an epidural hematoma?
Middle meningeal artery
Transient loss of consciousness after a lucid interval most often due to skull fracture?
Epidural Hematoma
Which brain tumor may present with endocrine signs and symptoms?
Pituitary tumor (may also occur with paraneoplastic syndrome e.g. SC lung CA)
Which brain tumor may present with cranial nerve palsy?
Brain stem tumor (may also occur with cerebral aneurysm and diabetic ischemic neuropathy)
Which brain tumor may present with visual hallucinations?
Occipital lobe tumor (may also occur with migraine and EtOH withdrawal)
Which brain tumor may present with seizures or sensory loss?
Parietal lobe tumor