Neurology Flashcards
Management of respiratory problem in Myasthenia gravis(3)
Stop acetyl cholinesterase inhibitor
Monitor CV and tidal volume
antibiotics
What to monitor in ptient with myastenia gravis and respiratory problem
vital capacity
or Tidal volume
trigeminal neuralgia management
carbamazepine
Next step if medical rx fails in trigeminal neuralgia(2)
gangliolysis
or decompression of trigeminal nerve
Method of decompressing trigeminal nerve
suboccipital craniectomy
clue of trigeminal neuralgia
shock like wave sensation
knife like sensation
Dx of pseudotumor cerebri
Lumbar ponction
Feature of pseudotumor
High intracranial pressure
finding for pseudotumor in LP
opening pressure >250mm de HG
Anatomic abnormality in subdural hematoma
rupture of bridging veins
anatomic abnormality in epidural hematoma
artere meningee moyenne
risk factor for pseudo tumor(2)
obesity
med rich in vit A
risk factor for subdural hematoma(2)
alcohol
increase age during trauma
CT finding of subdural hematoma
semilunar hemorrage
Rx of parkinson disease
trihexyphenidyl
side effect of antichlinergic drug(6)
red-flushing dry-mucous membrane hot- mad-agitation blind-precipitation of glaucoma full-constipation, retention urinaire
opthtalmologic problem with anticholinergic
precipitation of glaucoma
Urinary problem with anticholinergic
void impossibility
digestive problem with anticholinergic
constipation
Monitoring of respiratory difficulty in Guillain barre
Vital capacity
redflag VC in Guillain barre
<15
first symptom of lewy body demencia
visio-spatial impairment
late finding in lewy body dementia(2)
memory impairment
hallucination
specfic findings for lewy body
parkinsonism
Rx of lewy body(2)
rivastigmine
or atypical psychotic
indication of surgery in carotid stenosis (2)
> 60% stenosis asymptomatic
symptomatic
Quid of Todd’s Palsy
paralysis transient after seizure
work up for weight loss
hiv test
Endocarditis plus hemiplegia
embolic stroke
Rx of stroke caused by endocarditis
Antibiotics
cause of cord compression(3)
injury
malignancy
infection
cord compression clue
Pain worse in reccubent position
Initial work up in intracerabral hemorrage
Ct scan of the head
clue for thalamic stroke(2)
no motor problem
sensesory problem
sensory problem in thalamic stroke(2)
anesthesia
dysesthesia
Quid of dyesthesia
stimulus to pain is exagerated
Most important feature of dementia
functionnal impairement
Differentiate aging from dementia
functionnal impairement=dementia
type of aphasia(3)
Broca
wernicke
conduction
features of broca aphasia (3)
difficulty speaking
hemiparesis
no comprehension problem
features of wernike(2)
no problem speaking but lack of meaning
comprehension problem
part of the brain involved in a right handed man with speech problem and right hemipresis
dominant frontal lobe
Quid of motor problem in wernike aphasia
controlateral visual field defect
Quid of motor problem in broca aphasia
contolateral hemiparesis
complication of increased intracranial pressure
blindness
Physical eye exam findings in patient with increased intracranial pressure
papilledema
Rx of multiple sclerosis acutely
corticosteroids
Management of MS rebellious to corticosteroids
plasma exchange
Physical eye exam in glaucoma
Mydriasis
Physical eye exam in cluster headache
Myosis
Dx of glaucoma
tonometry
quid of action tremor
essential tremor
Quid ot parkison tremor
resting tremor
rx for essential tremor
propranolol
alternative rx for essential tremor(2)
primidone
topiramate
what is the mx most commonly involved in Myasthenia gravis
extra occular muscle
Manifestation occular of Myasthenia gravis
diplopia
4 stages of pressure ulcers
redness
ulcer
ulcer plus subcutaneous fat
bone is seen tendon and muscle
Physiopatho of cerebral infarct after sub arachnoid hematoma
3 days after SAH ,vasospasm —>cause infarction
chronologic risk for patient with SAH
after 3 days risk of infarction
Physiopatho of difficulty walking in patient with cerebellar hemmorrage
balance problem
no mx weakness problem
Physiopatho af Myasthenia gravis
auto antibody against acetylcholine receptor
site of action of auto antibody in myasthenia gravis
Post receptor
organs run by upper motor neuron(2)
Moelle
cerveau
upper motor neuron findings in physical exam(3)
Hyperreflexia
Babinski +
Pronator drift
Cause of vertigo(5)
Benign paroxysmal positional vertigo Migraine vestibular neuritis Meniere disease brainstem /cerebellar stroke
Quid of Meniere disease(2)
Vertigo
auditory problem
Type of facial nerve palsy(2)
Peripherique
Central
quid facial paralysis below the pons
peripheric facial paralysis
Findings in facial paralysis below the pons(3)
problem in
eyebrows
palpebral ptosis
labial deviation
Findings in centrally located facial paralysis
Sensory problem in 2/3 inferior of hemi face
clue for cluster headache
horner syndrome=Myosis
Rx of cluster headache
100% oxygen
Clue for cavernous sinus thrombosis(2)
orbital cellulitis
vomiting
headache
Physiopatho of vomiting in cavernous sinus thrombosis
High intracranial pressure
Veins forming cavernous sinus(6)
Ethmoidale 2 ant et post
nasofrontale
lacrymale
ophtalmique 2 superieur et inferieur
Nerves that could be reached in case of cavernous sinus thrombosis(4)
3,4,5,6
Disease associated with acoustic neuroma
Neurofibromatosis
Dx of acoustic neuroma
MRI with gadolinium
Drug induced vestibulo cochleaire toxicity(2)
gentamycin(aminoglycoside)
furosemide
Clue for angle closure glaucoma(2)
Pain in eye
dilated pupil
Neurologic finding in dead person
Deep tendon reflexes still present
why deep tendon reflexes are still present in dead people
because spinal cord is still functionnal
cause of heat stroke(2)
Inadequate of thermoregulation
failure of thermoregulation
Cause of cerebellar dysfunction
alcohol
cerebellar signs(4)
gait problem
ataxia
nystagmus
tremor
Best initial rx in Myastheni gravis
Pyridostigmine
gold standard test to Dx herpes encephalitis
PCR
Management of cerebral hemorrage in patient on warfarin(2)
stop warfarin
give fresh frozen plasma
period of acting for vitk in case of warfarin side effect
8-12 h
CT finding in patient with anaerobic cerebral abcess
ring enhancing lesion
clue to make you think of anaerobic cerebral abcess
History of sinusitis
Manif of Hypokliemie(2)
Mx weakness
Hyporeflexia
EKG findings in hypokaliemia
flat and broad t waves
Dx for painless loss of vision
amaurosis fugax
Next step after dx amaurosis fugax
duplex of the neck
Quid of duplex of the neck
to see plaques in carotid artery
Med causing increase intracranial hypertension(2)
tetracyclines
vit A
Drug of choice of Parkinson(2)
carbilevodopa
trihexyphenidyl
Side effect of levo carbi dopa
hallucination
site of motor problem in cerebellar hemorrage
only in face
eye exam findings in cerebellar hemorrage
deviation of the eye towards the normal size
Cause of SAH
rupture of berry aneurysm
First site of hypertensive stroke
Putamen
Clinical dx of Multiple sclerosis(3)
Optalmoplegia
other neurological findings
Patchy neurologic problem
Best test to Dx Multiple sclerosis
MRI
Finding in steppage gait(2)
foot drop
Hip flexion
Cause of steppage gait(2)
Peroneal nerve problem or
L5 radiculopathy
Patient with spatial organisation problem after stroke,Dx
hemineglect syndrome
What part of the brain is affected in hemineglect
syndrome
parietal lobe ,the non dominant part
what test will help you to dx hemi neglect syndrome
the clock test
What ‘s the clock test from a patient with parietal lobe stroke
the pateint draws a clock and put number only in the right
symptoms of lewy body dementia(4)
visiospatial impairment
Hallucination
loss of memory
parkinsonism
Rx of restless leg syndrome
dopamine agonist
give me one dopamine agonist
pramipexole
cause of focal dystonia(2)
Trauma
medication
Long term treatment of Multiple sclerosis
interferon B
What’s cushing reflexe
bradycardia in a context of high intracranial pressure
When to consider ICH
when the intracranial pressure > 20
clinical findings of craniopharyngioma(2)
Bitemporal loss of vision
Hypopituitarism
symptom of hypopituitarism in adult
sexual dysfunction
symptom of hypopituitarism in children
retarded growth
Dx of Cranyopharyngioma(2)
MRI or
ct scan of head
Rx of craniopharyngioma(2)
surgery/and or
radiotherapy
syncope while standing
neurocardiogenic syncope=vasovagal syncope
trigger of vasovagal syncope(3)
Pain
emotionnal stress
prolonged standing
Syncope with positional changes
orthostatic hypotension
syncope with exercice (4)
aortic stenosis
HOC
VTAC
anomalous coronary arteries
syncope associated with hypokaliemie and hypomagnesemie
torsades de pointes
syncope with bradycardia(3)
sick sinus syndrome
brady arrythmia
AV block
Syncope during sleep or with exercice or sudden noise
congenital long Qt syndrome
Measure of opening pressure in idiopathic intracranial pressure(pseudotumor cerebri)
> 250
Rx of IIH(2)
acetazolamide
furosemide
frequet cause of increased intracranial pressure in
USMLE
IIH
Quid of shy drager syndrome
multiple system atrophy
triad of shy drager syndrome(3)
autonomic dysfunction
parkisonism
neurologic findings
quid automonic dysfunction(5)
importence hyoptension orthostatic gastroparesis disturbance of bladder and bowel control extreme salivation and lacrymation and sweating
what kill patient with shy drager(2)
Bulbar dysfunction
laryngeal stridor
Difference between syncope and seizure
tongue bite and/or
confusion after the spell
lower motor neuron dysfunction
fasciculations
areflexia
Patient diabetic IV drug user with paresis but no fever hyperreflexia,Dx
Epidural abcess
Confirmatory dx of epidural abcess
MRI
Symptom in statin induced myositis(2)
weakness
no eye involvement
Vessel involved in pure motor hemiparesis
lacunar infarct=internal capsule infarct
sympton of lacunar infarct(2)
only motor involvement
hemiaaresis invoving hemiface
Laps ot time to begin alteplase after ischemis stroke
within 3 a 4,5 H
Quid of wernicke encephalopathy
B1 deficiency
what part of the brain is involved in wernicke encephalopathy?
cerebellum
risk factor for wernicke
alcohol
what ‘s the cranial nerve most commonly involved in diabetic mononeuropathy
3
Manif of cranial nerve 3 diabetic mononeuropathy(3)
ptosis
eye go down and out
pupil reactive
why pupil is reactive in cranial nerve 3 neuropathy
because parasympathis fibers are intact
you have involvement of somatic fibers
Is there speaking problem in lacunar infarct
Never
Triad for creutzfeld Jacob
Dementia
Myoclonus
EEG changes
EEG changes in Creuztfeld Jacob
sharp,synchronic, triphasic discharge
Cause of creutz feld Jacob
Prion
other name for creutzfeld Jacob
spongiform encephalopathy
cancer causing eaton lambert syndrome
small cell carcinoma of lung
manif of eaton lambert syndrome
mx weakness
Physiopatho of eaton lambert syndrome
antibody against voltage gate channel calcium
site of neuromxar blockage in eaton lambert
presynaptique
Quid of pseudo dementia
Major depression in aging people
remember SIGECAP
the single test to differentiate Pseudodementia and dementia
dexamethasone suppression test
Disease involving upper and lower motor neuron at the same time
Amyotrophic lateral sclerosis
drug of choice for amyotrophisc lateral sclerosis
riluzole
what’s riluzole
glutamate inhibitor
Quid of korsakoff syndrome
irreversible amnesia
cause of korsakoff syndrome
alcohol
What vessel is invoved in stroke anr aphasia
MCA
confirmatory dx for Eaton lambert syndrome
electrophysiological studies
Rx for eaton lambert syndrome(2)
Plasmapheresis
immunosuppresion drug therapy
Dx for ring enhancing lesion and EBV DNA positive
Primary CNS lymphoma
Best test in case of emergency patient wit seizure
CT scan of the head
Dx in elective situation for seizure
MRI
Dx in focal neurologic findings in HIV patient
progressive multifocal leukoencephalopathy
Dx of PML
MRI
cause of PML
JC virus
finding n MRI in cas of PML
Multiple ring enhancing lesions
prognosis in case of PML in HIV patients
6 months to live
risk factor for epidural abcess(3)
HIV
diabetes
IV drug user
Rx of epidural abcess
surgical decompression
Bugs involved in epidural abcess
staph aureus
Management acute of confusionnal state(4)
Dextrose
oxygen
Naloxone
Thiamine
Disease causing cord cavitation
syringomyelie
Manif of syringomyelia(4)
weakness of upper extremities
hyperreflexia of “ “ “ “
pain and temperature absent
Position and vibration conservees
Manif of carpal tunnel syndrome(2)
Paresthesia of first 3 digits and half 4e
atrophy eminence thenar
Triad of huntington
Mood disturbances
choreiform mvt
dementia
Quid of choreiform mvts(5)
facial grimacing dystonia writhing mvts of extremities ataxia tongue protrusion
Transmission of Huntington
autosomal dominant
cerebellar tumor manifestation(3)
Nystagmus
Coordination problem
Ataxia
Dx differentiel of progressive ascending paralysis(2)
GBS
Lyme disease
Differnce entre GBS and Lyme(2)
No autonomic dysfunction in Lyme
CSF is normal
Physio patho of tick borne paralysis
relargage de Neurotoxine
First step in Lme disease
Meticulous search of tick
Role of spino thalamic tract
Temperature
Pain
Motricite
Patient with loss of pain and temperature depuis T12 and hemiparesis a droit .What ‘s the problem and what’s the level(2)
Spinothalamic tract gauche
Level is at T10
Quid for alzheimer dementia(2)
memory problem first
visuo spatial later
When will see changes on CT after ischemic stroke
after 24 H
Benefit riluzole
prolong survival in Amyotrophic lateral sclerosis
Eye exam in opiod intoxication
Mioisis
Quid of brown sequard syndrome
Lateral spinothalamic tract damage
quid of apraxia
difficulty of using comb
Minimental score confirming dementia
< 24
CT findings scan in alzheimer(2)
Temporal atrophy
parietal atrophy
clue for fronto temporal dementia
deshinibition
Chorea of Huntington on CT
atrophy of caudate nucleus
1 Bug causing Guillain barre syndrome
Campylobacter jejuni
Triad of parkisonism
RBR
Rest tremor
Bradykinesia
rigidity
histopatho in alzheimer
neurofibrillary tangles
severe Pain management in drug addict
give morphine anyway
site of compression of ulnar nerve
elbow
Manif of Ulnar nerve compression
Paresthesia of 4e and 5e Finger
Cause of tremor in parkisonism
Basal ganglia problem
cause of tremor in alcoholics(2)
cerebellum atrophy
role de thiamine
Cause of physiologik tremor(3)
hyperthyroidie
caffeine intake
anxiety
Clue for essential tremor
it’s relieved bay alcohol
what’s Dejerine roussy syndrome
thalamic stroke
cause of ophtalmoplegia in MS
MLF dysfunction
Medial longitudinal fasciculus
Pseudo dementia rx
SSRI
Wallenberg syndrome manif (4)
vestibular cerebellar symptom
sensory problem
BulbarMx weakness
autonomic dysfunction
Quid of Wallenberg syndrome
Lateral medulla stroke
Vestibullar cerebellar symptom in Wallenberg syndrome(3)
vertigo
Nystagmus
limb ataxia (ipsilateral)
Sensory problem in Wallenberg syndrome(2)
facial pain
Loss of pain and T ipsilateral face and controlateral limbs and trunk
Bulbar MX weakness in Wallenberg syndrome Manif
Hoarseness
Autonomic dysfunction in Wallenberg
Horner syndrome ipsi lateral
Artery involved in lateral medulla syndrome
intracranial vertebral artery
horner’s syndrome (3)
Miosis
Ptosis
anhidrosis
Painful loss of vision and neurologic problem
MS
Acute rx of migraine(3)
(iv)chlorpromazine + Nsaids
metochlopramide
Prochlorperazine
Patient with MS and absent sensation from the nipple downwards, paraplegia,rectal and urine incontinence localisation de la plaque
Upper thoracic localisation
Patient with MS and absent sensation from the umbilicus downwards paraplegia rectal and urine incontinence,quid de la localisation de la plaque
Lower thoracic
CSF findings in GBS(3)
dissociation albumino cytologic
high protein
Normal WBC
Rx of GBS (2)
Immunoglobuline IV and
Plasmapheresis
Rx of metochlopramide induced extrapyramidal syndrome
benztropine or
diphenidramine
differentiale parkison from lewy body(3)
Motor problem first
dementia later for parkinson
inverse pour Lewy body
non intrinsic neurologic cause of seizures(3)
flashlights in club
alcohol
sleep deprivation
first symtom in alzheimer
memory loss(dementia)
Late findings in alzheimer(3)
visio spatial
Hallucination
Difference with lewy body
