Neurology Flashcards by Darshan Vora

Management of respiratory problem in Myasthenia gravis(3)

Stop acetyl cholinesterase inhibitor
Monitor CV and tidal volume
antibiotics

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What to monitor in ptient with myastenia gravis and respiratory problem

vital capacity

or Tidal volume

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trigeminal neuralgia management

carbamazepine

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Next step if medical rx fails in trigeminal neuralgia(2)

gangliolysis

or decompression of trigeminal nerve

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Method of decompressing trigeminal nerve

suboccipital craniectomy

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clue of trigeminal neuralgia

shock like wave sensation

knife like sensation

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Dx of pseudotumor cerebri

Lumbar ponction

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Feature of pseudotumor

High intracranial pressure

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finding for pseudotumor in LP

opening pressure >250mm de HG

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Anatomic abnormality in subdural hematoma

rupture of bridging veins

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anatomic abnormality in epidural hematoma

artere meningee moyenne

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risk factor for pseudo tumor(2)

obesity

med rich in vit A

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risk factor for subdural hematoma(2)

alcohol

increase age during trauma

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CT finding of subdural hematoma

semilunar hemorrage

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Rx of parkinson disease

trihexyphenidyl

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side effect of antichlinergic drug(6)

red-flushing
dry-mucous membrane
hot-
mad-agitation
blind-precipitation of glaucoma
full-constipation, retention urinaire

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opthtalmologic problem with anticholinergic

precipitation of glaucoma

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Urinary problem with anticholinergic

void impossibility

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digestive problem with anticholinergic

constipation

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Monitoring of respiratory difficulty in Guillain barre

Vital capacity

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redflag VC in Guillain barre

<15

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first symptom of lewy body demencia

visio-spatial impairment

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late finding in lewy body dementia(2)

memory impairment

hallucination

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specfic findings for lewy body

parkinsonism

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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

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

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