Neurology Flashcards
Uncooked pork
Neurocysticercosis
Anti-GAD antibodies
Stiff Person Syndrome
Aqua-porin 4 antibodies
Neuromyelitis Optica
Anti-GQ1b antibodies
Miller Fischer Variant of GBS
Acetylcholine antibodies
Myasthenia Gravis
Voltage Gated Ca Channel antibodies
Lambert-Eaton
Stiff neck, can’t move eyes up/down, hallucinations
Progressive Supra Nuclear Palsy
Morning headaches, cold winter months, new house
Carbon Monoxide Poisoning
MS Pregnancy Rx
Glatiramir
Polydipsia, polyurea, CN palsy (3) that is pupil sparing
Type 1 Diabetes
Proximal leg weakness + decreased grip strength
Inclusion Body Myositis
DX steps for Temporal Arteritis
steroids THEN biopsy
Vitamin Deficiency - confusion, confabulation, 6th nerve palsy
Thiamine (B1)
Vit. Def. - 3D’s = dementia, diarrhea, dermatitis
Niacin (B3)
Vit. Def. - fatigue, memory loss, proprioception loss, macrocytic anemia
Cobalamin (B12)
Vit. Def. - neuropathy, anemia, cracked lips, swollen tongue
Pyridoxine (B6)
Vit. Def. - fatigue, weakness, lethargy, pale skin, SOB, irritability, neural tube defects
Folate (B9)
Vit. Def. - idiopathic intracranial HTN
A (surplus)
Vit. Def. - bone density, depression, autoimmune disease
D
Vit. Def. - neuropathy, ataxia, muscle weakness
E
Min. Def. - microcytic anemia, restless legs, crave ice
Iron
CN Abn - Kleinfelter’s, craniopharengioma
1
CN Abn - optic neuritis (MS, lupus, NMO)
2
CN Abn - pupil sparing, can’t move eye up/down
3 (diabetes)
CN Abn - can’t move eye up/down
PCOM aneurysm
CN Abn - VZV, HSV
5
CN Abn - Thiamine deficiency, B12
6
CN Abn - Bell’s Palsy
7
CN Abn - Acoustic Neuroma, superfical siderosis
8
STROKE: contralateral pure motor or combined sensorimotor deficits
internal capsule
STROKE: loss of pain/temperature ipsilateral face and contralateral body; ipsilateral bulbar muscle weakness; Horner Syndrome
lateral medullary (PICA)
STROKE: ipsilateral oculomotor nerve palsy; ataxia; contralateral hemiparesis
midbrain
STROKE: contralateral sensory loss; hemiparesis; cortical signs (aphasia, agnosia)
postcentral gyrus (ACA, MCA)
STROKE: contralateral hemiparesis; sensory loss; conjugate gaze palsy towards lesion
putamen/internal capsule
Most common site of hypertensive intraparenchymal brain hemorrhage
putamen (internal capsule is nearby so is usually involved)
STROKE: pure sensory; contralateral loss of all sensory modalities;
posterolateral thalamus (usually a lacunar stroke)
Arterial supply associated with lacunar infarct in thalamus
Small branches of PCA
1st line pharmacotherapy for RLS
dopamine agonists: pramipexole, ropinirole, rotigotine, cabergoline, levodopa with carbidopa
Order for carpal tunnel treatment
- night splint
- injection with steroid
- nerve decompression surgery
organophosphate poisoning that results in increased __________ activity
acetylcholine
treatment for organophosphate poisoning
atropine and pralidoxime
causes of organophosphate poisoning
nerve gas, insecticide, herbicide, industrial chemicals
gastric motility drug that will cause parkinson symptoms
metoclopramide
The pelvic and shoulder girdle muscles are most commonly affected. Other muscles, e.g., the neck flexors, may also be affected.
Leads to difficulties combing hair, standing up, and climbing stairs.
polymyositis
triceps + neck involvement =
cervical nerve root problem
bilateral schwanommas
NMF2
taking isoniazid? vit. deficiency leading to neuropathy…
b6 (pyridoxine)
s/e of ethambutol
eye stuff
1st line = Alzheimer
donepezil/physostigmine (acetylcholinesterase inhibitor)
2nd line = Alzheimer
memantine (NMDA antagonist)
motor neuron degeneration
ALS
1st line = dystonia
anticholinergic
bilateral temporal hemianopia
pituitary adenoma
lead poisoning (ABCDE)
anemia (microcytic) basophilic stippling constipation drop (foot/wrist) encephalopathy
autoimmune disorder of the basal ganglia
sydenham chorea
emotional lability + tic like movements (acute)
sydenham chorea
spinal compression tx
IV steroids
hasn’t peed =
cord compression (give steroids!!)
meyers loop
part of nerve in temporal lobe (eyes)
pie in the sky
top left/right portion of visual field missing (temporal lobe)
hearing loss + other facial nerve stuff
acoustic neuroma
multiple ring enhancing lesions + HIV
TOXO
tx for vertebral/carotid dissection =
heparin
normal rinne (ear) + abnormal weber (forehead)=
sensorineural hearing loss (think about acoustic neuroma)
RA + Down Syndrome = pre-op xrays for…
upper cervical spine (atlantoaxial instability)
headache + bitemporal hemianopsia think…
pituitary gland mass
risperidone
dopamine
lead pipe rigidity
neuroleptic malignant syndrome
specks of calcium + pituitary mass
craniopharyngioma
pituitary mass + urinary frequency
craniopharyngioma
encephalopathy + icterus + asterixis
hepatic encephalopathy
chronic GBS (year +) think…
poliomyelitis
% considered “high grade” for aortic stenosis
70
stroke + urinary incontinence
ACA
Niemann Pick vs Tay Sachs
NP: cherry red macula, areflexia, hepatosplenomegaly (sphingo)
TS: cherry red macula, hyperreflexia (beta a)
Cauda equina vs. conus medularis
CE: radicular pain (radiating), saddle anesthesia, asymm. weakness, hypo/areflexia
CM: back pain, perianal anesthesia, symm. weakness, hyperreflexia
First line therapy for sciatica
NSAIDS
rapidly presenting + severe symptoms + ischemic stroke =
cardioembolic (probably some heart disease as well)
amarosis fugax think…
ipsilateral internal carotid
tilt test negative
NOT vasovagal
shaving and pass out…
carotid sinus hypersensitivity
tx for hepatic encephalopathy
lactulose
McArdle Syndrome
little bouts of rhabdo
glycogen storage + autosomal recessive + acute rhabdo
McArdle Syndrome
hard, thick nerve =
leprosy
the biggest arch EVER
Charcot-Marie-Tooth Disease
stroke + pupil dilation problems
PCA
REM sleep d/o dx
polysomnography
axillary nerve
deltoid
long thoracic nerve
winged scapula
musculocutaneous nerve
brachialis + biceps
dorsal hand, wrist drop
radial
give b1 to alcoholics prevent…
wernickes (anterograde amnesia)
AMS + ataxia + ophthalmoplegia
wernickes
most common cause of noncongenital hearing loss
CMV
toxo tx
sulfadiazine-sulfamethoxaloe
single ring enhancing lesion + HIV
think cns lymphoma vs. toxo
tx toxo
still sx – brain bx
cns lymphoma tx
methotrexate
mesolimbic pathway
antipsychotic effect (decreased - therapeutic; increased - euphoria)
nigrostriatal pathway
extrapyramidal symptoms (decreased - Parkinsons; increased - movement d/o)
tuberoinfundibular pathway
hyperprolactinemia (increased - prevents prolactin release; decreased - increased prolactin)
Self mutilation + chorea + hyper reflexes in a child think…
Lesch-Nyhan Syndrome
star on CT
subarachnoid hemorrhage (berry aneurysm)
uncal herniation can cause…
oculomotor nerve palsy
uti + delirium think…
metabolic encephalopathy
ipsilateral sensory face + contralateral sensory body think…
PICA (lateral medullary)
Weber =
ipsilateral CN3 palsy + contralateral hemiplegia (medial midbrain); acoustic neuroma
Benedikt =
ipsilateral CN 3 palsy + contralateral ataxia (paramedian midbrain); pineal tumor
neurogenic bladder =
overflow incontinence
vision stuff + homemade liquor
methanol
sensory problems that stop at midline think…
conversion disorder
macrocytic anemia + no FND + more common…
B9
gait problems + tongue problems think…
tumor of foramen magnum
hypertension + retinal hemorrhage
nimodipine (or nifedipine)
EBV DNA in CSF
CNS lymphoma
decreased grip strength + swallow problems + facial weakness in a 12-30 y/o
myotonic muscular dystrophy
ataxia + AMS + eye stuff =
Wernickes encephalopathy
ataxia + AMS + eye stuff + amnesia + confabulation =
Korsakoffs
loss of pain/temperature + weakness + areflexia in upper limbs think…
cervical cord/syrinx
loss of pain/temperature + weakness + areflexia + paralysis think…
anterior cord syndrome (spinal shock)
Wilson disease dx…
serum ceruloplasmin (blood) + Kayser-Fleischer rings (eye)
1st step for MG
ct of chest (THYMOMA)
lancating back pain + dribbling urine + ataxia + pupils think…
neurosyphilis
tx for neurosyphilis
IV penicillin
ANYTHING THAT IS CEREBELLAR THINK…
ipsilateral
1st line for cancer pain (mild) =
NSAIDS
2nd line for cancer pain (refractory) =
short-acting opioids
3rd line for cancer pain (refractory/severe) =
long-acting opioids + short for breakthrough pain
conduction aphasia =
articulate fasiculus
muscle wasting + balding + testicular atrophy + v shaped upper lip =
Myotonic Muscular Dystrophy
Lower Motor Neuron Sx
Muscle atrophy, fasiculations, weakness, hypotonia, hyporeflexia
Upper Motor Neuron Sx
Spasticity, brisk reflexes, Babinski sign
Sympathetics make pupils…
big
Parasympathetics make pupils…
small
Sympathetic =
fight or flight
Parasympathetic =
rest and digest
Diplopia worse when reading/walking downstairs =
CN 4
Superior oblique lesion –
trouble looking down
Inferior oblique lesion –
trouble looking up
Lesions to the MLF lead to…
internuclear ophthalmoplegia
Intraparenchymal hemorrhages think….
Charcot-Bouchard microaneurysm
brachioradialis + triceps
radial
give b2 to kids for….
headaches + migraines