Neurology Flashcards
HSV encephalitis with high erythrocyte count on CSF.. explanation?
hsv encephalitis can cause temporal lobe hemorrhage
Associated conditions of wernicke
Chronic alcohol abuse
malnutrition (anorexia for eg)
hyperemesis gravidum
Clinical feature of wernickes
Encephalopathy, oculomotor dysfunction (horizontal nystagmus)
postural and gait ataxia
Clinical features of refeeding syndrome
Heart failure, edema and seizures
Deep tendon reflex work may be present in brain death true or false
True.. spinal cord may still be functioning in the presence of brain death
Will the heart accelerate in brain death after atropine injection
no due to loss of vagal control of the heart.
What symptoms usually preceed a vasovagal episode
Nausea, diaphoresis, bradycardia and pallor
Deficiency in what can increase risk of MS
Vitamin D
What risk factors are associated with MS
Smoking, EBV, cold climate , HLA-DRB1
What abnormality will be seen on MRI in a patient with Alzheimers
Temporal lobe atrophy
First line therapy for Fibromyalgia
TCA (eg amitriptyline)
The most common cause of CN III palsy
Ischemic neuropathy due to poorly controlled DM
REM Sleep behaviour disorder has a very strong association with?
- Men >50
2. alpha-synuclein neurodegenerative disorders (parkinsons, dementia with lewy bodies etc)
Which cell groups are primarily degenerated in Huntington’s Disease
GABA
Underlying pathology of lacunar strokes
Microatheroma formation and lypohyalinosis leading to chromatic small-vessel occlusion
Complications of a Subarachnoid hemorrhage
Rebleed (first 24hrs) Vasospasms (after 3 days) SIADH (hyponatremia) Hydrocephalus/ICP Seizures
Manifestations of optic neuritis
Acute (2 weeks) monocular vision loss
Eye pain with movement
Washed out colour vision
Afferent pupillary defect
Features of Subclavian steel syndrome
- Lower brachial systolic blood pressure in affected arm
2. Systolic bruit in supraclavicular fossa on affected side
Diagnosis and treatment of subclavian steel syndrome
Doppler U/S or MRA and lifestyle intervention (smoking cessation, lipid lowering interventions)
stent placement in some cases
Patient with AIDS presents with progressive confusion, lethargy, seizures in the setting of a solitary, irregular ring enhancing lesion on MRI.. CSF shows EBV DNA on analysis.. DX?
Primary CNS lymphoma
How do you classify a Generalised convulsive status epilepticus (GCSE)
- Seizure lasting >5 mins
OR - > 2 seizure events in which the patient does not completely regain consciousness
Next best step in a patient withGeneralised convulsive status epilepticus (GCSE)
- Stabalization (ABCs) + IV access and glucose fingers tick
PLUS - At the same time IV benzos (lorazepam, diazepam) for seizure termination!!
PLUS - Non benzo infusions (fosphenytoin, phenytoin, valproic acid) to prevent seizure recurrence!!!
Manifestations of common perineal nerve neuropathy
U/L Foot drop
Impaired ankle dorsiflexion
Preserved plantar flexion
Numbness/tingling over dorsal foot and lateral shin
Diagnosis and treatment of common perineal neuropathy
Dx- Electromyography and nerve conduction studies
Tx- Physical therapy, avoid crossing legs
What part of the CNS is affected in Wallenberg syndrome
lateral medulla
Features of Wallenberg syndrome
Hoarsness (CN X)
Diminished gag reflex (CN IX)
Ipsilateral Horner syndrome
Diplopia and nystagmus
Vertigo (falling to side of lesion)
Loss of pain and temp on ipsilateral face
loss of pain and temp on contralateral limbs
Features of lateral Mid pontine lesions
Weakness of mastication (Trigeminal dysfunction)
Diminished jaw reflex
Impaired tacticle and position sense over face
Which artery is responsible for medial medullary syndrome
Occlusion of the vertebral or anterior spinal artery
Features of Medial medullary syndrome
Contralateral paralysis of arm and leg
Tongue deviation toward lesion
Medial mid-pontine infarction presents with what features
Contralateral Ataxia
contralateral hemiparesis of face, trunks and limbs
What problems can precipitate a myasthenic crisis
Infection
surgery
Medications (eg. fluorquinolones)
61 year old male comes in with with a resting tremor frequency of 4-5 cycles/sec and some muscle rigidity in both arms… dx and treatment
Dx- Early stage Parkinsons
Tx- Trihexyphnidyl (mostly in younger patients)
