Neurology I Flashcards
A “steppage gait” secondary to foot drop is often caused by […] radiculopathy and common peroneal neuropathy.
A “steppage gait” secondary to foot drop is often caused by L5 radiculopathy and common peroneal neuropathy.
both pathologies result in weakness with dorsiflexion; L5 radiculopathy also causes weak foot inversion and plantar flexion, as well as back pain radiating to the foot
A “steppage gait” secondary to foot drop is often caused by L5 radiculopathy and […] neuropathy.
A “steppage gait” secondary to foot drop is often caused by L5 radiculopathy and common peroneal neuropathy.
both pathologies result in weakness with dorsiflexion; L5 radiculopathy also causes weak foot inversion and plantar flexion, as well as back pain radiating to the foot
A pure motor stroke is typically caused by a lacunar infarct of the […] limb of the internal capsule.
A pure motor stroke is typically caused by a lacunar infarct of the posterior limb of the internal capsule.
Abortive treatment for cluster headaches includes […] (preferred) or sumatriptan.
Abortive treatment for cluster headaches includes 100% O2 (preferred) or sumatriptan.
Acute angle-closure glaucoma is characterized by sudden vision loss with “[…]” around lights.
Acute angle-closure glaucoma is characterized by sudden vision loss with “halos” around lights.
Acute subdural hematomas appear […]-dense on CT.
Acute subdural hematomas appear hyper-dense on CT.
red arrows; versus chronic SDH, which is typically hypodense on CT (blue arrows)
Acute-onset focal neurological findings, fever, and behavioral changes in a young patient are suggestive of […] encephalitis.
Acute-onset focal neurological findings, fever, and behavioral changes in a young patient are suggestive of HSV encephalitis.
Alcoholic cerebellar degeneration is caused by damage to the […] cells in the anterior cerebellar vermis.
Alcoholic cerebellar degeneration is caused by damage to the Purkinje cells in the anterior cerebellar vermis.
Alcoholic […] degeneration typically affects patients with extensive alcohol abuse and presents with progressive wide-based gait and postural instability.
Alcoholic cerebellar degeneration typically affects patients with extensive alcohol abuse and presents with progressive wide-based gait and postural instability.
other signs of cerebellar damage include intention tremor, hypotonia, and dysdiadochokinesia; truncal coordination is impaired (e.g. tandem gait) but limb coordination is typically intact (e.g. finger-nose testing)
Are patients with pseudodementia typically distressed by their memory impairment?
Yes
helpful distinguishing feature from Alzheimer’s dementia, in which patients are relatively unconcerned
Are steroids useful in the management of Guillain-Barre syndrome?
No
Brain abscess is often visualized on CT or MRI as a […] lesion with central necrosis.
Brain absess is often visualized on CT or MRI as a ring-enhancing lesion with central necrosis.
a single absess typically results from direct extension of adjacent infection
Broca (expressive) aphasia is characterized by […] repetition (intact or impaired).
Broca (expressive) aphasia is characterized by impaired repetition (intact or impaired).
Broca (expressive) aphasia is characterized by […] comprehension (intact or impaired).
Broca (expressive) aphasia is characterized by intact comprehension (intact or impaired).
Broca (expressive) aphasia is characterized by […] speech (fluent or nonfluent).
Broca (expressive) aphasia is characterized by nonfluent speech (fluent or nonfluent).
i.e. agrammatic speech
Brown-Sequard syndrome presents with […]-lateral loss of pain and temperature below the level of the lesion (due to spinothalamic tract damage).
Brown-Sequard syndrome presents with contra-lateral loss of pain and temperature below the level of the lesion (due to spinothalamic tract damage).
Brown-Sequard syndrome presents with […]-lateral loss of vibration, proprioception, and touch below the level of the lesion (due to dorsal column damage).
Brown-Sequard syndrome presents with ipsi-lateral loss of vibration, proprioception, and touch below the level of the lesion (due to dorsal column damage).
Brown-Sequard syndrome presents with […]-lateral upper motoneuron signs below the level of the lesion (due to corticospinal tract damage).
Brown-Sequard syndrome presents with ipsi-lateral upper motoneuron signs below the level of the lesion (due to corticospinal tract damage).
e.g. weakness, spastic paralysis, positive babinski
Can a patient be diagnosed with brain death if they have intact deep tendon reflexes?
Yes
brain death is characterized by absent cortical and brain stem function; the spinal cord may still be functioning
Can a patient with severe, acute pain refractory to NSAIDs and a history of IV drug abuse be given opioids for acute pain management?
Yes
management of acute pain is similar for all patients, regardless of substance abuse history
Can epidural hematomas cross suture lines?
No
important distinguishing feature from subdural hematoma
Can subdural hematomas cross suture lines?
Yes
important distinguishing feature from epidural hematoma
Cancer of what organ most commonly metastasizes to the brain?
Lung
lung > breast > melanoma > GI
Carotid endarterectomy should be considered for symptomatic patients (e.g. TIA, stroke) with carotid stenosis between […] - […]% to reduce future stroke risk.
Carotid endarterectomy should be considered for symptomatic patients (e.g. TIA, stroke) with carotid stenosis between 70 - 99% to reduce future stroke risk.
patients with disabling neurologic deficits, 100% occlusion of the carotid artery, or life expectancy < 5 years are unlikely to benefit
Cauda equina syndrome may be associated with “[…] anesthesia”.
Cauda equina syndrome may be associated with “saddle (S3-S5) anesthesia”.
Cauda equina syndrome occurs due to compression of […] from L2 and below.
Cauda equina syndrome occurs due to compression of spinal nerve roots from L2 and below.
thus a lesion of the peripheral nervous system; usually caused by intravertebral disk herniation or tumors
Central retinal artery occlusion is characterized by acute, […] monocular vision loss (painful or painless).
Central retinal artery occlusion is characterized by acute, painless monocular vision loss (painful or painless).
Central retinal artery occlusion is most commonly caused by an embolized atherosclerotic plaque from the ipsilateral […] artery.
Central retinal artery occlusion is most commonly caused by an embolized atherosclerotic plaque from the ipsilateral internal carotid artery.
Cerebral amyloid angiopathy is associated with […] dementia.
Cerebral amyloid angiopathy is associated with Alzheimer’s dementia.
it is not associated with systemic amyloidoses
Cerebral sinus thrombosis typically occurs in patients with […] conditions and manifests as headache and signs of intracranial hypertension (e.g. nausea/vomiting, papilledema).
Cerebral sinus thrombosis typically occurs in patients with hypercoaguable conditions and manifests as headache and signs of intracranial hypertension (e.g. nausea/vomiting, papilledema)
hypercoaguable conditions include contraceptive use, pregnancy, malignancy, and inherited disorders.
Chronic subdural hematomas appear […]-dense on CT and typically manifest as headache, somnolence, confusion, and focal neurologic deficits.
Chronic subdural hematomas appear hypo-dense on CT and typically manifest as headache, somnolence, confusion, and focal neurologic deficits.
e.g. mild trauma, cerebral atrophy, elderly, alcoholism (blue arrow)
Cleavage of SNARE proteins via tetanus toxins inhibits the release of […] and glycine from Renshaw cells in the spinal cord.
Cleavage of SNARE proteins via tetanus toxins inhibits the release of GABA and glycine from Renshaw cells in the spinal cord.
GABA and glycine are inhibitory neurotransmitters, therefore, there is a lack of motor inhibition
Cleavage of SNARE proteins via tetanus toxins inhibits the release of GABA and […] from Renshaw cells in the spinal cord.
Cleavage of SNARE proteins via tetanus toxins inhibits the release of GABA and glycine from Renshaw cells in the spinal cord.
GABA and glycine are inhibitory neurotransmitters, therefore, there is a lack of motor inhibition
Common early side effects of levodopa/carbidopa include dizziness, headache, agitation, and visual […].
Common early side effects of levodopa/carbidopa include dizziness, headache, agitation, and visual hallucinations.
involuntary movements (e.g. dyskinesia) typically occur after 5 - 10 years of therapy
Common presenting symptoms of cavernous sinus thrombosis include severe […], periorbital edema, and ophthalmoplegia.
Common presenting symptoms of cavernous sinus thrombosis include severe headache, periorbital edema, and ophthalmoplegia.
Conduction aphasia is caused by damage to the […], which is a large fiber bundle that connects Broca’s area with Wernicke’s area.
Conduction aphasia is caused by damage to the arcuate fasciculus, which is a large fiber bundle that connects Broca’s area with Wernicke’s area.
Conduction aphasia is characterized by […] speech (fluent or nonfluent).
Conduction aphasia is characterized by fluent speech (fluent or nonfluent).
Conduction aphasia is characterized by […] repetition (intact or impaired).
Conduction aphasia is characterized by impaired repetition (intact or impaired).
Conduction aphasia is characterized by […] comprehension (intact or impaired).
Conduction aphasia is characterized by intact comprehension (intact or impaired).
Conservative treatment of pseudotumor cerebri includes […].
Conservative treatment of pseudotumor cerebri includes weight loss.
Craniopharyngioma is a CNS tumor that arises from epithelial remnants of […].
Craniopharyngioma is a CNS tumor that arises from epithelial remnants of Rathke’s pouch (oral ectoderm).
Craniopharyngioma typically presents as a supratentorial mass in a […] or […] (age group).
Craniopharyngioma typically presents as a supratentorial mass in a child or young adult (age group).
while most common in children, nearly 50% of craniopharyngiomas occur in
Creutzfeldt-Jakob disease is characterized by periodic […] complexes on EEG.
Creutzfeldt-Jakob disease is characterized by periodic sharp wave complexes on EEG.
clasically sharp, triphasic, synchronous discharges are seen on EEG
CSF analysis in patients with idiopathic intracranial hypertension typically reveals an opening pressure > […] mm H2O with an otherwise normal analysis.
CSF analysis in patients with idiopathic intracranial hypertension typically reveals an opening pressure > 250 mm H2O with an otherwise normal analysis.
Diabetic neuropathy strictly affects […] motor neurons (upper or lower).
Diabetic neuropathy strictly affects lower motor neurons (upper or lower).
thus, signs of UMN lesion (e.g. hyperreflexia, positive Babinski sign) are suggestive of another disease process
Do patients with cerebellar lesions sway with their eyes open or closed?
Both
important distinguishing feature from dorsal column lesions (sway with eyes closed only; Romberg sign)
Do patients with dorsal column lesions sway with their eyes open or closed?
Closed (Romberg sign)
important distinguishing feature from cerebellar lesions (sway with eyes open and closed)
Do the symptoms of Lambert-Eaton syndrome improve with administration of an AChE inhibitor (e.g. edrophonium)?
No
treatment may include guanidine and/or 3,4-diaminopyridine to increase presynaptic acetylcholine levels
Do the symptoms of myasthenia gravis improve with administration of an AChE inhibitor (e.g. edrophonium)?
Yes
Does amyotrophic lateral sclerosis (ALS) damage upper or lower motoneurons?
Both
damages ventral horn (LMNs) and corticospinal tract (UMNs)
Does cauda equina syndrome present with upper or lower motor neuron symptoms?
Lower only
helpful distinguishing feature from conus medullaris syndrome, with causes both upper and lower motor neuron symptoms
Does cleavage of SNARE via botulinum toxin prevent release of excitatory or inhibitory neurotransmitters?
Excitatory (thus causing flaccid paralysis)
Does cleavage of SNARE via tetanus toxin prevent release of excitatory or inhibitory neurotransmitters?
Inhibitory (thus causing spastic paralysis)
Does conus medullaris syndrome present with upper or lower motor neuron symptoms?
Both upper and lower
helpful distinguishing feature from cauda equina syndrome, which causes lower motor neuron symptoms only
Does multiple sclerosis cause hemiparesis or hemisensory symptoms?
Can cause either or both
Early-onset dementia with Parkinsonian features is suggestive of […] dementia.
Early-onset dementia with Parkinsonian features is suggestive of Lewy body dementia.
however, if Parkinsonism predates cognitive impairment by > 1 year, the diagnosis is Parkinson disease dementia
Epidural hematoma is due to rupture of the […] artery (branch of maxillary artery).
Epidural hematoma is due to rupture of the middle meningeal artery (branch of maxillary artery).
Essential tremor is […] with movement or when anxious (relieved or worsened).
Essential tremor is worsened with movement or when anxious (relieved or worsened).
important distinguishing feature from resting tremor (better with movement)
Following intubation, myasthenic crisis is managed with […] (preferred) or […], as well as corticosteroids.
Following intubation, myasthenic crisis is managed with plasmapheresis (preferred) or IVIG, as well as corticosteroids.
Foodborne botulism in adults is associated with ingestion of improperly canned foods and aged […].
Foodborne botulism in adults is associated with ingestion of improperly canned foods and aged seafood (e.g. cured fish).
Frontotemporal dementia is characterized by […] aggregates (shape) of hyperphosphorylated tau protein known as Pick bodies; may be seen with silver stain.
Frontotemporal dementia is characterized by round aggregates (shape) of hyperphosphorylated tau protein known as Pick bodies; may be seen with silver stain.
versus neurofibrillary tangles in Alzheimer’s disease
Frontotemporal dementia is characterized by round aggregates (shape) of hyperphosphorylated tau protein known as […]; may be seen with silver stain.
Frontotemporal dementia is characterized by round aggregates (shape) of hyperphosphorylated tau protein known as Pick bodies; may be seen with silver stain.
versus neurofibrillary tangles in Alzheimer’s disease
Glioblastoma multiforme (GBM) is a malignant, high-grade tumor of […] (cell type).
Glioblastoma multiforme (GBM) is a malignant, high-grade tumor of astrocytes (cell type).
also known as grade IV astrocytoma
