Neurology II Flashcards
Glioblastoma multiforme is characterized histologically by “[…]”, which are tumor cells surrounding regions of necrosis and hemorrhage.
Glioblastoma multiforme is characterized histologically by “pseudo-palisading”, which are tumor cells surrounding regions of necrosis and hemorrhage.
Glioblastoma multiforme is characterized histologically by “pseudo-palisading”, which are tumor cells surrounding regions of […] and hemorrhage.
Glioblastoma multiforme is characterized histologically by “pseudo-palisading”, which are tumor cells surrounding regions of necrosis and hemorrhage.
Guillain-Barre syndrome is associated with […] DTRs beginning in the lower extremities.
Guillain-Barre syndrome is associated with decreased/absent DTRs beginning in the lower extremities.
Guillain-Barre syndrome is associated with […] CSF protein and […] CSF WBC count, which may cause papilledema.
Guillain-Barre syndrome is associated with increased CSF protein and normal CSF WBC count, which may cause papilledema.
increased CSF protein + normal cell count is known as an albuminocytologic dissociation; glucose and RBC count are typically normal as well
Guillain-Barre syndrome is typically preceded by an […] or […] infection.
Guillain-Barre syndrome is typically preceded by an upper respiratory tract or gastrointestinal infection.
e.g. Campylobacter jejuni; occurs due to cross-reacting antibodies (molecular mimicry)
Guillain-Barre syndrome may be associated with […] dysfunction, which can cause fluctuations in heart rate and blood pressure.
Guillain-Barre syndrome may be associated with autonomic dysfunction, which can cause fluctuations in heart rate and blood pressure.
Guillain-Barre syndrome results in symmetric […] muscle weakness/paralysis (ascending or descending).
Guillain-Barre syndrome results in symmetric ascending muscle weakness/paralysis (ascending or descending).
sometimes may involve sensory abnormalities as well
How long do episodes of trigeminal neuralgia (tic douloureux) typically last?
seconds to minutes
HSV encephalitis mainly affects the […] lobe of the brain.
HSV encephalitis mainly affects the temporal lobe of the brain.
Hypertensive intraparenchymal hemorrhage typically occurs in the […] and the adjacent internal capsule; other common sites include the cerebellum, thalamus, and pons.
Hypertensive intraparenchymal hemorrhage typically occurs in the basal ganglia (especially putamen) and the adjacent internal capsule; other common sites include the cerebellum, thalamus, and pons.
results in contralateral hemiparesis/hemisensory loss (internal capsule) and conjugate gaze deviation towards the lesion (frontal eye fields)
If a patient’s ptosis is due to myasthenia gravis, application of an […] over the eyelids will result in improvement in ptosis.
If a patient’s ptosis is due to myasthenia gravis, application of an ice pack over the eyelids will result in improvement in ptosis.
cold temperature inhibits the breakdown of acetylcholine in the NMJ; patients with a positive test should undergo confirmatory testing with acetylcholine receptor antibodies
If a patient’s ptosis is due to […], application of an ice pack over the eyelids will result in improvement in ptosis.
If a patient’s ptosis is due to myasthenia gravis, application of an ice pack over the eyelids will result in improvement in ptosis.
cold temperature inhibits the breakdown of acetylcholine in the NMJ; patients with a positive test should undergo confirmatory testing with acetylcholine receptor antibodies
If the lesion in Brown-Sequard syndrome occurs above T1, patients may present with […]-lateral Horner syndrome (due hypothalamospinal pathway damage).
If the lesion in Brown-Sequard syndrome occurs above T1, patients may present with ipsi-lateral Horner syndrome (due hypothalamospinal pathway damage).
In addition to CNs, the cavernous sinus also contains portions of the […] artery and post-ganglionic sympathetic fibers en route to the orbit.
In addition to CNs, the cavernous sinus also contains portions of the internal carotid artery and post-ganglionic sympathetic fibers en route to the orbit.
post-ganglionic sympathetic fibers travel within the carotix plexus
In addition to respiratory support, Guillain-Barre syndrome is typically treated with […] or IV […].
In addition to respiratory support, Guillain-Barre syndrome is typically treated with plasmapheresis or IV immunoglobulins.
In addition to β-blockers, essential tremor may also be treated with […] or topiramate.
In addition to β-blockers, essential tremor may also be treated with primidone (a barbiturate) or topiramate.
In the acute phase of spinal cord injury, patients can develop spinal shock with […] reflexes and […] paralysis.
In the acute phase of spinal cord injury, patients can develop spinal shock with absent reflexes and flaccid paralysis.
eventually, spinal cord injury can result in hyperreflexia with spastic paralysis
Initial management of acute spinal cord compression includes emergency MRI and IV […].
Initial management of acute spinal cord compression includes emergency MRI and IV glucocorticoids.
radiation-oncology and neurosurgery consultations are indicated as well
Internuclear ophthalmoplegia has normal […], which is a distinguishing feature from a CN III lesion.
Internuclear ophthalmoplegia has normal convergence, which is a distinguishing feature from a CN III lesion.
CN III lesion would also result in ptosis and mydriasis, in addition to lack of convergence
Internuclear ophthalmoplegia results in inability to […] the ipsi-lateral eye.
Internuclear ophthalmoplegia results in inability to adduct the ipsi-lateral eye.
e.g. right INO = impaired adduction of right eye with left gaze
Internuclear ophthalmoplegia results in inability to adduct the […]-lateral eye.
Internuclear ophthalmoplegia results in inability to adduct the ipsi-lateral eye.
e.g. right INO = impaired adduction of right eye with left gaze
Internuclear ophthalmoplegia results in […] of the contra-lateral eye.
Internuclear ophthalmoplegia results in nystagmus of the contra-lateral eye.
e.g. right INO = nystagmus of left eye (CN VI overfires to stimulate CN III)
Internuclear ophthalmoplegia results in nystagmus of the […]-lateral eye.
Internuclear ophthalmoplegia results in nystagmus of the contra-lateral eye.
e.g. right INO = nystagmus of left eye (CN VI overfires to stimulate CN III).
Intraparenchymal hemorrage most commonly occurs due to rupture of […], secondary to chronic hypertension.
Intraparenchymal hemorrage most commonly occurs due to rupture of Charcot-Bouchard microaneurysms, secondary to chronic hypertension.
chronic hypertension causes hyaline arteriosclerosis of lenticulostriate vessels, weakening the vessel wall
Intraparenchymal hemorrage most commonly occurs due to rupture of Charcot-Bouchard microaneurysms, secondary to chronic […].
Intraparenchymal hemorrage most commonly occurs due to rupture of Charcot-Bouchard microaneurysms, secondary to chronic hypertension.
chronic hypertension causes hyaline arteriosclerosis of lenticulostriate vessels, weakening the vessel wall
Lacunar infarcts are most commonly associated with chronic […], which results in arteriolar sclerosis.
Lacunar infarcts are most commonly associated with chronic hypertension, which results in arteriolar sclerosis.
Lacunar stroke of the posterolateral […] results in sudden-onset contralateral loss involving all sensory modalities (pure sensory stroke).
Lacunar stroke of the posterolateral thalamus results in sudden-onset contralateral loss involving all sensory modalities (pure sensory stroke).
due to damage to the VPL and VPM nuclei; versus the posterior limb of the internal capsule in a pure motor stroke
Lambert-Eaton syndrome is caused by autoantibodies to […] at the NMJ.
Lambert-Eaton syndrome is caused by autoantibodies to pre-synaptic Ca2+ channels at the NMJ.
leads to impaired ACh release
Lambert-Eaton syndrome presents with muscle weakness that […] with muscle use.
Lambert-Eaton syndrome presents with muscle weakness that improves with muscle use.
e.g. isometric muscle contraction
Less common causes of subarachnoid hemorrhage include […] malformations and an anticoagulated state.
Less common causes of subarachnoid hemorrhage include arteriovenous (AV) malformations and an anticoagulated state.
more commonly due to aneurysm rupture or trauma
Lewy body dementia is characterized initially by dementia and […], followed by parkinsonian features.
Lewy body dementia is characterized initially by dementia and visual hallucinations, followed by parkinsonian features.
“haLewycinations”; frequent falls, fluctuating cognition, and sleep disturbances are also characteristic
Management of cauda equina syndrome involves emergent MRI and administration of […].
Management of cauda equina syndrome involves emergent MRI and administration of glucocorticoids.
Manifestations of acute angle-closure glaucoma include unilateral eye pain with conjunctival injection and a […], non-reactive pupil (size).
Manifestations of acute angle-closure glaucoma include unilateral eye pain with conjunctival injection and a dilated, non-reactive pupil (size).
Manifestations of […] glaucoma include unilateral eye pain with conjunctival injection and a dilated, non-reactive pupil (size).
Manifestations of acute angle-closure glaucoma include unilateral eye pain with conjunctival injection and a dilated, non-reactive pupil (size).
Multiple sclerosis is associated with a sensation of an electric shock running down the spine upon […] flexion (Lhermitte phenomenom).
Multiple sclerosis is associated with a sensation of an electric shock running down the spine upon neck flexion (Lhermitte phenomenom).
Multiple sclerosis may cause […], resulting in monocular vision loss, painful eye movements, and afferent pupillary defect (Marcus Gunn pupils).
Multiple sclerosis may cause optic neuritis, resulting in monocular vision loss, painful eye movements, and afferent pupillary defect (Marcus Gunn pupils).
Multiple sclerosis may present with transverse myelitis, which results in motor and sensory loss below the level of the lesion, often with […] and […] dysfunction.
Multiple sclerosis may present with transverse myelitis, which results in motor and sensory loss below the level of the lesion, often with bowel and bladder dysfunction.
causes flaccid paralysis initially (spinal shock) followed by spastic paralysis with hyperreflexia
Multiple sclerosis symptoms are often worsened upon exposure to […] (temperature).
Multiple sclerosis symptoms are often worsened upon exposure to heat (temperature).
e.g. hot shower, exercise ; known as Uhthoff’s phenomenon
Myasthenia gravis classically manifests as fatigable […] and bulbar (e.g. dysarthria) muscle weakness.
Myasthenia gravis classically manifests as fatigable ocular (e.g. ptosis, diplopia) and bulbar (e.g. dysarthria) muscle weakness.
Myasthenia gravis classically manifests as fatigable ocular (e.g. ptosis, diplopia) and […] muscle weakness.
Myasthenia gravis classically manifests as fatigable ocular (e.g. ptosis, diplopia) and bulbar (e.g. dysarthria) muscle weakness.
Myasthenia gravis is caused by autoantibodies to […] at the NMJ.
Myasthenia gravis is caused by autoantibodies to post-synaptic ACh receptors at the NMJ.
Myasthenia gravis presents with muscle weakness that […] with muscle use.
Myasthenia gravis presents with muscle weakness that worsens with muscle use.
Myasthenic crisis is managed with […] or intravenous […], usually in combination with corticosteroids.
Myasthenic crisis is managed with plasmapheresis or intravenous immunoglobulins, usually in combination with corticosteroids.
myasthenic crisis may manifest as severe respiratory muscle weakness and respiratory failure
Non-traumatic subarachnoid hemorrhage is most commonly due to rupture of a […].
Non-traumatic subarachnoid hemorrhage is most commonly due to rupture of a berry (saccular) aneurysm.
Once a diagnosis of myasthenia gravis is established, patients should receive a CT or MRI of the chest to evaluate for […].
Once a diagnosis of myasthenia gravis is established, patients should receive a CT or MRI of the chest to evaluate for thymoma.
thymectomy can result in long-term disease remission in patients with a thymoma or thymic hyperplasia
One contraindication to tPA administration in stroke patients is BP > […] mmHg.
One contraindication to tPA administration in stroke patients is BP > 185/110 mmHg.
Patients with […] tremor often self-medicate with alcohol, which decreases tremor amplitude.
Patients with essential tremor often self-medicate with alcohol, which decreases tremor amplitude.
Peripheral vertigo is most commonly due to […], which is tested with the Dix-Hallpike maneuver.
Peripheral vertigo is most commonly due to benign paroxysmal positional vertigo (BPPV), which is tested with the Dix-Hallpike maneuver.
BPPV is triggered by changes in head position; presumed to be debris or misplaced otoliths within the vestibular apparatus
Presbycusis is a form of sensorineural hearing loss, often at […] frequencies.
Presbycusis is a form of sensorineural hearing loss, often at higher frequencies.
typically a progressive, bilateral, symmetric hearing loss with/without tinnitus; due to destruction of hair cells at the cochlear base
Presbycusis is a form of […] hearing loss, often at higher frequencies.
Presbycusis is a form of sensorineural hearing loss, often at higher frequencies.
typically a progressive, bilateral, symmetric hearing loss with/without tinnitus; due to destruction of hair cells at the cochlear base
Pronator drift is a relatively sensitive and specific sign for […] or […] disease affecting the upper extremities.
Pronator drift is a relatively sensitive and specific sign for UMN or pyramidal tract disease affecting the upper extremities.
UMN lesions cause more weakness in the supinator muscles compared to the pronator muscles of the upper limb
Pseudotumor cerebri is also known as […].
Pseudotumor cerebri is also known as idiopathic intracranial hypertension.
