Neurology Shelf Flashcards
What type of deficits is a person with hypertension who has small infarcts likely to exhibit?
- pure motor stroke
- hemiplegia unassociated with cognitive, sensory, or visual deficits
What causes most cases of lateral medullary infarct?
occlusion of the vertebral artery
An aneurysm of ________ is likely to compress the oculomotor nerve
PCA
___________ reduces the risk of stroke in patients with symptomatic stenosis by 70%+
carotid endarterectomy
What type of speech problem has impaired comprehension and repetition?
Wernicke’s aphasia
____________ is similar to Broca’s aphasia with the exception of preserved repetition
transcortical motor aphasia
Rapid infusion of _________ during a seizure can produce a cardiac arrhythmia or hypotension
phenytoin
What medication should be given ASAP after spinal cord injury?
methylprednisone
What is the most common neurologic injury that develops with sarcoidosis?
facial paresis
What EEG finding is associated with herpes encephalitis?
bilateral, periodic epileptiform discharges
What is the best treatment for rabies?
supportive therapy
Fungal malignant external otitis and osteomyelitis of the base of the skull in HIV patients is most commonly caused by which of the following?
aspergillus
What is the most common cause of brain abscess in patients with AIDS?
toxoplasma gondii
What is the most common primary brain tumor in adults?
astrocytoma (glioblastoma multiforme)
What type of brain tumors have calcifications?
astrocytomas, meningiomas, oligodendrogliomas
Back pain, cachexia, elevated alk phase, and osteoblastic/osteolytic vertebral lesions suggest spine metastases from what type of cancer?
hepatocellular carcinoma
The disease responsible for an accumulation of glucosylceramide is…
Gaucher’s disease
Fairy’s disease involves the accumulation of _____________
trihexosylceramide
Long-standing liver disease causes an increase in what type of brain cells?
astrocytes
A positive Romberg sign develops with impaired ____________, a sensory modality carried in the ____________
- impaired position sense
- sensory modality carried in the posterior columns of the spinal cord
Spinocerebellar degeneration, polyneuropathy, and pigmentary retinopathy are suggestive of what vitamin deficiency?
vitamin E deficiency
Myoclonus is seen in what dementia-causing disease?
creutzfeldt-jakob
Lesions of the arcuate fascicles causes problems with what?
conduction (isolated deficit of repetition)
MPTP toxicity is indistinguishable from…
Parkinson’s
Where are Lewy bodies located?
intracytoplasmic (eosinophilic inclusions in the substantial nigra, locus coeruleus, and substantial innominata)
What is the mechanism of action of trihexyphenidyl?
anticholinergic (decreases signs of parkinsonism)
What is the function of the following cell types?
- astrocyte
- microglia
- oligodendroglia
- schwann cells
- astrocyte: support, repair
- microglia: CNS macrophages
- oligodendroglia: myelinate axons
- schwann cells: myelination, axonal regeneration
A lesion of the mammillary body causes…
Wernicke-Korsakoff
Bitemporal hemianopsia and contralateral LE hemiparesis are suggestive of…
saccular aneurysm
Mydriasis, ptosis, and a “down and out” eye are suggestive of a lesion in the…
PCA
Quadriplegia and lost voluntary face, mouth, and tongue movement suggest a stroke in the…
basilar artery
How do you remember the signs/sxs of Friedreich Ataxia?
He’s your favorite frat (frataxin) bro, always staggering (staggering gait) and falling (frequent falls) with an ataxic GAAit (GAA repeat) but has a sweet (DM), big heart (HCM)
Pseudopalisading pleomorphic tumor cells are seen in what brain tumor?
GBM (an astrocytoma)
What type of tumor has fried egg cells (round nucleus, clear cytoplasm, calcified)?
oligodendroglioma
What type of brain tumor is seen in kids in the 4th ventricle and causes hydrocephalus?
ependymoma
What type of brain tumor is derived from Rathke’s pouch and presents with bitemporal hemianopsia, hypopituitarism, DI, and hydrocephalus?
craniopharyngioma
Carbamazepine and phenytoin block ___ channels
Na+
What is the most common cause of viral meningitis?
enterovirus (rash, pharyngitis, GI, etc)
What type of infarct presents with unilateral motor impairment, no sensory or cortical deficits, and no visual field abnormalities?
posterior limb of internal capsule (lacunar infarct)
Which dopamine pathway regulates hyperprolactinemia?
- mesolimbic: antipsychotic
- nigrostriatal: EPS (dystonia, akathisia, parkinsonism)
- tuberoinfundibular: hyperprolactinemia
What medication can be used as therapy to treat spasms in MS?
baclofen
How is Leber’s optic atrophy inherited?
mitochondrial
What helps to diagnose metachromatic leukodystrophy?
nerve biopsy
Is HSM associated with Tay-Sachs or Niemann-Pick disease?
Niemann-Pick
The association of erythrocytosis with cerebellar signs, microscopic hematuria, and HSM suggests…
von Hippel-Lindau syndrome
What is the brain finding for patients with tuberous sclerosis?
subependymal glial nodules that have calcified
What are the treatments for myasthenia graves?
pyridostigmine, edrophonium
Elevated ESR, anemia, weight loss, and malaise in someone ~60 years old suggests…
polymyalgia rheumatica
People who ingest methyl alcohol have what eye problems?
central scotoma
Concentric pupillary constriction is suggestive of what eye problem and is associated with what infectious process?
- optic atrophy
- neurosyphilis
Which cranial nerve is at risk of injury with trauma to the orbit or face?
CN 4 (extends anterior in the orbit so more at risk to blunt trauma)
With nerve deafness, perception with _____ conduction will be superior to that with _____ conduction
air > bone
With conductive hearing loss, sound waves are conducted better through the ______ than the ______
bones of the skull than through air
Unlike the deficit of presbycusis, _____ tones are most susceptible to impaired perception during the initial phases of Meniere’s disease
lower tones
What is the most common cause of mononeuropathy multiplex?
diabetes
What is the triad of Wernicke’s encephalopathy?
opthalmoplegia (nystagmus, CN VI palsy), ataxia, confusional state (amnesia)
What is Landau-Kleffner syndrome?
epileptic aphasia
What is Lennox-Gastaut Syndrome?
- multiple seizure types (GTC, atonic, atypical absence)
- EEG slow 1-2 Hx spike and wave discharges
- impaired cognitive function
Asymmetric, lower motor neuron, decreased reflexes, and absent babinsky is suggestive of…
cauda equina syndrome
Symmetric, mixed UMN and LMN, increased reflexes (quadriceps, achilles), and present babinski is suggestive of…
conus medullaris syndrome
In SMA, there is death of the ___________, which leads to (UMN/LMN) signs
- death of the anterior horn cells
- LMN signs
Seizures, port wine stains, contralateral homonymous hemianopia, glaucoma, and mental retardation are suggestive of…
sturge weber
Ependymomas are tumors of the ______ cells that line the ________
- tumors of the ependymal cells
- line the ventricles
Loss of verbal and social skills, repetitive hand and body movements, respiratory difficulties, and gait disturbance are suggestive of…
Rett syndrome
A 30-50 y/o with a mass in the cerebral hemisphere and seizures has…
- an oligodendroglioma
- astrocytoma if also presenting with focal signs/sxs
A child with a brain mass in the cerebellum and Rosenthal fibers on pathology has…
pilocytic astrocytoma
A child presenting with signs and sxs of increased ICP has a ___________ in the _________
ependymoma, 4th ventricle
People with essential tremor have involvement of the…
thalamus
The drugs donepezil, rivastigmine, and galantamine are used in Alzheimer’s to raise the availability of what transmitter in the brain?
acetylcholine
Segmental demyelination of nerve axons is diagnostic of…
chronic inflammatory demyelinating polyneuropathy
Which of the following clinical features is associated with ALS?
- sensory loss on face
- resting tremor of the hands
- slurred speech
- loss of position sense of the toes
slurred speech
ALS is motor neuron disorder and is not associated with sensory sxs
What is the most common tumor in the cerebellopontine angle?
acoustic neuroma
If suspecting acute angle closure glaucoma, what should be done to confirm?
tonometry (measure IOP)
What can be used to treat restless leg syndrome?
pramipexole (DA promoter)
What is the adverse effect of metoclopramide?
Parkinsonism
What is the fastest way to decrease ICP?
intubate and hyperventilate
Widespread muscle cramping, foot drop, diffuse muscle atrophy, brisk DTRs, fasciculations, and no sensory abnormalities suggests…
ALS
Weakness more pronounced in the upper extremities than lower with a local deficit of pain and temperature is suggestive of…
central cord syndrome
How do you treat Guillian Barre?
IVIg or plasmapheresis
Weak abduction of shoulder is caused by injury to what nerve?
axillary n
What nerve causes the biceps reflex?
musculocutaneous
Contralateral hemiparesis and hemisensory loss, homonymous hemianopsia, and gaze palsy suggest hemorrhage where?
basal ganglia
Facial weakness, ataxia, nystagmus, occipital HA, and neck stiffness suggest hemorrhage where?
cerebellum
Contralateral hemiparesis and hemisensory loss, nonreactive miotic pupils, upgaze palsy, and eyes deviated toward the hemiparesis suggests hemorrhage where?
thalamus
Deep coma and total paralysis within minutes with pinpoint reactive pupils suggests hemorrhage where?
pons
What is used to treat the following?
- acute dystonia
- tardive dyskinesia
- acute dystonia: anticholinergics
- tardive dyskinesia: clonazepam
Where is the localization?
- double vision
- throbbing pain exacerbated by head movement
- left ptosis
- dilated L pupil
- L eye upward gaze and adduction limited
Left PCA
What is the purpose of acute B1 therapy in patients with alcoholism who are admitted to the hospital?
prevent anterograde amnesia
_______________ is associated with pain in the lower back or buttock region, often radiating down the posterior thigh and calf to the lateral and plantar surfaces of the foot and affecting the 4th and 5th digits of the foot
S1 nerve root compression
What do you treat a person who has vasospasm with to prevent stroke?
nimodipine
What drug treats absence seizures in patients who cannot tolerate ethosuximide?
divalproex sodium
What is the most common etiology of rim-enhancing lesions in AIDS patients?
CNS lymphoma
CSF EBV PCR is highly sensitive and specific for…
CNS lymphoma
What parts of the brain and spinal cord are most affected by neurosyphilis?
- posterior column of spinal cord
- dorsal root ganglia
General paresis is a manifestation of…
neurosyphilis
Another name for Wilson’s disease is…
hepatolenticular degeneration
Paraparesis, bladder and bowel dysfunction, and sensory deficit signal a…
transverse myelitis
