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Neuro > objectives-1 > Flashcards

objectives-1 Flashcards

1
Q

for paralysis of face, does LMN and UMN affect ipsilateral or contralateral face?

A

LMN- ipsi

UMN- contra

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2
Q

bulbar palsy

A

weakness in chewing, speaking, or swallowing (aka bulbar functions)

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3
Q

UMN pseudobulbar vs LMN (CN 7, 9, 10, 12) bulbar palsy

A

UMN: hyperactive jaw jerk (masseter reflex)

LMN: atrophy and fasciculations of muscles of the face, jaws, palate or tongue

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4
Q

tabetic gait

A

foot slapping

from syphilis or severe polyneuropathy

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5
Q

pseudotumor cerebri presentation

A

throbbing HA, +/- N/V, diplopia.

Patients are often obese

papilledema on exam

LP will have normal CSF @ high opening pressure

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6
Q

what causes should you think when an older vs younger patient presents with trigeminal neuralgia?

A

younger: MS
older: Tortuous or kinked BV compressing trigeminal

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7
Q

treatment of trigmenial neuralgia

A

carbamazapine

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8
Q

bulbous neuroma

A

following aberrant re-growth of a damaged

nerve, often exquisitely painful.

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9
Q

where is lesion with Ataxic respiration (variable breaths at an irregular interval)?

A

medulla

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10
Q

where is lesion with large fixed pupils

A

tectal (dorsal) midbrain lesion involving the parasympathetic fibers there

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11
Q

where is lesion with UNILATERAL BLOWN PUPIL, unresponsive consensually or directly?

A

ipsilateral CN III compression from swollen temporal lobe (uncal herniation)

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12
Q

where is lesion with small fixed pupils

A

pontine lesion involving sympathetic fibers

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13
Q

Oculocephalic reflex:

A

eyes roll in opposite direction of head turn with intact brainstem.

Remain in fixed position despite rolling if brainstem not intact

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14
Q

Oculovestibular (cold caloric) reflex:

A

eyes should move slowly toward the cold (irrigated) ear

i. If not present, brainstem compromised

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15
Q

how is sleep apnea diagnosed?

A

sleep study

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16
Q

cataplexy

A

periodic loss of muscle tone often provoked by emotional triggers

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17
Q

narcolepsy features

A

REM naps suddenly

cataplexy

sleep paralysis (REM hypotonia)

hynapgogic/pompic hallucinations

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18
Q

diagnosing narcolepsy

A

via multiple sleep latency tests, where the abnormally early onset of REM is
recorded as the patient is allowed to fall asleep several times but not in a state of sleep deprivation

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19
Q

syncope symptoms

A

dimming vision, tachycardia, diaphoresis, and “light-headedfeeling”.

can recall after episode; return to baseline

20
Q

seizure prodrome symptoms

A

nausea or dizziness,

but patient cannot remember events

+/- urinary incontinence, post-ictal confusion/lethargy/irritation

21
Q

seizure signs

A

tongue bite mark, rapid RR, bowel/bladder incontinence. Can have elevated WBC

22
Q

simple partial seizure of motor cortex

A

jerking, rhythmic movements

23
Q

simple partial seizure of temporal lobe

A

deja vu, amnesia, dysphoric/euphoric feelings, abnormal taste/smell

24
Q

simple partial seizure of parietal lobe

A

paresthesia, dysesthesia, numbness, vertigo

25
Q

simple partial seizure of occipital lobe

A

visual hallucinations

26
Q

complex partial seizures

A

LOC

Usually involves medial temporal lobe=staring into space, deja vu, emotional changes,
automatisms

27
Q

generalized absence seizure

A

LOC several seconds of staring/freezing in place, post-ictal phase,
pediatric.

3 hz spike and wave, sux to have absence seizures

28
Q

generalized tonic clonic contraction

A

seizure=LOC, first tonic contraction forcing air out (cry) and arching of back, then clonus with violent jerking, salivation/drooling, tongue biting, post-ictal phase

29
Q

tremor causes

A

resting: parkinsons
postural: essential
kinetic: essential or cerebellar

30
Q

dystonia causes - focal vs gen

A

Focal=localized (ie Torticollis)

Generalized=diffuse, disabling (seen in hereditary disorders)

31
Q

dystonia description

A

continual, sustained, painful contractions leading to spasms, turning of limbs

32
Q

myoclonus associations

A

toximetabolic encephalopathy, Cruetzfeldt-Jacob Dz, Wilson’s Dz

33
Q

Asterixis description

A

flapping tremor that “looks like foot tapping”

34
Q

asterixis cause if bilateral vs unilateral

A

bilateral: Hepatic/metabolic encephalopathy
uni: Structural or ischemic lesion

35
Q

TIAs last how long

A

usually 15 min, within 24 hrs

36
Q

where is path for amaurosis fugax

A

carotids via ophthalmic artery

37
Q

MCA infarct characterized by what symptoms

A

transient hemiparesis, aphasias

38
Q

PCA infarct characterized by what symptoms

A

transient homonymous hemianopsia

39
Q

Basilar/SCA/AICA characterized by what symptoms

A

Dizziness, dysphagia, dysarthria, diplopia, cerebellar ataxia

40
Q

Vertebral/PICA characterized by what symptoms

A

cerebellar ataxia, +/- medullary syndrome

41
Q

workup for potential stroke

A

MRI/MRA brain, carotid doppler, TTE/TEE,

check glucose and BP control,

if no yield:

  • vasculitis autoimmune serum panel
  • LP for CSF analysis
42
Q

treatment for atherosclerotic stroke

A

Start antiplatelet (ASA, or ASA+ clopidigrel common) and statin

  1. Surgical approach: carotid endartectomy, possibly ballooning/stenting
  2. Prevention: control DM, HTN, HLD, smoking cessation
43
Q

treatment for embolic stroke

A

start anticoagulation (heparin, warfarin, Factor X inhibitors, etc)

44
Q

pathophys mechanisms for intracranial hemorrhage

A

i. Deep hemorrhage-from small vessel, (lenticulostriate) rupture due to HTN (remember cocaine)
ii. Superficial hemorrhage-from head trauma, possibly CT disorders
iii. Both can be compounded if patient is on anticoagulation

45
Q

workup of intracranial hemorrhage

A

CT non contrast looking for bright blood!!!,

others CTA, MRI/MRA, CBC/CMP, check INR

46
Q

treatment for intracranial hemorrhage

A

Manage underlying bleeding disorder if any,

FFP and coag factors in some cases,

Neurosurg for coil/clip placement

Neuro (22 decks)

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