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neurology > pathology II > Flashcards

pathology II Flashcards

1
Q

What is conduction aphasia?

A

Caused by damage to the arcuate fasciculus (connects wernickes and brocas area) - patient can’t repeat what you say

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2
Q

What is global aphasia?

A

Wernickes, brocas and arcuate fasciculus are all affected

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3
Q

What is transcortical motor aphasia

A

affected frontal lobe around broca area, but broca is spared

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4
Q

what is transcortical senosry aphasia

A

affects temporal lobe around wenicke area but wernicke area is spared

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5
Q

what is transcortical mixed aphasia?

A

broca and wernicke areas and arcuate fasciculus remain intact but surrounding watershed areas are affected

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6
Q

saccular aneurysm aka

A

berry aneurysm

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7
Q

most common location for a berry aneurysm

A

junction of Acomm and ACA

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8
Q

how do berry aneurysms prsent

A

silent until they rupture -> subarachnoid hemorhage

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9
Q

An aneurysm in the Acom may compress surrounding structure resulting in what?

A

Bitemporal hemianopia (compresses optic chiasm)

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10
Q

An aneurysm in the Pcom may compress surrounding structures resulting in what?

A

CN III palsy -> mydriasis, down and out eye and ptosis

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11
Q

What presents similarly to a CN III palsy?

A

Ischemic neuropathy seen in diabetes, however pupil is spared

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12
Q

What are Charcot-Bouchard microaneurysms commonly found?

A

Small vessels such as lenticulostriate arteries

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13
Q

What are Charcot-Bouchard microaneurysms associated with?

A

chronic hypertension

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14
Q

What can Charcot-Bouchard microaneurysms result in?

A

hemorrhagic intraparenchymal strokes

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15
Q

Where do most partial (focal) seizures originate?

A

medial temporal lobe

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16
Q

Types of partial seizures

A

simple partial and complex partial

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17
Q

How do simple partial seizures present

A

consciousness remains, may be motor, sensory, autonomic or psychic

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18
Q

How do complex partial seizures present

A

impaired consciousness and automatisms

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19
Q

Status epilepticus

A

continues (>5min) or recurring seizures that may result in brain injury

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20
Q

types of generalized seizures

A 
absence (petit mal)
Myoclonic
Tonic-clonic (grand mal)
Tonic
Atonic
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21
Q

What will be seen on a EEG of an absence seizure?

A

3 Hz spike-and-wave discharges

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22
Q

Atonic seizures are commonly mistaken for…

A

drop seizures

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23
Q

What is Juvenile Myoclonic epilepsy?

A

characterized by absence, myoclonic and grand mal seizures. Common in children.

Absence -> myoclonic -> grand mal

Typically myoclonic jerks on awakening from sleep

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24
Q

What is post-ictal state mean?

A

After a grand-mal seizure, this is a period of brain recovery that presents as confusion/lack of alterness and lasts minutes to hours

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25
Q

Treatment for childhood absence epilepsy

A

Ethosuxamide

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26
Q

Cause of fever

A

cytokine activation during inflammation (infection)

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27
Q

Cause of heat stroke

A

the inability of body to dissipate heat (exertion)

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28
Q

temperature seen in fever

A

Usually <40 C

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29
Q

temperature seen in heat stroke

A

usually > 40 C

30
Q

Complications of fever

A

febrile seizures (usually benign, self-limiting)

31
Q

Complications of heat stroke

A

CNS dysfunction (confusion), end-organ damage, acute respiratory distress syndrome, rhabdomyolysis

32
Q

Management of fever

A

acetominaphen or ibuprofen for comfort and antibiotics if necessary

33
Q

Management of heat stroke

A

rapid external cooling, rehydration and electrolyte correction

34
Q

What causes headaches?

A

pain due to irritation of structures such as the dura, cranial nerves, or extracranial structures

35
Q

Which type of headache is more common in males?

A

cluster

36
Q

Location and duration of cluster headaches

A

unilateral

15min-3 hours, repetitive

37
Q

Presentation of cluster headaches

A

excruciating perioorbital pain (suicide headache) with lacrimation and rhinorrhea
May present with horner syndrome

38
Q

Treatment of cluster headaches

A

Acute: sumatriptan, 100% O2
Prophylaxis: verapamil

39
Q

Migraine location and duration

A

unilateral, 4-72 hours

40
Q

presentation of migraine

A

pulsating pain with nausia, photophobia or phonophobia. May have aura.

41
Q

Cause of migraine

A

irritation of CN V, meninges or blood vessels (release of vasoactive peptides such as substance P, calcitonin gene-related peptide).

42
Q

Acute treatment of migraines

A

NSAIDS, triptants, dihydroergotamine

43
Q

Prophylaxis treatment of migraines

A

lifestyle changes (sleep, exercise, diet), B-blockers, aitriptyline, topiramate, valproate, botox

44
Q

tension headache location and duration

A

> 30 minutes, usually 4-6 hours

Bilateral in band like pattern

45
Q

Presentation of tension headaches

A

Steady band like pain with NO aura

46
Q

Acute treatment of tension headaches

A

analgesics, NSAIDs, acetominaphen

47
Q

Prophylaxis of tension headaches

A

TCAs, behavioural therapy

48
Q

Presentation of trigeminal neuralgia

A

repetitive, unilateral, shooting/shock like pain in distribution of CN V. Triggered by chewing, talking, touching certain parts of the face. Lasts seconds to minutes. Intensity and frequency increases over time.

49
Q

Treatment of trigeminal neuralgia

A

carbamazepine

50
Q

Common aura

A

scintillating scotoma

51
Q

Triptans MOA

A

5-HT agonists - inhibit trigeminal nerve and decrease vasoactive peptide release.
Also cause vasoconstriction

52
Q

Triptans are contraindicated for which patients

A

coronary disease and coronary vasospasm

53
Q

Akathisia presentation

A

restlessness and intense urge to move

54
Q

asterixis

A

flapping of wrists on extension

55
Q

athetosis presentation

A

slow, snake-like, writhing movements, especially in fingers

56
Q

which disease has athetosis

A

huntingtons

57
Q

chorea

A

sudden, jerky, purposeless movements

58
Q

which disease has chorea

A

huntingtons

59
Q

dystonia

A

sudden, involuntary muscle contractions

60
Q

examples of dystonia

A

writers cramp, blepharospasm, torticollis

61
Q

what is blepharospasm

A

abnormal contraction of eyelids

62
Q

essential tremor presentation

A

high-frequency tremor with sustained posture. Worsened with movement or when anxious.

63
Q

Treatment of essential tremor

A

nonselective beta-blockers or primidone

64
Q

Hemiballismus presentation

A

sudden, wild flaing of 1 arm +- ipsilateral leg

65
Q

a lesion WHERE leads to hemiballismus

A

contralateral subthalamic nucleus

66
Q

intention tremor presentation

A

slow, zigzag motion when pointing/extending toward a target

67
Q

Myoclonus presentation

A

sudden, brief, uncontrolled muscle contraction

68
Q

Myoclonus examples

A

jerks; hiccups; common in metabolic abnormalities such as renal and liver failure

69
Q

resting tremor

A

uncontrolled movement of distal appendages seen in parkinsons

70
Q

restless legs syndrome

A

worse at rest/nighttime and releived by movement

71
Q

What is restless legs syndrome associated with?

A

iron deficiency and CKD

72
Q

treatment of restless legs syndrome?

A

dopamine agonists

neurology (9 decks)

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