patient presentations Flashcards
newborn has frog-like appearance, mother had increased alpha-FP, polyhydramnios
anencephaly
newborn determined to have a dimple/tuft of hair on skin in lumbosacral area
spina bifida occulta –> occurs due to failure of closure of posterior vertebral arch
newborn is determined to have cystic mass containing meninges in lumbosacral area
meningocele
newborn is determined to have cystic mass containing meninges and spinal cord tissue in it
meningomyelocele
caudal extension of medulla and cerebellar vermis through foramen magnum
arnold-chiari malformation
newborn is noted to have platybasia, meningomyelocele, syringomyelia, and noncommunicating hydrocephalus
arnold-chiari malformation
treatment of arnold chiari malformation
decompression surgery
partial or complete absence of cerebellar vermis
dandy-walker malformation
cystic dilatation of 4th ventricle, noncommunicating hydrocephalus
dandy-walker formation
treatment for dandy walker
shunt to treat hydrocephalus
30-40 year old person presents to ED with a loss of pain/temperature sensation in the hands although tactile sensation was preserved as well as atrophy of intrinsic muscles in hand
Syringomyelia
patient is noted to have fluid-filled cavity in the cervical spinal cord, expanding to disrupt the anterior horns of the spinal cord
syringomyelia
MRI shows cystic cavity in cervical spinal cord as well as cervical spine enlargement
syringomyelia
meningitis with CSF culture that is positive with hippurate test
group B strep
meningitis with CSF culture that is bacitracin resistant
group B strep
meningitis with CSF culture that has K capsule
e coli
meningitis with CSF culture that is beta-hemolytic
listeria monocytogenes
meningitis with CSF culture that appears to have lancet-shaped organism
s. pneumoniae
meningitis with CSF culture that appears to have IgA protease and is gram negative diplococci
neisseria meningitidis
meningitis with CSF culture that has maltose and glucose fermentation
neisseria meningitids
meningitis with CSF culture that appears to have gram negative coccobaccilus organisms
h. influenzae type B
meningitis with CSF culture that ferments lactose and is a gram negative rod
e. coli
meningitis with CSF culture that has an organism that usually colonizes the vagina
group B strep
meningitis with CSF culture that has facultative intracellular microbe
listeria monocytogenes
meningitis with CSF culture that shows gram + cocci
group B strep
meningitis with CSF culture that with rocket tails
listeria monocytogenes
meningitis with CSF culture that appears to have gram positive rods
listeria monocytogenes
meningitis with CSF culture that appears to have gram positive diplococci
strep pneumoniae
severe headache, nausea, vomiting, and eventual coma
intracerebral hemorrhage, most commonly due to rupture of charcot-bouchard microorganism, secondary to chronic hypertension at basal ganglia
“worst headache of my life”
subarachnoid hemorrhage
xanthochromia upon CSF
yellow hue due to breakdown of bilirubin - subarachnoid hemorrhage
lens shape lesion upon CT
epidural hematoma
pt is in hospital after fracture to temporal lobe. what is ddx?
epidural hematoma
crescent shaped lesion upon cT
subdural hematoma
demyelinating plaques found in spinal cord and brain
MS
patient is found to have HLA-DR2, putting them at higher risk for this disease
MS
Patient had CMV a few weeks ago, now is developing parasthesias, loss of pain/temp sensation, and has babinski reflex, scanning speech, and blurry vision/sudden loss of vision
MS
child has progressive neurological problems and was known to have measles as an infant
subacute sclerosing panencephalitis
viral inclusions within neurons (gray matter) and oligodentdrocytes (white matter)
subacute sclerosing panencephalitis
patient is found to have large multinucleated histiocyte cells
krabbe
patient is found to have deficiency of galactocerebrosidase
krabbe disease
patient is found to have an x-linked leukodystrophy
adrenoleukodystrophy
patient is found to have accumulation of fatty acid in white matter of brain and adrenals
adrenoleukodystrophy
patient is found to have impaired addition of CoA to long chain fatty acids in peroxisome
adrenoleukodystrophy
patient is found to have deficiency of arylsulfatase
metachromatic leukodystrophy
patient cannot break down myelin and is found to have increased sulfatides
metachromatic leukodystrophy
patient has JC virus recurrence due to immunosupression because of AIDS and has progressive neurological problems
progressive multifocal leukoencephalopathy
alcoholic patient comes in, given IV and promptly has locked in syndrome
central pontine myelinolysis
patient comes in with internuclear opthalmoplegia
MS
symmetric ascending weakness beginning in the lower extremities, recently had CMV
guillian barre
scanning speech, intention tremor, nystagmus
MS
confusion, ataxia, ophthalmoplegia
Wernicke’s encephalopathy
incontinence, balance problems, and dementia
normal pressure hydrocephalus (communicating hydrocephalus)
weakness, hypotonia, flaccid paralysis with headache, fever, and nausea
LMN lesions + signs of infection –> poliomyelitis
infant with tongue fasiculations
infant with LMN lesion –> Werdnig Hoffman
genetic test shows GAA repeats
freidrichs ataxia
child presents with staggering gait, frequent falling, loss of vibratory sense and proprioception, muscle weakness in lower extremities, and loss of DTR
freirich ataxia
ptosis, anhidrosis, and miosis of face
horner’s syndrome
