Pretest Flashcards
cranial nerve palsy in sarcoid?
Cr VII
-same in Lyme disease
mcc of fungal meningitis
cryptococcus
(encapsulated fungus)
-acquired from lungs and spreads to CNS hematogenously
brain abscesses:
- most common organism?
- most common site?
- most common mechanism of spreading?
- Streptococcus
- gray-white matter junction
- hematogenous spread of infection
-Staph post-neurosurgery
most common organism of brain abscess in AIDs pt?
toxoplasma gondii
most common fungal brain abscess?
aspergillus
rabies invasion of CNS?
- retrograde axoplasmic flow
- from periphery extending centripetally along peripheral nerves
-only supportive tx available
source of CJD?
growth hormone treatment from cadaver pituitary gland
cysticercosis
- taenia solium
- pork tapeworm
- hatch in GI –> spread to CNS –> multiple cysts in cerebrum
-feco-oral spread; S. America, SE Asia, Africa
von Hippel Lindau syndrome
- autosomal dominant
- multiple tumors & cysts in different organs (CNS, kidneys, eye)
- hemangioblastoma* –> lethal if bleeds into brain
- clear cell renal carcinoma, pheochromocytoma, pancreatic tumors/ cysts
brain metastases with highest mortality?
malignant melanoma
common maligancies in AIDS pts?
- lymphoma (primary CNS tumor)
- Kaposi sarcoma (rarely mets to brain)
gelastic seizure
uncontrollable laughter
-seen in hypothalamic hamartomas
hyperCa –> dec membrane excitability –> what symptoms?
- lethargy
- weakness
- areflexia
deficient enzymes of:
- Tay Sachs
- Gaucher
- metachromatic leukodystrophy
- Neimann-Pick
- hexaosaminidase A (Tay-Sax lacks hex)
- glucocerebrosidase
- arylsulfatase A
- sphingomyelinase (No man picks his nose with his sphinger)
`things that precipitate subacute combined degeneration?
- giving folate before B12 (when both deficient)
- atrophic gastritis –> intrinsic factor deficiency
- nitrous oxide
visual defect with B12 deficiency?
centrocecal scotoma
chlordiazepoxide
- benzodiazepine
- tx alcohol withdrawal, anxiety
alcohol vs benzodiazepine withdrawal symptoms
- alcohol: within 72 hours
- benzodiazepines: 7-10 days post abstinence
pellagra
- B3 (nicotinic acid) deficiency
- dermatitis, diarrhea, dementia, death
kwashiorkor
- protein-energy malnutrition
- symptoms: edema, irritability, anorexia, dematoses, enlarged liver
Pickwickian syndrome = obesity hypoventilation syndrome
obesity + hypersomnia + hypoxemia + pulmonary HTN
transcortical sensory aphasia
seen in what disease?
decreased ability to understand complex linguistic structures
-seen in Alzheimer’s; along with aphasia (dec fluency, dysnomia, etc)
MPTP addiction causes what to brain?
- damage to substantia nigra –> Parkinson-like symptoms which develops over a few months (vs years in regular Parkinson’s disease)
- MPTP is similar to heroin
chorea gravidarum
- chorea in a pregnant woman
- asymmetric, forceful movements
- caused by dramatic change of hormonal environment of brain
-can happen with estrogen replacement, as well
Sydenham’s chorea px
- after Group A beta-hemolytic Streptococcus infection
- chorea
- dysarthria, behavior changes, gait disturbance, slowed cognition, hypotonia
- kids, girls
- no genetic or MRI abnormalities
substantia nigra in Parkinson’s disease show what?
Lewy bodies
= intracytoplasmic inclusion bodies = eosinophilic inclusions
flexion of neck causes electrical sensation to radiate down spine
Lhermitte’s sign
-seen in MS
Canavan’s disease px
- occurs in infants by 6 months
- extensor posture
- rigidity
- myoclonic seizures
- spongiform change to white matter
abetalipoproteinemia px, cause
- dec LDL, VLDL, chylomicrons
- acanthocytes
- ataxia
- posterior column & spinocerebellar degeneration
- retinitis pigmentosa
-MTP mutation –> impaired VLDL formation –> dec vit E delivery & dec fat absorption
Sturge-Weber syndrome px
- port wine stain*
- glaucoma
- seizures
- mental retardation
- abnormal blood vessels*
- ipsilateral leptomeningeal angioma
- tram track calcifications*
phenylketonuria
- autosomal recessive
- phenylalanine hydroxylase deficiency –> lack of tyrosine & accumulation of phenyl-alanine & -ketones
- some may restrict dietary phenylalanine intake
- px: seizures, intellectual delay, musty body odor
Hartnup’s disease
- tryptophan malabsorption –> nicotinamide (vit B3) deficiency
- autosomal recessive
- ataxia
- scaly erythematous rash
telangiectasias in fundi on retinal exam - what disease?
von Hippel Lindau
-numerous tumors and cysts
first trimester viral infection can lead to?
aqueductal stenosis –> hydrocephalus
tuberous sclerosis
- ash leaf spots
- shagreen patches
- adenoma sebaceum (malar distribution)
- CNS calcifications (calcified subependymal glial nodules –> hydrocephalus)
- renal tumors
- cardiac rhabdomyomas
- seizures
- retinal phakomas (no tx needed)
- autsomal dominant
fetal alcohol syndrome px
- intra- & post-uterine growth retardation
- dysmorphic facies
- CNS: brainstem/cerebellum malformation, learning disability, microcephaly, hetrotopia (cortical neurons in abnormal locations)
dermatomyositis px
- proximal muscle weakness
- heliotrope rash
- erythema over knuckles
-paraneoplastic syndrome
DMD carrier will have elevations of what in serum?
creatinine phosphokinase (CPK)
DMD can be seen in females with what genetic disorder?
Turner syndrome (XO)
ALS
- UMN & LMN symptoms –anterior horn cells, corticospinal tract, brainstem motor nuclei, etc
- fibrillations
- denervation atrophy of muscles
-bad prognosis: if cranial nerves affected –fasciculations of tongue (Cr XII)
Parinaud syndrome
- paralysis of upward gaze
- -> downward gaze primary position
-pinealoma association
