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CPD Spring Term > Quiz 3 - Neuro II > Flashcards

Quiz 3 - Neuro II Flashcards

1
Q

Generalized Seizures are correlated with?

A

metabolic disturbances
complete LOC
- seizure activity involving ENTIRE brain, entire cortex of both hemispheres

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2
Q

what are the 5 generalized seizures

A 
infantile spasms (RARE)
absence seizures (Petit Mal)
tonic-clonic seizures (Grand Mal)
atonic seizures
myoclonic seizures
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3
Q

what are common symptoms of absence seizures?

A

no falling or convulsing

neuro and cognitive exams are usually normal

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4
Q

what are common symptoms of tonic clonic seizures (grand mal seizures)

A

begin with OUTCRY, LOC, falling.

NO AURA

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5
Q

what are common symptoms of typical absence seizures?

A

no falling or convulsing
eyelid fluttering (sometimes)
staring vacantly
neuro and cognitive exams are usually normal

usually 4-12 yr old w. FHx

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6
Q

partial seizures are characterized by?

A
  • involvement of one cerebral cortex

- often from structural abnormalities

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7
Q

what are the types of partial seizures, what do they indicate and what is 100% mandatory?!

A

Types: Motor and Sensory Seizures
Indicate: structural brain disease

the focal onset localizing the lesion: FULL INVESTIGATION IS MANDATORY

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8
Q

what are the types of simple partial seizures, what do they indicate and what is 100% mandatory?!

A

Types: Motor and Sensory Seizures
Indicate: structural brain disease

the focal onset localizing the lesion: FULL INVESTIGATION IS MANDATORY

No LOC

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9
Q

Simple Partial Motor Seizures arise where?

What is a Jacksonian Motor seizure?

A

arise in the frontal motor cortex with movements in the CONTRALATERAL face, trunk or limbs

  • Jacksonian motor seizure - a simple partial seizure - march of involuntary muscle movement from one muscle group to the next
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10
Q

what are the types of simple partial seizures, what do they indicate and what is 100% mandatory?! KNOW THIS

A

Types: Motor and Sensory Seizures
Indicate: structural brain disease

the focal onset localizing the lesion: FULL INVESTIGATION IS MANDATORY

No LOC

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11
Q

Simple Partial Sensory Seizures present how?

A

parasthesias or tingling in an extremity or face sometimes associated with a distortion of body image

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12
Q

Complete partial seizures originate where?

A

temporal lobe

  • reduced but NOT complete LOC
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13
Q

ssx of partial seizures, in general what should be expected?

A

preceded by an aura

1-2 min duration

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14
Q

What are common causes of brain abscess?

A

direct extension of cranial infections:

  • mastoiditis
  • sinusitis
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15
Q

ssx of partial seizures, in general what should be expected?

A

MAY BE preceded by an aura
1-2 min duration
followed by post-ictal state - sleepy, HA, confusion, soreness

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16
Q

what is the etiology of encephalitis?

A

direct viral invasion

mosquito transmission, HSV, HIV

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17
Q

what is helpful in dx of rabies?

A

suspected in ptsd with encephalitis or ASCENDING PARALYSIS and recent HX of animal bite or bat exposure

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18
Q

what imaging would be ordered for imaging of suspected seizure patients?

A

EEG

- critical for dx, but normal EEG cannot necessarily r/o seizure

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19
Q

what are 6 brain infections an individual can get?

A 
brain abscess
encephalitis
rabies
helminthic brain infections
progressive multifocal leukoencephalopathy
subdural empyema
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20
Q

what is the definition of prion disease?

A

progressive, FATAL, and UNTREATABLE BRAIN DISORDERS

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21
Q

DX brain infections by?

A

MRI - multifocal, non-enhancing lesions w.o mass effect

CSF - look for JC virus DNA

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22
Q

KNOW - What is the common etiology of subdural empyema?

A

SINUSITIS

Ear infections

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23
Q

what are ssx of prion disease?

A

ssx:

  • memory loss
  • confusion
  • ataxia
  • startle myoclonus (provoked by noise or stimuli)
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24
Q

how is Creutfeldt-Jakob Disease dxd?

A

Suspect in elderly patients with RAPIDLY progressing dementia, esp if accompanied by ataxia or myoclonus

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25
Q

what are the ssx of meningitis?

A

headache
fever
nuchal rigidity (this may or may not be present)

26
Q

a patient ptc with 3-5 days of progressive malaise, fever, irritability, vomiting.. what condition is this and what may develop?

A

acute bacterial meningitis

meningeal sx may develop such as:
fever, HA, seizures (40% kiddos)

27
Q

how is acute bacterial meningitis dxd?

A

CSF

- increased WBCs (PMNs - highly active neutrophils), protein and decreased glucose

28
Q

what are common causes of viral meningitis?

A

enterovirus (MOST COMMON)

or HSV

29
Q

how is viral meningitis dxd?

A

CSF
- increased WBC (lymphocytes), protein is slightly increased, less than bacterial, and glucose is generally normal, or slightly decreased

30
Q

which virus is most commonly the cause for recurrent meningitis?

A

HSV

31
Q

what are the movement disorders?

A 
tremor
fragile x-associated tremor/ataxia syndrome (FXTAS)
Huntington's disease
Parkinson's Disease
Tic Disorders
Restless Leg Syndrome
32
Q

when do tremors occur? what typically alleviates sx?

A

during voluntary movement, typically bilateral
alcohol alleviates sxs

Fhx is pertinent in 50% of cases

33
Q

what are red flags of tremors?

A

abrupt onset

onset in people

34
Q

what is the definition of Parkinson’s Disease? what is present pathologically?

A

bardykinesia
RESTING tremor
cogwheel rigidity
postural reflex impairment

lewy bodies

35
Q

what are common signs and symptoms of parkinson’s disease

A 
mask-like facies
coarse tremor
rigidity
bradykinesia
shuffling gate
36
Q

what is a common tic disorder?

A

tourette syndrome

37
Q

when do tremors occur? what typically alleviates sx?

A

during voluntary movement, typically bilateral
ALCOHOL ALLEVIATES sxs

Fhx is pertinent in 50% of cases

38
Q

when do tremors occur? what typically alleviates sx?

A

during voluntary movement, typically bilateral
ALCOHOL ALLEVIATES sxs

20x more common than Parkinson’s
Fhx is pertinent in 50% of cases

39
Q

compare physiologic tremor vs pathologic tremor

A

physiologic

  • fast rate
  • enhanced by fatigue, anxiety, drugs
  • non-disabling

pathologic

  • slow rate
  • socially and physically disabling
40
Q

what symptoms are associated with huntington disease?

A 
choreic movements (dance)
dementia
41
Q

what are common signs and symptoms of parkinson’s disease

A 
mask-like facies
RESTING tremor
cogwheel rigidity
bradykinesia - slow movement
shuffling gate

approx. 10% have genetic predisposition.

42
Q

what symptoms are associated with huntington disease?

A 
choreic movements (dance)
dementia
43
Q

what clinical symptom helps with diagnosis of Parkinsons?

A

unilateral resting tremor

44
Q

what is the most sensitive test for MS?

A

MRI of brain/spinal cord

-reveals plaques

45
Q

What are common ssx of Myasthenia Gravis?

A

immune destruction of an acetylcholine receptor

  • fatigability
  • eyes - ptosis, diplopia
46
Q

what is the confirmatory lab work done of myasthenia gravis

A

serum Anti-AchR Abs**

EMG

47
Q

what is the difference in GBS and MS?

A

GBS is peripheral nerve myelin

MS is central nerve myelin

48
Q

Guillain-Barre syndrome presents with what symptoms, progress to what? ?

A

sensory sx begin: paresthesia of feet and hands
then, rapid onset of severe muscle weakness
usually weakness is SYMMETRIC and begins with legs and progresses to arms

MOST CONCERNING:
- respiratory paralysis may occur
- at it’s worse:
total flaccid quadriplegia

DTRs are lost. (LMN)

49
Q

what is the difference in GBS and MS?

A

GBS is peripheral nerve myelin

MS is central nerve myelin

50
Q

what is the DDX for GBS?

A

Myasthenia Gravis - weakness, early ptosis, DTRs retained
MS - no resolve, hyperreflexia
DM - glove and stocking prothesis, DRTs retained, elevated glucose

51
Q

multiple sclerosis presents in what gender at what age range?
what is the typical clinical course?

A

women, typically 20-40 y/o

  • relapsing-remitting pattern
  • primary progressive pattern
  • secondary progressive pattern
  • progressive relapsing pattern
52
Q

what is the DDX for GBS?

A

Myasthenia Gravis - weakness, early ptosis, DTRs retained
MS - no resolve, hyperreflexia
DM - glove and stocking prothesis, DRTs retained, elevated glucose

53
Q

ALS is? who is at greater risk? what are the SSX?

A

amyotrophic lateral sclerosis
random asymmetric - weakness, muscle atrophy of hands and feet (foot drop)
fasiculations, spasticity, hyperactive DTRs

54
Q

how is ALS dx’d?

A

Clinically -
requires BOTH
UMN and LMN disorders in MULTIPLE areas

55
Q

how is ALS dx’d?

A

Clinically -
requires BOTH
UMN and LMN disorders in MULTIPLE areas

56
Q

intracranial and spinal tumors present with what ssx?

A

HEADACHES!!! - made worse by sleep. different HA than they are used to. Very persistent.

or new seizures..

57
Q

which type of glioma is the most common? what age group are we expecting to see?

A

astrocytomas

  • tend to develop in younger patients
58
Q

for pituitary tumors, what are common ssx?

A
  • headache

- visual manifestations

59
Q

which structure do pineal tumors compress?

A

hypothalamus

60
Q

spinal cord tumors present with?

A

progressive back pain, unrelated to activity and worsened by RECUMBENCY

CPD Spring Term (6 decks)

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