random neuro Flashcards
testing language at bedside
naming
repetition
commands (multi step commands without pause that crosses the midline)
language hemi?
90% on L
30% of L handed people will be R side dominant
utoff’s phenomenon
sx get worse in warm weather
ms
inflammatory, demylinating dz of CNS, maybe autoimmune
differentiate in space and time
neuromyelitis optica
effects optic n and spinal cord
-dx: ab against aquaporin 4
single ring enhancing brain lesion vs multiple?
single: Lymphoma, post infectious (most likley staph or strep v)
multiple: toxo
cushing reflex
sign of brainstem compression
- HTN
- bradycardia
- decreased resps
dx of creutzfeld jakob
- myclonus
- akinetic mutism
- hypokinesia
- cerebellar/ visual dist
periodic sharp wave on EEG
14-3-3 CSF assay
hemmorhagic transformation
<48 hour post stroke –> ischemic, embolic or one tx with TPA
more commonly seen with septic emboli
most common etiology of “transiet curtains over my eye”
amarosis fugax –> from atherosclerotic emboli from carotids
paralysis of upper and lower facial muscles on one side, what level of injury
bell’s palsy, lesion below the pons
if forehead muscles are spared this suggests higher lesions
cranial nerves in cavernous sinus (and other structures)
III, IV, V, VI
ICA, post communicating artery
pituitary gland
optic chiasm
insular cortex
autonomic functions
lateral sulcus
causes/ treatment of peripheral facial nerve palsy
(FULL paralysis)
1) edema at faicla nerve canal
2) epidural hematoma
3) longitudinal fracture of temporal bone
for 1) tx with high dose short course of steroids
albuminocytologic dissociation
seen in CSF in GBS –> elevated protein, normal cell count
drooling in rabies?
hydrophobia form pharyngeal muscle spasm
when do you surgically intervene on a subdural
> 10mm
midline shift
mental status change
CSF in HSV encephalitis
lymphocytic pleocytosis minimally elevated protein nl glucose nl- inc opening pressure ***look for MRI changes in temporal regions
typical presentation of medullablastoma
signs of hydrocephalus
signs of cerebellar vermis involvement- n/v, headaches, gait difficulty
cognitive impairment manifestation that comes with NPH?
decreased attention
management of acute MS flair
high dose IV methylpred –> 500-1000mg 3-5 days
anti gm1 antibodies
chronic inflammatory demylinating polyneuropathy
tx with IVIG or plasmapheresis
tuberous sclerosis dx
neurocutaneous d/o characterized by benign hamartomas
- > 3 ash leaf spots (hypopigmented, ellipsoid patch)
- shagreen patches- raised, rough, dimpled skin usu on low back
- angiofibromas
- retinal
renal- RCC, cysts, angiomyolipomas
CNS- seizures, intellectual disorders
cardiac- rhabdomyomas
ALS symmetry?
Als is often Asymmetric
neurogenic shock
type: distributive shock
vasodilation, warm and flushed skin–> dec preload –> hypotn, bradycardia
**can be cause by spinal anesthetics in surgery
neurogenic shock
type: distributive shock
vasodilation, warm and flushed skin–> dec preload –> hypotn, bradycardia
**can be cause by spinal anesthetics in surgery
features of fetal alcohol syndrome
downslanting palpebral fissures – distance b/w med and lat canthi
epicanthal folds – fold of eye lid
flat philtrhum– fold between upper lip and nose
flattened, small upper lip
hypertelorism– inc space between two doubled up organs, ie eyes
microcephaly
palpebral fissures in Downs sysndrome
UPSLANTING
lisch nodules
hyperpigmented nodules seen in the iris in nf1
5 P’s of acute intermittent porphyria
painful abdomen psychologic disturbance polyneuropathy precipitant: drugs, alcohol purple pee
