Top 100 Secrets Flashcards
What are findings in myopathies?
proxmial symmetric weakness WITHOUT sensory loss
What is the triad of spinal cord disease?
distal symmetric weakness
sphincter problems
sensory level
Unilateral lesion in brainstem causes what?
causes “crossed syndrome”
ipsilateral dysfxn of CN
contralateral hemiparesis and/or hemisensory loss
what causes memory formation?
long-term potentiation
NT deficiency in alzheimers
Acetylcholine
NT deficiency in epilepsy
GABA
NT deficiency in parkinsons
dopamine
NT deficiency in migraine
serotonin
What muscle weakness causes a foot drop?
tibialis anterior muscle
what lesion causes a foot drop?
Common peroneal nerve
Or L5
Which portion of the face is paralyzed in Bells palsy? What nerve is damaged?
entire face
lower motor neuron of CN VII
what portion of the face is paralyzed with UMN of CN VII? Why?
Lower face because the upper face is innervated by bilateral CN VII
What causes a dilated or “blown” pupil?
compression of CN III by aneurysm or brain herniation
Which type of hydrocephalus is a medical emergency?
non-communicating hydrocephalus because increased ICP
How do you diagnose myopathies?
- CK
- EMG
- muscle biopsy
what is the most common muscular dystrophy in adults?
myotonic dystrophy
What structure is impaired in lamert-eaton myastenic syndrome?
pre-synaptic voltage gated calcium channels
what is myotonia?
delayed relaxation after muscle contraction
What does muscle disease show on EMG?
full contraction with short, small, motor units
what does nerve disease show on EMG?
dropout and reduction in muscle contraction
prolonged, large motor units
most common causes of peripheral neuropathy
diabetes and alcoholism
most common cause of motor neuropathy
guillan-barre
what is the most common overlooked cause of peripheral neuropathy?
genetic
spinal fluid of guillan barre?
high protein and low cell counts (normal)
most common motor neuron disease
ALS
indications for surgery in patient with radiculopathy
- intractable pain
- progressive motor weakness or sensory deficits
- symptoms refractory to reasonable degree of nonoperative therapy
What is neurogenic claudication (psuedoclaudication)
bilateral, asymmetric lower extremity pain that is provoked by walking, better with rest
what is spinal shock?
sudden damage to spinal cord leading to temporary flaccid paralysis, hyporeflexia, sensory loss, loss of bladder tone
Occlusion of what artery causes anterior spinal artery syndrome
Adamkiewicz
What are the findings of ASA syndrome?
- bilateral weakness
- loss of pain and temperature and hyperreflexia below lesion
- preserved dorsal column functions (position and vibration)
findings in cauda equina syndrome?
- weakness and sensory loss in lower extremities
- prominent radicular pain
- saddle anesthesia
- urinary incontinence
Triad of Meniere’s disease
- episodic vertigo
- tinnitus
- hearing loss
What causes of meniere’s disease?
- increased endolymph in scala media
- hair cells degenerate in the macula and vestibule
Where is the blood supply of the brain stem derived?
vertebrobasilar system of posterior circulation
What are the 2 causes of coma?
- process affecting reticular activating system in brain stem
- process affecting both cerebral hemispheres simultaneously
What is the most valuable treatment in parkinsons disease?
Sinemet (levodopa)
Whats the most common cause of tremor?
essential tremor
What is the most common form of focal dystonia?
torticollis
What is the treatment of most focal dystonia?
botulinum toxin
What are the cardinal symptoms of autonomic insufficiency?
- orthostatic hypotension
- bowel and bladder dysfunction
- impotence
- sweating abnormalities
what is syncope most commonly caused by?
cardiac problems, not neurologic
What does the diagnosis of MS require?
- two separate symptoms and two different time
- lesions disseminated in space and time
What is status epilepticus?
seizures that persist or recur without regaining consciousness
When do you need to stop status epilepticus?
within 1 hour of onset
How do you diagnose vascular dementia?
can’t use just MRI or CT scan alone, you also need a clinical picture of cerebral ischemia
What is the technical word for sleep lab testing?
polysomnographic evaluation
classic tetrad of narcolepsy
- excessive daytime sleepiness
- cataplexy
- sleep paralysis
- hypnagogic hallucinations
What are the most common primary brain tumors?
glioma
what is the most common spinal cord tumor?
astrocytoma
how much more common are metastatic brain tumors compared to primary?
10 times more likely
what is the treatment of spinal mets?
radiation
what is dysarthria?
defect in the way speech sounds
what is aphasia?
defect in the use of language
what is the most common sporadic encephalitis?
herpes simplex
first line treatment for acute migraines
triptans
best treatment for tension headache
amitriptyline + NSAID
What is normal adult EEG with eyes closed?
9-11 cycles/sec in occipital lobes
this is called the alpha rhythm
what are the 4 types of strokes?
- thrombotic
- embolic
- lacunar
- hemorrhagic
what are the most important modifiable risk factors for stroke?
- HTN
- smoking
- heart disease
- hyperlipidemia
- hyperhomocysteinemia
When do you do surgery on patients with symptomatic stroke?
70% stenosis or more in internal carotid arteries
most important complications of SAH
- rebleeding
- vasospastic ischemia
- hydrocephalus
- sz
- SIADH
what should you do for all partial seizures?
evaluate with MRI
when should you send someone to an epilepsy evaluation center?
when a patient fails 2 drug treatments
Broca aphasia
impaired comprehension, repetition, naming, and speech output d/t left frontal lobe lesion
Wernicke aphasia
fluent speech full of nonsense words and phrases d/t L temporal lesion
what is the drug most often recommended by neurologists?
acetaminophen
