UW3 (06 neuro) Flashcards
Concussion
Initial management?
How to return to activity? 3
Rest > 24h
Gradual return to activity
1) Light exercise
2) Non-contact sports
3) Contact sports
Location of brain lesion?
1) Construction apraxia / Dressing apraxia
2) Gerstman (Acalcula, Agraphia, L+R contusion)
3) Homonymous Upper Quadrant Anopia, Auditory Agnosia
4) Language / Aphasia
1) Parietal NonDominant
2) Parietal Dominant
3) Temporal NonDominant
4) Temporal Dominant
Cognitive Impairment Investigation
Labs? 3+4
Study? 1
Imaging? 3
1) CBC / TSH / CMP
Syphilis / Folate / Vit D / B12
2) CSF
3) CT / MRI / EEG
ALS treatment
Riluzole
Resting tremor, improve @ rest
Bradykinesia / Rigidity
Unilateral / Asymmetric
Diagnosis?
Treatment? 4
Parkinson’s disease
1) Ropinirole / Pramipexole
2) Carbidopa / Levodopa
3) Selegeline / Capones
4) DBS
B12 deficiency & Dementia
Diagnosed with subacute combined degeneration
PE findings? 4
1) Vibration ↓
2) Rhomberg ⊕
3) Spastic paresis
4) HyperReflexia
Tuberous Sclerosis
1) CNS findings? 2
2) Cardiac findings?
3) Kidney findings?
4) Mortality causes? 4
1) SubEpendymal tumor / Epilepsy
2) Cardiac RhambdoMyoma
3) Kidney AngioMyoLipoma
4) Epilepsy / Pneumonia / Ependymal tumor / Renal
Tonic clonic seizure
EEG shows PolySpike + Slow wave
Diagnosis?
Treatment?
MyoClonic Eplipsey
Valproate
Medication side effects
1) TCA?
2) Phenytoin? 2
3) OxyCarbazepine? 2
4) Valproate? 3
5) Carbamazepine? 2
1) Arrhythmia / EKG
2) Gingival hyperplasia / Nystagmus
3) SIADH / Na ↓
4) Plt ↓ / LFT ↑ / Pancreatitis
5) Pancytopenia / Agranulocytosis
Dementia (diagnosis)
- Early LT memory ↓
- Language ↓
- Spatial orientation ↓
- Late personality change
- Early executive ↓
- Cerebral infractions
- White matter changes
- Early personality change
- Apathy
- Dis-Inhibition
- Compulsion
- Visual hallucination
- Parkinsonism
- Fluctuating cognition
- Early ataxia
- Urinary incontinence
- Dilated ventricles
- Behavioral changes
- Rapid progression
- MyoClonus / Seizure
- Alzheimer
- Vascular
- FrontoTemporal
- Lewy Body
- NPH
- Prion
Alcoholic with thiamine deficiency
Eye finding in Wernicke encephalopathy?
Imaging finding in Korsakoff?
Lateral rectus palsy
Atrophy @ mamillary body
Brain infarction location
1) Ataxia / CN palsy / Motor ↓ / Sensory ↓
2) Pure motor
3) CN3 palsy = ptosis / Anisocoria
4) Ataxia / Bulbar dysfunction
1) BrainStem Ganglioma
2) Lacunar
3) Post Comm Art
4) Post Inf Cereb Art
Guilian Barre
1) Common Gi cause by microbe?
2) What to do for respiratory concern?
3) Treatment? 2
4) Course?
1) Campylobacter
2) PFT
3) IVIG / Plasma exchange @ non-ambulatory < 4w
4) 2w progression, 2-4w persistence, Slow recovery
Weakness / Sensory ↓
Bladder / Bowel dysfunction
Ataxia
Thoracic spine radicular dermatome
Diagnosis?
Treatment?
Epidural Spinal cord Compression
Dexamethasone
Sarcoidosis presentation
1) Pulmonary? 2
2) Cutaneous?
3) Eye? 3
4) Organ? 3
5) MSK? 2
6) CV? 2
7) CNS/Endo? 2
1) Bilateral hilar adenopathy / Interstitial infiltration
2) Papule / Nodule / Plaque / Erythema nodosum
3) Anterior uveitis (Iridocyclitis / Iritis), Posterior uveitis, KeratoConjunctivitis sicca
4) Peripheral lymphadenopathy / Hepatomegaly / Splenomegaly
5) Acute poly arthritis (ankles) / Chronic arthritis
6) AV block / Cardiomyopathy (Dilated, Restrictive)
7) Facial nerve palsy / Central Dibetes Insipidus
Sarcoidosis
Lab, elevated component? 2
What does biopsy show?
Ca ↑ (serum / urine)
ACE ↑
Non-caseating granuloma
⊝ fungal stain / ⊝ AFB
Headache types
Unilateral / Pulsation / Throb
Nausea / Vomit / Aura / Phobia
Posterior orbit / Sharp
Sweat / Flush / Lacrimation / Rhinorrhea
Band L+R / Dull / Tight / Persist
Tender
Migraine
Cluster
Tension
Epidural abscess
Initial labs? 4
Initial imaging?
Management? 3
CBC / ESR / CRP / BC
MRI
Aspiration (CT)
Antibiotics
Surgery
Tick paralysis symptoms? 5
Fatigue Paresthesia Ascending paralysis Ataxia DTR ∅
Patient with n/v and visual disturbance
Suspected of pseudotumor idiopatyhic ICP
Risks? 3
What to expect on fundoscope? 3
F > M
Overweight
OCP
Papilary (edema, hemorrhage, exuate)
VertebroBasilar Insufficiency
Common location? 2
Symptoms? 4
Labyrinth
Brainstem
Vertigo / Dizziness
Dysarthria
Diplopia
Numbness
Tabes dorsalis due to syphilis
Symptoms? 4
Sensory ataxia
Lancinating pain
Neurogenic urinary incontinence
Argyll Robertson pupil
Sudden monocular blindness
1) Diagnosis?
2) Lesion location?
3) Risk?
1) Amaurosis faugax
2) Ischemia @ retinal artery
3) Carotid artery atherosclerosis
Headache with
Orbit involvement, Unilateral. Ptosis / Miosis / Lacrimation
1) Diagnosis?
2) Prevention?
3) Acute treatment? 2
1) Cluster headache
2) Verapamil / CCB
3) Oxygen / Sumatriptan IN
Multiple Sclerosis
1) Eye problems? 2
2) MRI finding?
3) Lab finding?
4) Acute treatment?
5) Chronic treatment? 2
1) Optic neuritis / InterNuclear Opthalmoplegia
2) Ovoid, PeriVentricular - White matter lesion
3) Oligoclonal IgG ↑
4) Steroid
5) β-Interferon / Glatiramer
Carotid artery dissection
Symptoms?
What image study to do?
Medical Management? 2
Horners (Ptosis / Miosis / Anhidrosis)
Unilateral - Headache / Neckache / Vision ↓
Weakness
CT angio
Thrombolytic < 4h
Aspirin + AntiCoag
Cerebral palsy
1) Muscle PE? 2
2) Neuro PE? 2
3) MRI findings? 2
1) Muscle tone ↑ / spasm
2) HyperReflexia / Clonus
3) PeriVentricular LeukoMalacia / Basal Ganglial lesion
Convulsion
Medication management? 2 (+1)
1) Benzodiazepine
2) Phenytoin / Valproate
3) Midazolam / Phenobarbitol / Propranolol
Child with Starry, unresponsive, normal muscle tone
1) Diagnosis?
2) EEG finding?
3) Association? 3
4) Treatment?
1) Absence seizure
2) 3Hz spike & discharge
3) ADHD / Anxiety / Depression
4) Ethosuximide
Patient with LE weakness, reduced sensory, urinary retention.
Diagnosed with transverse myelitis.
Risk?
URTI
Pituitary prolactinoma
1) Treatment class & 2 med?
2) Effects? 2
1) Dopamine agonist - Bromocriptine / Carbergoline
2) Tumor size ↓ / Vision improve
AnteroLateral thigh Sensation ↓
No atrophy / No weakness / Normal DTR
Diagnosis?
Mechanism?
Treatment? 3
1) Meralgia Paresthetica
2) Lateral Femoral Cutaneous Nerve Entrapment
3) Weight ↓ / Avoid tight clothing / Steroid injection
Bell’s Palsy
Symptoms?
Treatment? 3
Course?
Unilateral: Upper + Lower face
Prednisone x3d
Artificial tear
Eye patch
Spontaneous recovery 1-6m
Involuntary eye closure
Worse @ light / irritant
Diagnosis?
Treatment?
BlepharoSpasm / Dystonia
Botulinum toxin
Blood in CSF.
Associated diagnosis
1) Xanthochromia?
2) RBC > 6k?
1) SAH
2) Traumatic LP
Parinaud’s (pineal tumor)
What causes headache?
4 PE findings?
What causes precocious puberty @ male?
Obstructive Hydrocelphalus
∅ pupillary reaction
Vertical gaze paralysis
∅ Optokinetic Nystagmus
Ataxia
HCG ↑
Opioid withdrawal treatment?
Preferred? 2
Symptomatic? 4
Methadone > Buprenophine
Clonidine / Benzo / Anti-emetic / Anti-diarrheal
Wide gait Imbalance / Fall Cognitive impairment Urinary urgency/inconvenience Depression
1) Diagnosis?
2) Image study finding?
3) Initial management?
4) Long term management?
1) Normal Pressure HydroCephalus
2) CT/MRI = VentriculoMegaly
3) LP = CSF drain
4) VP shunt
WallenBerg / Lateral Medulla
1) Eye symptoms? 2
2) GI issues? 3
3) Motor problem? 3
4) Neuro symptoms? 4
1) Diplopia / H+V nystagmus
2) Dysphagia / Aspiration / Intractable hiccups
3) Hoarseness / Dysarthria / Dysphonia
4) Vertigo / Ipsilateral Ataxia / Facial paresthesia & pain / Ipsilateral Horner
Narcolepsy
1) Criteria?
2) EEG finding?
3) Lab/CSF finding?
4) Initial management?
5) Medication management? 3 + 3 + 1
1) Recurrent slee/nap > 3day for >3/w /3m
2) Rem latency < 15m
3) Hypocretin-1 ↓ @ CSF
4) PolySomnogram
5) Modafamil > Amphetamine / Methylphenidate
SNRI / SSRI / TCA
Sodium Oxybate
Caloric Vestibular test
Normal response?
1) Cold water
2) Conjugate slow deviation to ipsilateral
3) Saccadic correction to midline
