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Neurology > UWorld > Flashcards

UWorld Flashcards

1
Q

Absence - post seizure finding

A

automatisms

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2
Q

Marfan syndrome vs homocysturia

A

Both: joint+skin hyperlaxity, tall, pectus deformity
Marfan: aortic root dilitation
Homocysturia: intellectual disability, thrombosis

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3
Q

TBI pts - most common morbidity

A

Diffuse axonal damage at gray-white junction

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4
Q

Myotonic dystrophy vs Duchenne and Becker

A

MD - Autosomal dominant, testicular atrophy, balding

D/B - X-linked Recessive

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5
Q

Aminoglycoside toxicity

A
  • hearing problems
  • VOR can elicit vestibular problems from gentamicin
  • pts can get oscillopsia (see objects moving around vision)
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6
Q

lacunar stroke

A

provides blood to deep brain structures (ex: subcortical, lenticulostriae)

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7
Q

Peripheral nerve compression can have intermittent symptoms

A

Peripheral nerve compression can have intermittent symptoms

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8
Q

Pronator drift vs Romberg

A
  • Palms up, if pronation occurs =
  • UMN sign in pyramidal/corticospinal tracts

Romberg: stand with eyes closed, this tests posterior tracks and proprioception

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9
Q

Absence seizure comorbidities

A

ADHD, anxiety

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10
Q

Status epilepticus/continuous brain seizing - Cx

A

cortical laminar necrosis - due to chronic excitatory toxicity, leads to chronic neurologic deficits and more seizures

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11
Q

Traumatic carotid injuries (internal carotid)

A
  • sports, falls with toothbrush in mouth

- Sx: gradual oneste hemiplegia, aphasia, neck pain, “thunder-clap” headache

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12
Q

“curtain descending over visual field”

A

amaurosis fugax - retinal ischemia from atherosclerotic emboli from ipsilateral carotid artery. Get a neck Doppler! (ICA)

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13
Q

NF 1

A
  • Auto-Dom
  • Café-au-lait spots
  • optic glioma
  • neurofibroma
  • lisch nodules
  • freckles (axillary, inguinal)
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14
Q

Multi-infarct dementia
vs
AD

A

Multi-infarct dementia = abrupt, step-wise deterioration in memory, strokes accumulate. *exec function worse than memory eary

AD = memory worse initially. poor speech = difficulty finding words. cognitive decline. Late findings: Neuropsych, lack of insight, non-cognitive neuro deficits: seizure, clonus

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15
Q

Most common causes of syringomyelia:

A
  • old spinal cord injuries, Arnold Chiari malformations

- symptoms develops months-years after initial injury and onset is gradual (why see hand muscle wasting)

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16
Q

cervical spondylosis

A
  • degenerative changes over the age of 40
  • neck pain and stiffness are most common Sx
  • may develop spinal stenosis –> neurologic deficits
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17
Q

Posterior cord vs
Central cord vs
Anterior cord syndromes

A

Posterior cord - posterior columns/vibration/proprioception

Central anterior spinal cord - hyper extension injuries in elderly, or prior degeneration of cervical spine… results in corticospinal tracts for upper extremities, lateral spinothalamic tracts (legs would be fine)

Anterior cord - bilateral motor spastic paresis distal to the lesion (anterior spinal artery)

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18
Q

Trihexyphenydil can cause acute angle-closure glaucoma

A

bc is an anti-cholinergic

19
Q 
Brain tumors and differentiations:
craniopharyngioma
ependymoma
glioblastoma
medulloblastoma
neuroblastoma
pilocytic astrocytoma
A

craniopharyngioma - bitemporal hemianopsia
ependymoma - 4th ventricle, supratentorial
glioblastoma - cerebral hemispheres, seizures
medulloblastoma - cerebellar vermis, infratentorial
neuroblastoma - symp ganglion cells, from abd mass
pilocytic astrocytoma - #1 child tumor

20
Q

anterior vs posterior tumor locations

A

anterior - seizure, weakness, sensory changes

posterior - cerebellar dysfunction

21
Q

AD vs Vascular Dementia

A

AD - early short term memory loss, late personality changes

Vascular Dementia - step wise decline. abrupt decline in exec function. objective neurologic deficits (left hemiparesis, Romberg sign, pronator drift –> may suggest ischemic stroke on top of vascular dementia)

22
Q

Cerebral Palsy - Risk factors, Sx/Comorbidites

A
  • Prenatal brain insults before 32 weeks gestation (most important factor–many things cause insults)
  • spastic diplegia is commonly seen in toddlers (no leg use, use arms to crawl instead)
  • Intellectual disability, epilepsy, strabismus, scoliosis
23
Q

Intraparenchymal hemorrhage -locations, desc order

A
  • basal ganglia (putamen)(contralat hemiparesis/sensory loss, gaze preference)
  • cerebellar nuclei (NO HEMIPARESIS!)
  • thalamus (contra hemiparesis, eyes deviate towards)
  • pons (Pinpoint* reactive pupils)
  • cerebral cortex (Sx depends on location)

-gradual onset Sx (min-hr)

24
Q

Intraparenchymal hemorrhage vs embolic stroke

A

Intraparenchymal hemorrhage = will have focal findings that then progress to show increased ICP (vomiting)

Embolic stroke - abrupt and Sx are maximal from the start

25
Q

neurogenic claudication vs cauda equine vs vascular claudication/PVD

A
  • neurogenic claudication = spinal stensosis, secondary to DJD –> worse Sx by spinal extension, relived by flexion (going uphill) still painful when standing still
  • cauda equine syndrome = saddle anesthesia, ANS sx
  • vascular claudication/PVD = worsened by walking, relived by standing still
26
Q

Greatest CVA risk factor

A

-having HTN (not sedentary lifestyle or Fhx)

27
Q

DiGeorge Syndrome - mnuemonic + neuro risk

A
  • thymic aplasia (T cell deficiency)
  • hypocalcemia (no parathyroid development)
  • tetralogy of Fallot (PROVe)
  • neuro risk: from recurrent sinusitis -> brain abscess (triad: fever, nocturnal/morning headaches, neurologic findings)
28
Q

Pseudo dementia and MDD

A

Pseudo dementia and MDD

29
Q

Evaluation head trauma 2-18 yo

A
  • no CT needed if only minor head trauma without other sx (vomiting)
  • otherwise, CT non-con
30
Q

Single vs multiple brain abscesses

A 
Single = direct spread (otitis, sinusitis, dental infection)
multiple = hematogenous spread (endocarditis, osteomyelitis)
31
Q

Most common single brain lesion species

A
  • virdans streptococci, staph aureus
  • direct spread (otitis, sinusitis, dental infection)
  • focal brain lesion: enhancing with central necrosis
32
Q

Subacute Combined Degeneration

A
  • B12 deficiency Cx
  • starts with dorsal/posterior tracts –> dec vib/proprio, then gait
  • Dz progression: cortico-spinal tract degeneration UMNs, spastic paresis, hyperreflexia
  • Other Cx: peripheral neuropathy, memory loss, dementia
33
Q

Example of how uncal herniation can occur

A

MVC -> Epidural hematoma -> uncal herniation -> CN 3 issues/hemiplegia and hemisensory loss

34
Q

Cushin’s Reflex:

A

1 - HTN
2 - Bradycardia
3 - Respiratory depression

35
Q

vasovagal/neuro-mediated syncope vs

orthostatic hypotension

A

vasovagal syncope = prolonged standing, emotional stress, painful stimuli (prodromal Sx: warmth, nausea, diaphoresis)

orthostatic syncope = postural changes

36
Q

MS - CSF

A
  • Nrm opening pressure
  • Nrm cell count (inc T-cell)
  • Nrm total protein (IgG elevated)

Albuminocytologic dissociation = in GBS

37
Q

Work up for distribution of weakness and numbness

A
  • start with distribution
  • localize by muscle or reflex
  • localize further by dermatomal distribution
38
Q

Viral meningitis CSF -odd finding

A

protein is <100

39
Q

Tx for pseduotumor cerebri / IIH

A

Tx = Acetazolamide (inhibits CSF production via choroid plexus carbonic anhydrase) +/- furosemide

(TX IS NOT MANNITOL!)(Mannitol is for severely obtunded pts/those with severe cerebral edema)

40
Q

Cushing Reflex

A

HTN, bradycardia, respiratory depression –> concerning for brainstem compression

41
Q

Intracranial HTN (pseudo tumor cerebri)

A
  • Sx: can be HA, mental status changes, blurred vision
  • PEx: +/- papilledema
  • Tx: weight loss / acetazolamide
42
Q

Wernicke Encephalopathy vs alcohol cerebellar degeneration

A
  • due to Thiamine deficiency-neuronal loss
  • Sx: gait ataxia, oculomotor dysfunction (horizontal nystagmus), encephalopathy
  • alcohol cerebellar degeneration: purkinje damage to cerebellar vermis.
  • Sx: slowly progressive ambulation difficulties (ex: wide-based gait)
43
Q

GTC pt no severe risk factors w/u algo:

A

1 - basic blood tests, check urine drug screen (rule out toxic/metabolic 1st)
2 - then, maybe get MRI for seizure

Neurology (5 decks)

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