Week 3 Flashcards
when you have an epidural hematoma, what are the signs of an uncal hernation?
compression of CN3 (fixed dialated pupil) contralateral lower limb paralysis
what nerve roots are in the femoral nerve
L2-L4
where is the sensory of the femoral nerve
anterior thigh, medial leg (by the knee), medial leg, knee
what nerve roots is in the pudendal nerve
S2-S4
what is transverse myelitis
this is when you have more acute demylinating diseases and it is segmental. There is hyperreflexia during the non acute phase, focal lesions on spinal cord
how can you treat essential tremor
propanolol or primidone
what does an anterior mediastinal mass on Xray mean
this always means a thymoma in our case and then you get myasthenia gravisI
what does a glioblastoma look like on imaging
it is usually a ring and has a central necrotic core, crosses the corpus callosum!
what neurotransmitter is bad with huntingtons
GABA
what vitamin is thiamine
B1
what is the drug of choice for parkinsons tremor
trihexyphenydil
what is a side effect of late untreated syphillis
aortic root disection, tabes dorsalis, argyll robertson pupil
what is the most common primary cancer for brain mets
breast and then lung then melanoma
imaging findings of alzheimers disease
imaging: diffuse cortical atrophy, atrophy of the hippocampus and basal nucleus of meynert
molecular findings alzhiemers
intracellular neurofibrillary tangles (hyperphosphorylated tau), extracellular beta amyloid plaques, nucleus basalis of meynert degeneration so less ACh
imaging frontal temporal dementia
“ice pick” gyri atrophy of the frontal and temporal lobes
molecular findings frontal temporal dementia
pick bodies –> hyperphosphorylated Tau-43 aggregates positive with silver stain
imaging of progressive supranuclear palsy
hummingbird sign: atrophy of the midbrain structures
molecular findings of progressive supranuclear palsy
neurofibrillary tangles
clinical findings of progressive supranuclear palsy
vertical gaze (esp. downward gaze) palsy, postural instability, frontal lobe changes
parkinsons imaging findings
nothing! clinical dx
parkinsons molecular findings
lewy bodys (alpha synuclein) dopamine dysfunction (ventral tegmental area and substantia nigra)
huntingtons imaging findings
atrophy of the caudate, hydrocephalus ex vacuo
what is the most central park of the cerebellum
the vermis! balance, coordination of the trunk etc.
manifestation of acute lithium toxicity
alterted mental status, tremor, dysarthria, decreased muscle strength, GI symptoms, dehydration (dry mucuous membranes)
in weber test where does the sound lateralize if the hearing loss is unilateral sensorineuronal
it lateralizes to the good ear
first line treatment of juveneille onset epilepsy
valproate
adverse effect of long term hydroxychloriquine
paracentral scotoma
what is the pathophys of NPH
decreased CSF absorption
signs of congenital toxo
hydrocephalus, intracranial calcifications, chorioretinitis, petechiae (blueberry muffin rash), lymphadenopathy
signs of congenital CMV
small for gestational age, petechiae (blueberry muffin rash), sensorineuronal hearing loss, chorioretinitis, seizures
what is akathesia
motor restlessness
define myotonic dystrophy symptoms
myotonia: slow relaxation of the muscle once its been contracted, myalgia, distal muscle weakness, high arched palate
empiric antibiotics for meningitis in an immunocomprimised patient
vanc, amp, cefepime
describe erb palsy and what trunk/nerve roots are damaged
erb palsy is when the arm is adducted and wrist is flexed because of injury to the musculotaneous nerve (biceps) and axillary nerve (no deltoid). this is bc of injury to the upper trunk so C5 and C6
what enzyme is missing in tay sachs and is there hepatosplenomeg
NO HepatoSplenoMegaly and it is B-hexosaminidase-A
is further workup necessary for peripheral nerve palsy (bells palsy)
NO!
in a patient with a traumatic brain injury what is the most important first thing to do
intubate
why is there incontinence in NPH
inability to suppress the detruser muscle
descrie polymyalgia rheumatica
fever, weight loss, headache, symmetric shoulder girdle and neck pain worse at night, morning stiffness
describe a co-occurent disease of polymyalgia rheumatica
giant cell arteritis causing vision loss
what do you give a patient with afib for stroke prevention
you need to give an anticoagulant so typically rivaroxaban (Eliquis)
in men with prolactinomas what symtoms do they usually exhibit vs. women
men: erectile dysfunction women: galactorrhea
what is the cause of bilateral occipital lobe infarcts
cardiac thromboembolism or if during a procedure, systemic hypotension
MDMA effect on the brain
sympothetic activation and bruxism (grinding of teeth), severe dehydration = hyponatremia
main cause of death of friedrich ataxia
cardiomyopathy
when do you do a carotid endarterectomy
> 70% stenosis
for everything but spinal mets do you need steroids forst
no, just spinal mets give steroids
how does optic neuritis present
central scotoma, sudden vision loss, blurry vision.
what is the most common cause of optic neuritis
multiple sclerosis
somatization disorder
when patients have multiple non-specific complaints and undergo frequent tests that all coem back normal
what is psychomotor slowing and is it normal
this is decline in executive function, memory impairments, attention span etc. it is normal with aging
how do you test for botulinum toxin in a baby
stool toxin assay
signs of compartment syndrome
cold limbs, trauma to the extremity, paresthesias (pain out of proportion to the injury) pulselessness etc.
what is a neurological sign of chronic lead exposure
distal motor neuropathy. This causes LMN signs (weakness, atrophy arreflexia, etc)
what is a surgical intervention for treatment resistant parkinsons
pallidotomy –> unilateral removal of the globus pallidus to decrease inhibitory signaling
results of caloric testing and what it means
COWS. cold water means that the slow phase is toward the cold ear and the fast beat is away from cold ear.
What do you need for brain death in terms of caloric results
no movement at all with cold water. if eyes move slowly towards the cold, this means brainstem function. If they fast beat away from the cold then the cortex is functioning
