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Neuro Shelf > Week 3 > Flashcards

Week 3 Flashcards

1
Q

when you have an epidural hematoma, what are the signs of an uncal hernation?

A

compression of CN3 (fixed dialated pupil) contralateral lower limb paralysis

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2
Q

what nerve roots are in the femoral nerve

A

L2-L4

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3
Q

where is the sensory of the femoral nerve

A

anterior thigh, medial leg (by the knee), medial leg, knee

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4
Q

what nerve roots is in the pudendal nerve

A

S2-S4

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5
Q

what is transverse myelitis

A

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

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6
Q

how can you treat essential tremor

A

propanolol or primidone

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7
Q

what does an anterior mediastinal mass on Xray mean

A

this always means a thymoma in our case and then you get myasthenia gravisI

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8
Q

what does a glioblastoma look like on imaging

A

it is usually a ring and has a central necrotic core, crosses the corpus callosum!

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9
Q

what neurotransmitter is bad with huntingtons

A

GABA

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10
Q

what vitamin is thiamine

A

B1

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11
Q

what is the drug of choice for parkinsons tremor

A

trihexyphenydil

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12
Q

what is a side effect of late untreated syphillis

A

aortic root disection, tabes dorsalis, argyll robertson pupil

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13
Q

what is the most common primary cancer for brain mets

A

breast and then lung then melanoma

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14
Q

imaging findings of alzheimers disease

A

imaging: diffuse cortical atrophy, atrophy of the hippocampus and basal nucleus of meynert

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15
Q

molecular findings alzhiemers

A

intracellular neurofibrillary tangles (hyperphosphorylated tau), extracellular beta amyloid plaques, nucleus basalis of meynert degeneration so less ACh

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16
Q

imaging frontal temporal dementia

A

“ice pick” gyri atrophy of the frontal and temporal lobes

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17
Q

molecular findings frontal temporal dementia

A

pick bodies –> hyperphosphorylated Tau-43 aggregates positive with silver stain

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18
Q

imaging of progressive supranuclear palsy

A

hummingbird sign: atrophy of the midbrain structures

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19
Q

molecular findings of progressive supranuclear palsy

A

neurofibrillary tangles

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20
Q

clinical findings of progressive supranuclear palsy

A

vertical gaze (esp. downward gaze) palsy, postural instability, frontal lobe changes

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21
Q

parkinsons imaging findings

A

nothing! clinical dx

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22
Q

parkinsons molecular findings

A

lewy bodys (alpha synuclein) dopamine dysfunction (ventral tegmental area and substantia nigra)

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23
Q

huntingtons imaging findings

A

atrophy of the caudate, hydrocephalus ex vacuo

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24
Q

what is the most central park of the cerebellum

A

the vermis! balance, coordination of the trunk etc.

25
Q

manifestation of acute lithium toxicity

A

alterted mental status, tremor, dysarthria, decreased muscle strength, GI symptoms, dehydration (dry mucuous membranes)

26
Q

in weber test where does the sound lateralize if the hearing loss is unilateral sensorineuronal

A

it lateralizes to the good ear

27
Q

first line treatment of juveneille onset epilepsy

A

valproate

28
Q

adverse effect of long term hydroxychloriquine

A

paracentral scotoma

29
Q

what is the pathophys of NPH

A

decreased CSF absorption

30
Q

signs of congenital toxo

A

hydrocephalus, intracranial calcifications, chorioretinitis, petechiae (blueberry muffin rash), lymphadenopathy

31
Q

signs of congenital CMV

A

small for gestational age, petechiae (blueberry muffin rash), sensorineuronal hearing loss, chorioretinitis, seizures

32
Q

what is akathesia

A

motor restlessness

33
Q

define myotonic dystrophy symptoms

A

myotonia: slow relaxation of the muscle once its been contracted, myalgia, distal muscle weakness, high arched palate

34
Q

empiric antibiotics for meningitis in an immunocomprimised patient

A

vanc, amp, cefepime

35
Q

describe erb palsy and what trunk/nerve roots are damaged

A

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

36
Q

what enzyme is missing in tay sachs and is there hepatosplenomeg

A

NO HepatoSplenoMegaly and it is B-hexosaminidase-A

37
Q

is further workup necessary for peripheral nerve palsy (bells palsy)

A

NO!

38
Q

in a patient with a traumatic brain injury what is the most important first thing to do

A

intubate

39
Q

why is there incontinence in NPH

A

inability to suppress the detruser muscle

40
Q

descrie polymyalgia rheumatica

A

fever, weight loss, headache, symmetric shoulder girdle and neck pain worse at night, morning stiffness

41
Q

describe a co-occurent disease of polymyalgia rheumatica

A

giant cell arteritis causing vision loss

42
Q

what do you give a patient with afib for stroke prevention

A

you need to give an anticoagulant so typically rivaroxaban (Eliquis)

43
Q

in men with prolactinomas what symtoms do they usually exhibit vs. women

A

men: erectile dysfunction women: galactorrhea

44
Q

what is the cause of bilateral occipital lobe infarcts

A

cardiac thromboembolism or if during a procedure, systemic hypotension

45
Q

MDMA effect on the brain

A

sympothetic activation and bruxism (grinding of teeth), severe dehydration = hyponatremia

46
Q

main cause of death of friedrich ataxia

A

cardiomyopathy

47
Q

when do you do a carotid endarterectomy

A

> 70% stenosis

48
Q

for everything but spinal mets do you need steroids forst

A

no, just spinal mets give steroids

49
Q

how does optic neuritis present

A

central scotoma, sudden vision loss, blurry vision.

50
Q

what is the most common cause of optic neuritis

A

multiple sclerosis

51
Q

somatization disorder

A

when patients have multiple non-specific complaints and undergo frequent tests that all coem back normal

52
Q

what is psychomotor slowing and is it normal

A

this is decline in executive function, memory impairments, attention span etc. it is normal with aging

53
Q

how do you test for botulinum toxin in a baby

A

stool toxin assay

54
Q

signs of compartment syndrome

A

cold limbs, trauma to the extremity, paresthesias (pain out of proportion to the injury) pulselessness etc.

55
Q

what is a neurological sign of chronic lead exposure

A

distal motor neuropathy. This causes LMN signs (weakness, atrophy arreflexia, etc)

56
Q

what is a surgical intervention for treatment resistant parkinsons

A

pallidotomy –> unilateral removal of the globus pallidus to decrease inhibitory signaling

57
Q

results of caloric testing and what it means

A

COWS. cold water means that the slow phase is toward the cold ear and the fast beat is away from cold ear.

58
Q

What do you need for brain death in terms of caloric results

A

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

Neuro Shelf (8 decks)

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