Whaba 2 Electric Boogaloo Flashcards
1
Q
Anterior ischemic optic neuritis clot where
A
Posterior ciliar arteries
Altitudinal defect
Temporal arterities
2
Q
Central retinal artery occlusion ophthalmic exam
A
Cherry red macular
3
Q
NMO tx
A
Plasma exchange, IVIG, steroids
eyes + loss of bladder control
4
Q
First line open angle glaucoma tx
A
Latanoprost
5
Q
Age related macular degeneration tx
A
VEGF inhibitor
6
Q
optic neuritis ophthalmic exam
A
Pink/swollen pale optic disk
7
Q
2 things that can compress CN III
A
Brainstem tumor (medial midbrain) or basilar anuerysm
8
Q
SAH w/ congenital aneurysm artery
A
PCOM
9
Q
GCA artery
A
Superficial temporal
10
Q
Why primitive reflexes in FTD
A
Decreased inhibition from impaired frontal lobe
11
Q
Two tauopathies
A
Alzheimers and Pick dz (FTD)
12
Q
Lobes most effective in AD? PET scan?
A
Temporal
PET: Parietotemporal hypoperfusion
13
Q
CEO comes in with cautious gait and forgets things
A
NPH
14
Q
CJD EEG
A
1 Hz triphasic waves
15
Q
Neurosyphilis features
A
Forgetfulness, personality change, dysarthria, intention tremor
16
Q
Big 3 of PD
A
Unilateral resting tremor
Bradykinesia
Cog wheeling rigidity
17
Q
Amantadine AE
A
Ankle edema, lived reticularis
18
Q
PD for younger than 65
A
Ropinerole or pramiprexole (but gradually so no nausea)
19
Q
Hemiplegic gait develops over months-year in what dz
A
Corticobasal ganglionic degeneration
20
Q
Can’t look where in progressive supranuclar palsy
A
Down
Also has cervical dystonia
21
Q
Fast/Abrupt rapidly deteriorating PD
A
Striatonigral degeneration
22
Q
Vascular PD involves what more than PD
A
Gait and lower extremities
23
Q
MSA features
A
Low BP, AUTONOMIC DYSFUNCTION, gait tremor
HOT CROSS BUN ON MRI
Autonomic failure with BP bedridden, pacemaker
24
Q
Serum Cu and Ceruplasmin in Wilsons
A
Low
PANDA FACE ON MRI
25
WK triad
Acute confusion, ophthalmoplegia/nystagmus, truncal ataxia
26
NO abuse/tox can cause
B12 def
27
B12 def S/S
Distal symmetric sensory loss
Weakness, may seen UMN signs
Optic neuropathy
Isolated cerebellar ataxia
28
B6 tox
Destruction of DRG, pain and numbness, motor neuropathy (prolonged F waves)
29
CU def can be caused by? MCC? Features?
Zinc tox (inhibits intestinal Cu absorption)
MCC is GI surgery
Sensory ataxia, myelodysplasia
Menkes --> genetic Cu def
30
What kind of amnesia keeps knowledge of personal identity
Transient global amnesia
31
Ankle jerk w/ what nerve root
S1
32
CMT 1 dx
1. Slowing of nerve conduction
2. Histology of segmental demyelination
3. Hypertrophy
4. PMP-22 AD
33
Superior gluteal nerve motions
Hip abduction
| Leg internal rotation
34
Why EMG vs MRI for some foot drop
To dx L5 radiculopathy vs common fibular etiology
35
Slow SNAP across fibular head in foot drop
Indicates common fibular entrapment
36
Sural N SNAP absent in foot drop
Probably sciatic N
37
Normal SNAP in foot drop
Lesion is root only
| Pseudo unipolar neuron --> root lesion leaves cell body intact
38
Acute foot drop mgmt
Admit to hospital, consult neurosurg, STAT imaging, steroids until surgery
39
When can you only find one white matter lesion on MRI to dx MS
In correct clinical context
40
MS tx
CRAP: Copaxone, Rebif (IFN B-1a), Avonex, Beaseron
| Natalizumab w/ more relapses
41
MS patient on Natalizumab, what do you worry about? features and tx?
PML --> Will see diffuse new hyper intensity of MRI
| Do ELISA for JC --> if Pos give Natalizumab for 1 year, If neg repeat ELISA every 6 months and continue Natalizumab
42
Posterior Interosseous nerve contrapment
NO SENSORY LOSS
Finger drop only
Wrist will extend with radial deviation
43
Cubital tunnel syndrome
Ulnar nerve and medial edge of elbow
| Weakness in hypothenar
44
Pan coast tumor will hit what chord first
Medial cord
45
Any tingling or numbness above wrist is what part of brachial plexus
Root or cord
46
What brainstem lesions cause horners
Glioma, infarction, syringobulbia
47
What cervical chord lesions can cause horners
Glioma, syringomyelia
48
SNS fibers to eye original where
Hypothalamus
49
DMD locaton
Xp21
50
What kills people with BMD
Heart failure (40-50 years old)
51
Friedrichs ataxia presentation
Spinocerebellar, Post columns, pyramidal tracts --> Gait ataxia, falls, dysarthria
*Concentric HCM*
52
Glucoroticoid induced myopathy features
Proximal muscle weakness/atrophy w/out pain/tenderness
| CK and ESR normal
53
Look for what with polymyositis
Vasculitis
| *High CK levels*
54
ALS can have what associated dz
Frontotemporal dementia
55
What is primary lateral sclerosis
Only LMN stuff
| No upper motor neuron signs
56
Signs and symptoms suggesting viral etiology of acute myelopathy
Weakness and sensory loss at level below lesions
Autonomic dysfunction
*NO STEROIDS IF VIRAL CAUSE*
57
MCC of transverse myelitis
Viruses
58
Hypertension of neck in elderly
Central chord syndrome
59
Motor weakness is cauda equine vs conus medullaris
Asymmetric in cauda
| Symmetric in conus
60
2 big diff for old man unable to climb stairs
LE vs Disc herniation (would have low back pain)
61
Bulbar involvement in GB will show
Diplopia, drooling, dysphagia
62
EMG of GB
Can be totally placid with normal nerve conduction in first few days, then only patchy nerve function
63
25% of GB will have what Ab
Anti-ganglioside
64
MF variant of GB
Ataxia + ophthalmoplegia + Areflexia (AOA)
| Little muscle weakness in limbs
65
CMAP in Botulism? Tx? AE?
Small CMAP in response to supramaximal stimulus
| Tx is Trivalent antitoxin (but can cause anaphylaxis)
66
CIPD features
```
Gradual progressive weakness
Areflexia
Increased CSF protein
NCD showing demyelination
Stocking glove pattern
(GAINS)
```
67
Why prolonged F wave latency in CIPD
Attack on myelin
*Motor nerve is stimulated distally, then travels retrograde back to anterior horn cell body, then back to starting point*
68
What presents like ALS but can be treated with IVIG
Multifocal motor neuropathy
69
MG ages
Women in 30s
| Men in 60s
70
What kind of MS is likely to be seronegative
Purely oculomotor
71
MS drugs
Pyridostigmine (Ach Inhibitor)
Azathioprine
Thymectomy
72
2 things for very weak and intubated MS patients
Atropine to minimize secretions
| Beta2 agonists to minimize bronchospasm
73
MG crisis tx
Plasmapheresis or IVIG
74
LE drug
Guanidine HCL (inhibits mitocondrial Ca uptake --> increases Ach release)
75
EEG of juvenile myoclonic epilepsy
4-6 Hz polyspike and wave
76
Multiple seizures and impaired cognition in kids
Lennox-Gaustaut
77
DOC for partial seizures
Phenytoin
78
Phenytoin tox
Direction changing nystagmus, yellow vision
| *interacts with Valproic acid*
79
Why naloxone in status epilepticus
Stimulates respiratory centers
80
No LP for what ED pt's with seizure
Baclofen withdrawal
| EtOH OD/abuse
81
EEG of HSV
Triphasic waves --> severe slowing over temporal lobes
82
CHADS
CHF, HTN, Age > 75, DM, prior Stroke
83
Migraine pathophys
Cortical spreading depression --> activation of trigeminal nucleus caudal and brainstem PS efferent projections
84
Cluster headache ppx? tx?
ppx: Verapamil, Lithium
tx: SubQ sumatriptan
85
What is paroxysmal hemicrainia
Like cluster, but in women with 10-30 min duration, and greater frequency
Tx Indomethacin
86
What provokes glossopharyngeal neuralgia
Swallowing, talking, yawing, or coughing
87
Postpartum headache + seziure
Venous sinus thrombosis
88
Medulloblastoma features
Small round blue cells
89
Ependymoma MRI
"Cauliflower" sticking out of 4th ventricle
90
If you diagnose meningioma in female, check what
Mammogram
91
what is Parinaud syndrome
Vertical eye movement impaired, pseudo AR pupil, convergence retraction nystagmus
92
Extra-axial posterior fossa tumors
Chordoma, Meningioma, NF
93
Most common CPA tumor
Acoustic Neuroma
94
Tinnitus with what inner ear infection
Labrynthitis
95
If epidural in posterior fossa, think what
Venous sinus tear vs MCA
96
What is Kernohan's Notch phenomenon
Uncle hertiaion compression CNIII, false localizing sign from subdural hematoma
97
Aneurysmal bleeding: blood will be restricted to where
Basal cisterns
98
HTN aneurysms where
BG, cerebellum, thalamus, PNS
99
Basal ganglia hemorrhage featuers
Contra hemiparesis, hemisensory loss
| Homonymous hemianopsia
100
Thalamic stroke eye featurs
Nonreactive miotic pupils
| Eyes deviate way from hemiparesis
101
pontine hemorrhage features
Deep coma and total paralysis w/in minutes
| Pinpoint reactive pupils
102
How does uncal herniation cause coma
Compression of reticular formation
103
Some big TPA contra
```
Stroke or head trauma w/in 1 month
Current bleed
BP > 185/110
Recent arterial puncture at non-compressive site
Platelets
```
104
Superior MCA features
Sensory and motor (face, arm > legs)
Contra gaze paresis
Brocas
105
Inferior MCA features
Optic radiations --> contra homonymous hemianopia
Wernickes
Poss behavioral changes if on non-dom side
106
MCA main stem stroke on dom side can cause
Global aphasia
107
When can you get a bilateral ACA infarct
Incomplete circle of willis
108
Ipsilateral blindness from what stroke
Central retinal branch of ophthalmic artery
109
MCA-ACA border zone stroke
Proximal arm and leg weakness with sparing of face
110
Trouble initiating spontaneous speech with what stroke
ACA
111
PCA stroke
Central homonymous hemianopia (with macular sparing)
112
SCA stroke
Ipsilateral truncal/gait ataxia
Dysarthria
Ipsilateral arm dysmetria
Nystagmus (fast phase towards lesion)
113
Pure motor stroke where
Posterior limb of internal capsule
| *No sensory loss and face and arms equally affected
114
Pure sensory hemiparesis
Ventroposterolateral nucleus of the pons
115
What is Dejerine-Roussy syndrome
Complication of thalamic infarction with severe intractable pain and allodynia
Tx w/ Gabapentin or TCAs
116
Sensory and motor loss with nothing else
Paramedian penetrating branches of basilar artery supplying pons (internal capsule and adjacent pons)
117
Dysarthria-Clumsy hand syndrome
Basis pontis stroke
118
CN3 palsy with cerebellar ataxia and tremor
Benedikt syndrome
119
Venous infarcts on MRI
Will look ragged (follow girl) and will have associated bleeding
Will not be wedge shaped like arterial
120
Predispositions to superior saggital sinus thrombosis
Pregnancy, OCPs, dehydration,sickle cell
| Inc ICP, seizures, clot in entire sinues
121
What do you look for with lateral sinus thrombosis
Mastoiditis/otitis
122
Dysarthria vs Broca's
Can write with dysarthira
123
What supplies Broca's area
Superior division of MCA
124
Conduction aphasia caused by
Damage to arcuate fasiculus of supra marginal gyrus
125
Anti HA of Traditional anti-psych
Histamine, adrenergic, muscarenic
| Weight gain, inc liver enzymes, rash, photosens
126
What is missing in serotonin syndrome
Fever
127
4 features of narcolepsy
Excessive daytime sleepiness, Cataplexy, Sleep paralysis, Hypnagogic hallucinations
*Low hypocretin in CSF*
128
Narcolepsy drug
Modafinil
129
Cerebellar tremor featurs
Increases steadily as hand reaches target
130
Psychologic tremors worse with
Movement
| *Not visible under normal circumstances*
