2013 Flashcards

Question

Gerstmann syndrome

Answer 1

Destruction to the inferior parietal lobule (dominant (usually left) hemisphere): 1. Dysgraphia 2. Dyscalculia 3. Finger agnosia: inability to distinguish the fingers on the hand 4. Left-right disorientation brain lesions, stroke.

Answer 2

paralysis of the entire right side of the face: the right lower face droops, the patient cannot tightly close the right eye and cannot wrinkle the forehead on the right. inability to abduct the right eye.

Answer 3

1. Suspected intracranial mass lesion. (can hasten incipient transtentorial herniation.) 2. Local infection overlying the site of puncture. 3. Coagulopathy. Clotting-factor deficiencies and thrombocytopenia (platelet count below 50,000/μL 4. Suspected spinal cord mass lesion. (fluid removal can produce a pressure differential above and below the block, which can increase the degree of spinal cord compression)

Answer 4

1. Excessive unaccustomed exercise 2. Crush injuries 3. Muscle infarction 4. Prolonged tonic-clonic convulsions 5. Polymyositis 6. Chronic potassium depletion 7. An acute alcoholic binge 8. Certain viral infections associated with muscle weakness and pain 9. Hyperthermia 10. Metabolic myopathies (eg, muscle glycogen phosphorylase deficiency [McArdle disease]) serum CK elevated myoglobin in urine treatment : severe - dialysis non severe - hydration, monitor potassium levels

Answer 5

פגיעה מוטורית פוקאלית קושי בהתחלת תנועה בריחת שתן ללא בושה!!! סטיית מבט לצד הגידול - אין בעיה בתנועת עקיבה עם העיניים שינוים התנהגותיים הופעת רפלקסים פרימיטיבים - כמו פאלמר מנטל, רוטינג או גראספ פגיעה בברוקה עצבים קרניאלים - 1,2 עצב 2 - foster kenedy - אופטיק אתרופי ופפילאדמה בעין השניה שלא נלחצת על ידי הגידול

Answer 6

combined degeneration of the posterior and lateral columns Onset of subacute combined degeneration is with #DISTAL PARAESTHESIS# and #WEAKNESS# in the extremities (involvement of the hands occurs relatively early), followed by the development of #SPASTIC PARAPERESIS#,with #ATAXIA# from the impairment of postural sensation in the legs. #LHERMITTE SIGN# may be present, and examination reveals a combined posterior column (vibration and joint position sense) and pyramidal deficit in the legs. Plantar responses are extensor, but tendon reflexes may be increased or depressed, depending on the site and severity of the involvement. Signs of cord involvement can be accompanied by centrocecal scotoma or optic atrophy from optic (II) nerve involvement, by behavioral or psychiatric changes (Chapter 4), or by peripheral neuropathy. The neurologic manifestations are often accompanied by #MACROCYTIC ANEMIA# but this is not invariably present.

Answer 7

unilateral chorea . vascular disease in the contralateral subthalamic nucleus

Answer 8

MEMANTINE- NMDA-type glutamate receptor antagonist drug, may produce modest improvement in patients with moderate or severe Alzheimer disease. tacrine, donepezil, rivastigmine, and galantamine, Acetylcholinesterase inhibitors, Antipsychotic drugs, antidepressants, and anxiolytics

Answer 9

weakness and wasting of distal muscles in the limbs, with or without sensory loss; pes cavus and reduced or absent tendon reflexes also occur

Answer 10

Progressive weakness of more than one limb Distal areflexia with proximal areflexia or hyporeflexia #Supportive of diagnosis: Progression for up to 4 weeks Relatively symmetric deficits Mild sensory involvement Cranial nerve (especially VII) involvement Recovery beginning within 4 weeks after progression stops Autonomic dysfunction No fever at onset Increased CSF protein after 1 week CSF white blood cell count ≤10/μL Nerve conduction slowing or block by several weeks

Answer 11

Markedly asymmetric weakness Bowel or bladder dysfunction (at onset or persistent) CSF white blood cell count >50 or PMN count >0/μL Well-demarcated sensory level Excluding diagnosis: Isolated sensory involvement

Answer 12

``` #children and adolescents #streptococcal GAS complication #most common cause of chorea developing acutely in children. #may recur during pregnancy #may be accompanying behavioral changes, #30% of cases there is evidence of cardiac ``` #diagnosis is supported by the presence of other manifestations of rheumatic fever Cerebral MRI or CT findings are usually normal. PET and SPECT studies show reversible basal ganglia hypermetabolism. ``` #treatment : bed rest, sedation, and prophylactic antibiotic therapy - penicillin chorea can be treated with valproic acid, risperidone, corticosteroids may be effective. ```

Answer 13

treatment: Parkinson's disease and restless legs syndrome MOA: dopamine receptor agonis

Answer 14

treatment: mild parkinsonism alone or in combination with an anticholinergic MOA: blockade of NMDA preferring glutamate and muscarinic cholinergic receptors and stimulation of dopamine release.

Answer 15

inhibits dopa decarboxylase, the enzyme responsible for the breakdown of levodopa to its active metabolite, dopamine. does not cross BBB

Answer 16

parkinson | moaB inhibitor

Answer 17

dystonic movements and postures and an absence of other neurologic signs inherited can begin in childhood (340)

2013 Flashcards

(41 cards)