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Flashcards in 8. Neurology Deck (91)
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1

Dandy maneuver

(CSF leak)
Hold head below waist for several minutes in sitting position

2

Quadriplegia, anarthria and preserved consciousness

Locked in syndrome (upper brainstem infarction)
Can involve 3rd nerve nucleus

3

Adam triad

NPH triad (apraxia, incontinence, dementia)

4

Failure of ventriculoperitoneal shunting in patients with idiopathic NPH

Likely vascular or Alzheimers

5

Top 3 causes of dementia

Alzheimers, Lewy body, multiinfarct

6

Main differentiating between Alzheimer and LB dementia

Alzheimer: cortical neuritic plaques and neurofibrillary tangles; early impairment in STM; women

LW: preserved memory with impairment in executive fx; parkinsonian/autonomic features; men

7

Pseudobulbar affect

Intermittent emotional expression disorder
Involuntary displays of crying/laughing, typically w/o assoc. of sadness/depression/euphoria

8

What is pseudobulbar assoc with?

MS, ALS, Alzheimers, Huntington, Parkinson, stroke, traumatic brain injury

9

Hearing loss from meniere vs acoustic tumor

Meniere: fluctuates
Tumor: progressive

Brainstem auditory evoked potentials normal in meniere

10

Most common cause of cushing syndrome

Iatrogenic administration of exogenous steroids

11

Classic symptoms of parkinson

resting tremor, cogwheel rigidity, bradykinesia

12

Abduction relief sign

Relief of radicular symptom when shoulder abducted and placing hand ipsilateral to radiculopathy on top of head
Worsening may point to thoracic outlet

13

Baclofen withdrawal

Rebound spasticity, hemodynamic lability, severe hyperthermia, altered mental status, pruritis, diaphoresis, intravascular coagulopathy, rhabdo, multiorgan system failure

14

Early vs late posttraumatic seizure

Early 7 days

15

Status epilepticus definition

>30m continuous seizure or multiple without full recovery of consciousness between seizures

16

Most common cause of status epilepticus

Subtherapeutic antiepileptic drug in known seizure

17

Pharm tx of status epilepticus

IV glucose 50% 50mL, IV thiamine 100mg
Then in order:
Lorazepam 1-2mg/5min up to 9mg (0.1mg/kg)
or
Diazepam 5mg/5min up to 20mg (0.2mg/kg)
Phenytoin loading dose 20mg/kg
Phenobarbital drip loading 20mg/kg
Pentobarbital drip 20mg/kg if seizure does not arrest in 30 min

18

Common causes of changes in mental status/coma

AEIOU TIPS
Alcohol (drugs/toxins)
Endocrine, exocrine, electrolytes
Insulin
Opiates/overdose
Uremia
Trauma, temperature
Infection
Psych
Seizure, stroke, shock, space-occupying lesion

19

Sudden unexpected death in epileptic patient

Seizure-related cardiac arrhythmia

20

Long-term outcome of patient with prolonged refractory status epilepticus?

50% mortality. Only 1/2-2/3 surviving will have functional cognitive status

21

When for hemispherectomy?

Intractable epilepsy in unilateral hemisphere damage
Congenital hemiplegia
Chronic encephalitis
Hemimegalencephaly
Sturge-Weber

22

Sturge-Weber syndrome: port-wine stains in distribution of which cranial nerve?

Trigeminal nerve
(Intracranial findings only in lesions involving first division of trigeminal nerve)

23

Most common type of seizure

Febrile convulsions

24

West syndrome: seizures?

infantile spasms
(+MR and hyparrhythmia on EEG)

25

Tx of infantile spasms

ACTH

26

Aicardi syndrome

Callosal agenesis, ocular abnormalities, infantile spasm

27

Most common cause of complex partial seizures

Mesial temporal lobe epilepsy (70-80% temporal, 65% mesial structures, esp. hippocampus, amygdala, parahippocampal gyrus)

28

Which region of hippocampus is spared in mesial temporal lobe epilepsy?

CA2 subregion and dentate granule cells
(More pronounced in CA1, CA3 and CA4 subregions)

29

Most common agents that cause transplacental infections?

TORCHeS
Toxo, Other agents (HIV), Rubella, CMV, Herpes, Syphilis

30

Most common viral meningitis

Enterovirus (~80%)