Flashcards in Exam 1 Deck (241):
Is horizontal or vertical nystagmus more often pathological?
Does a cortical stroke affect the frontalis muscle?
Which grade is muscle strength against only gravity?
What is the only toe that matters for Babinski?
What does a crossed brainstem injury mean?
sensory on one side and motor on the other
Prominent dysarthria could manifest as a lesion where in the CNS?
What two systems get involved with a myelopathy?
bladder and bowel
When would a person with M.G. feel stronger?
Does a neuropathy effect proximal or distal vessels?
Does a myopathy effect proximal or distal vessels?
Do both or one hemisphere have to be affected to cause coma?
Is the Reticular Activating System in the anterior or posterior pons?
The neurological exam in a comatose patient is designed to evaluate what?
Respiration requires what two parts of the CNS to be intact?
forebrain and brainstem
What is the rate during central neurogenic breathing?
Is Cheyne-Stokes a problem in the brainstem?
What do the pupils look like with a thalamic stroke?
small but reactive
What do the pupils look like with a midbrain stroke?
midposition and fixed
What do the pupils look like with a pontine stroke?
pinpoint but reactive
What do the pupils look like with an uncal stroke?
dilated and UNSYMMETRIC and fixed
Do the eyes move towards or away during cold water during caloric testing?
Do the eyes move towards or away during warm water during caloric testing?
Does decorticate posturing cause flexion or extension of the upper extremities?
Does decorticate posturing cause flexion or extension of the lower extremities?
Lesions causing decorticate posturing occuring above what brainsteam structure?
Does decerebrate posturing cause flexion or extension of all extremities?
In what two structures does cerebrate posturing occur?
midbrain or pons
A headache caused by what could wake a person up at night?
Progressive frequency and duration is indicative of what type of headache caused by what?
Perform what procedure if the CT is negative for blood during an SAH?
A meningitis headache is similar to what other type of headache?
When does a post-LP headche go away?
when patient lies down
Bilateral trigeminal neuralgia is specific for what disease?
What does CADASIL stand for?
cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy
What does HaNDL stand for?
headache with neurological deficit and lymphocytosis
What is a better imaging modality for headache, CT or MRI?
What is a better imaging modality for bleeding, CT or MRI?
What are the four criteria that a patient needs two of to be Dx with Migraine?
worsened by movement
What are the three criteria that a patient needs one of to be Dx with Migraine?
What are the three substances implicated in Migraine?
Pain in the neck can be indicative of what type of headache?
Is chronic sinusitis a cause of headache?
Which two receptors do Triptans target? Inhibit the release of what?
5HT1B and 5HT1D
How many weeks may it take for migraine prophylaxis to become effective?
8 to 12 weeks
What are three choices for symptom relief of cluster headaches?
10-15 L of oxygen
What class of meds are cluster headaches bridged with? Before being treated with?
What is the drug for paroxysmal hemicrania?
What is the most common risk factor for daily chronic headaches? How many days per month?
acute use of daily meds
Is jerk nystagmus pathological or physiological?
Is pendular nystagmus pathological or physiological?
Does peripheral or central jerk nystagmus have latentcy?
Does peripheral or central jerk nystagmus adapt?
Does peripheral or central jerk nystagmus fatigue?
Which two pathways proximally feed into the Medial Geniculate Nucleus?
Which part of the brainstem is the olive in?
Which part of the brainstem is the olive inferior colliculus?
When does peripheral vertigo occur?
Which type of vertigo occurs with movement and rest?
What two structures compose the meninges?
pia and arachnoid
What is meningoencephalitis?
inflammation of brain and meninges
What is myelitis?
inflammation of spinal cord
What is Kernigs Sign?
resistance to passive extension of the knee
What is Brudzinskis sign?
flexion of hips and knees when neck is extended
Does S. penumo cause meningitis in adults or young adults?
Does Neisseria cause meningitis in adults or young adults?
Would imaging precede LP with new onset seizure?
Would imaging precede LP with immunocompromised?
Would imaging precede LP with focal findings?
Would imaging precede LP with decreased level of consciousness?
What do steroids decrease during bacterial meningitis?
What is the most common type of meningitis?
What type of tick carries Lyme?
What is the imaging modality of chronic meningitis?
MRI with contrast
What infectious disease has caused an increase in CNS TB?
What specific structure is threatened during CNS TB?
Which immune cell is present during TB Meningitis?
Which aminoglycoside can be used for TB?
Which protein is elevated during CJD?
Which specific lobe houses semantic memory?
Which circuit becomes disrupted during Amnesia?
Which lobe does Herpes start in?
Does Gertsman Syndrome occur in the dominant or non-dominant lobe? Which lobe? Which specific area?
Which lobe would cause neglect? Dominant or non-dominant?
What is Anosagnosia? Which lobe?
defect of self-awareness
What is Apraxia?
inability to perform learned purposeful movements
What is Prosopagnosia? Where is the lesion?
inability to recognize known faces
What does visual agnosia occur?
Does Broca's Aphasia occur in the dominant or non-dominant frontal lobe?
Which two areas are considered Subcortical?
basal ganglia and white matter
Is prosopagnosia unilateral or bilateral?
Which lobe does apraxia occur?
Which lobe does Alzheimers originally manifest?
Which protein is found in Lewy Body Dementia?
Which protein is found in Fronto-Temporal Dementia?
What is the imaging modality of choice for dementia?
Which drug can decrease the absorption of B12?
Which ApoE molecule carries an increased risk of dementia?
Is amyloid intracellular or extracellular?
Is Tau intracellular or extracellular?
Which chromosome is ApoE4 on?
What is the most under diagnosed form of dementia?
What type of dementia would a REM sleep disorder be indicative of?
What gene may be affected during Vascular Dementia?
What are the three AchE Inhibitors used to treat alzheimers?
What vitamin for Alzheimers?
Which atypical antipsychotic for dementia related psychosis?
How many seizures need to manifest to diagnose epilepsy?
Where do generalized seizures come from?
Where do partial seizures come from?
Is consciousness lost during a simple partial seizure?
Is consciousness lost during a complex partial seizure?
What can provoke an absence seizure?
What is the pattern of Absence Seizure on EEG?
3 Hz spike and slow wave discharge
What two drugs if ethosuximide fails?
valproate or lamotrigine
What characterizes a rolandic seizure?
How are the extremities affected during a Rolandic seizure?
In what two situations does a Rolandic seizure precipitate?
during sleep or awakening
What does a Rolandic seizure look like on EEG?
Is rolandic seizuring normal or abnormal?
What are the two drugs of Rolandic seizuring?
carbamazepine or oxacarbamazepine
What type of movements does Juvenile Myoclonic Epilepsy manifest with? Progress to?
grand mal seizures
What is the EEG of Juvenile Myoclonic Epilepsy?
3-6 Hz polyspikes and waves
What is the drug of choice for Juvenile Myoclonic Epilepsy?
Dont use valproate for what age group during Juvenile Myoclonic Epilepsy?
What two drugs if valproate fails for Juvenile Myoclonic Epilepsy?
What is the most common seizure in kids?
Is a Simple Febrile Seizure generalized or partial?
How long must a Simple Febrile Seizure last less than?
How often can a Simple Febrile Seizure occur in 24 hours?
Which two vacciantions can cause a Complex Febrile Seizure?
MMR and TDP
LP should be initiated for kids with a febrile seizure if they havent been vaccinated for which two bugs?
Strep. pneumo and HiB
What family of drugs are used to ablate a Simple Febrile Seizure? If the seizure lasts longer than?
What is infantile spasm considered?
severe epileptic encephalopathy
What can Infantile Spasm occur in?
What is the most common cause of Infantile Spasm?
What does the EEG look like during Infantile Spasm?
Drug of choice for Infantile Spasm?
Drug of choice for Tuberous Sclerosis?
What is the EEG of Lennox Gastaut Syndrome?
less than 2.5 spike and slow wave
Two drugs of choice for Infantile Seizure?
How can a jitter be differentiated from a seizure?
holding a limb wont stop a seizure movement
What is present in the CSF during GBS?
What is the most sensitive and specific test for GBS?
nerve conduction study
Two drugs for GBS?
IVIG and plasmapharesis
What is the mode of inheritance for DMD?
What is the most common cause of death during GBS?
What two drugs may slow the progression of DMD?
prednisolone and deflazacort
What are the three most common causes of ataxia in kids?
post-infectious cerebellar ataxia
What brain imaging modality is needed to rule out infectious etiology of ataxia in kids?
Does ataxia in kids spontaneously resolve?
What type of injury is concusion?
diffuse axonal injury
WHat ions can be implicated in concussion?
potassium and calcium
Excess of what neurotransmitter may be implicated in concussion? Causing increase flux in which ion?
Does the brain require more or less glucose during a concussion?
What happens to cerebral perfusion during concussion?
What happens to oxidative metabolism during concussion?
Which two genes for concussion?
ApoE and Tau
What is the only agreed upon risk factor for concussion?
Which lobe is most likely to be affected during concussion?
What is the leading cause of death regarding head injury?
Which type of cerebral hemorrhage shows xanthochromia?
Which two lobes are most affected by Intracerebral Hemorrhage?
frontal and temporal
What is the most important step to initially evaluate in concussion?
Is the helmet removed in football?
Is the helmet removed in hockey?
What cerebellar test on the sideline?
Do symptoms get better or worse with head injury over time?
Use who to corroborate a patients concussion symptoms?
What is the standard of care for concussion management?
physical and cognitive rest until symptoms resolve
Which two OTC anto-inflammatories are contraindicated during concussion healing? Why?
aspirin and NSAIDs
Does second impact syndrome occur in mature or immature brains?
Which group of meds may help during 'post-concussion' syndrome?
Do helmets prevent concussion?
Do mouth guards prevent concussion?
Within how many years of life does Cerebral Palsy develop?
Does Cerebral Palsy have axial hypertonia or hypotonia?
Does Cerebral Palsy have peripheral hypertonia or hypotonia?
What is the skin manifestation of Cerebral Palsy?
Is a migraine unilateral or bilateral in children?
What drug can be used for migraine prophylaxis in kids?
What type of drug is cyproheptadine?
Topiramate is good for which two groups of kids?
obese and epileptic
Is Optic Glioma NF1 or NF2?
What is the skin manifestation of tuberous sclerosis?
ash leaf spot
What is the facial manifestation of tuberous sclerosis?
What develops in the eye of Tuberous Sclerosis?
What is the name of the growth in Sturge Weber? Where?
What happens to the meinges during Sturge Weber?
What happens to the eyes during Sturge Weber?
What is a disorder of language called?
What is a disorder of motor speech called?
What is the most reported trigger of migraine?
What specific lobe does praxis manifest in? What is apraxia?
difficulty with motor planning
Are imaging modalities normal or abnormal during concussion?
What two lobes show hypometabolism during concussion?
frontal and temporal
Where does 80% of Epidural hematomas have a skull fracture?
What mental exam on the sideline for concussion?
Does GBS have a normal or abnormal WBC count in CSF fluid?
What is the most common cause of ataxia in children?
post infectious ataxia
Which disease affects the diencephalon disrupting the Papez circuit?
If a patient cant over-power resistance on muscle testing, what grade does that make them?
three or less
Clonus is what grade?
Is seizure cortex or subcortex?
Are quadrantanopia and hemianopia cortical or subcortical sings?
Do radiculopathies follow dermatomal patterns?
What structure does the reticular activating system activate immediately? Where does this structure send fibers?
Do respirations become more normal or abnormal as you go down the brainstem?
more abnormal = further down
Is nystagmus driven by hemisphere or brainstem?
Can permanent vision loss occur in Pseudotumor Cerebri?
What class of drugs treats pseudotumor cerebri?
What drug treats trigeminal neuralgia?
What percent of migraine has an aura?
Which cortex can migraine arise in?
Migraine can be mediated by what type of leukocyte?
Which neurotransmitter can be involved in migraine?
Is nystagmus defined by the fast phase or slow phase?
Does Lyme produce lymphocytic or bacterial meningitis?
What may be the presenting sign in GBS?
Do steroids help GBS?
Is the prognosis better for kids or adults in GBS?
What causes the spastic diplegia?
Are nausea and vomiting more common in kids and adults during migraine?
What relieves migraine in kids?
Is migraine with aura more or less common?
What three drugs for a migraine in kids in ER?
What anti-epileptic for kids with migraine?
What tricyclic for kids with migraine?
Which beta-blocker for adolescent migraine?
Where are freckles during NF1?
axillary or inguinal
Which two bones during NF1?
sphenoid and long
What type of relative for NF1?
What structure causes the seizures during Tuberous Sclerosis?
What happens to the cardiac rhabdomyoma during Tuberous Sclerosis?
What does the cognitive outcome of Tuberous Sclerosis depend on?
severity of epilepsy
Apraxia manifests with damage to what lobe specifically? Dominant or non-dominant?
Which two drugs for moderate migraines in kids?
tylenol or ibouprofen
Do concussions resolve spontaneously?
Does the brain require more or less glucose following a concussion?
Is EEG needed for simple febrile seizure?
Is EEG needed for complex febrile seizure?