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1

Carotid dissection classic symptom

Horner syndrome

2

Eye movments in Pons damage

Downward gaze, NO NYSTAGMUS

3

Eye movements in cervicomedullary damage

Downard gaze WITH NYSTAGMUS

4

Hollenhorst plaques

cholesterol on fundoscopic exam

5

Which physical exam finding localizes a lesion to CNIII vs Superior cervical ganglion

Pupil diameter in affected eye

CNIII palsy --> lost constriction--> mydrasis
Superior ganglion --> loss of SNS --> miosis

6

Most common compliation of bells palsy after recovery

Aberrant regeneration of the facial nerve leads to involuntary facial movements (mouth twitch every time the ipsilateral eye blinks)

7

How to determine if RBCs in the CSF after LP are from traumatic procedure or from true CNS hemorrhage?

If true hemorrhage, RBCs will be equal in all the tubes

If traumatic LP, RBC count will decrease from tubes 1-->4

8

Next and best test after a positive LP for SAH

CT angio to look for aneurysm

9

Dandy walker MRI findings

Tiny cerebellar tonsil (leaves a cavern that you can WALK around in)

10

Chiari II malformation findings

downward herniation of the cerbellar vermis leading to aqueductal stenosis and noncommunicating hydrocephalus

11

what does hyperdense lesion mean on contrast vs non contrast enhanced CT?

Hyperdense on nonCon means CALCIFIED

Hyperdense on contrast enhanced means VASCULAR

12

"Brain tumor that appears to arise from the bone"

Meningioma (because the meninges are so closely adhered to the bone

13

telangectasias in the setting of proximal muscle weakness suggests?

Dermatomyositis

14

If you have myopathy, what does EMG show?

Brief low voltage action potentials or fibrillation potentials

15

Muscle bx findings in dermatomyositis vs polymyositis

dermato = perifasicular atrophy with perimysial inflammation

polymyositis= inflammatory cells within the actual fiber

16

CSF analysis in seizure patients

totally normal

17

nucleus ambiguous location and components

In the medulla, contains nuclei for CN9 and 10

dmg to it causes dysphagia

18

nucleus solitarius location and components

medulla, contains 7,8,9

19

2 most common arteries that cause lateral medullary syndrome

Vertebral and PICA

20

Artery supplying the medial medulla

Anterior spinal artery

21

Artery supplying lateral pons

AICA

22

Artery supplying medial pons

Basilar

23

Artery supplying the entire midbrain

Posterior cerebral artery

24

Mycotic aneurysm (appearance on CT and cause)

Small, multiple lesions that are contrast enhancing

Caused by BACTERIAL seeding from IV drug use --> aneurysm forms in the wall and then ruptures --> SAH

25

Intracerebral manifestation of Sturge Weber

Leptomeningeal angiomas

26

vision change seen in MCA vs ACA stroke

MCA --> contralateral homonymous hemianopsia 2/2 dmg of the optic radiations

ACA--> No vision change!

27

First imaging study to get in new seizure? EEG or MRI?

MRI because it will help point you to the etiology whereas EEG will simply confirm that they had a seizure

28

Timeline of alcohol withdrawal seizures vs. DT

Seizures 1-2 days
DTs 3-4days

29

Classic EEG finding for infantile spasms

Hypsarrhythmia

30

Psychiatric symptoms w/ bizzare psychotic behaviors AND an aura

Complex generalized seizure...don't necessarily need motor symptoms

31

Symptoms of basilar migraine

Weakness/paralysis
Vision changes
Transient LOC

HEADACHE FOLLOWS the above symptoms

32

how to differentiate between trigeminal neuralgia and atypical facial pain? both are unilateral...

Trigeminal neuralgia is PAROXYSMAL lanciating pain and is triggered

Atypical facial pain is constant and deep pain

33

What should you suspect if a patient with preexisting neuro deficits develops NEW onset unilateral facial pain?

MS--> trigeminal neuralgia is a common manifestation in MS, as demyelination can affect CN V

34

Pope sign (inability to extend 4th/5th digits) is caused by damage to which nerve

Ulnar nerve at the elbow --> ulnar nerve innrvates intrinsic hand muscles

35

Nerve responsible for flexion of the arm at the elbow. When is it classically damaged?

Musculocutaneous nerve --> also gives sensory to volar aspect of arm

Classically damaged in humerus fractures

36

2 lobes of brain most commonly injured in direct blow to the front of head (hit head on windshield)

Anterior temporal lobes
Inferior frontal lobes

These are the two most anterior parts of the brain

37

Most common long term side effect of a frontal head trauma?

Anosmia/Aguesia --> severing of the olfactory roots

38

First step in management of spinal cord injuries

IV Steroids!

39

Most common CN affected by neurosarcoid

CN VII --> patients often complain of unilateral facial weakness

40

Cystic brain lesion filled with multiple smaller cysts

Echicnococcus

41

Routine CSF finding in CJD

Typically normal...maybe mildly elevated protein

42

2 MCC of ring enhancing lesion in AIDS patient? Next test after identification of that lesion?

CNS lymphoma and toxoplasmosis

Next test is to get a LP with CSF analysis for EBV (to rule out CNS lymphoma)

43

Treatment for JC virus

HAART...not a cure but may improve prognosis

44

What must absolutely be done prior to LP in patient with concern for encephalitis?

Head imaging to r/o swelling or elevated ICP...if ICP is increased, LP could lead to herniation

45

buzzword: microglial nodules (2DDx)

HIV encephalitis
CMV

46

Early complication of HSV encephalitis

Seizures originating from the temporal lobes

47

MCC of fungal vs bacterial CNS abscess

Fungal- aspergillius
Bacterial- strep viridins/ staph

48

how to differentiate meningoencephalitis vs rhomboencephalitis

Meningoencephalitis --> dysarthria, seizures, UMN signs

Rhomboencephalitis --> localized brain stem signs (CN deficits)

49

PML histology

Dark staining inclusions iwthin the oligodendrocytes

50

Autonomic symptoms + distal weakness

Guillan Barre

51

Increase IgG and oligoclonal bands in csf ddx (2)

MS
SSPE

52

Unique meningoma PE finding

Hyperosteosis on the skull --> increased thickness

53

Cysts in multiple organs with brain lesion. What is the disease and brain lesion

VHL --> hemangioblastoma

54

Brain mets w/o known primary. MCC cause?

Lung CA

55

Highest risk associated with posterior fossa tumors

Brainstem herniation

56

Child with ataxia, hydrocephalus w/ posterior fossa tumor

Medulloblastoma

57

Tay Sachs deficiency

hexaminidase A

tAAAy sachs = hex A

58

Gaucher disease defective enzyme and toxic metabolite

Glucosidase deficiency --> glucosylceramide accumulation

59

Hypertensive encephalopathy CSF finding

Elevated protein

60

Most common neuro finding in CKD patients.Why? How to improve it?

Peripheral neuropathy 2/2 loss of B vitamins.... improves with dialysis or renal transplant

61

B12 def labs

High MMA, high homocystine, low methionine

62

Classic B12 def visual disturbance

Enlarged blind spot that obscures central vision