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Nervous System Flashcards

1
Q

what are common signs and symptoms of brain neoplasms

A
  • gradual onset
  • focal neuro defects
  • seizures
  • headache
  • confusion
  • n/v, papilledema
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2
Q

diagnostic study of choice for brain neoplasm

A

MRI with contrast

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3
Q

% of brain neoplasms that are metastasis from other primary sites

A

1/2

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4
Q

what primary cancer sites metastasis to the brain?

A

lung, breast, melanoma, colon

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5
Q

which inherited disease increase risk of brain tumors?

A

neurofibromatosis, tuberous sclerosis, multiple endocrine neoplasia type 1
retinoblastoma

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6
Q

most common type of brain neoplasm?

A

gliomas in the brain or spinal cord

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7
Q

List the major subtypes of gliomas

A

astrocytoma (35%) oligodendeogliomas, ependymomas (2%)

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8
Q

gliomas are more common in

A

males

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9
Q

what are the most common brain neoplasms in women?

A

Meningiomas (20%) schwannomas

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10
Q

what are the common signs and symptoms of acoustic neuroma? (vestibular schwannoma)

A 
hearing loss (cochlear nerve) 
imbalance ( vestibular nerve)
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11
Q

diagnostic imaging for acoustic neuroma?

A

MRI with gadolinium enhancement

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12
Q

what causes botulism?

A

Clostridium botulinum: neurotoxin

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13
Q

what are the 2 routes to be infected with botulism?

A
  1. foodborne from canned food or raw honey

2. wound from trauma or IV drug use

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14
Q

adult prodromal signs & sxs of foodborne botulism?

A

GI: N/V, dysphagia, dry mouth
neuro: sudden onset diplopia, dilated, and fixed pupils

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15
Q

wound-borne vs foodborne botulism?

A

no GI symptoms in wound botulism

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16
Q

how fast does botulism progress?

A

12-36 hours and progress quickly over 1-2 days

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17
Q

how would you describe the paralysis in botulism?

A

bilateral DESCENDING flaccid paralysis

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18
Q

what are the SENSORY deficits associated with botulism?

A

blurred vision

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19
Q

how high is the fever in botulism?

A

no fever

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20
Q

what is a likely sequelae of botulism?

A

respiratory arrest and/or death

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21
Q

if you have recovered from botulism, will you have future immunity?

A

NO

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22
Q

what is an inflammation of the brain called?

A

encephalitis

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23
Q

what usually causes encephalitis?

A
  1. secondary to virus : HSV or west nile
  2. bacterial: mycoplasma pneumonia
  3. fungal
  4. autoimmune SLE or Hashimotos
  5. trauma
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24
Q

signs and sxs of encephalitis

A 
fever 
altered conciousness 
personality changes, confusion 
seizures 
stiff neck 
n/v
focal neurological deficits 
rash
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25
Diagnostic test for encephalitis
CSF
26
ddx for encephalitis
- meningitis (can coexist with encephalitis) - lyme - syphilis - CVA - drug or alcohol intoxication - intracranial tumor
27
RAPIDLY PROGRESSIVE INFLAMMATORY DEMYELINATING POLYNEUROPATHY
guillan-barre
28
what are common causes of Guillan barre syndrome
1. post-viral 2-4 weeks or bacterial illness (2/3 cases) - resp most common and then GI 2. post vaccination 3. medication use: penicillin and anti-motility drug
29
bacteria associated with GBS
C JEJUNI
30
signs and symptoms of GBS
* * progressive ASCENDING symmetric muscle weakness starting in the fingers and lower extremities 2. parasthesias, numbness 3. pain: shoulder girdle, back, butt, thighs 4. autonomic changes 5. SOB, resp 6. bladder/bowel change
31
what do you find in CSF analysis of GBS?
INCREASE CSF protein | normal WBC
32
what are stages of progession with GBS
3rd week= greatest weakness recovery in 3-4 weeks after progression ceases 30% HAVE SXS FOR 3 years
33
Causative agents of bacterial meningitis?
- neisseria meningitides - haemophilus influenza B - streptococcus pneumonia (*80%)
34
signs and sxs of bacterial meningitis
``` rapid onset f/c stiff neck headache photophobia confusion seizures ```
35
how rapid is onset of bacterial meningitis?
very rapid
36
sequelae of bacterial meningitis
seizures deafness death
37
when do you see a petechial rash?
MENINGOCOCCAL | meningitis
38
what are the viral agents that cause viral meningitis
ENTEROviruses: coxsackie or echovirus (85%) mumps hsv 1 and 2 HIV
39
signs and sxs of viral meningitis
``` fever headache stiff neck altered mental status milk photophobia ```
40
which type of meningitis can have spontaneous recovery?
viral
41
2 positive physical exam signs for positive meningitis
``` Brudzinskis sign (Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed.) Kernigs Sign (Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees.) ```
42
diagnostic technique to diagnose meningitis
CSF exam and culture
43
what type of meningitis has low glucose in 60% of patients
BACTERIAL
44
what type of meningitis has lymphocytes in the CSF
VIRAL
45
ddx for meningitis
``` ecephalitis brain abcess febrile seizures subarachnoid hemmorahge toxoplasmosis CVA / stroke ```
46
how does herpes zoster most commonly present
painful unilateral vesicle eruption alone a single dermatome
47
physical therapy modality helpful for herpes zoster
UV light
48
what drug is primarily used to treat parkinsons disease can be used for herpes zoster
LEVODOPA
49
sequelae of herpes zoster
post-herpatic neuralgia
50
vaccination used to prevent herpes zoster
ZOSTAVAX
51
common signs and symptoms of acute poliomyelitis
5-10% develop symptoms 3 presentations: 1: abortive- flu like 2. non-paralytic - (aseptic meningitis) 3-7 days of abortive + stiff neck and back 3. paralytic - features above plus ASYMMETRIC, FLACCID LOWER MOTOR NEURON WEAKNESS AND INTENSE MYALGIA
52
common signs and symptoms of tetanus
- sore throat with dysphagia - local muscle rigidity at site of entry - headache - lockjaw and risus sardonicus (sustained spasm of the facial muscles that appears to produce grinning) - * NO FEVER** - muscle spasms and seizures - respiratory compromise
53
tx for patient suspected of having tetanus
tetanus immunoglobulin immunization: diazepam IV: mag sulfate IV, and metranidazole
54
risk factors associated with strokes
``` advanced age diabetes hypertension smoking AFIB anti-coagulant therapy ```
55
defects caused by brainstem stroke
respiratory | heart rate
56
what are 2 causes of inadequate perfusion of brain in a stroke
infarction or ischemia | hemorrhage
57
what position do you put a stroke victim in
head and back 30 degree elevation to relieve intracranial pressure
58
what effect does smoking have in women on oral contraceptives
increase risk of MI and hemorrage stroke
59
what are some of side effects of HRT
``` CV: stroke, MI migraine headaches breasts; fibrocystic and breast cancer GI: cholelithiasis, N/V Uterus and ovaries : endometrial cancer, worsening of leimyomata ```
60
what determines the types of defects seen with TIAS
the location of ischemia in the brain
61
what are some of the symptoms of carotid artery deficit
ipsilateral blindness | contralateral hemiparesis with paresthesias
62
what are some of the symptoms of vertebrobasilar deficit
vertigo - main confusion sudden sensorineural deafness ataxia: falling to the side of the lesion

my NPLEX II (28 decks)

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