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Neuro Flashcards

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1
Q

Unilateral, severe periorbital HA with tearing and conjuctival erythema

A

Cluster HA

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2
Q

Prophylactic Tx migraine

A

AntiHTN
Antidepressants
Anticonvulsants
Diet changes

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3
Q

Most common pituitary tumor. Tx?

A 
Prolactinoma
DA agonist (bromocriptine)
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4
Q

55 yo pt presents with acute “broken speech”. What type of aphasia? What lobe and vascular distribution?

A

Broca’s aphasia

Frontal Lobe, left MCA distribution

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5
Q

Most common cause SAH

A

Trauma

2nd: berry aneurysm

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6
Q

Crescent shaped hyperdensity on CT that does NOT cross midline
What vessels affected

A

Subdural hematoma

Bridging veins

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7
Q

Hx significant for initial altered mental status with an intervening lucid interval. Dx? Source? Tx

A

Epidural hematoma
Middle meningeal a.
Neurosurgical evacuation

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8
Q

CSF findings with SAH

A

Elevated ICP, RBC, xanthochromia

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9
Q

Albuminocytologic dissociation

A

GBS (inc protein in CSF without significant inc in cell count)

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10
Q

Cold water flushed into pt’s ear, fast phase of nystagmus toward opposite side, Normal or Pathological?

A

Normal

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11
Q

Most common primary sources of mets to brain

A

Lung
Breast
Skin (melanoma)
GI tract

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12
Q

May be seen in kids who are accused of inattention in class and confused with ADHD

A

Absence seizures

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13
Q

Most frequent presentation of intracranial neoplasm

A

HA

Primary neoplasm much less common than brain mets

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14
Q

Most common cause of seizures in children (2-10 yr)

A

Infection
Febrile seizures
Trauma
Idiopathic

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15
Q

Most common cause seizures young adults (18-35)

A

Trauma
Alcohol
Brain tumor

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16
Q

First line med for status epilepticus

A

IV BDZ

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17
Q

Confusion, confabulation, opthalmoplegia, ataxia

A

Wernicke’s due to def thiamine

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18
Q

% lesion for CAE

A

70% if Sx

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19
Q

Most common causes dementia

A

AD

multi-infarct

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20
Q

Combined UMN and LMN disorder

A

ALS

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21
Q

Rigidity and stiffness with unilateral resting tremor and masked facies

A

PD

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22
Q

Mainstay Tx PD

A

Leveodopa/carbidopa

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23
Q

Tx GBS

A

IVIG or plasmapheresis

Avoid steroids

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24
Q

Rigidity and stiffness that progress to choreiform movements, accompanied by moodiness and altered behavior

A

HD

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25
6 yo girl presents with port wine stain in V2 distribution with mental retardation, seizures, and ipsilateral leptomeningeal angioma
Sturge WEber Tx: Sx Possible focal cerebral resection of affected lobe
26
Multiple cafe au lait spots on skin
NF1
27
Hyperphagia, hypersexuality, hyperorality, hyperdocility
Kluver Bucy (amygdala)
28
May be administered to Sx pt to Dx MG
Edrophononium
29
ACA supplies
Medial and superior surfaces | Frontal lobes
30
MCA supplies
Lateral surfaces and temporal lobes
31
PCA supplies
Inferior surfaces and occipital lobes
32
Basilar artery supplies
Midbrain and brainstem-pons
33
AICA supplies
Brainstem (pons) | Part of cerebellum
34
PICA
Brainstem (medulla) | Parts of cerebellum
35
Dorsal columns medial lemniscus of spinal cord responsible for ... Anatomical structures involved with this pathway...
Pressure, vibration, 2 point discrimination, proprioception Pacini's Meissner's Mm spindles Golgi tendon organs
36
Fasciculus gracilis
Lower body, extremities
37
Fasciculus cuneatus
Upper body, extremities
38
Lateral corticospinal tract responsible for, what parts of body
Voluntary Motor - contralateral Arms more medial Legs more lateral
39
Spinothalamic tract responsible for.. Anatomical structures...
pain and temperature Sacral posterior Cervical anterior Free n endings, pain fibers
40
Tracts affected by ALS | Sx
Corticospinal trac - voluntary movement anterior horn - motor Sx: spastic and flaccid paralysis
41
Tracts affected by Poliomyelitis | Sx
anterior horn | Sx: flaccid paralysis
42
Tracts affect by tabes dorsalis Part of what disease process Sx
Dorsal columns Tertiary syphilis Impaired proprioception and pain
43
Tracts affected by Vit B12 def | Sx
Dorsal columns, corticospinal tract | Bilat loss vibration and discrimination; Bilateral spastic paresis affecting legs before arms
44
Tracts affected by spinal artery syndrome | Sx
Corticospinal, spinothalamic, central horn, lateral gray matter = DORSAL COLUMN SPARED Sx: bilat loss pain and temp (one level below lesion), bilat spastic paresis (below lesion), bilat flaccid paralysis (level of lesion)
45
Syringomelia - tracts affected | Sx
anterior horn, anterior white commissure | Sx: Bilat loss of pain and temp (one level below lesion), bilat flaccid paralysis (level of lesion)
46
Brown Sequard Syndrome- tracts | Sx
All tracts on ONE SIDE of spinal cord Sx: ALL ARE BELOW LESION- Ipsi loss of vibration and discrimination, ipsi spastic paralysis, contra loss of pain and temp
47
CN I Type Fcn
OLFACTORY Sensory Smell
48
CN II Type Fcn
OPTIC Sensory Sight
49
CN III Type Fcn
OCULOMOTOR Motor Medial, sup, inf rectus mm Inf oblique mm, ciliary mm, sphincter of eye
50
CN IV Type Fcn
TROCHLEAR Motor Superior oblique of eye
51
CN V Type Fcn
TRIGEMINAL Both Sensation face, mm of mastication
52
CN VI Type Fcn
ADBUCENS Motor Lateral rectus of eye
53
CN VII Type Fcn
FACIAL Both Taste (ant 2/3 tongue), mm facial expression, sapedius mm, stylohyoid mm, digastric mm, lacrimal, submandibular, sublingual
54
CN VIII Type Fcn
VESTIBULOCOCHLEAR Sensory Hearing, balance
55
CN IX Type Fcn
GLOSSOPHARYNGEAL Both Taste (post 1/3 tongue), pharyngeal sensation, stylopharyngeus mm, parotid gland
56
CN X Type Fcn
VAGUS Both Sensation of trachea, esophagus, viscera; laryngeal, pharyngeal mm; visceral autonomics
57
CN XI Type Fcn
ACCESSORY Motor SCM and trapezius
58
CN XII
HYPOGLOSSAL Motor Tongue
59
Newborn most common cause meningitis
GBS
60
1 month - 2 yr most common cause meningitis
Strep pneumo | N meningitidis
61
2-18 yr most common cause meningitis
N meningitidis
62
18-60 yr most common cause meningitis
S pneumo
63
80+ most common cause meningitis
S pneumo
64
Reason to not do lumbar puncture
``` Signs of increased ICP -Papilledema -Focal neuro deficits -Pupil assymetry Risk of uncal herniation ```
65
Children with viral infection given aspirin
Reye's syndrome | Encephalitis
66
Brudzinski sign
Neck flexion in supine pt causes reflexive hip flexion
67
Kernig sign
Painful knee extension with hip flexion in supinre pt
68
Meningitis + N. meningitidis causes what Sx
Petechiae
69
Tx bacterial meningitis
3rd gen cephalosporin until cultures return Close contacts: Rifampin and cipro if Neisseria
70
Tx fungal meningitis
Amphotericin B
71
Tx TB meningitis
RIPE | Rifampin, isoniazid, pyrazinamde, ethambutol
72
Labs meningitis: Inc WBC w/ PMN, INc P, Dec Glc, Dec Prot
Bacterial
73
Labs meningitis: Inc WBC w/ lymph, INc P, dec glc, inc prot
Fungal or TB
74
Labs meningitis: inc WBC w/ lymph, INc P, glc and prot normal
Viral
75
Encephalitis infection - skin lesions
HSV
76
Encephalitis infection - parotid swelling
Mumps
77
Encephalitis infection- macupapular rash
WNV
78
Ring enhancing lesion
Brain abscess
79
Negri bodies
Rabies | Round eosinophilic inclusions in neurons
80
Branches affected in trigeminal neuralgia
Maxillary(V2) and mandibular (V3)
81
Tx trigeminal neuralgia
Carbamazepine | Baclogen, phenytoin, gabapentin, valproate, clonazepam, other antivonculsants
82
Unilateral throbbing HA w/ N/V
Migraine
83
Tx migraines
NSAID, ergots, sumatriptans, metoclopramide | Prophy: TCA, Beta blocker, CCB, ergots, anticonvulsants
84
HA in young man, unilateral, periorbital, lacrimation, Horner
Cluster
85
Tx cluster
100% O2, ergots, sumatriptan | Prophy like migraines
86
Horner syndrome
Ptosis Miosis Anhidrosis
87
Bilateral HA with tightness in occipital region or neck
Tension
88
Tx tension
NSAID, ergots, sumatriptan, relaxation exercises
89
TIA w/ carotid bruits
Suggest atherosclerosis origin
90
TIA w/ harsh systolic murmur
Suggest AS cause
91
Why not Tx HTN immediately after stroke | When to Tx
Dec cerebral perfusion | YES: BP >220/120 or CAD
92
Associated with berry aneurysm
polycystic kidney disease | Marfan
93
Traumatic lumbar puncture vs SAH
Traumatic- decline RBC in CSF
94
Lucid interval
Epidural
95
Slowly progressive HA wks to days -brain hematoma
Subdural
96
Convex, lens shaped hyperdensity
Epidural
97
Concave, crescent hyperdensity
Subdural
98
Hematoma crosses midline
Epidural
99
Emergent surgery drainage essential
Epidural
100
Rupture middle meningeal a/
Epidural
101
Rupture bridging vv
Subdural
102
Aphasia: nonfluent with good comprehension, writing aphasia, aware of inabilities
Broca (Expressive)
103
Located Broca
Inferior frontal gyrus, dorsolateral frontal cortex, anterior parietal
104
Poor comprehension, word salad, neologisms, not aware of disorder
Wernicke
105
Posterior superior temporal gyrus, inf parietal lobe
Wernicke
106
Fluent speech, frequent attempt to corrext word, word substitations
Conduction
107
Supramarginal gyrus and angular gyrus
Conduction
108
Nonfluent speech and poor comprehenesion
Global
109
Large infarct left cerebral hemisphere
Globral
110
3 W normal P hydrocephalus
Wacky- cognitive impaired Wet- incontinence Wobbly- gait changes
111
Epilepsy vs seizures
Epilepsy: recurrent seizures
112
Generalized vs partial seizures
Generalized: entire cortex Partial: focal neuro deficits
113
Focal sensory or motor WITHOUT loss of consciousness
Simple partial Sensory- paresthesias, hallucinations Motor- repetitive or purposeless movement
114
Hallucinations, automatisms, deja vu, impaired consciousness, postictal
Complex Partial
115
Sustained contraction of mm (name), repetitive contract and relax (name) brief contraction then repetitive contraction (name), brief repetitive contractions (name), loss of tone (name) LOSS OF CONSCIOUSNESS, postictal, unilat weakness lasting hrs (name)"
``` Tonic Clonic Tonic clonic myoclonic atonic Todd paraylsis ``` Generalized
116
Brief episodes (5-10 s) of impaired consciousness with normal mm tone, possible eye blinking, no postictal, children Appear to be daydreaming, are amnestic of evet, stare off into space
Absence
117
Most commonly in temporal lobe (seizure)
complex partial
118
EMG shows 3 cycle/s spike and wave pattern
Absence/petit mal
119
Repetitive or unremitting seizures for > 20 minutes without any period of consciousness Tx
Status epilepticus Tx: IV BDZ, if refractory phenobarb or pentobarb
120
Common signs of PD
``` SMART Shuffling gait Masklike facies Akinesia Rigidity (cogwheeling) Tremor (resting) ```
121
Spasticity, increased DTR, + Babinski
UMN damage
122
Flaccid paralysis, atrophy, fasciculations decreased DTR, - Babinski
LMN damage
123
Neurodegenerative disorder that affects substantia nigra
PD
124
Neurodegenerative disorder that affects anterior horn and corticospinal
ALS
125
Neurodegenerative disease affecting caudate and putamen
HD
126
Lewy bodies
PD
127
Cortical atrophy
AD
128
White matter atrophy w/ oligoclonal bands on LP
MS
129
``` AB bind AchR Testing Tx Assoc Sx ```
``` MG Edrophonium improves Sx Anticholinesterase: neostigmine, pyridostigmine Thymoma, thyroiditis, thyrotoxicosis Sx: proximal mm weakness ```
130
Paraneoplastic, Ab to presynaptic Ca channels
Lambert Eaton | Most commonly assoc w/ lung ca
131
Tx benign essential tremor
``` Beta blocker Primidone Clonazepamn Thalamotomy Deep brain stimulation ```
132
Chorea - assoc diseases
``` HD Hyperthyroidism Stroke SLE Levodopa use Rheumatic fever (Sydenham) ```
133
Describe athetosis | Associated diseases
``` Writhing snakeline movements Cerebral palsy Encephalopathy HD Wilson disease ```
134
Described dystonia | Assocaited diseases
``` Sustained proximal limb and trunk contractions Wilson PD HD Encephalitis Tardive dyskinesia ```
135
Describe hemiballismus | ASsociated diseases
Flinging of extremities | Stroke of subthalamic nucleus
136
Associated disease w/ tics
Tourette OCD ADHD
137
Most common primary brain tumor adults
Glioblastoma
138
Most common primary brain tumor kids
Astrocytoma- benign | Medulloblastoma - malignant
139
Tentorium as landmark, where are tumors adults vs kids
Adults: above Kids: below
140
chr 22- nf1 or 2
2
141
chr 17 - - nf1 or 2
1
142
bilat acoustic neuroma - nf1 or 2
2
143
Dx criteria NF1
COFFINS ``` Cafe au lait Optic glioma Freckling FH Iris hamartomas Neurofibromas Skeletal lesions ```
144
BDZ affect on sleep cycle
Lengthen N2, shorten N3
145
Coma causes: pupils large, nonreactive - where lesion
``` Below midbrain (CN III involved) Possible uncal herniation ```
146
Coma causes: pupils small and reactive- where lesion
Thalamic involvement, transtentorial herniation
147
Coma causes: pinpoint pupils
Opiod
148
Coma causes: pupils immobile
Metabolic
149
Normal response to ice water in ear
Conjugate deviation toward ice water
150
Ice water in ear - no ABD or ADD
CN VI, CN III
151
Ice water in ear - conjugate nystagmus
Psychogenic
152
Spastic paralysis - where lesion
High spinal cord
153
Decorticate posturing - elbow flex, legs extended - where lesion
Cortical or thalamic compression
154
Decerebrate posturing - elbow extend, legs flex - where lesion
Pontine, medullary
155
Describe persistent vegatative state | Recovery unlikely after how long
Normal sleep cycles, inability to perceive/respond to environment, preserved ANS >1 month >3 month
156
Type of seizure with febrile seizure
Tonic clonic
157
Communicating vs noncommunicating hydrocephalus
Noncomm: obstruction 4th ventricle Comm: dysfcn subarachnoid cistern or arachnoid villi
158
Cherry red spots on retina, Ashkenazi Jew Enzyme def Genetics
Tay Sachs Hexosaminidase A (ganglioside) AR
159
Defect in closure of vertebral arches, usu at LS jcn
Spina bifida occulta
160
Defect in closure of vertebral arches with meninges and spinal cord herniation
Myelomeningocele
161
Defect in closure of vertebral arches with herniation of meninges
Meningocele
162
Failure of NT closure, absence forebrain, meninges, portions of skull
Ancephaly
163
Labs during pregnancy that indicate neural tube problems
Increased alpha fetopreotin and acetylcholinesterase
164
2 types cerebral palsy
Spastic | Dyskinetic: choreathetoid, dystonic ataxic
165
Argyll Robertson pupil What is it Diseases
Accommodation to near object, nonreactive to light Syphilis, SLE, DM
166
Marcus Gunn pupil What is it Diseases
Light in affected pupil causes minimal bilat constriction Light in normal pupil- normal bilat constriction Afferent n defect
167
Horner syndrome What is it Diseases
Ptosis, miosis, anhidrosis Sympathetic trunk lesion (Pancoast tumor)
168
MLF syndrome What is it Diseases
With lateral gaze, absent contralat eye adduction Intracranial lesion, MS
169
Adie pupil What is it Diseases
Minimally reactive dilated pupil Abnormal innervation of iris
170
Focal point anterior to retina, refracting power of eye too great
Myopia Far vision blurry
171
Image focal point posterior to retina | Refracting power of eye insufficient
Hyperopia Near vision blurry
172
Asymmetric cornea surface causing inconsistent refraction of light
Astigmatism
173
Deviation of eye unable to be overcome by normal motor control
Strabismus Double vision and progressive blindness
174
Development defect in neural pathways of eye leading to poor visual acuity and spatial differentiation in affected eye
Amblyopia
175
Uveitis - 3 areas affected
Iris Choroids CIliary bodies
176
Anterior vs Posterior uveitis
Ant: painful, slit lamp shows inflammation and keratin deposits on corniea Post: slit lamp shows eye inflammation and retinal lesions
177
Most common viral cause conjunctivitis
Adenovirus
178
Bacterial conjunctivitis in young people
Chlamydia | GC
179
Perinatal from mom to baby
GC | C. trachomatis
180
When to suspect glaucoma
Frequent changes of lens prescriptions
181
Open vs closed angle glaucoma
Open: gradual Closed: acute
182
Glaucoma vs macular degen vision loss
Glaucoma: peripheral to central, closed unilat Macular: central to peripheral, bilat
183
Retinal a vs v occlusion exam
Artery: cherry red spot Vein: cotton wool spots, edema, retinal hemorrhages
184
Retinal a vs v occlusion exam
Artery: cherry red spot Vein: cotton wool spots, edema, retinal hemorrhages
185
Causes otitis media
``` Strep pneumo H. flu Moraxella S pyogenes Viruses ```
186
Tx otitis media
Unresolved - 10 d amoxicillin; resistant use amoxicilin- clauvulanic acid or stronger cephalosporin
187
Complications otitis media
``` Mastoiditis Meningitis Hearing Loss Sigmoid sinus thrombosis Middle ear drainage ```
188
Causes otitis externa/swimmers ear
Staph aureus Pseudomonas S epidermidis
189
Tx otitis externa
Topical polymyxin, neomycin, hydrocortisone | Pseudomonas: oral ceph or cipro
190
Dix Hallpike maneuver
Moving from sit to supine while turning head to side induce nystagmus in benign positional vertigo
191
Cause benign positional vertigo Tx
Otolith in inner ear - problem w/ semicircular canal Tx: Epley, meclizine CI
192
Cause meniere/endolymphatic hydrops
Vertigo caused by distension of endolymph compartment of inner ear LOW FREQUENCY HEARING LOSS
193
Tx meniere
Antichol, antiemetics, antihistamine decrease exacerbation; thiazide reduce occurrences; surgery
194
Benign tumor of Schwamm cells of CN VIII can lead to hearing loss 2/2 nerve compression
Acoustic neuroma/ schwanomma
195
Preserved bone conduction, poor air conduction
Conductive hearing loss confirmed via Rinne test
196
Both impaired bone and air conduction
Asymmetric Weber, normal Rinne shows sensorineural hearing loss
197
Biceps DTR
C5
198
Triceps DTR
C7
199
Patella DTR
L4
200
Achilles DTR
S1
201
Babinski sign indicates
UMN lesion, ok first year of life
202
Stroke - aphasia of dominant hemisphere, neglect of nondominant hemisphere, contralateral paresis and sensory loss in face and arm, gaze toward lesion, homonymous hemianopsia What vessel?
MCA
203
Stroke- Contra paresis and sensory loss in leg, cognitive or personality changes What vessel?
ACA
204
Homonymous hemianopsia, memory deficits, dyslexia/alexia | What vessel?
PCA
205
Locked in syndrome, coma, CN palsies (diplopia), apnea, visual Sx, drop attacks, dysphagia, dysarthria, vertigo, "crossed weakness and sensory loss" affecting the ipsi face and contra body What vessel?
Basilar artery
206
Pure motor or sensor stroke, dysarthria - clumsy hand syndrome, ataxic hemiparesis
Basal ganglia lacunar
207
MCA stroke Sx
``` CHANGes Contralateral paresis and sensory loss in face and arm Homonymous hemianopsia Aphasa- dominant Neglect- nondominant Gaze toward lesion ```
208
CI tPA therapy after stroke
SAMPLE STAGES ``` Stroke or head trauma in last 3 months Anticoag with INR>1.7 or prolonged PTT MI recent Prior intracranial hemorrhage Low platelet 185 or >100 Surgery past 14 d TIA Age 400 or low <50 glc Seizures present at onset of stroke ```
209
Conditions associated with berry aneurysm that make SAH more likely
MAKE and SAH more likely ``` Marfan Aortic coarctation Ehlers Danlos Sickle cell Atherosclerosis History - Fh ```
210
2/2 mass lesions of frontal lobes, no specific s/s, see on CT - type of herniation
Cingulate
211
Large supratentorial mass lesions push midbrain inferiorly; presents with rapid change in mental status, bilat small and reactive pupils, Cheyne-Stokes respiration, flexor or extensor posturing
Downward transtentorial (central) herniation
212
2/2 mass lesions of middle fossa. CN III entrapped leading to fixed and dilatered ipsi pupi followed by eye that is down and out. Ipsilesional hemiparesis (false localizing) results from compression of cerebral peduncle against tentorial edge
Uncal herniation
213
2/2 posterior fossa mass lesions. Tonsillar herniation-->medullary compression-->respiratory arrest. Usually rapidly fatal
Cerebellar tonsillar herniation into foramen magnum
214
HA associated with vascular and 5HT changes
Migraine
215
Classic vs common migraines
Classic: unilat w/ preceeding visual aura with scotomas (bright or flashing lights) or visual field cuts Common: May be bilat and periorbital without preceeding auras
216
Most common organism of cavernous sinus thrombosis
S aureus Fungi- Mucor or Aspergillus
217
Dx cavernous sinus thrombosis
MRI with gadolinium, MR venograph
218
Tx cavernous sinus thrombosis
Penicillinase resistant Rx (nafcillin and oxcillin) + 3rd/4th cephalosporin Need IV abx 3-4 wks
219
elevated postictal
Prolactin
220
Generalized epilepsy in infant, interictal EEG with hypsarrhythmia Tx
Infantile spasms/West syndrome Tx: ACTH hormone, prednisone, clonazepam, valproic acid
221
Childhood onset seizure, refractory to Tx, daily multiple seizures, ages 2-6, assoc mental retardation, behavior disorders, abnormal interictal EEG with slow spike and wave complexes
Lennox-Gastaut syndrome
222
Acute onset severe vertigo, head motion intolerance, gait unsteadiness, N/V, nystagmus If has auditiory or aural Sx? If not?
Acute peripheral vestibulopathy ``` Labyrinthitis Vestibular neuritis (can be Dx after viral infection) ```
223
Recurrent vertigo without auditory Sx that affect migraine suffers
Vestibular migraine Like Meniere's without auditory or visual Sx
224
Repetitive nerve stimulation | MG vs Lambert Eaton
MG: decremental response Lambert: incremental response
225
Triad of MG
Scanning speech Intranuclear opthalmoplegia Nystagmus
226
Cause GBS
CAMPYLOBACTER JEJUNI, virus, influenza
227
Presentation GBS
Acute, rapidly progressive demyelinating AI of peripheral nn == WEAKNESS, ascending paralysis
228
5 A GBS
``` Acute inflammatory demyelinating polyradiculopathy Ascending paralysis Autonomic neuropathy Arrhythmias Albuminocytologic dissociation ```
229
Type of MS: full recovery or deficits may remain after each episode
Relapsing-remitting
230
Type of MS: minor remission and plateaus may take place during progression
Primary progressive
231
Type of MS: full recovery or progressive deficits after each episode
Progressive relapsing
232
Type of MS: relapses, minor remissions, plateaus may take place during progression
Secondary progressive
233
Best prognosis MS
relapsing remitting
234
Causes dementia
``` DEMENTIAS NeuroDegenerative diseases Endocrine Metabolic Exogenous Neoplasm Trauma Infection Affective disorders Stroke/Structural ```
235
Pseudodementia
Difference with AD is in pseudo pt concerned about memory loss
236
Triad normal pressure hydrocephalus
Dementia-wacky Gait aprazia-wobbly Urinary incontinence- wet
237
Rapid cognitive decline over wks to months
CJD
238
Gait PD vs normal P hydrocephalus
NPH: arms still swing
239
Primary CNS tumor arises in brain parenchyma. Presents with seizures and focal deficits
Astrocytoma
240
Primary CNS tumor with high mitotic activity and endothelial proliferation/necrosis in tumor = ring enhancing lesion with central necrosis on MRI
Glioblastoma multiforme Poor prognosis
241
Originates from dura mater or arachnoid, imaging reveal dural tail
Meningioma
242
Derived from Schwann cells, presents ipsi tinnitis, hearing loss, vertigo
Acoustic neurona/ Schwannoma
243
Primary CNS tumor kids: primitive neuroectodermal from 4th ventricle causes inc ICP, very malignant
Medulloblastoma
244
ARise from epndyma of centricle or spinal cord, low grade, may cause obstructive hydrocephalus
Ependymoma
245
Most common suprasellar tumor in kids, calcification common, benign, may cause hypopituitarism
Craniopharyngioma
246
Convulsive seizures, ash leaf lesions, mental retardation, shagreen patch, sebaceous adenoma
Tuberous sclerosis
247
Vit def Wernicke and Korsakoff
Vit B1/thiamine
248
Triad Wernicke's
Encephalopathy Opthalmoplegia Ataxia
249
Korsakoff
Wernicke + anterograde and retrograde amnesia, horizontal nystagmus, confabulations
250
Peripheral neuropathy Vit Def
B12/cyanocobalamin Posterior and lat columns of spnal cord
251
Vit def: irritability, personality changes without neuro Sx
Folate
252
Positive India Ink prep
Cryptococcus
253
Area: decreased or no reflexes or fasciculations
LMN
254
Area: hyperreflexia
UMN
255
Area: apathy, inattention, unhibited or labile affecte
Frontal lobes
256
Area: Broca/motor aphasia
Dominant frontal lobe
257
Area: Wernicke/sensory aphasia
Dominant temporal lobe
258
Area: memory impairment, aggression, hypersexuality
Temporal lobes
259
Area: inability to read, write, name, do math
Dominant parietal lobe
260
Area: ignoring one side of body, difficulty dressing
Nondominant parietal lobe
261
ARea: visual hallucinations, illusions
Occipital
262
Area: CN III and IV
Midbrain
263
Area: CN V< VI< VII< VIII
Pons
264
Area: CN IX, X, XI, XII
Medulla
265
Area: ataxia, dysarthria, nystagmus, intention tremor, dysmetria, scanning speech
Cerebellum
266
Area: resting tremor, chorea
Basal ganglia
267
Area: hemiballismus
Subthalamic nucleus
268
Anosmia plus hypogonadism 2/2 def gonadotropin releasing hormone
Kallman syndrome
269
Intracranial HTN, papilledema, daily HA worse in morning, may be N/V, obese
Pseudotumor cerebri
270
Tx meningitis <1 month
Ampicillin: Listeria Cefotoxamine: Vancomycin: MRSA
271
Tx meningitis 1month to 50 yrs
Vancomycin | Ceftriaxone
272
Prophy for meningococcal meningitis
Rifampin or cipro
273
AR degeneration of anterior horn cells (LMN), hypotonic at birth, slowly progressive course
Werdnig Hoffman disease
274
Ragged red fibers on mm biopsy
Mitochondrial myopathies- Leverl hereditary optic atrophy
275
Cause resting tremor
basal ganglia disease
276
Cause intention tremor
Cerebellar disease
277
Cause hemiballismus
Subthalamic nuclei
278
Orthostatic hypotension
Drop BP >20 mmHg or reflex tachy 20 bpm
279
Cushing triad indicating inc ICP
Increasing BP Bradycardia Respiratory irregularity
280
Conjunctivitis that occurs in first 24 hrs of life
Most likely chemical 2/2 silver nitrate/erythromycin given prophy for GC conjunctivitis prevention
281
Conjunctivitis in infant at age 2-5 d, purulent discharge | Mom has Sx
GC; Tx topical erythyromycin plus IV or IM 3rd gen cephalosporin
282
Conjunctivitis of infact at age 5-14 d | Mom no Sx
Chlamydia | Tx: systemic abx - oral erythromycin to prevent chlam pneumo
283
Dot blot hemorrhages, microaneurysms, neovascularization - retinal changes in what disease?
DM
284
Arteriolar narrowing, copper or silver wiring, cotton wool spots, papilledema- retinal changes in what disease
HN
285
Sudden unilateral painless vision loss
Central retina a/v occlusion Retinal detachment Stroke or TIA - amaurosis fugax Vitreous hemorrhage
286
Sudden unilateral painful vision loss
Closed angle glaucoma Migraine Optic neuritis or papillitis Trauma
287
Sudden bilateral vision loss
Conversion reaction or hysteriA Exposure to UV Toxins- methanol
288
Gradual onset vision loss, uni or bi
``` Cataracts Diabetes Direct insult to brain Eye infection Open angle glaucoma Macular degen Optic neuritis Papilledema Presbyopia Uveitis ```
289
Cataracts in neonate
``` TORCH Toxoplasmosis Other Rubella CMV HSV ```
290
Presbyopia
inability to accomodate to near vision
291
Orbital cellulitis vs preorbital cellulitis
Both: fever, swollen eyelids, history trauma, Orbital: opthalmoplegia, proptosis, severe eye pain, dec visual acuity = MEDICAL EMERGENCY
292
Most common bugs orbital/periorbital cellulitis
Strep pneumo, Hib, staph or strep
293
Complication orbital cellulitis
Meningitis Vein thromboses Blindness
294
Hordeolum
Painful red lump along eyelid margin 2/2 acute glandular obstruction
295
Chalazion
Painless lump on eyelid margin from chronic granulomatous inflammation
296
Conjuctivitis and vesicular eyelid eruption that progresses to dendritic keratitis seen with fluorescein
Herpes simplex keratitis Tx: topical antiviral s(idoxuridine or trifluridine) NO STEROIDS
297
When to refer child with lazy eye or strabismus
>3 months
298
Lesion CN III/oculomotor causes
Eye down and out, latearl movement only possible Resolves on own If pupil blown, emergency!!
299
Lesion CN IV/trochlear causes
When gaze is medial, pt cannot look down = vertical diplopia
300
Lesion CN VI/abducens causes
Cannot look laterally = horizontal diplopia | Most common
301
Lesion CN V and VII causes
corneal drying due to loss of corneal blink reflex

First Aid Step 2 🐰 (22 decks)

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