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PANCE > Neuro > Flashcards

Neuro Flashcards

1
Q

Involuntary spasms/movements and repetitive motions

A

Dyskinesia

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2
Q

Sustained contraction, abnormal posturing

A

Dystonia

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3
Q

Rapid involuntary jerky, uncontrolled, purposeless movements?

A

Chorea

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4
Q

spinal cord tract that controls Voluntary motor activity: Terminates at anterior horn cell: ascends/descends same side

A

Costicospinal Tract

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5
Q

senses vibration, position and light touch:

Ascends same side, decussates @ medulla

A

Dorsal Columns tract

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6
Q

Senses pain and temperature and ascends at opposite sides crosses immediately

A

Spinothalamic Tract

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7
Q

Motor efferent pathway (Away) of spinal cord

A

Anterior (Ventral Root) (Fast action front)

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8
Q

Sensory Afferent pathway (Towards) of spinal cord

A

Posterior (Dorsal Root)

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9
Q

Progressive motor degeneration 2T UMN/LMN necrosis: dysphagia, eventually respiratory: fatal 3-5 years

sensation, urinary sphincter, voluntary eye movement spared Tx:

A

Amyotrophic Lateral Sclerosis (ALS)

Tx: Riluzole

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10
Q

Autosomal dominant nuero-degenerative disease: Chromosome 4 mutation/Abnormal CAG transcription:

behavioral (irritability), chorea, and dementia (<50):   Tx?
Caudate nucleus (Putamen) Atrophy: Fatal 15-20 years
A

Huntington Disease

Tx: Chorea (Tetrabenzine Antidopaminorgics)

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11
Q

Idiopathic dopamine depletion–> failure to inhibit acetylcholine in the basal ganglia

(loss of pigment cells in substantia Nigra)

A

Parkinson’s Disease

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12
Q
  • Resting Tremor (MC lessened with voluntary m.)
  • Bradykinesia (slow voluntary movement)
  • Rigidity
  • Flat Facis (Myerson’s nose tap=blink)
  • Instability w posture
A

Parkinson’s disease clinical manifestations X5?

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13
Q

Parkinson’s Disease Tx?

A
  • Levodopa/Carbidopa- converted to dopamine (M.E Tx)
  • Bromocriptine (D. Agonists)
  • Benztropine (Anticholinergic)
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14
Q

Demyelinating polyradiculopathy of the peripheral nerves. Ascending symmetric weakness/paresthesia

Assoc. w Campylobacter. Tx:

A

Guillian Barre Syndrome

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15
Q

Autoimmune Inflammatory demyelinating degeneration of white matter. sensory pain/fatigue, cramping,

suspect w young and trigeminal neuralgia, optic neuritis episodic exacerbations; :Tx

A

Multiple Sclerosis

Tx: IVCS, plasmapheresis, Amantadine (Fatigue)
Glatiramer acetate (Reduces relapse severity)
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16
Q

Autoimmune peripheral nerve disorder against Ach Receptors. Thymic hyperplasia/thymoma

General muscle weakness (Ocular, Resp., Bulbar): relieved w rest Tx:

A

Myasthenia Gravis

Tx: Pyridostigmine or Neostigmine 1st line
Plasmapheresis or IV Ig

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17
Q

Restless leg syndrome treatment?

A
  • Pramipexole

- Ropinirole (Both domapine Agonists)

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18
Q

CSF: High protein (>400) with a normal WBC (Albumin cytological dissociation)

Electrophysiologic decreased motor nerve conduction: Diagnosis studies for?

A

Guillain Barre Syndrome

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19
Q

MRI with Gadollinium (TOC) confirms disorder showing white matter plaque hyper densities (Periventricular).

A

Multiple Sclerosis

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20
Q

LP CSF shows increase IgG oligoclonal bands “Pleocytosis”

A

Multiple Sclerosis

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21
Q

Blood test shows Acetylcholine receptor Antibodies (+) Muscle specific Tyrosine Kinase (Musk)

A

Myasthenia Gravis

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22
Q

Myasthenia gravis Test that includes a rapid response to short acting IV_______?

A

Edrophonium

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23
Q

Intentional tremor worse with emotional stress and intentional movement

Tx:

A

Essential Familial Tremor

Propranolol

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24
Q

Tics associated with obsession-compulsion
Motor, phonetic, self-mutilating.

Tx:

A

Tourette syndrome

Tx: Risperidone (Clonidine or Haloperidol)

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25
Q

CNS postural muscle tone abnormality 2T brain injury perinatal prenatal. spasticity is hallmark.

Tx:

A

Cerebral Palsy

Tx: Baclofen

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26
Q

RF with Post URI, DM, pregnancy. Ear pain, UL face paralysis, taste disturbance

Tx:

A

Bell Palsy (CN VII)

Tx: Prednisone (w/I 72 h of s/x), Artificial tears, Acyclovir

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27
Q

Constant daily Headache: not worse with activity: BL tight-band/vise-like no phono/photo phobia

Tx: Prophylaxis and abortive

A

Tension Headache

Tx: A-NSAID/APAP Amitriptyline P- BBs

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28
Q

Headache 4-72 hour in duration: pulsatile, lateralized, throbbing. NV, Phono/Photo phobia, worse w activity

Tx: Abortive and Prophylaxis

A

Migraine Headache

Tx: A- Triptans/Ergotamines (5HT-1) vasoconstrictions
Metoclopramide, Promethazine, Prochlorperazine. (DBs)
P- BBs/CCBs/TCAs

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29
Q

UL Headache: Temporal, periorbital, lancinating, < 2hoursseveral times a day/6-8 weeks. worse night/Etoh

Horner’s syndrome, UL congestion/lacrimation:
Tx: A- P-

A

Cluster Headache

Tx: A- 100% O2: Triptan/Ergotamines (Sumatriptan nasal)
P- Verapamil

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30
Q

Brief episodic stabbing lancinating pain at eye, nostril and mouth. Worse with touch, wind, eating:

Tx

A

Trigeminal Neuralgia (Tic Douloreoux)

Tx: Carbamazepine (Anticonvulsant)
Gabapentin

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31
Q

Headache worse with straining, NV, tinnitus, visual changes–> blindness, papilledema. CN6 Palsy, Obese W

LP- Increased CSF pressure (Idiopathic) TX:

A

Idiopathic Intracranial HTN (Pseudomotor Cerebri)

Tx: Acetazolomide

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32
Q

Concussion syndrome management?

A
  • CT (SOC MRI Sx > 7-14 days)

- Cognitive/Physical rest

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33
Q

Acute abrupt transient confused state (medication or infection)

A

Delirium

34
Q

Progressive, chronic, intellectual deterioration. Memory loss. RF > 60

A

Dementia

35
Q

2nd MC type of dementia due to chronic ischemia or multiple lacunar infarcts. HTN most important RF

A

Vascular dementia

36
Q

MC Dementia 2T amyloid deposition: Neurofibrillary tangles (Tau protein): cholinergic deficiency

A

Alzheimer Disease

37
Q

Alzheimer Disease CT scan Dx?

Tx?

A

Cerebral Cortex Atrophy

Tx: Ach-esterase inh. (Donepezil, Rivastigmine, Tacrine)
Memantine (NMDA reduce glutamate excitotoxicity)

38
Q

Diffuse Lewy bodies (Protein Deposits) –> hallucinations and delusions.

A

Diffuse Lewy Body Disease

39
Q

star shaped Tumor of the brain/spinal cord: primary CNS tumor in adults:

Headaches + wakes patient up at night.

A

Astrocytoma

40
Q

MC and aggressive primary CNS tumor in adults: Focal Deficits, headaches that wakes patient up at night.

(+) Cushing’s reflex

A

Glioblastoma

41
Q

what is Cushing’s reflex?

A

Hypertension, bradycardia, and irregular respirations.

42
Q

Benign Tumor Associated with neurofibromatosis (NF-2)

A

Meningiomas

43
Q

Atlas C1 Fracture (Ant/post arches): Increase in predental space > 3mm in adults; >5 mm in children

A

Jefferson fracture

44
Q

C2 Axis/pedicle fracture –> spondylolisthesis (forward slipping) between C2-C3 (Unstable Fx)

> 5mm Operative

A

Hangman’s Fracture

45
Q

Fracture of Dens that is unstable

A

Dens fracture Type II ( MC @ base)

46
Q

Extreme flexion fracture involving C1 and C2 associated with odontoid fracture

A

Atlanto-occipital dislocation

47
Q

spinous process avulsion fracture: MC @ the lower cervical C-6 or C-7: Sx- only if non union or pain

A

Clay- Shoveler’s fracture

48
Q

Anterior displacement of wedge-shape g=fracture fragment. MC @ C2

Highly unstable that may cause anterior cervical cord syndrome.

A

Flexion Teardrop Fracture

49
Q

is stable if all ligaments are intact and there is no posterior displacement of fractured segment

A

Burst Fractures

50
Q

BP difference between arms 15mmHg 2T flow reversal at the expense of the basilar artery to arm. L Arm MC

A

Subclavian Steal Syndrome

51
Q

Motor and sensory deficits in upper extremities in a “shawl distribution.

A

Central cord syndrome

52
Q

Ipsilateral motor vibratory and proprioception deficits and contralateral pain and temperature deficits

A

Brown Sequard syndrome

53
Q

Loss of temperature and pain in lower extremities. TEE-Pee

A

Anterior Cord Syndrome

54
Q

TIA: Transient episode of neurological deficits las t less than ____ most resolving in __to___ MC due to ____?

A

<24 hours (resolve in 30-60 minutes) MCC Embolus

55
Q

Damage Associated with voluminous meaningless effortless speech (Word Soup)

with impaired comprehension of error

A

Wernicke’s Aphasia

56
Q

Damage Associated with partial loss or difficulty in ability to produce language: mild comprehension deficit

A

Broca’s Aphasia

57
Q

Ischemic strokes includes

A
  • Hemiparesis (Cant’ feel, move, see, talk)
  • sensory loss
  • Hemianopsia (half field blindness)
  • dysarthria
  • Aphasia
58
Q

MC type of stroke and what vessel?

A

Ischemic (Middle cerebral Artery)

59
Q

MC Arterial bleed: Between skull and Dura: involves medial meningeal artery: Lens shape (Convex)

A

Epidural Hematoma (Hemorrhage)

60
Q

MC Venous bleed: Between dura and arachnoid: involves tearing of bridging veins: Blunt Trauma “elderly”

Slow onset and crescent shape: “Midline shift”

A

Subdural Hematoma (Hemorrhage)

61
Q

Bleed between arachnoid and pia: MC Berry Aneurysm rupture: Sudden thunderclap worse HA of life:

A

Subarachnoid Hemorrhage

62
Q

Intraparenchymal hemorrhage: HTN, trauma or arteriovenous malformation: LP–> herniation

A

Intracerebral Hemorrhage

63
Q

fever, chills, headache, photosensitivity, NV, AMS/seizures, nuchal rigidity Kernig’s and Brudzinki’s

A

Acute Bacterial Meningitis

64
Q

MCC of bacterial meningitis 1 month- 18 yo

A

N. Meningitides

65
Q

MCC of bacterial meningitis 18-50 yo? what about >50?

A

S. Pneumoniae (>50 Listeria)

66
Q

MCC of bacterial meningitis < 1 month

A

Group B strep Agalactiae

67
Q

CSF Glucose is decreased with increased lymphocytes, and increased protein.

A

Fungal or Tuberculosis Meningitis

68
Q

CSF Glucose is normal with increased lymphocytes, and normal or decreased protein.

A

Viral Meningitis

69
Q

CSF Glucose is decreased with increased Neutrophils PNMs, and increased protein .200.

A

Bacterial Meningitis

70
Q

MCC is HSV1, Echo or coxsackie: profound lethargy with abnormal focal neurogocal deficits CN II, IV, VI, VII.

CSF Lymphocitosis w normal Glucose Tx:

A

Encephalitis (Brain Parenchyma infx)

71
Q

Viral Meningitis highlights

A
  • Nuchal rigidity
  • mild meningeal symptoms
  • AMS with No focal deficits
72
Q

what are the Type of seizures?

A

Partial (Focal)- Simple or complex

Generalized- Absence (Petit) or Tonic-clonic (Grand Mal)

73
Q

Seizure that involve impaired consciousness with lip smacking, manual picking or patting/ coordinated m.

A

Complex Partial

74
Q

Seizures where consciousness if fully maintained

A

Simple Partial seizure

75
Q

Seizure involves brief lapse of consciousness stating w eyelid twitching

A

Absence (petit Mal)

76
Q

status epilepticus are seizures without recovery for >___?

A

30 minutes

77
Q

what is the 1st line Drug for Absence seizure

A

Ethosuximide

78
Q

what is the 1st line drug for Status epilepticus?

A

Lorazepam/Diazepam –> Phenobarbital

Phenytoin LD infused >30 min.

79
Q

Anticonvulsants include

A
  • Valproate (Lavaca de Mili)
  • Lamotrigine
  • Carbamazepine
  • Benzos, Phenytoin, Phenobarbital
80
Q

Foot drop suspect injury to what nerve?

A

Peroneal nerve

81
Q

Tachycardia, Mydriasis, diarrhea/cramps, Agitation, tremor/twitching, hyperthermia, and hyperreflexia?

A

Serotonin syndrome

PANCE (13 decks)

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