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The One Deck To Rule Them All > Neuro: Aphasia, Memory + Trauma > Flashcards

Neuro: Aphasia, Memory + Trauma Flashcards

1
Q

CAN OPEN

Confusion
Ataxia
Nystagmus
Ophthalmoplegia
PEripheral Neuropathy
A

Wernicke’s Encephalopathy

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2
Q

Wenicke’s Encephalopathy is caused by

A

Thiamine (Vit B1) deficiency

- Usually underlying alcoholism

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3
Q

Investigation findings of Wernicke’s encephalopathy

A

Decreased Red cell transketolase

MRI: Petechial haemorrhages

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4
Q

Management of Wernicke’s Encephalopathy

A 
Vitamin B1
IV Pabrinex (Vit B/C)
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5
Q

If Wernicke’s Encephalopathy is not treated is can become

A

Korsakoff’s psychosis

  • non-reversible
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6
Q

Retrograde amnesia

Confabulation

A

Korsakoff’s psychosis

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7
Q

Urinary incontinence
Dementia
Bradyphrenia (slow thought)
Gait abnormality

A

Normal pressure hydrocephalus
“Wet, wobbly + whaley”

  • onset: months
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8
Q

Cause of Normal pressure hydrocephalus

A

decreased CSF absorption at arachnoid villi

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9
Q

Imaging: - Enlarged 4th ventricle

- Sulcal atrophy

A

Normal pressure hydrocephalus

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10
Q

Management of normal pressure hydrocephalus

A

Ventriculoperitoneal shunting

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11
Q

Causes of cerebellar injury

A

PASTRIES

Posterior fossa tumour
Alcohol
Sclerosis (MS)
Trauma
Rare (Freidrich's ataxia)
Iatrogenic (Epilepsy drugs= Phenytoin)
Endocrine (hypothyroidism)
Stroke
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12
Q

Disruption and tearing of axons following a deceleration injury

A

Diffuse axonal injury

  • best seen on MRI
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13
Q

Peri-orbital bruising (raccoon eyes)
Post-auricular bruising
Mastoid bruising

A

Basilar skull fracture (base of skull)

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14
Q

Double vision (diplopia)
Painful to open mouth (trismus)
Hx of assault

A

Zygoma fracture

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15
Q

Difficulty opening mouth

A

Ramus fracture

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16
Q

Management for depressed skull fractures

A

Surgical reduction and debridement

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17
Q

Displacement of cingulate gyrus under the flax cerebri

A

Subfalcine herniation

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18
Q

Herniation occurs when brain is displaced through a defect in the skull (from fracture/ craniotomy)

A

Transcalvarial herniation

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19
Q

Displacement of the uncut of temporal lobe under the tentorium cerebelli

  • ipsilateral fixed + dilated pupil (CNIII)
  • contralateral paralysis (cerebral peduncle)
A

Transtentorial (uncal) herniation

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20
Q

Downwards displacement of the brain

A

Central herniation

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21
Q

Displacement of the cerebellar tonsils through the foramen magnum

  • increased ICP
  • Cushing’s triad
    - Wide pulse pressure
    - Resp changes (cheyre-strokes)
    - Bradycardia
    - HTN

Associated with chiari 1 malformations

A

Tonsillar herniation (coning)

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22
Q

Inability to:

  • write
  • mathematics
  • identify fingers (finger agnosia)
  • identify side of body
A

Gerstmann syndrome

- lesion of angular gyrus

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23
Q

Language comprehension + word formation is controlled by

A

Wernicke’s area

24
Q

Word articulation is controlled by

A

Broca’s area

25
Q

Connects Wernicke’s area to broca’s area

A

Arcuate fasiculus

26
Q

Non-fluent aphasias

A 
Global aphasia (comprehension impaired)
Broca's aphasia (comprehension intact)
Transcortical motor aphasia (comprehension intact)
27
Q

Fluent aphasias

A 
Wernicke's aphasia (comprehension impaired)
Conduction aphasia (comprehension intact)
Anomic aphasia (comprehension intact)
28
Q

Large lesion affecting all 3 areas
Severe expressive + receptive aphasia
Communicates in gestures

A

Global aphasia

  • non-fluent
  • comprehension impaired
29
Q 
Lesion of inferior frontal gyrus 
          (supplied by superior left MCA)
- laboured speech 
- halting 
- impaired repetition
A

Broca’s aphasia
“Expressive aphasia”

  • non-fluent
  • comprehension intact
30
Q
  • laboured speech
  • halting
  • strong repetition skills
A

Transcortical motor aphasia

  • non-fluent
  • comprehension intact
31
Q
  • difficulty finding words
  • generic fillers “things”
  • many words needed to explain (circumulocution)
  • repetition good
A

Anomic aphasia

  • fluent
  • comprehension intact
32
Q
  • Aware of errors
  • Repetition is poor

Hx of stroke affecting the arcuate fasiculus

A

Conduction Aphasia

  • fluent
  • comprehension intact
33
Q 
Lesion of superior temporal gyrus 
      (supplied by inferior left MCA)
Damage in temporal lobe
- intact sentence structure 
- lacking meaning 
- word salad
A

Wernicke’s aphasia “receptive aphasia”

  • fluent
  • comprehension impaired
34
Q

DANISH

Dysdiadochokinesia (difficulty repeating movements)
Dysmetria (past-pointing)
Ataxia 
Nystagmus
Intention tremor
Slurred staccato speech
Scanning dysarthria (syllables are broken up)
Hypotonia
A

Cerebellar injury

35
Q

Intervertebral disc prolapse is more likely to herniate

A

laterally due to weaker ligament

36
Q

Weakness of muscle strength
Decreased muscle tone
Decreased reflexes
Muscle wasting

A

Lower motor neuron lesion (LMN lesion)

37
Q

Weakness of muscle strength
Increased muscle tone
Increased reflexes
Muscle mass maintained

A

Upper motor neuron lesion (UMN lesion)

38
Q

Causes of upper motor neuron lesion

A

Stroke

Tumour

39
Q

Dyskinesia

A

Dystonia
Chorea
Athetosis

40
Q

Involuntary contraction of muscles

A

Dystonia

41
Q

Irregular unpredictable movements

A

Chorea

42
Q

Involuntary writhing of fingers

A

Athetosis

43
Q 
Impaired balance (prone to falls)
Vertical gaze
Symmetrical onset 
Speech difficulties
Swallowing difficulties
A

Progressive supranuclear palsy (PSP)

  • Levodopa can sometimes help
44
Q

Genetics of Huntington’s Disease (Chorea)

A

Autosomal dominant
Tri-nucleotide repeat disorder

Anticipation: the younger age of onset the severity in later generations

45
Q

30 years old
Uncontrolled movements
Falls
Difficulty speaking

A

Huntington’s Disease (Chorea)

46
Q 
Symmetrical fine tremor
Worsens on intentional movements 
Disappears on rest
Improves with alcohol 
Can effect vocal cords
A

Benign essential tremor

47
Q

Management of benign essential tremor

A

Propranolol

Primidone

48
Q

A collection of CSF (syrinx cyst) within the spinal cord that causes compression of spinothalamic tract fibres decussating at anterior white commissure of spine

A

Syringomyelia

49
Q 
Cape-like loss of temperature (neck + arms)
    - accidental burns
Upper limb weakness
Preserved: 
   - light touch
   - proprioception 
   - vibration
Paraesthesia
Neuropathic pain 
Bowel + bladder dysfunction
A

Syringomyelia

  • 20-40 years old
50
Q

Causes of Syringomyelia

A

Arnold-chiari malformation
Trauma
Tumours
Idiopathic

51
Q

Investigations for syringomyelia

A

Full spine + brain MRI

52
Q

Complications of syringomyelia

A

Syringobulbia
Scoliosis
Horner’s syndrome

53
Q

Fluid filled cavity in the medulla

A

Syringobulbia

54
Q

Causes of peripheral neuropathy

A

ABCDE

Alcohol
B12 Deficiency
Cancer
CKD
Diabetes
Drugs (Isoniazid)
Every vasculitis
55
Q

Causes of predominantly motor loss

A

Guillain-Barre syndrome
Porphyria
Lead poisoning
Hereditary Sensorimotor Neuropathies (HSMN)
Charcot Marie Tooth
Chronic inflammatory demyelinating polyneuropathy
Diptheria

56
Q

Causes of predominantly sensory loss

A 
Diabetes "glove and stocking"
Uraemia
Leprosy
Alcoholism
Vitamin B12 deficiency 
Amyloidosis

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