SIN - Scanning speech - Intention tremor (also Incontinence and Internuclear ophthalmoplegia - Nystagmus

NEURO: first aid 485-489 Flashcards by Teresa Wang

Why do you see optic neuritis in MS?

CN II is only nerve myelinated by oligodendrocytes

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what is marcus Gunn pupils?

someone explain?

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MS more common in what type of population?

whites living far from equator

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What type of bowel incontinence is seen in MS?

Urge

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What type of hypersensitivity is MS?

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charcot triad of MS?

SIN

Scanning speech
Intention tremor (also Incontinence and Internuclear ophthalmoplegia
Nystagmus

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woman in 20 with sudden loss of vision and it’s relapsing and remitting course

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Diagnostic test for MS

Oligoclonal bands

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Gold standard for MS and what do you see

MRI and periventricular plaques (areas of oligodendrocyte loss and reactive gliosis)

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Bonus: Reactive gliosis by what cells

astrocytes

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MS: multiple white matter lesions separated in time and space mean?

anyone?

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DMARDS for MS

IFNB and natalizumab

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what is natalizumab?

against integrin4

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Whats the treatment of acute flares of MS

IV steriods

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list Muscarinic antagonist to treat neurogenic bladder

oxybutynin

Tolterodine

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What do you use for Spasticity in MS

Baclofen (GABAb agonist)

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where do you see albuminocytologic dissociation?

Guillain Barre

Increased CSF protein with normal cell count

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GB associated infections

Associated with infections (eg, Campylobacter

jejuni, viral)

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can you use steriod in GB?

“Respiratory support is critical until recovery.
Additional treatment: plasmapheresis, IV
immunoglobulins. No role for steroids.”

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Patient comes to you with Ptosis, “down and out” gaze and normal pupillary light reflexes. What is the most common cause of this type of nerve injury?

Vascular disease

eg. DM

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What is the function of parasympathetic out of CN 3

pupillary light reflex

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What type of aneurysm AND herniation that can affect sympathetic fibers of CN3?

Posterior communicating artery aneurysm

Uncal herniation

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If you have CN IV damage, what are the symptoms?

SO4
Function of SO
1. trouble going downstairs ( SO depresses and abduct)
2. Head tilt towards the side of the lesion (So intort, now no SO –> you extort –> so may present with compensatory head tilt in the opposite direction)

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What will happen to L CN VI palsy when you tell that patient to look L?

L eye will not look L

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What happen to the R eye in Right CN IV palsy with L gaze?

R eye looks upward = R hypertropia

List the causes of R anopia?

Optic neuritis, central retinal A occlusion

Tunnel vision, what lesions?

Pituitary lesion | Optic chiasm

Patient has L parietal lesion because of MCA infract, what type of visual field defect would he have?

Calcarine fissure --> R lower quadrantic anopia

Meyer loop 1. which lobe 2. what vision defect 3. what blood supply

1. temporal 2. upper quadrantic anopia 3. MCA

you lesion the optic tract, what visual defect?

Homnoymous hemianopia | **** optic tract is in occipital lobe and supplied by MCA

What else can cause Homnoymous hemianopia?

LGB complete lesion

Macula --> bilateral projection to occiput. What does it mean?

I don't know too, anyone?

Meyer loop is responsible for what part of retina? and what vision loss?

inferior --> Pie in the sky ( upper quadrantic anopia)

Meyer loop loops around?

Inferior horn of lateral ventricle

What goes through internal capsule?

Dorsal optic radiation

Patient has R MLF lesioned, what are the symptoms?

When eye looks L, R eye cannot look L ( Right MR is not working)

Convergence normal or abnormal? 1. MLF 2. CN 3 lesion Explain why?

1. MLF is normal | 2. CN 3 is not

Bilateral INO seen in

What eye gets nystagmus in R-MLF lesion in L gaze?

L | Explanation: Abducting eye gets nystagmus (CN VI overfires to stimulate CN III)

When you say this patient has R INO, it means what?

R eye paralyzed

Senile plaques and tau, which one is intracellular and which one is extracelluar

plaques is extra | tau is intra

to determine the degree of dimentia, what do you look for?

number of tangles

What decreases the risk of Alzheimer? What increases?

ApoE2 decrease | ApoE4 increases

Early onset dimentia by down why?

chr 21 has APP gene on it

what are presenilin 1 and 2?

gene that increases risk of early onset

where do you see spherical tau and what do you stain with

Pick, silver

Patient with change in personality which type of dimentia

Pick (FT dimentia)

Paitent with visual hallucinations followed by parkinsonian features

Lewy

How do you DDx Lewy body dimentia and Parkinson patient with dimentia?

Lewy is early onset

Dimentia with myoclonus

Creutzfeldt-Jakob (rapid!)

What are prions?

PrPc---> PrPsc sheet which are Bpleated sheet reisstant to proteases

where do you see 14/3/3 protein

Where do you see Hirano bodies in hippocampal

Alzheimer

Name 2 infections and 2 vaccinations that can cause acute disseminated (postinfectious) encephalomyelitis

1. measles or VZV | 2. rabies, small pox

Demyelinating disease with Pes cavus and foot drop

Charcot-marie-tooth, AD

Krabbe what enzyme deificiency

Galactocerebrosidase

Glucocerebrosidase deficiency

Gaucher

Metachromatic leukodystrophy enzyme deficiency?

Arylsulfatase A

JC virus can cause what type of demyelinating diease?

Progressive multifocal leukoencephalopathy

PML also seen in 2-4% of what patient

AIDS

Patient with MS, we give this antibody-drug and she suddenly develops Dementia, weakness, sensory loss, and every possible CNS symptoms, what drug did you give her?

Natalizumab --> PML

Patient with follicular lymphoma, we give this antibody-drug and she suddenly develops Dementia, weakness, sensory loss, and every possible CNS symptoms, what drug did you give her?

Rituximab CD20-

explain adrenoleukodystrophy and how do they die?

X linked, males very long chain FA cannot be broke down --> built up in CNS, adrenal gland, testes die with adrenal crisis

What is partial seizures?

it's focal seizure, single area

Generalized?

diffuse

Whats the origin of partial seizures?

medial temporal lobe

what's simple partial?

simple = consciousness intact | complex is not

causes of simple partial can be? (4)

motor, sensory, autonomic, pyschic

the one with no postictal confusion

absence

the one with repetitive jerks

myoclonic

metabolic disorders of myoclonus?

renal and liver

what's grand-mal seizures?

tonic-clonic (stiff and move)

atonic is mistaken for what?

fainting

febrile seizures are epilepsy? T or F?

Define status epilepticus

continous or recurring seizures that may result in brain injury (duration is >10-30 min)

causes of seizures by age | children? MCC

genetic, infection, trauma, congenital, metabolic

Adults causes of seizures

tumor, trauma, stroke, infection

elderly

stroke, tumor, trauma, metabolic, infection

NEURO: first aid 485-489 Flashcards

(78 cards)