Neuro Shelf Flashcards
(266 cards)
1
Q
CSF in MRI types
A
dark in T1 and flair, bright in T2
2
Q
Color of Abnormalities on MRI types
A
dark on T1, bright on T2 and flair
3
Q
Color of white matter on MRI types
A
light on T1, dark on T2 and flair
4
Q
Color of gray matter on MRI types
A
gray on T1, light on T2 and flair
5
Q
increased T2 signal often found in what condition
A
demyelinating dz
6
Q
intention tremors are assoc with damage to
A
cerebellum
7
Q
Weber test louder in unaffected ear in what type of hearing loss
A
sensorineural
8
Q
Weber test louder in affected ear in what type of hearing loss
A
conduction
9
Q
hyperacusis
A
damage to CN VII that innervates stapedius
10
Q
first fundoscopic sign of increased ICP
A
blurring of margins of optic disc
11
Q
direction of nystagmus with caloric stim
A
COWS: cold opp, warm same
12
Q
LP findings for subarach hem
A
RBCs, xanthochromia, incr opening press (above 20/25)
13
Q
noncommunicating hydroceph
A
blockage of ventricular system that can be acquired or congenital
14
Q
communicating hydroceph
A
mismatch betw CSF pdtion and absorption
15
Q
meningiomas and bilat acoustic neuromas assoc with which familial dz (and chrom)
A
NF2 on chrom 22
16
Q
normal EEG activity with eyes closed
A
8-13 Hz
17
Q
time window for tPA
A
within 3 hours of having a stroke (look at CT estab cause as ischemic not hem)
18
Q
test for peripheral neuropathy
A
nerve conduction study
19
Q
tests for myopathy
A
creatine kinase levels, EMG, muscle biopsy
20
Q
poly vs dermatomyositis
A
poly shows necrosis of musc fiber segments with lymph and neut infiltration. derm shows perifascic atrophy and inflamm cells in
21
Q
LP of guillian barre
A
elevated prot with everything else normal aka albuminocytologic dissociation
22
Q
LP of MS
A
elevation of gamma globulin with rel normal protein, oligoclonal bands
23
Q
Small infarctions often in ppl with HTN
A
lacunar strokes
24
Q
Most common location of lacunar stroke and assoc sx’s
A
internal capsule–pure motor deficits
25
Location of lesion with pure sensory stroke
posteroventral nucl of lateral thalamus
26
location of Wallenberg syndrome and arteries involved
lateral medulla supplied by PICA which is branch of vertebral
27
structures in lateral medulla
CN V, IX, X, nucl ambiguus, lat spinothalamic, inf cerebellar peduncle, symp fibers
28
sx's of Wallenberg
difficulties with swallowing, hoarseness, dizziness, nausea and vomiting, rapid involuntary movements of the eyes (nystagmus), and problems with balance and gait coordination. Some individuals will experience a lack of pain and temperature sensation on only one side of the face, or a pattern of symptoms on opposite sides of the body – such as paralysis or numbness in the right side of the face, with weak or numb limbs on the left side.
29
damage to nucl ambiguus
dysphagia and hoarseness
30
most common cause of lobar hemorrhage in elderly pts without HTN
amyloid angiopathy
31
mycotic aneurysm
from bacterial infection of arterial wall, common in IV drug users
32
Bilateral RCC, hemangioblastoma, angiomatosis, pheo
VHL
33
Vascular birthmark (port-wine stain)
Nevus flammeus (cutaneous angioma) assoc with Sturge-Weber
34
neuro Sturge-Weber sx's
leptomeningeal angioma, intellec disabled,, hemiparesis/atrophy of side opp portwine stain, cataracts, seizures
35
arteries affected by Charcot Bouchard aneurysm
lenticulostriate
36
area most commonly affected by Charcot Bouchard aneurysm
putamen
37
What artery is most likely involved in aneurysm that compresses CN III
PCA
38
complications of subarach hem
vasospasm and hydrocephalus
39
med to help prevent occurrence of stroke due to vasospasm
nimodipine
40
test to check for carotid artery disease
Doppler US
41
transient monocular blindness and art that is affected
amaurosis fugax often from extracranial carotid art dz that occludes central retinal art
42
best treatment for symptomatic carotid artery dz
endarterectomy
43
AICA sx's
ipsilateral facial weakness, gaze palsy, deafness, and tinnitus. To diff from PICA, no Horner syndrome, dysphagia, dysarthria, and hiccup
44
Pt with MS has what sx with neck flexion
Lhermitte sign: electrical sensation radiating down spine
45
Treatment for acute MS flare
corticosteroids
46
Treatment to reduce freq of MS flares
interferon beta-1B and glatiramer
47
Test that can show early MS
visual evoked response (optic nerve is often affected early on)
48
demyelinating disease assoc with virus
PML (strains of papovirus)
49
hot weather in MS pts
makes sx's worse
50
head tremor often occurs in
essential tremor, not PD
51
ET: when it occurs, what makes it better/worse, sx's
b/l tremors during voluntary movement. alcohol lessens sx's
52
ET treatment
beta blockers, primidone (antiepil), DBS
53
latency/time of onset for tremor in ET vs PD
longer time for tremor to appear when holding arms up in PD compared to ET
54
genetics of Huntington
CAG repeat on huntingtin gene on chrom 4
55
athetosis
twisting and writhing assoc with chorea
56
dystonia
sustained musc contraction that cause twisting, repetitive movement and posturing
57
treatment for patients with chorea
dopamine blockers like haloperidol
58
area of brain most commonly affected in childhood HD
neostriatum with atrophy of caudate nucl and putamen
59
syndrome that mimics Wernicke encephalopathy
central pontine myelinolysis
60
MRI shows extensive white matter damage with high ESR
acute disseminated encephalitis
61
disorder with centrocecal scotoma that impairs central vision
Leber optic atrophy
62
rapid correction of hyponatremia in alcoholic can lead to
central pontine myelinolysis
63
EEG finding for generalized epilepsy
3 Hz spike and wave
64
rapid infusion of which antiepileptic can cause arrhythmia
phenytoin
65
peak time period for alc withdrawal seizures
within first day
66
mental dysfunction, multiple seizure types, 1-2 Hz spike waves
Lennox-Gastaut
67
loss of language and abnormal EEG in sleep
Landau-Kleffner
68
olfactory aura indicates lesion in what area
hippocampus
69
cause of intractable complex partial seizures
hippocampal sclerosis (mesial temp sclerosis)
70
focal seizure activity that is mostly motor and spreads often starting with thumb
Jacksonian march
71
seizure disorder that can be mistaken for psych problem
complex partial
72
status epilep
30 mins continuous or series over 30 mins without regaining consciousness
73
seizure disorder in infants: recurrent spasms, hypsarrhythmia on EEG, retardation
West syndrome
74
treatment for West syndrome
ACTH
75
prevent/treat seizures in (pre)eclampsia
mag sulfate
76
type of migraine with aura
classic
77
type of migraine associated with visual changes and lack of coordination
basilar
78
causes of trigeminal neuralgia
MS, basilar artery aneurysm, acoustic schwannoma, post fossa meningioma
79
ophthalmoplegia with HA and forehead loss of sensation; inflamm of cavernous sinus
Tolosa-Hunt syndrome
80
meds to stop acute migraines
triptans, metoclopramide
81
preventative meds for migraines
amitriptyline and verapamil, propanolol, valproate
82
injury to this nerve causes wrist drop (aka sat night palsy)
radial
83
Cushing effect of rapidly incr ICP
slow pulse and high BP
84
evolution of density of bleed on CT scan
initially hyperdense then fades to isodense after days/weeks and eventually hypodense
85
areas most often injured in TBIs like accel-decel injuries
temporal and inferior frontal
86
sign of carpal tunnel
Tinel
87
Tinel sign
tingling sensation that radiates away with percussion of periph nerve
88
signs of meningeal irritation
Brudzinski and Kernig
89
CO poisoning results in lesions where
globus pallidus
90
DD for horner syndrome
Lateral medullary infarcts, cervical cord lesions, pulmonary apical or mediastinal tumors, neck trauma or masses, carotid artery dissection or thrombosis, intrapartum brachial plexus injury, cluster headache
91
argyll robertson pupil
unequal constricted pupils that are poorly reactive to light, in neurosyph but also DM, MS
92
exophthalmus/proptosis DD
Graves, orbital tumor, pseudotumor, carotid artery-cavernous sinus aneusyrm
93
musc innervated by trochlear and abducens
trochlear: SO; Ab: lat rectus
94
lesions in occipital cortex pduce
CL homonymous hemianopia with mac sparing
95
most common cause of visual impairment in occipital lobe
infarction in PCA terr
96
Mass lesions that exert downward pressure on dorsal midbrain cause
upgaze paralysis (Parinaud)
97
hemispheric gaze palsy: eyes point
toward side of lesion, away from hemiparesis
98
pontine gaze palsy: eyes point
towards side of hemiparesis
99
INO: where's lesion and what does it cause
in MLF, disconjugate gaze with impaired adduction and nystagmus of the abducting eye
100
What nerves run in cav sinus?
III, IV, VI, V1 and sometimes V2
101
myotonic dystrophy
progressive musc weakness/wasting but often with sustained contractions (like cant let go of doorknob)
102
meds for restless leg syndrome
pramipexole and ropinirole
103
treatment for cervical artery dissection
antiplatelet or anticoag
104
most common form of retinal degen
retinitis pigmentosum
105
ret pigment is often found with which other disorders
abetalipo and other metab dzs
106
lack of red reflex
cataract
107
cause of congen cataracts
intrauterine infections like CMV and rubella
108
papillitis can result in
vision loss, pain with moving globe, sensitivity to pressure
109
swinging flashlight test looks for
Marcus Gunn or afferent pupillary defect
110
Marcus Gunn
affected eye constricts more with consensual than direct. Usually sign of optic nerve atrophy
111
visual acuity controlled by
macula
112
causes of nyctalopia (night blindness)
retinal degen (retinitis pigmentosa), vit A defic, color blindness
113
retinal findings in person with longstanding HTN
segmental narrowing of arterioles
114
drusen
yellow deposits under the retina that incr risk of mac degen
115
findings of small red dots (retinal microaneurysms) on fundoscopy with what dz
diabetes
116
horizontal diplopia
abducens palsy
117
vertical or oblique diplopia
trochlear palsy
118
where are the nerve fibers that control of pupillary constriction within CN III
superficial: therefore affected by aneurysms or things that compress the nerve but not from DM which affects the deeper fibers that control motor
119
optokinetic nystagmus
rhythmic jerking while looking at spinning stripey thing. this is normal
120
most common ocular CN palsy
abducens
121
CN palsy that can lead to horiz nystagmus
vestibulocochlear (VIII)
122
What happens to uvula in CN IX and X palsies
deviation away from affected side
123
What happens to tongue in CN XII palsy
deviation towards affected side
124
dorsal root carries which fibers
sensory
125
ventral root carries which fibers
motor
126
anterior horn cells have what kind of neurons
motor
127
purkinje cell damage leads to
ataxia
128
chiari malformation findings
syringomyelia, low lying vermis/cerebellum, small posterior fossa
129
brown-sequard (hemisection)
loss of ipsi corticospinal and dorsal medial and contra spinothalam
130
complete transection of spinal cord
b/l spastic paralysis
131
posterior column syndrome
b/l loss of proprioception (medial dorsal)
132
syringomyelia
b/l loss of pain/temp in cape like formation
133
where's decussation of dorsal medial
medulla
134
risk factor for aneurysms
atherosclerosis
135
what artery supplies lower portion of spinal cord and at what level does it enter
great anterior medullary art of adamkiewicz that enters at t10 to l1
136
central cord syndrome
weakness and loss of pain/temp sensation primarily in arms and hands b/c fibers supplying upper extremities are more central
137
ulnar nerve entrapment sx
weak grip and decr sensation over digits 4 and 5
138
pronator drift tests function of
pyramidal/corticospinal tract
139
basal ganglia dysfunc presents with
extrapyramidal signs
140
cerebellar dysfunc presents with
ataxia, intention tremor, messed up rapid alternating movements
141
pyramidal tract dysfunc presents with
pronator drift, local weakness, hyperreflexia, spasticity, babinski
142
most common casues of brain abscess
viridans strep and staph aureus
143
brain abscess on CT
ring-enhancing
144
meds for Alzheimers
cholase inhibs: rivastigmine, donepezil NMDA antags: memantine
145
midbrain stroke sx's
ipsi oculomotor palsy, ataxia (cerebellary peduncle), CL hemiparesis (cerebral peduncle)
146
transverse myelitis
loss of sensory and motor below lesion with bowel and bladder dysfunc. Starts with spinal shock (flaccid paral) that progresses w/i days to weeks to spastic paral with hyperreflex
147
neurosyph sx's
sensory ataxia, lancinating pain, urinary incontinence (tabes dorsalis) and Argyll Robinson
148
area affected by tabes dorsalis
posterior spinal column (medial lemn) and nerve roots (sensory)
149
dorsal column degen sx's
loss of proprioception, vibration, pos Romberg
150
sx's B12 defic
subacute combined degen that affects dorsal, corticospinal and spinocerebellar (ataxia)
151
migraine abortives
NSAIDS, triptans, ergots, metoclompromide
152
migraine preventives
triptyline, topiramate, valproic, beta block (propan)
153
forced gaze preference indicates lesion where
frontal eye fields
154
age related hearing loss
presbyacusis
155
meniere dz
accum of endolymph leads to vertigo, aural fullness, tinnitus, and sensorineural loss
156
myas gravis sx's
weakness, ocular-->ptosis, diplopia, bulbar-->chewing weakness, dysphagia, dysarthria
157
MG assoc with abnormalities of what other organ
thymus that makes autoabs
158
degen of nerves in myenteric plexus causes
achalasia
159
syndrome assoc with lung cancer
lambert eaton
160
syndrome assoc with thymoma
myasthenis
161
Lambert sx's
weakness, diminished reflexes
162
appearance of GBM on MRI
butterfly with necrosis with enhancement
163
peripheral facial palsy
nasolab flattening, can't close eye or raise eyebrow
164
central facial palsy
forehead sparing
165
drug approved for ALS
riluzole is glutamate inhib
166
types of meds that can trigger acute angle glaucoma
anticholinergics, antiemetics, decongestants
167
test for BPPV
dix-hallpike
168
ways to relieve BPPV sx's
epley maneuver
169
acute and more long term side effects of levodopa
acute: hallucinations, somnolence, dizziness, HA; later: dyskinesia
170
lesion to Edinger-Westphal nucleus
IL fixed and dilated pupil that's nonreactive to light. Nucl is involved in pupillary reflex
171
damage to lateral geniculate nucleus
CL homonymous hemianopsia. It relays visual info to IL visual cortex
172
most impt risk factor for ischemic or hem stroke/TIA
HTN
173
acute, severe periorbital pain with autonomic instability
cluster HA
174
best abortive measure for cluster HA
100% oxygen
175
gradual loss of periph vision and eventual tunnel vision
open angle glaucoma
176
elements of diabetic retinopathy
microaneurysms, hemorrhage, edema, exudate, neovascularization
177
which vessel often affected in subclavian steal
left subclavian
178
alteplase
tPA
179
dermatome at umbilicus
T10
180
dermatome at nipples
T4
181
dermatome at top of foot
L5
182
dermatome at thenar eminence
C6
183
dermatome at pinky
C8
184
C5 dermatome
chest, shoulder, lateralish arm
185
loss of central vision with periph maintained
macular degen
186
gradual loss of peripheral vision with sparing of central vision
open angle glaucoma
187
treatment for restless leg syndrome
dopamine agonists like pramipexole and ropinirole
188
fever, back pain, neuro dysfunc like sensory/motor, paralysis, bowel/bladder issues
spinal epidural abscess
189
nasal congestion assoc with what type of HA
cluster
190
treatment for essential tremor
beta block (propanolol) and second line is AED like topiramate
191
curtain coming down over my eyes
retinal detachment that also presents with flashes of light and floaters
192
central cord syndrome
weakness in upper extremities is most pronounced
193
anterior cord syndrome
b/l spastic motor paresis and loss of pain/temp
194
posterior cord syndrome
b/l loss of vibration/proprio
195
triad of Wernicke's
confusion, eye findings (ophthalmoplegia, nystagmus), ataxia
196
What do you need to take along with antiTB drugs to prevent neuropathy?
pyridoxine
197
most common cause of mononeuritis multiplex
diabetes
198
where is degen found in Friedreich ataxia
spinocerebellar tracts
199
physical findings of Friedreich
kyphoscoliosis, pes cavus, msk
200
What do you give in hypertensive emergency?
nitroprusside
201
lesion in parasagittal cerebral cortex can lead to what along with difficulty walking and and abnormal reflexes
seizures
202
first sign of uncal herniation
pupillary dilation due to compression on outside of oculomotor. Leads to IL 3rd nerve palsy
203
duret hemorrhage caused by
transtent hernation
204
changes in LOC, apnea, posturing and circulatory collapse in what type of hernia
foramen magnum
205
Kernohan's notch
false localizing sign in uncal herniation that causes ipsi hemiparesis
206
child with ataxia after illness
acute cerebellar ataxia
207
ataxia and abnormal eye movements
ataxia telangiectasia
208
neurologic dysfunc, cardiomyopathy, diabetes in what condition
friedreich ataxia
209
Reflexes nerve roots
S1,2: buckle shoe L3-4 kick the door C5-6 pick up sticks C7-8 lay them straight (triceps) L1-2 testicles move (cremaster) S3-4 winks galore (anal wink)
210
pseudoclaudication
lumbar spinal stenosis
211
territory of spine affected by spinal infarction
anterior so loss of motor and pain/temp
212
preventative stroke treatment for pts with atherosclerosis or carotid bruit
antiplt
213
preventative stroke treatment for pts with Afib
warfarin
214
indications for carotid endarterectomy
symptomatic pts with high grade stenosis (>70%) but with 100% won't be helpful
215
older adults with spastic gait, weakness, atrophy of hands, sensory loss
cervical spondylotic myelopathy
216
innervate the diaphragm, the chief muscle of inspiration, via the phrenic nerve
C3 through C5
217
innervate the shoulder and arm musculature
C4 through C7
218
innervate the forearm extensors and flexors
C6 through C8
219
innervate the hand musculature
C8 through T1
220
nerve mediate hip flexion
L2 and L3
221
nerve mediate knee extension
L3 and L4
222
nerve mediate ankle dorsiflexion and hip extension
L4 L5
223
nerve mediate knee flexion
L5 S1
224
nerve mediate ankle plantar flexion
S1-2
225
Where does cauda equina start
L2
226
causes of central cord syndrome
syringomyelia, intramed tumor, hyperextension injury
227
conditions with lhermitte sign
MS, cervical spondylotic, B12 defic
228
syndrome with saddle anesthesia
conus medullaris (symm) and cauda equina (asymm)
229
areas of stiffness in polymyalgia rheumatica
shoulder, hip girdle, neck, torso
230
urinary retention along with back pain and weakness
neoplastic epidural cord compression
231
treatment for vascular dementia
not much. use good HTN meds
232
side effects of metoclompramide
extrapyramidal
233
corneal vesicles and dendritic ulcers
herpes simplex keratitis
234
motor and sensory loss, urinary retention, absent rectal tone
spinal cord compression
235
cause of morbidity in MVCs
diffuse axonal injury at gray-white junction
236
corneal involvement in keratitis vs conjunctivitis
yay in keratitis
237
painful red eye with blurred vision and fixed, mid-dilated pupil
acute angle closure glaucoma
238
reflexes in cauda equina
hyporeflex--lower motor neuron signs
239
reflexes in conus medullaris
hyperreflex
240
late manifestations of Lyme
encephalopathy and axonal polyneurop
241
type of stroke with early focal neuro sx's followed by sx's of incr ICP
intracerebral hem
242
fatigue, widespread pain, and cognitive/mood changes
fibromyalgia
243
distortion of straight lines so they appear wavy is sign of
macular degen
244
pathologic cupping of optic disc in
open angle glaucoma
245
optic disc swelling, hemorrhage, dilated veins, cotton wool spots
central retinal vein occlusion
246
what's seen on brain MRI in late stage Alz
temporal and parietal atrophy
247
most common rim-enhancing lesions in AIDS pts
lymphoma (test for EBV) and toxo
248
in what part of the brain do abscesses normally form
junction of gray and white matter
249
brain biopsy shows oligodendrocytes with nuclear inclusions and giant astrocytes
PML; inclusions are JC virus
250
signs of tabes dorsalis
3 Ps: pain, posterior/position (sensory ataxia), pee (urinary probs)
251
organism that causes neurocysticercosis and method of transmission
taenia solium (pork tapeworm) that's transmitted fecal-oral
252
somatosensory and motor deficits more pronounced in lower limb for occlusion of which major artery
ACA (more pronounced in face and upper extrem for MCA)
253
first line medication for IIH
acetazolamide: lessens CSF production by inhib'ing choroid plexus carbonic anhydrase
254
most significant complication of IIH
blindness
255
diseases with cherry red spots in macular
Niemann-Pick, Tay-Sachs, Gaucher
256
reason for urine incontinence in MS
spasticity
257
where's lesion that causes atonic bladder
LMN
258
sign of subfalcine herniation
b/l lower extrem weakness from compression of ACA
259
complications of Lyme disease
aseptic meningitis, CN palsies, then later with leukoenceph and painful polyradic
260
most common locations for intracereb hem from HTN
1) basal ganglia, 2) thalamus 3) pons 4) cerebellum
261
railroad track pattern seen on head CT that represents calcifications seen in what hereditary dz
sturge-weber
262
type II chiari malformation often assoc with what spinal abnormality
myelomeningocele
263
adenoma sebaceum in
tuberous sclerosis
264
cafe au lait spots in
neurofibromatosis
265
what's major path effect of alcohol on developing fetus?
impaired neuronal migration
266
carriers of Duchenne may have elevated
creatinine phosphokinase
