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Neurologie Flashcards

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1
Q

contrindication of TPA in stroke(11)

A

systolic BP>185 and diastolic >110
prior intracranial hemorrage
stroke or head trauma within the last 3 months
recent MI
current anticoagulation with INR>1,7 or prolonged PTT
platelet count< 100000
major surgery in 14 days
GI or unrinary bleeding in the past 21 days
seizures present at the onset of the stroke
blood glucose< 50 or> 400
age < 18

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2
Q

clue for SAH

A

worst headache of my life

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3
Q

complication of berry aneurism in eye

A

CN 3 palsy with pupil involvement

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4
Q

3 common cerebral aneurisms

A

ACA 30%
PSA 25%
MCA 20 %

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5
Q

Apres combien de tempa you can have mental changes in epidural hematoma(2)

A

within minutes to hours

classic lucid interval

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6
Q

Apres combien de tempa you can have mental changes in sub dural hematoma

A

within days to weeks

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7
Q

quid of blown pupil

A

fixed and dilated pupil

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8
Q

disease with blown pupil

A

epidural hematoma

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9
Q

CT for epidural hematoma

A

biconvex lens shaped

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10
Q

recent onset of headaches next step

A

immediate work up

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11
Q

most common type of headache in adults

A

tension headaches

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12
Q

causes of seizure in infant(4)

A

perinatal injury
infection
metabolic
congenital

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13
Q

causes of seizure in children 2-10 ans(4)

A

idiopathic
infection
trauma
febrile seizure

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14
Q

causes of seizure in adolescent(4)

A

idiopathic
trauma
drug withdrawal
AVD

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15
Q

cause of seizure in adult 18-35 ans(3)

A

trauma
alcohol
brain tumor

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16
Q

5 A for dementia

A 
aphasia
apraxia
agnosia
amnesia
abstract thought disturbance
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17
Q

cause of seizures in adult > 35 ans(4)

A

stroke
metabolic disorder
alcoholism
brain tumor

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18
Q

triad of MS(3)

A

scanning speech
intranuclear ophtalmoplegia
nystagmus

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19
Q

physiologic condition associated with decreased frequence of MS episode

A

pregnancy

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20
Q

CSF protein level in GBS

A

> 55 mg/dl

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21
Q

5 A for GBS

A 
acute inflammatory demyelinatingpolyradiculopathy
ascending paralysis
autonomic neuropathy
arrythmias
albuminocytologic dissociation
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22
Q

most common CNS tumor

A

metastatic

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23
Q

most common CNS tumor in adult(2)

A

glioblastoma

meningioma

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24
Q

most common CNS tumor in children(2)

A

meduloblastoma

astrocytoma

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25
localisation of brain tumor in kids
1/3 supratentorial
26
localisation of brain tumor in adults
2/3 supratentorial
27
other name of neurofibromatosis type 1
von recklinghausen disease
28
association of NF2
acoustic neuroma
29
genetic problem in NF 2
chromosome 22
30
quid of Lysh nodules in NF1
pigmented iris hamarthoma
31
criteria for NF 1(5)
``` six cafe au lait spots freckling in axillary or inguinal area optic glioma 2 lish nodules first degree relative with NF 1 ```
32
triad for wernicke encephalopathy(3)
encephalopathy ophtalmoplegia ataxia
33
classic patient with b1 deficiency(5)
``` alcoholics hyperemesis dyalisis starvation aids ```
34
what can elicited wernicke encephalopathy
large dose of glucose administration
35
quid of ophtalmoplegia in Wernicke encephalopathy(3)
nystagmus lateral rectus palsy conjugate gaze palsy
36
risk factor for dementia(4)
age positive family history head trauma down syndrome
37
mutation associated with the most severe form of NF2(2)
nonsense | frame shift mutation
38
quid of same sense mutation (2)
silent mutation | not severe
39
clue for normal pressure hydrocephalus(3)
gait disturbance dementia' urinary incontinence
40
PL in normal pressure hydrocephalus
normal opening pressure
41
MRI of NPH
enlarged ventricle
42
MRI of PML
multiple non enhancing lesions
43
CT of alzheimer
diffuse cortical atrophy greater in temproal and parietal lobe
44
side effect of trihexyphenidil
anticholinergic effect
45
quid of anticholinergic effect(7)
``` dry skin dry mouth constipation urinary retention flushing visison changes confusion ```
46
disease associated with vascular dementia
stroke
47
CSF analysis in herpes encephalitis(3)
lymphocytosis pleiocytosis high erythrocytes high protein
48
symptomatic hypokaliemie
< 2,5 meq/l
49
EKG of hypokaliemia(3)
U waves flat and broad T waves premature ventricular beats
50
initial imaging in the setting of unprovoked seizure
CT of head without contrast
51
Dx of epidural abcess
MRI with gadolinium
52
types of stroke(4)
ischemic thrombotic ischemic embolic intra cerebral hemorrage spontaneous sub arachnoid hemorrage
53
treatment of of myasthenie gravis crisis(2)
endotracheal intubation | withdrawal of anticholinesterase inhibitor
54
site of lesion for myasthenie gravis
neuromuscular
55
criteria to declare brai death in the setting of mechanical ventilation(2)
absent cranial nerves reflexes fixed and dilated pupils no spontaneous breath agreement of 2 physicians
56
quid of glioblastome multiforme(2)
astrocytoma de grade 4 or | high grade astrocytoma
57
CT for glioblastoma multiforme
butterfly appearance
58
early symptom in normal pressure hydrocephalus
gait impairment
59
differenciate NPH from alzheimer(2)
in NPH first symptom gait impairment | in alzheimer gait impairment comes later
60
pill rolling tremor
parkinson disease
61
CT for high grade astrocytoma
heterogenous and serpiginous contrast enhancement
62
predisposing factor for delirium(5)
``` dementia parkinson prior stroke advanced age sensory impairement ```
63
precipitating factors for delirium(6)
``` drugs infections electrolyte disturbances metabolic derangements systemic illness central nervous system necrosis ```
64
drugs percipitating delirium(5)
``` narcotics sedatives antihistamines muscles relaxers polypharmacy ```
65
infections precipitating delirium(3)
pneumonia IGU meningitidis
66
electrolytes disturbances precipitating delirium(2)
hyponatremia | hypercalcemia
67
metabolic disturbances precipitating delirium(3)
volume depletion B 12 deficiency hyperglycemia
68
systemic disturbances precipitating delirium(3)
CHF hepatic failure Malignancy
69
CNS disturbances precipitating delirium(3)
seizures head injury subdural hematoma
70
quid of delirium(3)
confusion desorientation reduced or fluctuate level of consciousness
71
Symptom accompany delirium(3)
agitation anxiety hallucination
72
only abnormality in CSF analysis in GBS
increased protein
73
other appelation peripheral facial paralysis
Bell's palsy
74
other symptom of bell's palsy(3)
decreased tearing hyperacusis loss of taste sensation over the 2/3 ant of the tongue
75
most common cause of subdural hematoma
blunt trauma
76
finding in CSF in MS
oligoclonal bands
77
quid of conus medularis
spinal cord termination
78
what cauda equina syndrome will give
lower motor neuron
79
finding in cauda equina syndrome(6)
``` usually unilateral radicular pain asymetric muscular weakness hypo or areflexia late onset of bowel and bladder dysfunction saddle hypo or anesthesia ```
80
finding in conus medullaris syndrome(5)
``` sudden onset of severe back pain perianal hypo/ oranesthesia symetric motor weakness hyperreflexia early onset of bowel or bladder dysfunction ```
81
rx of conus medullaris syndrome(3)
MRI IV glucocorticoids neurosurgical evaluation
82
quid of cauda equina syndrome
lumbo sacral nerve roots from cauda equina
83
what consequence will have a lesion in cauda equina syndrome
lower motor neurone
84
what consequence will have in conus medullaris syndome
both upper and lower motor neuron
85
sensory role in cauda equina
saddle area
86
motor role in cauda equina
control of sphincter anal and uretral | parasympathetic to bladder and lower bowel
87
congenital foot drop
charcot marie tooth disease
88
first rx of NPH
large volume of lumbar puncture
89
failure in large volume lumbar puncture in NPH
ventriculoperitoneal shunt
90
symptom for Cauda equina syndrome(4)
weakness of both legs numbness from buttocks to feet loss of rectal tone retention d'urine
91
retention d'urine in USMLE
foley catheter ramene 800 CC d'urine
92
next step in in cauda equina syndrome(2)
MRI | surgical in emergency
93
clue for ACA stroke(2)
controlateral motor and sensory deficits | more pronounced in the lower limbs than the upper
94
bloof supply of the brain(2)
ant circulation | post circulation
95
quid of anterior circulation of the brain
internal carotid arteries | and its branches
96
brain branches of carotid arteries(2)
ACA | MCA
97
Post circulation of the brain
paired of vertebral arteries | forms basilar artery
98
origin of post cerebral arteries
from basilar arteries
99
med used in thrombotic stroke(2)
TPA | tissue plasminogen activator
100
example of TPA
alteplase
101
cause of lacunar strokes(2)
microatheroma | lipohyalinosis of the small penetrating arteries of the brain
102
risk factor for lacunar infarct(2)
HTA | diabetes
103
most common site of lacunar infarct
post internal capsule
104
lacunar stroke type(2)
thrombi | not embolic
105
conduction aphasia(2)
fluent spontaneous speech but phonemic errors | comprehension relatively preserved
106
repetition in wernicke and broca
impaired
107
repetition in conduction aphasia
very poor
108
associated features with broca
right hemiparesis
109
associated features with wernicke
right superior visual field defect
110
associated features with CONDUCTION APHASIA
none
111
clue for broca
broken speech
112
artery in broca
MCA
113
complication of subarachnoid hemorrage
hyponatremia
114
clue for lacunar infarct(3)(post limb interbnal capsule)
unilaterla motor impairment no sensory or cortical deficits no visual field defect
115
clue for MCA
``` controlateral somato sensory motor weakness in face arm and legs conjugate eye deviation toward side of the infarct aphasia hemineglect syndrome ```
116
aphasia in MCA occlusion
dominant sphere atteint
117
hemineglect syndrome in MCA occlusion
non dominant sphere
118
ACA occlusion(6)
``` controlateral somato sensory motor weakness predominat in lower extremities abulia dyspraxia urinary incontinence emotionnal disturbances ```
119
quid of abulia
lack of will and initiation
120
vertebro basilar system occlusion(3)
alternate syndrome with controlateral hemiplegia ipsilateral cranial nerve involvement possible ataxia
121
best tool to confirm parkinsonism
physical exam
122
torticolis in USMLE(2)
periodic involuntary head turning | hypertrophied STERNO CLEIDO MASTOID muscle
123
synonym of torticolis
focal dystonia
124
acute agitation in elderly and demented people(2)
antipsychotics | no benzodiazepines
125
risk in status epilepticus
cortical laminar necrosis
126
quid of status epilepticus
seizures for more than 5 mn
127
consequence of cortical laminar necrosis
persistent neurologic deficits | recurrent seizures
128
ischemic stroke on CT
hypodense area
129
hemorragic stroke on CT
hyperdense area
130
broad based shuffling gait
NPH
131
cause of NPH in USMLE
decreased CSF absorption
132
physiopatho of amaurosis fugax
cholestrerol emboli from plaques in carotid artery
133
next step after dx myasthenia gravis and why(2)
chest CT | look for thymoma
134
most common cause of of hemorragic intraparenchymal(2)
uncontrolled HTA | amyloid angioplasty
135
most common site of hTA bleeding(2)
basal ganglia | specially in putamen
136
stroke with no prior antiplatelet rx
aspirin
137
stroke on aspirin ,rx
aspirin plus dypiridamole or clopidogrel
138
stroke on aspirin plus large intracranial artery atherosclerosis
aspirin plus clopidogrel
139
stroke with AFIB ,management
long term anticoagulation
140
memory loss ,constipation and weight gain
hypothyroidism
141
gait in parkinsonism(2)
hypokinetic | shuffling gait
142
quid of shuffling gait
patient is chasing his center of gravity
143
problem in parkinson
underactivity of dopaminergic neuron in substantia nigra
144
clue for parkinson (extra)
fixed facial expression | resistance to passive flexion
145
cause of CN 3 neuropathy
nerve ischemia
146
target in pharmacotherapy restless leg syndrome
dopamine
147
firs line rx of restless leg syndrome
dopamine agonist
148
second line rx of restless leg syndrome
gabapentin
149
quid of gabapentin
alpha 2 delta calcium channel ligands
150
cause of RLS
``` iron deficiency anemia uremia diabetes mellitus MS parkinson pregnancy drugs ```
151
drugs causing RLS(2)
antidepressants | metochlopramide
152
rx of intermittent mild symptom of RLS(3)
iron supplementation supportive measures avoid aggravating factors
153
supportive measures in RLS(3)
leg masssage heating exercice
154
aggravating factor in mild intermittent RLS(2)
sleep deprivation | medications
155
when to give medication in RLS
persistent moderate to severe form

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