Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Internal Medicine > Neurology > Flashcards

Neurology Flashcards

(81 cards)

Start Studying
1
Q

What are serum prolactin levels used for?

A

Differentiate seizure from pseudoseizure (psychogenic nonepileptic seizure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Multiple pigments on iris suggests…

A

Lisch nodules - raised hyperpigmented hamartomas
Neurofibromatosis type I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Neurofibromatosis type I findings

A

Cafe-au-lait spots
Skinfold freckling (age 5)
Lisch nodules (age 6)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Neurofibromatosis type I cancer risks

A

Peripheral nerve sheath tumor malignant transformation
Optic pathway glioma
CNS tumors
Pheochromocytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Neurofibromatosis type II findings

A

Vestibular schwannoma (acoustic neuroma)
Some cafe-au-lait macules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Retinal hemangioblastomas are associated with…

A

von Hippel Landau (–> clear cell carcinoma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Renal angiomyolipoma is associated with…

A

Tuberous sclerosis (benign hamartomas in many organs + various skin findings)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Treatment for idiopathic intracranial hypertension

A

Weight loss (including bariatric surgery)
Carbonic anhydrase inhibitor (acetazolamide), topiramate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Triptan MOA

A

Serotonin receptor agonist (5-HT 1B/1D) –> decreases neurogenic inflammation and calcitonin gene-related peptide (CGRP) release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Persistent migraine medications

A

Triptan
Antiemetics (e.g. promethazine)
Dihydroergotamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cluster headache treatment

A

100% oxygen via nonrebreathing mask
Triptan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ophthalmic findings in glaucoma

A

Atrophy of optic nerve head: optic disc rim thinning, increased cup/rim ratio (“cupping”)
Increased IOP
Gradual loss of peripheral vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Glaucoma medications from first-line downward

A
  1. Topical prostaglandin (latanoprost, carboprost) - increased drainage through uveroscleral pathway
  2. Topical beta-blocker (Timolol) - decrease aqueous humor inflow; use with caution in comorbid asthma
  3. Surgical (laser trabeculoplasty)

Less effective: Alpha agonists and carbonic anhydrase inhibitors (decrease aqueous humor inflow); cholinergic agonists (increase trabecular outflow)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Carbonic anhydrase inhibitors - difference between open and closed-angle glaucoma

A

Open: Topical dorzolamide
Closed: Systemic/oral acetazolamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Open globe laceration - signs

A

Peaked/teardrop pupil
Anterior chamber depth increased/decreased
Reduced IOP
Absent afferent pupillary response
Acuity decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is signified by acute corneal opacification?

A

Angle closure glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is are hypopyon and perilimbic injection?

A

Hypopyon: layering of inflammatory cells in the anterior chamber
Perilimbic injection/ciliary flush: dilation of vasculature at junction of sclera and cornea

Seen in inflammatory and infectious conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Orbital compartment syndrome - treatment

A

Orbital decompression by cutting eyelid from lateral canthus to orbital rim (lateral canthotomy) and then dividing inferior limb of lateral canthal tendon (inferior cantholysis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What causes paradoxical improvement in hearing speech in noisy environments?

A

Conductive hearing loss (e.g. otosclerosis - may also have reddish hue behind tympanic membrane)

Sensorineural hearing loss would result in worse speech understanding with increased background noise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Decreased vision, floaters, and fluffy yellow-white chorioretinal lesions

A

Candida endophthalmitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Candida endophthalmitis - risk factors

A

Hospitalized patients with central venous catheters
TPN
Immunocompromise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How could cancer metastases to the brain affect vision?

A

Space occupying lesion –> increased intracranial pressure (e.g. bilateral papilledema)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Common drug-induced glaucoma causes

A
  1. Glucocorticoids
  2. Systemic sympathomimetics (e.g. ephedrine)
  3. Systemic anticholinergics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is xerophthalmia?

A

Excessive dryness of conjunctiva/cornea that causes ridges - seen in vitamin A deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Who has paraneoplastic optic neuritis?
Small cell lung cancer Acute unilateral vision loss, painful Papillitis on exam
26
Pain medications for post-traumatic neuroma
1. Local anesthetic (diagnoses and treats) 2. TCA 3. Antiepileptic
27
How do glucocorticoids cause open-angle glaucoma?
Decrease aqueous humor drainage --> increased IOP Rapid increase in IOP leads to: 1. Halos around lights 2. Decreased visual acuity 3. Eye pain 4. Headache 5. Corneal edema Advanced disease --> peripheral vision loss
28
Meningioma characteristics on MRI imaging; epidemiology; dx; treatment
Extra-axial Well-circumscribed Round homogeneously enhancing dural-based mass Calcification Hyperdense on non-contrast head CT These are considered benign - commonly found in middle-age to elderly women Dx intraoperatively Tx complete resection
29
Brain metastasis appearance on imaging
Multiple ring-enhancing lesions at grey-white junction (intra-axial)
30
What can cerebral amyloid angiopathy lead to?
Intracerebral hemorrhage
31
When is urgent surgical decompression and clot evacuation indicated for intracerebral hemorrhage?
Cerebellar hemorrhage with area >3 cm, brainstem compression (stupor, coma, death), or obstructive hydrocephalus Signs of neurologic deterioration (lethargy, obtundation, coma)
32
Pterion region
Junction of frontal, parietal, temporal, and sphenoid bones Fracture here often occurs with epidural hematoma and tearing of middle meningeal artery
33
What artery is most associated with epidural hematoma?
Middle meningeal artery
34
Acute epidural hematoma - signs, imaging
Loss of consciousness followed by lucid interval (however, some may initially remain alert) Elevated ICP - headache, n/v, altered mental status - within minutes to hours CT - hyperdense biconvex lesion
35
Intracerebral hemorrhage etiologies
Usually older patients: 1. Severe HTN 2. Cerebral amyloid angiopathy 3. Anticoagulant/antiplatelet use
36
Subarachnoid hemorrhage - signs, etiology
Sudden, severe "thunderclap" headache Loss of consciousness Meningismus Usually due to rupture of intracranial aneurysm
37
Subdural hematoma - etiology
Trauma --> tearing of bridging veins --> venous bleeding Typically older adults, those on antithrombotic agents Acute --> coma Chronic --> insidious onset of confusion, headache, somnolence over days/weeks
38
When does paroxysmal sympathetic hyperactivity occur?
10-20% of those with severe traumatic brain injury Thought to be due to loss of cortical inhibition of lower sympathetic centers (e.g. hypothalamus, brainstem, spinal cord) Opioids, GABA-agonists, and a2-agonists may help
39
What is the most common cause of focal epilepsy?
Mesial temporal (hippocampal) lobe sclerosis
40
Gerstmann syndrome
Lesions in dominant (left) parietal lobe - difficulties with: 1. Writing 2. Calculations 3. Distinguishing fingers 4. Left-right disorientation
41
Lesions in dominant (right) hemisphere affect?
Nonverbal spatial mapping and orientation: 1. Neglect 2. Distortions in position sense (e.g. feeling of floating) 3. Visual interpretation (e.g. object size)
42
Myopia causes focal point to move in which direction relative to retina?
Anterior to retina Anterior-posterior diameter of eye is increased in myopia Use diverging (concave) lens
43
What is considered high myopia? What bad things can happen? Treatment?
>=6 diopters of correction required Stretching/thinning of sclera, choroid, retina --> retinal detachment, macular degeneration Treatment: 1. Antimuscarinic drops (e.g. atropine) 2. Orthokeratology (i.e. rigid contact lens)
44
Who has cotton-wool spots (yellow-white retinal lesions)?
Hypertension, diabetes - retinal microinfarctions caused by arteriolar obstruction and ischemia
45
Spinal epidural abscess - treatment
Antibiotics + emergency surgical decompression
46
How may antipsychotics contribute to orthostatic syncope?
Alpha-1 blocking properties (e.g. haloperidol, risperidone, quetiapine)
47
Brown-Sequard syndrome
Hemisection (disruption of half) of spinal cord: 1. Ipsilateral hemiparesis 2. Ipsilateral loss of proprioception, vibration, light touch 3. Contralateral loss of pain and temperature (spinothalamic tract) 1-2 levels distal to cord injury and below - axons move up 1-2 levels before crossing over, saving those at the level of the injury 4. Ipsilateral Horner syndrome (if cervical) 5. Spinal shock --> ipsilateral reflexes initially absent --> ipsilateral hyperreflexia and positive Babinski
48
Anterior cord syndrome affects which tracts?
Distal paralysis (LCT) and decreased pain/temperature (LST)
49
Cyclopentolate
Anticholinergic eye drops Traumatic iritis (e.g. left perilimbal conjunctival injection) Treat with physostigmine (cholinesterase inhibitor)
50
Where do brain mets tend to localize on MRI?
Multiple well-circumscribed lesions with vasogenic edema at gray-white matter junction
51
Primary CNS lymphoma on MRI
Periventricular lesion, irregular and nonhomogeneous
52
Most common intracranial tumor of NF1?
Optic pathway glioma in toddlerhood Then astrocytomas, brainstem gliomas into adulthood
53
Trochlear nerve innervates which muscle?
Superior oblique - eye downward and intorsion Palsy leads to hypertropia and extorsion; chin tuck head tilt to compensate
54
Meningioma appearance
Dural based, calcified, homogeneously enhancing lesion Arise from meningothelial cells of arachnoid mater
55
Anti-GQ1b antibodies
GQ1b ganglioside is found in peripheral nerves; antibody can contribute to rapid-onset ophthalmoplegia Sensitive for Miller Fisher syndrome (MFS) variant of Guillain-Barre but may be present in other variants with predominant ophthalmoplegia
56
Miller Fisher Syndrome variant of Guillain-Barre
1. Ophthalmoplegia 2. Ataxia 3. Areflexia Strength often preserved vs classic GBS Associated with anti-GQ1b antibody
57
What labs should be obtained in anyone with clinical diagnosis of restless legs syndrome?
Serum iron studies Those with iron deficiency or even low-normal ferritin (<=75) should take supplemental iron
58
How does pupillary involvement of CN III palsy help distinguish etiology?
Parasympathetic component (pupil constriction) is on outside of fascicle and less susceptible to ischemia - if non-pupil sparing, consider mass effect and intracranial aneurysm Motor component runs within nerve and can be damaged by compression or microvascular ischemia - if pupil-sparing, consider microvascular ischemia from diabetes, HTN, HLD, or age
59
Progressive, painless, symmetric loss of visual acuity and color vision
Toxic optic neuropathy
60
Complex regional pain syndrome
Pain does not follow specific peripheral nerve Typically follows trauma or surgery Associated with edema, vasomotor signs, and trophic changes in skin and hair
61
Spinal epidural hematoma
Can lead to cauda equina syndrome Slowly progressive Management includes MRI and is a surgical emergency, typically requiring urgent decompression (e.g. laminectomy)
62
What makes essential tremors better?
Alcohol
63
What is myoclonus status epilepticus?
Symmetric irregular muscle contractions, within 72 hours of hypoxic brain injury Manage with antiepileptic meds, supportive care
64
Folate vs B12 deficiency
Folate deficiency does not cause neuro issues Folate deficiency has normal methylmalonic acid
65
Opaque conjunctival plaques
Bitot spots - specific for vitamin A deficiency Would also see xerophthalmia, follicular hyperkeratosis
66
Small vs large nerve fibers convey...
Small: pain, allodynia, paresthesia Large: numbness, vibration proprioception, reflexes
67
CNS hamartomas are associated with...
Tuberous sclerosis
68
AVM appearance on MRI
Dark flow voids and little surroundong edema
69
Triptan mechanism
Serotonin receptor agonist Decrease CGRP release, but also has vasoconstrictive effects Ergots work similarly, but higher potency and less selectivity
70
What should be done to prevent falls in elderly with delirium inpatient?
Direct line of sight of nursing staff Rails, restraints, and bed alarms bad
71
72
What diabetes med can cause B12 deficiency despite no changes in CBC?
Metformin - effect on absorption in ileum
73
Head tremor is associated with...
Cervical dystonia Tremor is more jerky, less rhythmic than essential tremor
74
Essential vs intention tremor
Essential can occur with and without intentional movement Both are action tremors, essential is kinetic whereas intention is a subtype of kinetic that worsens as it approaches Intention often caused by cerebellar pathology
75
What causes most cases of mononeuritis multiplex?
Vasculitis, particularly polyarteritis nodosa
76
Only homocysteine or only MMA elevation is associated with folate deficiency?
Homocysteine elevation only If both elevated, then B12 deficiency
77
Salt wasting syndrome
Polyuria, hyponatremia and hypovolemia after brain injury - urinary sodium losses due to BNP secretion
78
Lambert-Eaton - treatment
Amifampridine or guanidine - decrease K efflux from presynaptic neurons -> prolonged depolarization and ACh release Pyridostigmine IVIG followed by oral immunosuppressive agents if persistent disease
79
Myasthenia gravis - treatment
Plasmapheresis or IVIG +/- steroids Pyridostigmine +/- glycopyrrolate (antimuscarinic to counter pyridostigmine) for symptoms Steroids may transition to nonsteroidal immunosuppressants (e.g. azathioprine)
80
Botulism treatment depending on source
Infant: human botulism Ig - due to ingestion of spores, maybe from honey Foodborne or wound: equine botulinum antitoxin
81
Lyme ascending paralysis vs GBS
Lyme doesn’t have autonomic dysfunction

Internal Medicine (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions