Neurology 15

Question 1

What is the babinski’s equivalent of the upper extremity?

What is a positive sign and what pathology does it indicate?

Answer 1

Hoffman’s sign

Flicking of middle finger causes Adduction of the thumb. Positive hoffmans suggest contralateral corticospinal tract damage.

Question 2

What is Romberg’s sign?

What pathology does a positive Romberg’s suggest?

Answer 2

Patient loses balance when they stand up straight with eyes closed.

Suggest Cerebellar damage AND/OR posterior column disease of spinal cord (loss of proprioception and/or vibratory)

Question 3

VAGAL nerve simulation is FDA approved for what illnesses?

Answer 3

Refractory partial complex epilepsy in patients >12 yo

AND

Refractory MDD

Question 4

What is Hallervorden Spatz syndrome?

What is the pathophysiology of this illness?

Answer 4

A rare autosoma recessive disease of childhood that presents as a combination of dementia and parkinsonsim.

deficiency of enzyme cysteine dioxygenase, causing cysteine to build up in the brain, causing build up of Iron bc cysteine chelates Iron –> Iron build up in basal ganglia.

Question 5

What is the triad of Wernike’s encephalopathy?

Is it permanent of reversible?

Answer 5

1. Confusion
2. Eye movement abnormalities
3. Ataxia (stance and gait)

Reversible if given high dose thiamine.

Question 6

1. Subacute combined degeneration is due deficiency of what vitamin?
2. Which CNS area is affected?
3. How does it present?

Answer 6

1. B12
2. Posterior and lateral columns of spinal cord
3. Posterior Column deficits = loss proprioception and vibratory, UMN limb weakness, spasticity and babinskis,

Question 7

Isoniazid treatment for TB can cause what vitamin deficiency?

Symptoms?

Answer 7

B6 (Pyridoxine deficiency)

Symptoms = sensorimotor polyneuropathy (distal paresthesias, motor weakness and sensory loss)

Question 8

West Nile virus belongs to what family of virus’?

Answer 8

Arbovirus (refers to any virus that uses arthropod vector)

Question 9

Deficiency of what neurotransmitter in what area of the brain has been implicated in the pathophysiology of Alzheimer’s dementia?

Answer 9

Ach deficiency in Nucleus basalis of Meynert in forebrain.

Ach is responsible for short term memory, attention, executive functioning through the Nucleus Basalis of Meynert

Question 10

Aspergillosis if a fungal infection that usually occurs in immunocompromised patients.

1. Where in the body does it usually originate?
2. What CNA lesions are characteristic?

Answer 10

1. Lungs
2. Predilection for infiltration of posterior circulation causing veterbrobasilar stroke. Also sinus infection that can extend into brain.