neurology Flashcards
1
Q
treatment of trigeminal neuralgia
A
carbamazepine
2
Q
resting tremor, cogwheel rigidity, bradykinesia, postural instability
A
PD
3
Q
loss of dopamine in the substantia nigra
A
PD
4
Q
tremor with movement, hx in family, propranolol
A
essential tremor
5
Q
is there a tx for intention tremor?
A
NO, based in cerebellum
6
Q
AD, anticipation, chorea, trinucleotide repeat
A
HD
7
Q
first line tx for cluster HA
A
OXYGEN!
8
Q
verapamil as ppx for _____ HA
A
cluster HA
9
Q
*** 3 ppx meds for migraine HA
A
propranolol, topiramate, valproic acid
10
Q
young woman on OCP with HA, papilledma, and LP with opening pressure > 25
A
pseudo tumor cerebri
11
Q
*** tx of pseudo tumor cerebri
A
Acetolamide
Serial LPs
VP shunt
12
Q
*** suspect cord compression, what rx to give?
A
steroids
13
Q
plaques and tangles, chromosome 21, diffuse cortical atrophy
A
alzheimers
14
Q
frontotemporal degeneration, personality changes
A
Pick’s disease
15
Q
undercooked meat, myoclonus, dementia in young person
A
CJD
16
Q
wet, wobbly, weird
A
normal pressure hydrocephalus - increased ICP, sx relieved with LP
17
Q
how to differentiate labrynthitis from vestibular neuritis
A
labrynthitis = hearing loss
18
Q
hearing loss, tinnitus, vertigo
A
meniere’s disease
19
Q
meniere’s tx
A
salt restrict, thiazides, meclizine for anti-vertigo
20
Q
corneal copper accumulation on slit lamp + dysarthria, dystonia, depression
A
Wilson’s disease, copper accumulation in brain and liver
21
Q
*** pill-rolling tremor, fluctuating cognition and visual hallucinations, dementia BEFORE PD symptoms
A
Dementia with Lewy Bodies
22
Q
ataxia, urinary incontinence, dilated ventricals on brain imaging
A
normal-pressure hydrocephalus
23
Q
*** microatheroma, lipohyalinosis, internal capsule of brain, pure motor hemiparesis
A
lacunar infarct
24
Q
risk factors for lacunar infarct
A
HTN, hyperlipidemia, DM, smoking
25
*** bridging veins + concave hemorrhage that crosses suture lines
subdural hematoma
26
head/neck pain + ipsilateral ptosis, miosis, anhidrosis
carotid artery dissection
27
profound neurological deficits - hemi sensory and vision loss
carotid artery thrombosis with infraction to cerebral hemisphere
28
pt on OCP or with malignancy + new HA, AMS, seizures, focal neuro deficits
cerebral sinus thrombosis
29
thunderclap HA + ruptured saccular aneurysm
subarachnoid hemorrhage
30
*** oligoclonal IgG bands on CSF
MS
31
albuminocytologic dissociation
Guillan Barre
32
CSF with neutrophillic pleocytosis
bacterial CNS infection, meningitis
33
HIV with AMS, EBV DNA in CSF, solitary ring-enhancing lesions
primary CNS lymphoma
34
tremor of both hands with ACTION, relieved by alcohol, tx with propranolol
essential tremor
35
tremor at REST that decreases with voluntary movement
PD
36
tremor WORSE as hand reaches target + ataxia, dysmetria, gait disorder
cerebellar dysfunction
37
encephalopathy, ocular dysfunction, gait ataxia
wernicke encephalopathy due to THIAMINE deficiency
38
what are TWO important things to rule out in FIRST time seizure
metabolic causes (electrolytes, blood glucose) and toxic causes (urine drug screen)
39
if urine tox screen and metabolic labs are BOTH NORMAL, what next in first seizure workup?
imaging to rule out structural cause + EEG
40
lacunar infarct/posterior limb of internal capsule
unilateral motor impairment - NO sensory or visual deficits
41
MCA occlusion
CONTRALATERAL somatosensory + motor deficit
Aphasia
Hemineglect
Homonymous hemianopia
Conjugate eye deviation toward side of infarct
42
ACA occlusion
CONTRALATERAL somatosensory + motor deficit
Lack of will/initiative
Dyspraxia, emotional disturbance, urinary incontinence
43
occlusion of this artery can result in urinary incontinence
ACA
44
occlusion of these TWO arteries can result in contralateral somatosensory and motor deficits
MCA and ACA
45
occlusion of this artery results in aphasia
MCA
46
*** If a person is right handed and has an occlusion of the Left MCA, what unique symptom may they develop?
Aphasia
47
Occlusion of the MCA of the dominant lobe can lead to ____
APHASIA
48
Occlusion of the MCA of the NON-dominant lobe can lead to _____
hemineglect or anosognosia (lack of awareness regarding one's illness)
49
antibodies against ACh receptors of the motor end plate
myasthenia gravis
50
eyes, neck and upper extremity fluctuating weakness
myasthenia gravis
51
inflammatory demyelination and ascending paralysis
GBS
52
autoimmune demyelination of white matter tracts in CNS
MS
53
inability to raise the eyebrow, close the eye, drooping of mouth corner, disappearance of nasolabial fold
Bell's palsy - peripheral neuropathy of 7th cranial nerve `
54
4 migraine preventative meds
topiramate, divalproex sodium, TCA, beta blockers
55
"washed-out" color vision in young woman + afferent pupillary defect on exam
MS with optic neuritis
56
*** acute painless vision loss + exam with retinal whitening and cherry red spot
central retinal artery occlusion
57
*** drusen yellow deposits
macular degeneration, central vision leoss
58
*** gradual painless peripheral vision loss + exam with increased cup:disc ratio
open-angle glaucoma
59
*** floaters, flashes of light + peripheral vision loss
retinal detahcment
60
*** rapid severe eye pain, halos around lights, pupil dilated and minimally responsive to light, tearing, HA, N/V
acute angle glaucoma
61
anorexic/alcoholic with confusion, horizontal nystagmus and wide-based gait
Wernicke encephalopathy - give thiamine then glucose
62
large ischemic strokes and those treated with thrombolytics are at risk of ____
hemorrhagic transformation - if suspect, get an emergent noncontrast CT, surgical decompression needed
63
imaging to rule out brain bleed
CT WITHOUT contrast
64
visual defects, HA, sx of hormonal deficiencies
think SELLAR mass - pituitary adenoma, craniopharyngioma, meningioma
65
arises from Rathke's pouch, compresses optic chiasm, bitemporal blindness
craniopharyngioma
66
*** tumor that causes HA, hearing loss, vertigo, tinnitus, balance problems
cerebellopontine angle tumors
67
*** bridging veins, crescent-shaped hypodensity that crosses the suture lines
subdural hematoma
68
early personality changes, compulsive behaviors, executive dysfunction
fronto-temporal dementia
69
loss of GABA, caudate nucleus and putamen atrophy, CAG trinucleotide, AD with anticipation
Huntington disease
70
*** loss of ACh producing neurons in nucleus basalis of Meynert
Alzheimers
71
loss of dopamine-producing neurons
PD
72
brain abscess bugs
strep viridans and staph aureus
73
*** this toxin BLOCKS the release of inhibitory neurotransmitters glycine and GABA
tetanus
74
*** flaccid paralysis, impariment of presynaptic ACh release
botulism
75
this physical exam finding is sensitive and specific for upper motor neuron OR pyramidal/corticospinal tract disease
pronator drift
76
ataxia, intention tremor, imparied rapid alternating movements
cerebellar dysfunction
77
*** movement of distal phalange with patients eyes closed and Romberg test *stand with eyes closed
tests for proprioception
78
CSF with normal glucose and lymph predominance
viral meningitis
79
CSF with low glucose < 40 and high WBC
bacterial meningitis
80
this nerve is injured with anterior hip dislocation or pelvic surgery
obturator nerve - weakness with adduction
81
*** Two most common cancer metastases to brain
lung and breast
82
*** Patient is found to have multiple brain metastases, what cancers are likely?
lung and malignant melanoma
83
CD4 < 100, fever, HA, AMS, seizures, multiple ring-enhancing lesions
toxoplasmosis
84
*** brain cysts at various stages of developement
neurocysticercosis - pork tapeworm
85
degenerative disease with parkinsonism, autonomic dysfunction, widespread neurological signs
multiple system atrophy (Shy-Drager syndrome)
86
anhydrosis, miosis, ptosis
Horner syndrome
87
*** chemo rx that can cause peripheral neuropathy
vincristine, paclitaxel and cisplatin
88
ascending paralysis preceded by URI or diarrheal illness
GBS
89
CSF with high protein and normal WBC and glucose
GBS
90
*** GBS tx
IVIG and plasmapharesis
91
cerebellar hemorrhage sx
occipital HA, neck stiffness, N/V, nystagmus, ipsilateral hemiataxia
92
*** How often do nerve deficits related to MS generally hang around? vs TIA?
MS = days to weeks, TIA = seconds to minutes
93
*** 3 things to treat acute MS exacerbation
glucocorticoids, immunoglobulins, plasma exchange therapy
94
acute confusion, extreme hyperthermia, tachycardia, coagulopathic bleeding after prolonged exposure to high temp
exertional heat stroke
95
*** unilateral foot drop, impaired ankle dorsiflexion, preserved plantar flexion, sensory changes over dorsal foot and lateral shin
common fibular neuropathy due to compressive injury
96
subcortical white matter demyelination
MS
97
MOA and application of pyridostigmine
acetylcholinesterase inhibitor, myasthenia gravis tx
98
patient with ptosis found to have thymoma on chest CT
myasthenia gravis
99
myasthenia crisis tx
plasmapharesis and immunoglobulin
100
*** ____ is the only antiplatelet agent that is effective in reducing the risk of early recurrence of ischemic stroke
aspirin; given to all patients with 24 hrs of presentation for stroke
101
*** What to do for patients > 70% stenosis or carotid AND symptomatic?
endarectomy
102
*** early side effects of carbidopa-levidopa
hallucinations, confusion, agitation, dizziness, somnolence, nausea
103
painless flashes, floaters and curtain across visual field
retinal detachment
104
autoantibodies against nicotinic acetylcholine receptors at the NMJ
MG
105
pt with fever, AMS, focal neuro deficits, seizures and CSF with normal glucose, elevated WBC with lymphocytes, tx with acyclovir
herpes encephalitis
106
another word for vasovagal syncope
neurocardiogenic
