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Flashcards in Pretest Deck (41):
1

cranial nerve palsy in sarcoid?

Cr VII

-same in Lyme disease

2

mcc of fungal meningitis

cryptococcus
(encapsulated fungus)

-acquired from lungs and spreads to CNS hematogenously

3

brain abscesses:
-most common organism?
-most common site?
-most common mechanism of spreading?

-Streptococcus
-gray-white matter junction
-hematogenous spread of infection

-Staph post-neurosurgery

4

most common organism of brain abscess in AIDs pt?

toxoplasma gondii

5

most common fungal brain abscess?

aspergillus

6

rabies invasion of CNS?

-retrograde axoplasmic flow
-from periphery extending centripetally along peripheral nerves

-only supportive tx available

7

source of CJD?

growth hormone treatment from cadaver pituitary gland

8

cysticercosis

-taenia solium
-pork tapeworm
-hatch in GI --> spread to CNS --> multiple cysts in cerebrum

-feco-oral spread; S. America, SE Asia, Africa

9

von Hippel Lindau syndrome

-autosomal dominant
-multiple tumors & cysts in different organs (CNS, kidneys, eye)

-hemangioblastoma* --> lethal if bleeds into brain
-clear cell renal carcinoma, pheochromocytoma, pancreatic tumors/ cysts

10

brain metastases with highest mortality?

malignant melanoma

11

common maligancies in AIDS pts?

-lymphoma (primary CNS tumor)
-Kaposi sarcoma (rarely mets to brain)

12

gelastic seizure

uncontrollable laughter

-seen in hypothalamic hamartomas

13

hyperCa --> dec membrane excitability --> what symptoms?

-lethargy
-weakness
-areflexia

14

deficient enzymes of:
-Tay Sachs
-Gaucher
-metachromatic leukodystrophy
-Neimann-Pick

-hexaosaminidase A (Tay-Sax lacks hex)
-glucocerebrosidase
-arylsulfatase A
-sphingomyelinase (No man picks his nose with his sphinger)

15

`things that precipitate subacute combined degeneration?

-giving folate before B12 (when both deficient)
-atrophic gastritis --> intrinsic factor deficiency
-nitrous oxide

16

visual defect with B12 deficiency?

centrocecal scotoma

17

chlordiazepoxide

-benzodiazepine
-tx alcohol withdrawal, anxiety

18

alcohol vs benzodiazepine withdrawal symptoms

-alcohol: within 72 hours
-benzodiazepines: 7-10 days post abstinence

19

pellagra

-B3 (nicotinic acid) deficiency
-dermatitis, diarrhea, dementia, death

20

kwashiorkor

-protein-energy malnutrition
-symptoms: edema, irritability, anorexia, dematoses, enlarged liver

21

Pickwickian syndrome = obesity hypoventilation syndrome

obesity + hypersomnia + hypoxemia + pulmonary HTN

22

transcortical sensory aphasia
seen in what disease?

decreased ability to understand complex linguistic structures

-seen in Alzheimer's; along with aphasia (dec fluency, dysnomia, etc)

23

MPTP addiction causes what to brain?

-damage to substantia nigra --> Parkinson-like symptoms which develops over a few months (vs years in regular Parkinson's disease)

-MPTP is similar to heroin

24

chorea gravidarum

-chorea in a pregnant woman
-asymmetric, forceful movements
-caused by dramatic change of hormonal environment of brain

-can happen with estrogen replacement, as well

25

Sydenham's chorea px

-after Group A beta-hemolytic Streptococcus infection
-chorea
-dysarthria, behavior changes, gait disturbance, slowed cognition, hypotonia
-kids, girls
-no genetic or MRI abnormalities

26

substantia nigra in Parkinson's disease show what?

Lewy bodies
= intracytoplasmic inclusion bodies = eosinophilic inclusions

27

flexion of neck causes electrical sensation to radiate down spine

Lhermitte's sign

-seen in MS

28

Canavan's disease px

-occurs in infants by 6 months
-extensor posture
-rigidity
-myoclonic seizures
-spongiform change to white matter

29

abetalipoproteinemia px, cause

-dec LDL, VLDL, chylomicrons
-acanthocytes
-ataxia
-posterior column & spinocerebellar degeneration
-retinitis pigmentosa

-MTP mutation --> impaired VLDL formation --> dec vit E delivery & dec fat absorption

30

Sturge-Weber syndrome px

-port wine stain*
-glaucoma
-seizures
-mental retardation
-abnormal blood vessels*
-ipsilateral leptomeningeal angioma
-tram track calcifications*

31

phenylketonuria

-autosomal recessive
-phenylalanine hydroxylase deficiency --> lack of tyrosine & accumulation of phenyl-alanine & -ketones

-some may restrict dietary phenylalanine intake
-px: seizures, intellectual delay, musty body odor

32

Hartnup's disease

-tryptophan malabsorption --> nicotinamide (vit B3) deficiency
-autosomal recessive
-ataxia
-scaly erythematous rash

33

telangiectasias in fundi on retinal exam - what disease?

von Hippel Lindau

-numerous tumors and cysts

34

first trimester viral infection can lead to?

aqueductal stenosis --> hydrocephalus

35

tuberous sclerosis

-ash leaf spots
-shagreen patches
-adenoma sebaceum (malar distribution)
-CNS calcifications (calcified subependymal glial nodules --> hydrocephalus)
-renal tumors
-cardiac rhabdomyomas
-seizures
-retinal phakomas (no tx needed)
-autsomal dominant

36

fetal alcohol syndrome px

-intra- & post-uterine growth retardation
-dysmorphic facies
-CNS: brainstem/cerebellum malformation, learning disability, microcephaly, hetrotopia (cortical neurons in abnormal locations)

37

dermatomyositis px

-proximal muscle weakness
-heliotrope rash
-erythema over knuckles

-paraneoplastic syndrome

38

DMD carrier will have elevations of what in serum?

creatinine phosphokinase (CPK)

39

DMD can be seen in females with what genetic disorder?

Turner syndrome (XO)

40

ALS

-UMN & LMN symptoms --anterior horn cells, corticospinal tract, brainstem motor nuclei, etc
-fibrillations
-denervation atrophy of muscles

-bad prognosis: if cranial nerves affected --fasciculations of tongue (Cr XII)

41

Parinaud syndrome

-paralysis of upward gaze
--> downward gaze primary position

-pinealoma association