Flashcards in Pretest Deck (41):
cranial nerve palsy in sarcoid?
-same in Lyme disease
mcc of fungal meningitis
-acquired from lungs and spreads to CNS hematogenously
-most common organism?
-most common site?
-most common mechanism of spreading?
-gray-white matter junction
-hematogenous spread of infection
most common organism of brain abscess in AIDs pt?
most common fungal brain abscess?
rabies invasion of CNS?
-retrograde axoplasmic flow
-from periphery extending centripetally along peripheral nerves
-only supportive tx available
source of CJD?
growth hormone treatment from cadaver pituitary gland
-hatch in GI --> spread to CNS --> multiple cysts in cerebrum
-feco-oral spread; S. America, SE Asia, Africa
von Hippel Lindau syndrome
-multiple tumors & cysts in different organs (CNS, kidneys, eye)
-hemangioblastoma* --> lethal if bleeds into brain
-clear cell renal carcinoma, pheochromocytoma, pancreatic tumors/ cysts
brain metastases with highest mortality?
common maligancies in AIDS pts?
-lymphoma (primary CNS tumor)
-Kaposi sarcoma (rarely mets to brain)
-seen in hypothalamic hamartomas
hyperCa --> dec membrane excitability --> what symptoms?
deficient enzymes of:
-hexaosaminidase A (Tay-Sax lacks hex)
-sphingomyelinase (No man picks his nose with his sphinger)
`things that precipitate subacute combined degeneration?
-giving folate before B12 (when both deficient)
-atrophic gastritis --> intrinsic factor deficiency
visual defect with B12 deficiency?
-tx alcohol withdrawal, anxiety
alcohol vs benzodiazepine withdrawal symptoms
-alcohol: within 72 hours
-benzodiazepines: 7-10 days post abstinence
-B3 (nicotinic acid) deficiency
-dermatitis, diarrhea, dementia, death
-symptoms: edema, irritability, anorexia, dematoses, enlarged liver
Pickwickian syndrome = obesity hypoventilation syndrome
obesity + hypersomnia + hypoxemia + pulmonary HTN
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)
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
-chorea in a pregnant woman
-asymmetric, forceful movements
-caused by dramatic change of hormonal environment of brain
-can happen with estrogen replacement, as well
Sydenham's chorea px
-after Group A beta-hemolytic Streptococcus infection
-dysarthria, behavior changes, gait disturbance, slowed cognition, hypotonia
-no genetic or MRI abnormalities
substantia nigra in Parkinson's disease show what?
= intracytoplasmic inclusion bodies = eosinophilic inclusions
flexion of neck causes electrical sensation to radiate down spine
-seen in MS
Canavan's disease px
-occurs in infants by 6 months
-spongiform change to white matter
abetalipoproteinemia px, cause
-dec LDL, VLDL, chylomicrons
-posterior column & spinocerebellar degeneration
-MTP mutation --> impaired VLDL formation --> dec vit E delivery & dec fat absorption
Sturge-Weber syndrome px
-port wine stain*
-abnormal blood vessels*
-ipsilateral leptomeningeal angioma
-tram track calcifications*
-phenylalanine hydroxylase deficiency --> lack of tyrosine & accumulation of phenyl-alanine & -ketones
-some may restrict dietary phenylalanine intake
-px: seizures, intellectual delay, musty body odor
-tryptophan malabsorption --> nicotinamide (vit B3) deficiency
-scaly erythematous rash
telangiectasias in fundi on retinal exam - what disease?
von Hippel Lindau
-numerous tumors and cysts
first trimester viral infection can lead to?
aqueductal stenosis --> hydrocephalus
-ash leaf spots
-adenoma sebaceum (malar distribution)
-CNS calcifications (calcified subependymal glial nodules --> hydrocephalus)
-retinal phakomas (no tx needed)
fetal alcohol syndrome px
-intra- & post-uterine growth retardation
-CNS: brainstem/cerebellum malformation, learning disability, microcephaly, hetrotopia (cortical neurons in abnormal locations)
-proximal muscle weakness
-erythema over knuckles
DMD carrier will have elevations of what in serum?
creatinine phosphokinase (CPK)
DMD can be seen in females with what genetic disorder?
Turner syndrome (XO)
-UMN & LMN symptoms --anterior horn cells, corticospinal tract, brainstem motor nuclei, etc
-denervation atrophy of muscles
-bad prognosis: if cranial nerves affected --fasciculations of tongue (Cr XII)