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1
Q

Romberg test

A

feet close together with eyes closed testing for proprioception/joint sense (dorsal columns)

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2
Q

S1 nerve root compression 2/2 to herniated disc. Symptoms? What’s spared?

A
  • pain in buttock region or lower back often radiating down posterior thigh and calf
  • loss of ankle jerk (S1)
  • bowel and bladder PRESERVED
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3
Q

What does COWS help you remember in assessing nystagmus?

A

Cold water in ear, the nystagmus will be Opposite side

Warm water in ear, the nystagmus will be Same side

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4
Q

Most likely site producing non-communicating/obstructive hydrocephalus?

A

aqueduct stenosis

cerebral aqueduct connects 3rd and 4th ventricles

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5
Q

Cafe au lait spots + b/l acoustic neuromas?

A

NF type 2 -problem with chromosome 22

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6
Q

relaxed adult will show what waves on EEG

A

alpha waves (8-13 hz)

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7
Q

What is disconnection syndrome?

A

alexia WITHOUT agraphia (cannot read words but can write words) due to lesions in left occipital lobe and splenium of corpus callosum

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8
Q

Visual and auditory hallucinations
Paranoia
Personality changes
Which viral infection?

A

HSV encephalitis affecting medial temporal lobes

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9
Q

What is thalamic pain syndrome?

A

recovering from a thalamic stroke (contralateral sensory loss, numbness and tingling), paradoxical pain can develop in the same regions

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10
Q

Symptoms of Wallenberg Syndrome

A
  • ipsilateral horners, loss of facial pain and temp
  • contralateral pain and temp
  • dysphagia, dysphonia, hiccups, headaches
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11
Q

Injury to which nucleus can cause hoarseness and dysphagia?

A

nucleus ambiguous in ventrolateral medulla b/c it contains MOTOR NEURONS to CN 9 and 10.

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12
Q

What’s the most common cause of lobar hemorrhage in elderly patients without hypertension

A

cerebral amyloid angiopathy

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13
Q

Sturge weber syndrome

A
  • port wine stain on face
  • seizures
  • leptomeningeal angiomatosis
  • V1 sensory involvement
  • railroad like calcifications
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14
Q

unilateral CNIII deficits, pupil dilated and oculomotor impairment -etiology?

A

posterior communicating artery aneurysm compressing on nerve

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15
Q

Hollenhurst plaque

A

cholesterol emboli that ca obstruct central reintal artery causing half of vision to go black, but it’s transient and vision returns in 30 min

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16
Q

Global aphasia is characterized by

A

impaired comprehension, repetition and fluency

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17
Q

Conduction aphasia is characterized by the biggest problem in repetition due to

A

probs with arcuate fasciculus

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18
Q

Side effects of phenytoin intoxication

A

nystagmus
cardiac arrhythmias
hypotension

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19
Q

If someone has seizures, what should be done?

A

Get imaging to rule outbrain tumors before EEG

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20
Q

What is Lennox-Gaustat disease?

A

congenital disorder iny oung with hypotonia, falls, generalized tonic clonic seizures, decreased cognifitive functions, slow EEG (1-2Hz), may have h/o of infantile spasms

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21
Q

Left temporal infarct will lead to what types of visual field deficits

A

Right superior quadrantanopsia

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22
Q

What’s the most common cause of intractable complex partial seziures in adults?

A

Medial Temporal Sclerosis aka hippocapal sclerosis

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23
Q

What is Jacksonian march?

A

Aka sequential seizure: focal seizure activity that is primarily motor and spreads often secondarily generalized that can lead to loss of consciousness. Hand is common focal place to start.

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24
Q

If someone with absence seizures cannot take ethuxsuximide, what is the next option of choice?

A

valproic acid

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25
elbow fracture: which nerve will be more commonly involved?
elbow --> ulnar nerve (C8-T1) leading to claw hand when there's impaired extension of unlar 2 dights when pts try to straighten
26
Failure to flex biceps = injury to which nerve?
musculocutaneous nerve (lateral cord, C5, C6, C7)
27
CT shows hemorrhage and pt has increased BP and decreased HR (Cushing response) -what to do next?
surg evacuation of hematoma
28
TBI caused by MVA commonly affect which parts of brain
temporal lobes and inferior frontal lobe
29
Economo encephalitis aka encephalitis lethargica can cause long-lasting side effects similar to which disease?
parkinsons
30
In Brazil, someone develops b/l LE weakness with granulomas in spinal cord, which parasite is involved?
Schistosoma mansoni
31
CJD -CSF findings?
normal
32
What can you assess when you order CT with contrast?
infection | malignancy
33
What kind of nodules are fund in someone with HIV and CMV infections in the brain?
microglial nodules (resident macrophages of CNS)
34
EEG assoc with herpes encephalitis
b/l periodic epileptiform discharge with slow waves over temporal lobes
35
An iv drug user can develop mycotic aneurysms 2/2 to endocarditis. Where can you find these aneurysms and abscesses in the brain?
around gray white matter
36
Bacterial abscess in brain most causative organism is
strep pneumo
37
PML is infection of JC virus in immunocompromised. Will find inclusion bodies where
in oligodendrocyte nuclei therefore causing a demyelinating disease
38
SSPE -characteristic CSF finding?
SSPE caused by reactivation of measles virus years later. CSF will show increased gamma-globulins, oligoclonal bands
39
Cats scratch disease caused by bartonela hensalae is assoc with regional adenitis and what types of CNS symptoms
aseptic meningitis | status epilepticus
40
Brain mets from which primary cancer can cause high likelihood of bleed
melanoma
41
Parinaud syndrome
can be caused by problems of pineal gland (pineocytoma) --> loss of vertical gaze, loss of pupillary light reflex
42
Symptoms of hypercalcemia
fatigue, letharge, weakness, areflexia
43
Which abs are assoc with paraneoplastic cerebellar degeneration?
anti-purkinje abs aka anti-Yo abs
44
Alcohol affects what types of neurons?
striatal neurons, purkinje cells
45
Most common neurologic complication of chronic kidney disease?
peripheral neuropathy involving axonal degeneration
46
Vitamin E deficiency can cause what type of CNS symptoms
- spinocerebellar degeneration, polyneuropathy, pigmentary retinopathy - can see increased CPK, increased bilirubin
47
Someone with NPH will have CSF results of
normal
48
What are some complications of ventriculoperitoneal shunt?
complications like subdural hematoma 2/2 to decreased ICP causing brain to pull away from meninges stretching bridging veins; infections
49
What are the language deficits assoc with AD
transcortical sensory aphasia, decreased fluency
50
Coarse skin, macroglossia, delusions, ataxia can be due to
hypothyroidism
51
MRI/CT of someone with HD
caudate atrophy --> lateral ventricles having a common boomerang shape
52
What happens when you give someone with HD dopa-like drugs?
unmask corea
53
Where do you find the substantia nigra?
midbrain | substantia nigra is a basal ganglia nuclei
54
intoxification with MPTP drug can cause?
progressive damage to substantia nigra --> parkinsonism
55
What is Meige syndrome?
focal dystonia with blepharospasm (involuntary tight closure of eyelids), forceful jaw opening, lip retraction, neck contractions and tongue thrusting
56
What 4 conditions can show oligoclonal bands on CSF
MS syphilis SSPE lyme
57
Canavan disease
AR disorder: rapid regression of psychomotor function, loss of sight, increased urinary excretion of N-acetyl-L aspartic acid,
58
Explain the bladder problems assoc with MS
- bladder is spastic (UMN-corticospinal tract is involved) - little or no residual urine after voiding b/c contractility is good - bladder has POOR distensibility though leading to urinary urgency and incontinence - can treat with anti-cholinergics like oxybutynin
59
What is Uhthoff phenomenon found in MS
heat sensitivity | -MS symptoms worsen when temperature is high
60
Neuromyelitis optica (abs against aquaporin channels) characterized by
b/l optic neuritis | transverse myelitis
61
Adrenoleukodystrophy is an X-linked d/o characterized by
``` limb ataxia nystagmus mental retardation cerebellar involvement decreased cortisol ```
62
No arylsulfatase A --> schwann cells with sulfatides
metachromatic leukodystrophy
63
Agenesis of corpus callosum leads to which characteristic imaging finding
batwing conformation of lateral ventricles
64
VHL syndrome
microscopic hematuria, RCC, retinal angiomas, hemangioblastomas
65
Tuberous sclerosis
``` AD d/o shagreen patches adenoma sebaceum retinal phakomas CNS calcifications ```
66
Werdnig Hoffman
congenital weakness, hypotonia, muscle atrophy
67
Someone with cancer with muscle weakness, worry about which paraneoplastic problems
lambert eaton | dermatomyositis
68
Onset at age 12-30 with Early cataracts, testicular atrophy, baldness, increase stubborness, hostility, cardiac defects --> ? which is an AD d/o due to expansion of CTG repeats on chromosome 19
myotonic dystrophy
69
Lead intoxication in adults can cause what nervous system effects?
- death by brain herniation 2/2 to brain edema - radial nerve palsy - peripheral neuropathy
70
Mercury poisoning can cause what types of nervous system effects
- memory problems - depression - gait ataxia - limb and facial tremors - decreased pain and temp sensation
71
Arsenic poisoning can cause what types of symtpoms
- tonic clonic seizures - hemolysis - GI symptoms - headache - hallucinations - absent DTRs
72
Ergot (found in rye) poisoning can cause what type of nervous system invovlement
-degeneration of posterior columns --> problems with sensory (vibratory and proprioception)
73
What are some delayed neuro findings of CO poisoning
1-3 weeks after can cause parkinsonian gait
74
Manganese inhalation causes neuro symptoms similar to which disease
wilsons' disease, parksinons
75
What type of poisoning can cause temperature reversal phenomenon (hot feels cold and cold feels hot)
-ciguatera poisoning
76
Absent vs white relfex
absent reflex -congenital cataracts | white reflex -Retinitis pigmentosa
77
Marcus Gunn pupil
afferent pupillary defect that can be assessed with swinging flashlight test; often develops in pts with MS
78
of 3, 4, 6 -which CN palsy is most common
6
79
Which nerve is most likely involved in VZV affection
CN 4
80
Initial sign of CNIII compression
impaired constriction to light
81
Medial longitudinal fasciculus syndrome
incomplete adduction ipsilateral to lesion in the MLF on conjugate gaze
82
ocular bobbing is assoc with damage to
pons
83
Cyclosporine and tacrolimus can cause nephrotoxicity and what on the brain?
hypertensive encephalopathy
84
What is adie tonic pupil aka adie syndrome?
tonically dilated pupil that reacts slowly to light but shows a more definite response to accommodation. It is frequently seen in females with absent knee or ankle jerks and impaired sweating. It is caused by damage to the postganglionic fibers of the parasympathetic innervation of the eye, usually by a viral or bacterial infection which causes inflammation, and affects the pupil of the eye and the autonomic nervous system
85
Most common cause of acute monocular blindness?
ischemic optic neuropathy caused by occlusion of posterior ciliary artery --> sudden painless loss of vision in one eye; opposite eye can be involved days later
86
Presbycusis
most common cause of hearing loss in elderly. high frequency perception is impaired due to neuronal degeneration most likely of the spiral ganglion neurons of cochlea
87
BC > AC signifies
conduction hearing loss -problems with middle ear
88
explosion causing acoustic trauma leads to
high tone sensorineual loss; trauma is in the cochlea
89
Characterize the sensorineural hearing loss found in Meniere's
loss of lower tones first (differs from presbycusis when higher tones are lost)
90
What are some drug induced causes of viral labyrinthitis
salicylates alcohol quinine aminoglycosides
91
drug induced tinnitus caused by
acetylsalicylate toxicity
92
Where do you find olfactory cortex
in prepiriform gyrus/lateral olfactory gyrus
93
Spinal fracture leading to spinal shock characterized by
1) areflexia and flaccidity then days to weeks later 2) hypereflexia and spasticity
94
In MVA, which movement causes lumbar vertebral body fracture
extreme flexion
95
What's the significance of artery of Adamkiewcz (aka arteria radiclaris magna or anterior medullary artery)
it is a major anterior radicular artery that supplies lower 2/3 of spinal cord. It's at risk of occlusion during AAA repair. It enters at T10-L1
96
Spinal cord ischemia is usu most severe in the distribution of which artery?
anterior spinal artery leading to probs with spinothalamic and corticospinal tracts.
97
CSF findings in cerebral or spinal cord infarction
usu just increase CSF proteins
98
Lyme neuropathy
- facial nerve palsy | - can affect deep peroneal nerve that supplies anterior tibial muscle that is responsible for dorsiflexion --> foot drop
99
Knee jerk level
L2, L3, L4
100
Fredriechs ataxia
AR d/o chromosome 9 gait ataxia peripheral neuropathy 2/2 to degeneration of dorsal root ganglia cardiomyopathy (EKG changes will show myocarditis)
101
Parsonage-Turner syndrome
acute brachial plexopathy without known cause begins with acute onset of pain in neck, shouler, or upper arm followed by 3-10 days of proximal muscle weakness, resp dysfunction
102
Familial Dysautonomia aka Riley day disease
AR d/o affecting jewish kids leading to impariment in pain and temp sensation, parasym and symp distrubances
103
NO poisoning causes neuropathy similar to
vit b12 deficiency b/c also causes megaloblastic anemia and peripheral neuropathy
104
Presence of raccoon eyes aka periorbital ecchymoses is evidence of
basillar skull racture
105
What method that can be induced in someone with TBI assoc with decrease cerebral injury
induce hypothermia

Neurology (5 decks)

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