Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine Clerkship > Rest of neuro > Flashcards

Rest of neuro Flashcards

1
Q

presentation of early parkinsons vs late

A

Early PD presents as TRAP –
pill-rolling Tremor, cogwheel
Rigidity, Akinesia, Postural
instability

late PD presents as Alzheimer-like dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

pathophys of parkinsons + treatment

A

loss of DA neurons in substantia nigra

early PD → Tx Sinemet (carbidopa + levodopa)
late PD → Tx subthalamic nucleus deep brain stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

pathology seen in brain with PD

A

PD brain: neuronal death in substantia nigra, senile plaques, Lewy bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

PD + autonomic insufficiency

A

Shy-Drager syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

PD w/o ophthalmoplegia or tremors

A

Progressive supranuclear palsy (PSP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

genetics of huntingtons

A

AD CAG trinucleotide repeats on

chromosome 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

presentation and pathophys of huntingtons + Tx

A

↓GABA → chorea, apathy, depression,
dementia w/ onset at 35-50 y/o

no tx available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

AD tremor w/ intentional activity but not at rest,
improved w/ EtOH use

Tx?

A

essential tremor

Bblockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

gait instability, loss of balance,

impaired limb coordination

A

ataxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ataxia w/ staggering gait, nystagmus, pes

cavus and hammer toes

A

fridreich ataxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Friedreich ataxia (ataxia w/ staggering gait, nystagmus, pes cavus and hammer toes) + telangiectasias

A

Ataxia-telangiectasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Etiologies of aquired ataxia?

A

EtOH, B12/thiamine deficiency, cerebellar dz, demyelinating dz, or 3° syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

most severe tic disorder w/
multiple daily motor/vocal tics,
onset before 18 y/o; associated
w/ OCD and ADHD

tx?

A

tourettes

rx with clonidine or pimozide (haldol if severe)

*Coprolalia: involuntary swearing, pathognomonic but rare in Tourette syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

selective CNS demyelination → optic neuritis, intranuclear ophthalmoplegia (crazy eyes), transient sensory deficits, etc.

how to dx? treat?

A

MS

Dx MRI (multiple white plaques), LP w/ CSF analysis (oligoclonal bands)

Tx IFN-β (prevent relapses), high-dose steroids (for acute attacks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

rapid PNS demyelination → ascending weakness/paralysis, possible respiratory arrest

how to Dx? tx?

A

guillian-Barre syndrome

Dx CSF (↑protein), EMG (↓nerve conduction)

Tx IVIG vs. plasmapheresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

differential dx for ring enchaning lesions

A 
MALT
mets
abcess
lymphoma
toxo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

general brain cancer smx/ mass effect smx?

A

HA, seizures, focal neuro smx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MC brain cancers?

A

Mets&raquo_space;> astrocytoma (adults) > infratentorial (kids)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

can cross corpus callosu, pseudopalisading

necrosis, GFAP+

A

GBM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Rosenthal fibers, GFAP+

A

astrocytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

“fried egg” cells, chicken-wire

capillary pattern

A

oligiodendroglioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Psamomma bodies, attached to

dura

A

meningioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

S-100+, CN VIII

A

acoustin neuroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

multiple ring-enhancing lesions + AIDS/immunosuppresion

A

primary CNS lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

MC souces of brain mets

A

lung > breast > skin > kidney > colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Bilateral schwannoma, think:

A

NF type 2

27
Q

cancer that metastasizes to meninges via bloodstream → focal neuro sx, meningitis,
hydrocephalus

Dx with? tx?

A

Meningeal carcinomatosis

Dx with LP and CSF analysis showing malignant cells

tx intrathecal chemotherapy

28
Q

gradually progressive muscle weakness
(initial sx is ptosis, diplopia, blurry vision) that get worse w/ repetitive muscle use

pathophys? how to dx/work up? tx?

A

Myasthena gravis

Dx ↑anti-nAChR (best),
edrophonium test, EMG (decreased response w/ repetitive stimulation), chest CT to look for thymoma

Tx pyridostigmine, plasmapheresis (if severe), thymectomy (if thymoma)

29
Q

treatment for myathenic crisis

A

emergent ventilation

30
Q

gradually progressive muscle weakness
that get better w/ repetitive muscle use

pathophys? how to dx?

A

SCLC → anti-VGCC

dx with elevated anti-VGCC

31
Q

ascending weakness w/ Gowers maneuver, calf
pseudohypertrophy, death by 15 y/o

pathophys, how to dx?

A

Duchenne MD

XR ∆dystrophin → muscle cells
die off

Dx ↑CPK, DNA testing, bx with fatty/fibrotic replacement of muscle cells

32
Q

café-au-lait spots, Lisch nodules (iris hamartomas), CNS tumors, pheos

pathyophys, how to dx?

A 
NF 1 (von Recklinghausen disease)
AD ∆NF1

Dx pheo in pt with NF w/ HTN → Dx urinary metanephrines

33
Q

bilateral acoustic neuromas, juvenile cataracts

A

NF 2

AD ∆NF2

34
Q

CNS/retinal hamartomas, sebaceous

adenomas, hypopigmented “ash leaf spots”, Shagreen patches, renal angiomyolipoma, cardiac rhabdomyoma

A

Tuberous sclerosis

AD ∆TSC1/2

35
Q

facial “port-wine stain” w/ ipsilateral brain AVM

A

Struge-weber

36
Q

hemangioblastomas, bilateral RCC, pheochromocytomas

A

VHL

37
Q

Corticospinal tract carries what kind of info and where does it cross?

A

Motor

crosses in medulla

38
Q

what tract carries touch and proprioception and where does it cross

A

dorsal columns

crosses in medulla

39
Q

what tract carries pain and temp and where does it cross?

A

spinothalamic (anteriolateral system)

crosses in spinal cord

40
Q

central cavitation of cervical cord → bilateral “cape-like”

what tracts are affected? ow to dx? tx?

A

syrinomyelia

loss of spinothalamic and corticospinal

Dx with MRI

Tx with syringosubarachnoid shunt

41
Q

stab wound → spinal cord
hemisection

what tracts are affected and what is presentation

A

Brown-Sequard syndrome

ipsilateral loss of DC and CS, contralateral
loss of ST

paralysis and loss of proprioception on the same (or ipsilateral) side as the injury or lesion, and loss of pain and temperature sensation on the opposite (or contralateral) side as the lesion

42
Q

viral infx → loss of function of entire spinal cord at a single level → bilateral loss of CS/DCML/ALS below level of lesion + sphincter dysfunction

Dx? Tx?

A

Transverse myelitis

Dx with MRI na Tx with high dose steroids

43
Q 
polio infx (fecal-oral) → bilateral lower motor neuron loss of function → asymmetric
muscle weakness w/ normal sensation
A

poliomyelitis

44
Q

What are the 5 types of vertigo?

A 
(BLAME) – 
Benign paroxysmal positional vertigo 
Labyrinthitis
Acoustic
neuroma
Meniere disease,
EtOH/drug-induced
45
Q

treatment of vertigo

A

Tx underlying cause + meclizine for nausea

46
Q

how to dx and treat vasovagal syncope

A

Dx tilt-table study,

Tx β-blockers + disopyramide

47
Q

transient unilateral movements w/o LOC

work up? tx?

A

simple partial sz

first time → Dx labs (renal panel, glucose) + EEG + MRI (r/o mass lesions)
if, epileptic → check anticonvulsant levels

Tx: phenytoin or CBZ

48
Q

transient automatisms w/ LOC → postictal confusion

work up? tx?

A

complex partial sz

first time → Dx labs (renal panel, glucose) + EEG + MRI (r/o mass lesions)
if, epileptic → check anticonvulsant levels

Tx: phenytoin or CBZ

49
Q

sudden LOC → rigidity (tonic phase) →
musculature jerking (clonic
phase) → postictal confusion

A

grandmal sz

50
Q

“staring into space” for a few seconds

tx?

A

absence sz

ethosuximide

51
Q

etiologies of seizures

A 
4 Is + 4 Ms – 
Infx,
Ischemia (stroke/TIA), 
↑ICP,
Intoxication,

Metabolic and electrolytes,
Mass lesions,
Missing drugs (anticonvulsants, sedatives/EtOH)
Misc

52
Q

looks like sz but no EEG changes

A

pseudo seizure

53
Q

partial sz → generalized sz

A

secondary generalized sz

54
Q

brain is stuck in a state of persistent seizure

A

status epilepticus

55
Q

upper and lower motor neuron lesions → progressive muscle weakness → death in 5-10 yrs

how to dx? tx?

A

ALS

Dx EMG (fasciculations, fibrillations), nerve conduction studies (↓conduction velocity)

Tx supportive care + riluzole (glutamate-antagonist that delays death by 3-5 months)

56
Q

Wernike’s: where is the lesion? how does it present?

A

superior temporal gyrus lesion → fluent

w/ impaired comprehension

57
Q

Broca’s: where is the lesion? how does it present?

A

inferior frontal gyrus lesion → nonfluent w/

intact comprehension

58
Q

Conduction aphasia : where is the lesion? how does it present?

A

both gyri lesion → nonfluent w/ impaired

comprehension

59
Q

Global aphasia : where is the lesion? how does it present?

A

arcuate fasciculus lesion → can’t repeat

“no ifs, ands, or buts”

60
Q

etiology of aphasias

A

Etiology: stroke (#1), trauma, tumors, Alzheimer dz

61
Q

b/l bells palsy, think

A

Lyme disease or Guillain-Barre syndrome

62
Q

treatment for bells palsy

A

Tx : depends on etiology

steroids if ≥10 days,
ACV if shingles,
doxycycline if Lyme disease

63
Q

treatment for trigeminal neuralgia

A

CBZ

Medicine Clerkship (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions