Neuro Shelf – Flashcards
Unlock all answers in this set
Unlock answersquestion
What happens to tremor in Parkinsons when sleeping?
answer
It goes away
question
What ocular finding is seen in phenytoin toxicity?
answer
Nystagmus
question
If a patient has sciatica radiating down the back of their leg, what exam finding will be seen? What dermatome is this?
answer
S1 dermatome Loss of Achilles reflex
question
What is the first sign of increased ICP on fundoscopic exam?
answer
Blurred disc margins
question
How do the eyes react to hot caloric testing?
answer
Nystagmus toward ear
question
What is a common sign of carotid dissection?
answer
Horner's Syndrome
question
What findings are expected with CN III palsy?
answer
Mydriasis, ptosis
question
Besides bone, what is most dense on head CT?
answer
Blood
question
What may be the cause of facial tics following Bell's palsy?
answer
Aberrant regeneration of the facial nerve
question
What do you do if you suspect SAH, but a CT is normal?
answer
LP
question
What type of tumor commonly arises from the tentorium cerebelli?
answer
Meningioma
question
A contrast enhancing lesion lying close to the bone with slowly developing neuro s/s is most likely what?
answer
Meningioma
question
Where is the lesion in a pure motor stroke?
answer
Internal capsule
question
Where is the lesion in a pure sensory stroke?
answer
Thalamus
question
What are the findings in lateral medullary syndrome? What artery is affected?
answer
Vomiting, vertigo, nystagmus Dec. pain/temp ipsilateral face, contra body DYSPHAGIA AND HOARSENESS IPSILATERAL HORNER SYNDROME Ataxia, dysmetria PICA and/or Vertebral artery
question
Damage to which nucleus might cause dysphagia?
answer
Nucleus ambiguus - 9th and 10th nerves are here
question
In elderly patients without hypertension, what is the most common cause of cerebral hemorrhage?
answer
Amyloid angiopathy
question
What is the drug of choice for post-stroke seizure?
answer
Phenytoin - immediately therapeutic vs lamotrigine or some other choice
question
How do you recognize a patient with Sturge Webber? What lesions might they have in the brain?
answer
Port wine nevus Leptomeningeal angiomas
question
What site commonly has a saccular aneurysm compressing the III nerve?
answer
PComm
question
What vessel is likely affected with painless transient monocular vision loss?
answer
Central retinal artery
question
What can result from rapid phenytoin infusion?
answer
Arrhythmia
question
When are the peak times after drinking cessation for seizures and DT's respectively?
answer
1-2 days 2-4 days
question
What characterizes Lennox-Gastaut syndrome?
answer
Mental dysfunction, multiple seizure types, 1-2Hz spike-wave discharges on EEG
question
Where in the brain do olfactory auras with seizures originate?
answer
Mesial temporal lobe or hippocampus
question
What is the most common deficit experienced after temporal lobectomy?
answer
Superior quadrantanopsia
question
What is a Jacksonian march?
answer
Focal seizure activity that slowly and sequentially spreads
question
What type of seizure may cause loss of awareness, but performing tasks, especially odd ones?
answer
Partial complex
question
What is epilepsia partialis continua?
answer
Focal seizure activity that continues, may not have LOA
question
What differentiates classic and common migraine?
answer
Classic has a visual aura
question
What disease is commonly associated with trigeminal neuralgia?
answer
MS
question
What physical finding is seen in patients with tension headache?
answer
Slightly reduced neck ROM
question
If you do a CT on a patient with subdural hematoma ~1 week after the incident, what will you see?
answer
Possibly nothing because the blood has become similar density to the cortex by then
question
What is the most common neurologic sequelae of sarcoid?
answer
Facial nerve paralysis
question
How do you treat toxoplasma?
answer
Sulfadiazine and pyrimethamine
question
What characteristic structure is seen on pathological exam of a patient with HIV dementia?
answer
Microglial nodules
question
What EEG findings are seen in HSV encephalitis?
answer
Bilateral periodic eplileptiform discharges
question
What organisms causes fungal otitis externa and osteomyelitis?
answer
Aspergillus
question
What is the most common symptom in patients with brain abscess?
answer
Headache
question
Rapidly progressive dementia and increased T2 signal in basal ganglia indicate...
answer
spongiform enecphalopathy
question
What are the three ways you can get CJD?
answer
Corneal transplant Dural transplant HGH preps from cadaver pituitary
question
What CSF findings are present in SSPE?
answer
Increased IgG fraction and oligoclonal bands
question
What are the most common childhood brain tumors?
answer
Astrocytomas and medulloblastomas
question
What might be seen on imaging of a meningioma?
answer
Mass near bone with thinning or hypertrophy of overlying skull
question
What brain tumor is common in patients with VHL?
answer
Hemangioblastoma
question
What is the most common primary tumor site for seeding the CNS?
answer
Lung
question
If a tumor is causing neuroendocrine abnormalities or fits of laughter, where is it likely located?
answer
Hypothalamus
question
What tumor may arise in a patient with NF1 and cause blindness?
answer
Optic glioma
question
What neuropathy can occur in multiple myeloma?
answer
Paraproteinemic polyneuropathy
question
What pathologic change is seen in the brain of patients with long standing hepatic dysfunction?
answer
Increased # of astrocytes
question
What is the most common neuro complication of renal failure? What is the treatment?
answer
Peripheral neuropathy Dialysis helps but transplant is the definitive treatment
question
How does vision change with B12 deficiency?
answer
Normal blind spot enlarges and affects central vision
question
What will the EEG look like in a patient with Alzheimer's?
answer
Background slowing
question
What is the most common complication of VP shunt placement?
answer
Subdural hematoma
question
What aphasia is common with Alzheimer?
answer
Transcortical sensory aphasia
question
Prior to exhibiting myoclonus, what are the symptoms of CJD?
answer
Ataxia, dysarthria, diplopia, blurred vision, visual agnosia 14-3-3 protein in CSF
question
What are the two common manifestations of neurosyphilis called?
answer
Tabes dorsalis General paresis
question
What disease causing alien hand syndrome and visual complaints, may be seen in immunocompromised patients?
answer
PML
question
What will be seen on pathologic exam of the substantia nigra in a patient with Parkinson's?
answer
Lewy bodies
question
What happens to speech and writing in Parkinson's?
answer
It gets progressively more quiet and writing gets smaller.
question
What test is sensitive for optic neuritis, and is often used as a component of MS diagnosis?
answer
Visual evoked responses
question
Is tuberous sclerosis AD or AR?
answer
AD
question
What additional pathology is associated with Chiari 2 malformation?
answer
Spina bifida
question
In which patients do you see adenoma sebaceum?
answer
Tuberous sclerosis
question
What retinal findings is seen in TSc?
answer
Retinal phakomas
question
Patients with TSc will have what findings on head CT after age 5?
answer
Calcified subependymal glial nodules
question
In an infant with TSc and seizures what is the treatment?
answer
ACTH
question
What lab finding may indicate that a woman carries the muscular dystrophy mutation?
answer
High CPK
question
What intellectual finding is seen in DMD?
answer
Mild MR
question
An EMG in a person with myotonic dystrophy will show:
answer
Repetitive discharge with minor stimulation
question
In ALS which spinal tract is destroyed? What is the worst prognostic indicator?
answer
Corticospinal tract Involvement of cranial nerves
question
What area is most often atrophied in the CNS of alcoholics?
answer
Superior vermis of cerebellum
question
In young children, what is the most severe consequence of lead poisoning?
answer
Cerebral edema --> herniation
question
What are the symptoms of mercury poisoning?
answer
Tremors, memory loss
question
What are the symptoms of lead poisoning?
answer
Peripheral motor neuropathy
question
What are the symptoms of arsenic poisoning?
answer
Hemolysis, encephalopathy, neuropathy
question
What are the symptoms of manganese poisoning?
answer
Parkinsonism - looks like Wilson's
question
How do you treat pseudotumor cerebri in a young patient?
answer
LP
question
What is indicated by absent red reflex in a newborn?
answer
Congenital cataracts
question
What is the first sign of CN III impingement?
answer
Pupillary dilation
question
What occurs with diabetic damage of CN III?
answer
Sparing of pupillary action - affected vessel supplies inner portion of CN III
question
What are the findings in INO?
answer
When looking away from affected eye the unaffected eye will exhibit nystagmus with the fast component directed temporally
question
What vascular issues causes abrupt painless vision loss? What if it is transient?
answer
Retinal artery thrombosis OR Posterior ciliary artery in AION but this is usually just inferior vision Internal carotid disease - essentially TIAs
question
What type of hearing loss results from hearing an explosion?
answer
High tone sensorineural
question
Severe vertigo from a stroke is likely due to occlusion of what artery?
answer
PICA
question
What types of sound are lost initially in Meniere disease?
answer
Low tones
question
Fullness, tinnitus, hearing loss, vertigo =
answer
Meniere Disease
question
Which nerve roots contribute to the ulnar nerve?
answer
C8-T1
question
What may occur after cord contusion?
answer
Syrinx formation
question
At what level does the artery of Adamkiewicz branch?
answer
T10-L1
question
Which spinal roots contribute to the patellar reflex?
answer
L2-L3
question
What is the most common cause of mononeuropathy multiplex?
answer
Diabetes
question
Injury to which cord of the brachial plexus would cause wrist drop?
answer
Posterior cord
question
Which disease is highly associated with Friedrich ataxia?
answer
Diabetes
question
On what chromosome is frataxin located?
answer
9
question
An MRI showing diffuse punctate hemorrhages following an MVC indicates what?
answer
Diffuse axonal injury
question
What is the best treatment for optic neuritis?
answer
IV methylprednisolone
