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