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Flashcards in Neurology Deck (280)
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31

Thunderslap h/a, CT head neg, CSF xanthochromia

Subarachnoid hemorrhage

32

Chronic h/a inc'd with lying down

brain tumor

33

Young obese pt with headache and horizontal nysstagmus

Pseudotumor cerebri

34

Acetazolamide

Pseudotumor cerebri

35

50yo F seizure or focal weakness, h/a worse on coughing/lying down CT 4cm large edema/mass effect NO CA+

Glioblastoma/astrocytoma
most common and aggressive primary brain tumor
Surgery primary therapy with chemo/radiation
dexamethasone

36

50yo h/a worse on coughing, lying down, CT INTRAVENTRICULAR tumor

Choroid plexius papilloma
slow growing benign tumor of ventricular system in choroid plexus - inc'd CSF production - inc'd OCP -> hydrocephalus
Tx: Surgery

37

50yo F h/o seizure d/o for 4 years - CTH 3cm tumor in sylvian fissure - diffuse enhancement with contrast

Meningioma
Usually benign
Arise from meninges
Seizures or weakness
Syvian fissure
Inc'd ICP

38

Following tumors metastasize to brain

Breast, lung melanoma, lymphoma, renal
(NOT prostate)

39

45yo F lighting pain jabs in gums, cheek, chin, several times per day and last few seconds at a time - no focal neurolgical signs, oral exam normal

Carbamazepine

40

Facial Palsy

Supranuclear (CVA) - Upper face spared

Infranuclear - both UPPER AND LOWER face
Bell's palsy
Accoustic Neuroma
Ramsay Hunt syndrome
Guillain-barre
Lyme Dz
Sarcoidosis

41

Motor Neuron Disease

Lower motor neuron (Infra-nuclear) - dec'd reflexes, dec'd muscle tone, +Fasciculations

Upper motor neurons (Supra-nuclear) - inc'd reflexes, inc'd muscle tone, NO fasciculations

42

30yo with erythema chronicum migrans 4 weeks ago now with left sided upper and lower face paralysis preceded by ha

Infranuclear lesion

43

55yo vesicular lesions on R side face with pain involving ear

Supra-nuclear lesion

44

65yo M with slurred speech and lower face paralysis

Suprnuclear lesion

45

55yo pw R sided facial paralysis of unknown etio

infranuclear lesion

46

60yo M sudden onlset R facial weakness, drooling of saliva inability to close R eye - mouth deviating to left side, unable to raise eyebrows - rest of neuro exam normal

Artificial tears, patch R eye at night, start PREDNISONE

47

Young woman co diplpia - closing one eye - diplpia persists dx?

Monocular psychogenic diplopia

48

CN III palsy

can't look up, down or inward
Where is lesion?
posterior commuicating artery
Dx: MRA brain

49

Pt in MVA brought to ER with h/a - PE shows R pupil 2mm, left pupil 4mm - ptosis of R eye - wtd?

CT angio neck
dx: Carotid artery dissection

50

Pt with acute onset diplopia h/o DM, Ptosis

Acute cranial mononeuropathy

51

Pt with hyperthyroid and exopthalmos - unable to completely abduct and has double vision - cause?

Thyroid opthalmopathy
Tx: steroids

52

R optic neuritis

MS with blindness in right eye

53

Tumor pressing on optic chiasma (acromegaly)

Bitemporal hemianopia

54

Left Optic tract

Right dense homonymous hemianopia

55

Left optic radiation (occipital lobe)

Right homonymous quadrantanopia

56

Stroke

Days
Throbotic - 50% preceeded by TIA
Embolic - more rapid onset
Hemorrhagic - HTN, amyloi angiopathy

Minutes

TIA -
Carotid artery syndrome -
Ipsillateral visual loss (amaurosis fugax)
Shadow in front of eye - contralateral motor or sensory changes

Vertebrobasilar syndrome DDD
Dizziness, Diplopia, Dysarthria
Sudden wk of legs -> dorp attacks
B/l Wk
Tx: ASA

57

Pt with TIA higher risk of stroke if...

Duration >10min
Speech disturbance
Age>60
DM

58

Most important risk factor for stroke?

HTN

59

Pt with TIA

Hopsital w/u - carotid dopper, EKG, CT brain, Coags, TEE r/o PFO

60

If carotid shows >70% wtd?

Carotid endarectomy + ASA