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Flashcards in Neurology Deck (280)
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91

Pt with dizziness, n/v, loss of pain/tmep sensation L half of face adn R side body, wavy lines, tends to fall to left while trying to sit up, hoarsemneess, dysphagia

Left Lateral Meduallary syndrome

92

32yo F no Pmhx p/w stroke - exam pain and tenderness over calk - etio?

PFO

93

45yo F lupus and Antiphospholipid syndrome with h/o DVT in past on warfarin PT 3.4 with TIA with R eye blury vision whic resolves in 10 min wtd?

Echo with bubble study

94

82yo M brought in with h/a and R wkness - CT hyperdense lesion in pareital area suggestive of subarachnoid hematoma BP 135/76 - no h/o trauma cause?

Amyloid angiopathy

95

Hepatopul syndrome

see bubbles q4 beats

96

Broca's aphasia

non-fluent speech
CAN comprehend
Frontal lobe
MCA

97

Wernicke's aphasia

fluent speech but non-sensical
Can't comprehend
Temporal lobe
MCA

98

Conductive Aphasia

Can't repeat
CAN comprehend and read

99

Global Aphasia

Sensory and motor aphasia
Branch of middle cerebral or internal carotid artery

100

Pure word blindness

can't read - occipital lobe - PCA

101

Subarachnoid hemorrhage

Thunderclap headache, hit by hammer headache, worst h/a of life
nausea, vomiting, alter conciousness, neck stiffness, seizure, CNIII palsy wtd?
CTH -
If neg -> LP check for xanthochormia
LP neg? - MRA r/o reversible cerebral vasocontriction syndrome (tx'd with CCB)
Tx: Amlodipine
Best test to confirm prior to surgery: Cerebral angiogram

102

Complications of SAH

Rebleed 24hrs - 1 month
Vsaospasm 4 to 10 days
Hydrocephalus - late

103

Best drug to tx vasospam

Nifedipine

104

Best time to do surgery

ASAP - clipping or coiling for causative aneursym

105

1 week after aneurysm surgery stroke develops - cuase?

vasospasm induced infarct

106

Vertigo - Central

Cause - brainstem/cerebellar dz, MS, cerebellar atrophy, basilar infarct, arnold chiari malformation
Nystagmus - Horizontal OR vertical
Visual fixation - NO inhibition of nystagmus
Hearing loss/tinnitis +-
N/V - Pos
Severity - severe

107

Vertigo - peripheral

Cause - vestibular neuritis, labrythnthitis, Menier's dz, benign positional vertigo
Nystagmus - ONLY horizontal
Visual fixation - inhibition of nystagmus
Hearing loss/tinnitus - labyrinthitis (vestibular nerutis - ), Menier's dz +
N/V - very bad
Severity - very bad

108

Pt with vertigo and horizontal nystagmus - on visual fixation nystagmus dissappears - dx?

peripheral vertigo

109

Pt with vertigo/horizontal nytagmus - visual fixation negates nystagmus - - inovlvmenet of vestbular portion of 8th nerve with diziness lasting hours to days - no deafness - URI 1 week ago dx?

Vestibular neuritis (Labyrinthitis)
Tx: Meclizine

110

35yo recurrent dizzziness and tinnitius and sensation fullness in ear for months aw n/v - exam horizontal nystagmus disappears with visual fixation - audiogram with hearing loss dx?

Meniere's dz (tinnitus, hearing loss, vertigo)
Tx: Salt restriction, diuretics, surgical ablation

111

70yo M with new onset dizziness x 2 hours, BP high wtd?

MRA posterior vessels r/o brainstem stroke

112

Dx of benign positiional vertigo?

Dix halpike maneurver

113

Pt with vertigo, unilateral tinnitus, progressive hearing loss dx?

Accoustic Neuroma
Etio - Schwann cells
Dx test - MRI

114

Pt with vertigo while turing in bed, getting in and out of bed, bending over and straightening up, extending neck to look up, epsisoes >30s NO hearing loss dx?

Benign positional vertigo - Dx with Dix halpike maneuver
Tx: Epley otiolith manuever -> Vestibular rehab

115

Pt with vertigo, dysarthria, diplopia, ataxia dx?

Vertebral bulabar insufficiency

116

Duration of vertigo

Seconds: BPPV, TIA
Minutes: Migraine, orthostatic hyptension, TIA
Hours: Migraine, Meniere's
Days: Migraine, Labryrinthitis, Meneire's
Weeks: Labryrinthitis

117

Hearing testing

Normal: Webber - tuning fork on forehead - both ears hear same, Rhinne test AC>BC b/l ears
Unilateral air conduction deafness - Webber - hear better in affected ear (from forehead) - BC>AC Rhinne test
b/l conductive deafness/otosclerosis - webber - both ears hear equally, BC>AC both ears (rhinne)
Unilateral sensory deafness - no bone or air conduction from rhine test - webber test on forehead - only normal ear hears
b/l sensory deafness - both rhine and webber no hearing either ear...

118

Vertigo with fluctuating hearing loss, tinnitis lasting hours to days

Meniere's dz

119

Vertigo with progressie hearing loss and tinnitus, whisper test decreased - tuning for non left mastoid without response - tuning for on forehead with better hearin gon right

Acoustic neuroma (unilateral sensory hearing loss) - lateralize to good ear

120

Vertigo lasting 30 s and wakes up pt no hearing loss

Benign positional vertigo