NEUROLOGY 4 Flashcards Preview

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Flashcards in NEUROLOGY 4 Deck (15)
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1
Q

PINEAL GLAND TUMORS, can sometimes secrete what hormone causing what syndrome?

A

HCG, causing precocious puberty.

2
Q

What are the most common causes of Vertebrobasilar insufficiency which is caused by decreased blood flow to base of brain…causing a wide variety of Labyrinth and Brain stem issues IE vertigo, dizziness, dysarthria, diplopia and numbness.

A
  • DM ***
  • Emboli
  • Thrombi
  • Arterial dissection
3
Q

What are the three indications for Carotid Endarterectomy?

A

> 80% occlusion

OR

> 70% occlusion + symptoms

OR

Male with >59% + symptoms

4
Q

What are the three nerves that can get damaged during Carotid Endarterectomy?

What symptoms do you see due to damage of these nerves?

A
  1. Hypoglossal Nerve (CN 12)
    - -> tongue deviation toward lesion
  2. Facial Nerve (CN 7)
    - -> Asymmetric smile
  3. Recurrent Laryngeal Nerve
    - -> unilateral vocal cord paralysis
    - -> change in voice.
5
Q

Posterior communicating Artery aneurysm often presents with what symptoms?

A

CN 3 pathology (Occulomotor)

  • Ptosis (laveter palpebra)
  • Aniscoria (unequal pupils)
  • diff with accommodation
  • problem with eye movement, diplopia
6
Q

Spina Bifida is the failure of neural tube closure during fetal development…what is the difference between

Meningocele and Myelomeningocele?

In patient with Myelomeningocele…even after surgery many can have what deficits?

A
Meningocele = herniation of meninges only 
Myelomeningocele = Herniation of meninges and spinal cord. 

Neurogenic bladder, neurogenic bowel and motor/sensory deficits.

7
Q

Amyotrophic Lateral Sclerosis is a CLINICAL dx with >2 regions of UMN disease and >1 region with LMN disease…

What are symptoms of UMN vs LMN disease?

What is PROGNOSIS?

A

UMN:

  • Spastic paralysis
  • Increased DTR
    • babinski

LMN:

  • Flaccid Paralysis
  • Decreased DTR
  • Fasciculations
  • Muscle atrophy

DEATH IN 3-5 YEARS due to respiratory failure

8
Q

What drug can help prolong survival in ALS?

What is the mechanism of action?

A

RILUZOLE

glutamate inhibition

9
Q

Treatment of essential tremor?

A

Propranolol

10
Q

What is the genetics of TUBEROUS SCLEROSIS?

What are the S/S you see in the following systems:

  1. SKIN
  2. CNS
  3. HEART
  4. RENAL
A

Autosomal dominant mutation of TSC 1 or TSC 2 gene. \

  1. SKIN:
    - Ash leaf spots – hypo pigmented macules
    - Shagreen patches – thick, pebbly skin
  2. CNS
    - Glioneuronal hamartomas
    - Autism/Cognitive disability
    - Epilepsy
  3. HEART
    - Rhabdomyoma
  4. RENAL:
    - Agiomyolipoma
11
Q

Are individuals with Tuberous Sclerosis at an increased risk of malignancy, given their numerous growths?

A

NO, growths rarely undergo malignant transformation.

12
Q

IF you suspect Tuberous Sclerosis, what five exams must you do in your initial work up?

A
  1. Thorough skin exam
  2. EEG
  3. MRI brain –> hamartomas
  4. Fundoscopy –> Hamartomas
  5. Abd imaging –> Renal mass
13
Q

What is the leading cause of death for individuals with Tuberous Sclerosis?

A

Neurologic impairment (seizures, hydrocephalus, ext)

14
Q

What is the first line TRX for a PROLACTINOMA?

A

DA RECEPTOR AGONIST

  • Bromocriptine
  • Cabergoline

(even large tumors can be managed medically)

15
Q

What is First line TRX for Alzheimers?

What agent can you add if mod-severe (mmse < 17)

A

FIRST LINE = Acetylcholinesterase Inhibitors

  • DONEPEZIL
  • RIVASTIMINE
  • GALANTAMIE

Add Memantine