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Flashcards in Neurology Deck (31)
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1
Q

Cranial nerves name and function

A
1- olfactory (smell)
2- optic (vision)
3- oculomotor (eye mvmt, light reflex)
4- trochlear (eye mvmt)
5- trigeminal (mastication, sensory face)
6- abducens (lat eye mvmt)
7- facial ( facial expression, taste)
8- vestibulocochlear (hearing, balance)
9- glossopharyngeal ( taste, swallow, speech)
10- vagus (taste, swallow, lift palate, speech)
11- accesory (turn head, lift shoulder)
12- hypoglossal (move tongue)

EXPLICIT PNEUMONIC: oh oh oh to touch and feel virgin girls’ vaginas arouses harry

2
Q

Cranial nerves and if they control sensory, motor, or both

A
1- sensory
2- sensory
3-motor 
4-motor
5- both
6- motor
7- both
8-sensory
9- both
10-both
11-motor
12-motor

EXPLICIT PEUMONIC: some say marry money but my brother says big boobs matter more

3
Q

Parkinson’s disease

A
S/s:
resting tremor
bradykinesia
rigidity
posture/balance changes
insidious onset
unilateral
constipation

Eval:
response to Parkinson meds

txt:
Levodopa
deep brain stim

4
Q

dementia

A

Def: Acquired, sustained impairment in intellectual function in at least 3 areas

SS: 
Major memory changes
Language deficits
Perceptual deficits
Praxis disturbances
Types:
Alzheimer's dx (donepezil 5 mg po qd)
diffuse lewy body disease
vascular dementia
frontotemporal dementias
5
Q

MS

A
SS: 
blurred vision
visual field defect
paresthesia
numbness
weakness
dysarthria
loss balance
urinary abnormalities
lhermitte's sign - flick distal end of finger and it curls up

Eval:
MRI w and w/out contrast (T2)

Txt:
symptomatic

6
Q

MS Types

A

Relapsing/Remitting MS - discrete attaches that evolve over days to weeksusually complete recovery back to baseline

Secondary Progressive MS - Begins as RRMS
steady deterioration where between acute attacks the pt does not return to baseline

Primary Progressive MS - no attacks but steady decline from disease onset

Progressive/Relapsing MS - occasional attacks steady deterioration from onset

7
Q

Migraine

A
SS:
lasts 4-72 hrs
unilateral
pulsating
intensity moderate to severe
aggravated by physical activity
N/V
photophobia
phonophobia

Eval:
Have to have 5 attacks before dx
debilitating

Txt:
- Prophyalixis
BB
CCB
SSRI
TCA
anti-seizure meds
- abortive
OTC analgesics
sumatriptan 25 mg po x 1
vasoconstrictors/ergots
anti-emetics
serotonin agonists
IV/IM NSAID's
Narcotics
Steroids
8
Q

Cluster HA

A
SS:
unilateral
excrutiating
penetrating pain
trigeminal nerve distribution
lacrimation
conjunctival injection
nasal congestion/rhinorrhea
ptosis
miosis

Txt:
Oxygen
similar to migraine but no BB

9
Q

Tension HA

A
SS:
pressing/tightness/band-like
mild-moderate intensity
unaffected by physical activity
possible photo/phonophobia

Txt:
Mild analgesics
stress reduction
relaxation techniques

10
Q

Subdural Hematoma summary

A

Def: bleeding between dura and arachnoid/brain with significant brain injury

Cause: tears of bridging veins between cerebral cortex and dura

SS:
sickle shape
HA with confusion
obtundation
Elderly/alcoholics

Eval:
CT

11
Q

Epidural Hematoma summary

A

Def: bleeding between inner skull table and dura with no brain injury

Cause: skull fx tear middle meningeal artery

SS: 
lenticular
Brief LOC
awake with HA
deteriorating mental status
rapidly progress to herniation of brain

Eval:
CT

Txt:
neurosurgery -> good prognosis

12
Q

Grand mal seizure

A

SS:
Begin with abrupt LOC usually without warning
Pt falls to ground with trunk/extremities ext (tonic)
Then, rhythmic jerking of trunk and extremities (clonic)
often apnea, cyanosis, tongue-biting, urinary incontinence
lasts 60-90 seconds

Eval:
Glucose
Mg
Ca
Lumbar puncture
Txt:
phenytoin
carbamazepine
valproic acid (500 mg bid)
phenobarbital
13
Q

Petit mal seizure

A

SS:
brief, abrupt LOC
blank stare with eyelids twitching
no response to voice
no falls, involuntary mvmt, post-ictal phase, attacks cease abruptly
Typically seen in little kids and then they grow out of it

Eval:
Glucose
Mg
Ca
Lumbar puncture

Txt:
valproic acid

14
Q

Partial seizure

A

Simple partial seizure - no alt or loss consciousness

Complex partial - involves change in LOC or mentation
usually bizarre sx like visceral, hallucinations, memory disturbances, dream like states, automatisms, affective disorders

15
Q

Concussion

A

Def: Transient LOC or alteration conciousness

SS: 
Duration secs to hours
Post-concussive syndrome SS
- HA
- memory
- anxiety
- insomnia
- dizziness
16
Q

Basilar skull fracture gen char

A

Def: across base temporal bone

SS:
hemotypanum
raccoon's eyes
battle's sign
CSF rhinorrhea/otorrhea

Txt:
Observe

17
Q

Encephalitis

A

def: inflammation of the brain parenchyma

SS:
abnormalities in brain function
fever
HA
N/V
signs outside of CNS
Eval:
PCR/cultures
CSF
CT/MRI
EEG

txt:
acyclovir (antiviral)
supportive

18
Q

What are signs of UMN lesion

A

weakness

spasticity

19
Q

What are signs of LMN lesion

A

weakness
flaccidity
atrophy

20
Q

Muscular Dystrophy summary

A

Def: progressive muscle weakness and atrophy in predictable patternsInherited disorder

SS:
frequent falls
gower's sign
not hitting major milestones while growing
trouble clearing throat
heart arhythmias
intestinal pseudo-obstruction
lower IQ
Eval:
Muscle biopsy
Serum Creatine Kinase
ALT/AST
Gene testing
EKG
Txt:
PT
ventilation
prednisone
creatine
ACEI or BB
Immunizations
21
Q

Myasthenia Gravis summary

A

Autoimmune disorder
affects neuromuscular junction

SS:
diplopia
ptosis
dysphagia
asthesia
muscle fatigue
dyspnea

Eval:
Acetylcholine Receptor Antibody Test
Anti-MUSK antibody test
Repetitive Nerve Stimulation

Txt:
acetylcholinesterase inhibitors
steroids

22
Q

ALS

A

Def: sclerosis of umn and lmn involved with corticospinal tract

SS:
muscle weakness
sapsticity
stiffness
difficulty walking
weird laughing/crying
trouble swallowing

Eval:
labs
imaging
EMG

Txt:
Riluzole
supportive txt

23
Q

What is visual acuity

A

distance normal person see object

24
Q

Blepharitis summary

A

Def: inflammation of lid margin

Txt:
lid scrubs
topical abx

25
Q

Hordeolum summary

A

Def: stye - painful pustule of meibomian gland

Txt:
warm compresses
massage
self-limiting

26
Q

Chalazion summary

A

Def: painless nodule of lid

Txt: warm compress

27
Q

Conjunctivitis summary

A

Def: Bac - pink eye (purulent drainage all day long)
Viral - MC

Viral SS:
self-limiting
Itching
burning
watery discharge
Unilateral start

Bac Txt:
cleanse
abx
NO sulfa

Viral Txt:
warm/cool compresses
chilled eye drops
steroids

28
Q

glaucoma summary

A

primary open angle (MC)

Once visual acuity lost will not get back

Optic disc changes due to pressure

Txt:
prostaglandins
BB
surgery

29
Q

Pupils dx

A

Anisocoria = asymmetric sizes of pupils
RAPD = pupil not restrict due to direct light
Adie’s (tonic) pupil = no or sluggish response to light

30
Q

Cataract summary

A

Def: loss transparency lens
nuclear sclerosis MC

SS:
blurry vision
worsening visual acuity
improved near vision
black/white with red reflex
31
Q

retinopathy

A

HTN cause formation new vessels

SS:
blind spots
blurry vision
vision loss
copper wire arterioles
AV nicking
cotton wool spots
dot blot/flame shaped hemorrhages

Txt:
BP
blood sugar