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Flashcards in Pretest Deck (105)
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1
Q

Romberg test

A

feet close together with eyes closed testing for proprioception/joint sense (dorsal columns)

2
Q

S1 nerve root compression 2/2 to herniated disc. Symptoms? What’s spared?

A
  • pain in buttock region or lower back often radiating down posterior thigh and calf
  • loss of ankle jerk (S1)
  • bowel and bladder PRESERVED
3
Q

What does COWS help you remember in assessing nystagmus?

A

Cold water in ear, the nystagmus will be Opposite side

Warm water in ear, the nystagmus will be Same side

4
Q

Most likely site producing non-communicating/obstructive hydrocephalus?

A

aqueduct stenosis

cerebral aqueduct connects 3rd and 4th ventricles

5
Q

Cafe au lait spots + b/l acoustic neuromas?

A

NF type 2 -problem with chromosome 22

6
Q

relaxed adult will show what waves on EEG

A

alpha waves (8-13 hz)

7
Q

What is disconnection syndrome?

A

alexia WITHOUT agraphia (cannot read words but can write words) due to lesions in left occipital lobe and splenium of corpus callosum

8
Q

Visual and auditory hallucinations
Paranoia
Personality changes
Which viral infection?

A

HSV encephalitis affecting medial temporal lobes

9
Q

What is thalamic pain syndrome?

A

recovering from a thalamic stroke (contralateral sensory loss, numbness and tingling), paradoxical pain can develop in the same regions

10
Q

Symptoms of Wallenberg Syndrome

A
  • ipsilateral horners, loss of facial pain and temp
  • contralateral pain and temp
  • dysphagia, dysphonia, hiccups, headaches
11
Q

Injury to which nucleus can cause hoarseness and dysphagia?

A

nucleus ambiguous in ventrolateral medulla b/c it contains MOTOR NEURONS to CN 9 and 10.

12
Q

What’s the most common cause of lobar hemorrhage in elderly patients without hypertension

A

cerebral amyloid angiopathy

13
Q

Sturge weber syndrome

A
  • port wine stain on face
  • seizures
  • leptomeningeal angiomatosis
  • V1 sensory involvement
  • railroad like calcifications
14
Q

unilateral CNIII deficits, pupil dilated and oculomotor impairment -etiology?

A

posterior communicating artery aneurysm compressing on nerve

15
Q

Hollenhurst plaque

A

cholesterol emboli that ca obstruct central reintal artery causing half of vision to go black, but it’s transient and vision returns in 30 min

16
Q

Global aphasia is characterized by

A

impaired comprehension, repetition and fluency

17
Q

Conduction aphasia is characterized by the biggest problem in repetition due to

A

probs with arcuate fasciculus

18
Q

Side effects of phenytoin intoxication

A

nystagmus
cardiac arrhythmias
hypotension

19
Q

If someone has seizures, what should be done?

A

Get imaging to rule outbrain tumors before EEG

20
Q

What is Lennox-Gaustat disease?

A

congenital disorder iny oung with hypotonia, falls, generalized tonic clonic seizures, decreased cognifitive functions, slow EEG (1-2Hz), may have h/o of infantile spasms

21
Q

Left temporal infarct will lead to what types of visual field deficits

A

Right superior quadrantanopsia

22
Q

What’s the most common cause of intractable complex partial seziures in adults?

A

Medial Temporal Sclerosis aka hippocapal sclerosis

23
Q

What is Jacksonian march?

A

Aka sequential seizure: focal seizure activity that is primarily motor and spreads often secondarily generalized that can lead to loss of consciousness. Hand is common focal place to start.

24
Q

If someone with absence seizures cannot take ethuxsuximide, what is the next option of choice?

A

valproic acid

25
Q

elbow fracture: which nerve will be more commonly involved?

A

elbow –> ulnar nerve (C8-T1) leading to claw hand when there’s impaired extension of unlar 2 dights when pts try to straighten

26
Q

Failure to flex biceps = injury to which nerve?

A

musculocutaneous nerve (lateral cord, C5, C6, C7)

27
Q

CT shows hemorrhage and pt has increased BP and decreased HR (Cushing response) -what to do next?

A

surg evacuation of hematoma

28
Q

TBI caused by MVA commonly affect which parts of brain

A

temporal lobes and inferior frontal lobe

29
Q

Economo encephalitis aka encephalitis lethargica can cause long-lasting side effects similar to which disease?

A

parkinsons

30
Q

In Brazil, someone develops b/l LE weakness with granulomas in spinal cord, which parasite is involved?

A

Schistosoma mansoni

31
Q

CJD -CSF findings?

A

normal

32
Q

What can you assess when you order CT with contrast?

A

infection

malignancy

33
Q

What kind of nodules are fund in someone with HIV and CMV infections in the brain?

A

microglial nodules (resident macrophages of CNS)

34
Q

EEG assoc with herpes encephalitis

A

b/l periodic epileptiform discharge with slow waves over temporal lobes

35
Q

An iv drug user can develop mycotic aneurysms 2/2 to endocarditis. Where can you find these aneurysms and abscesses in the brain?

A

around gray white matter

36
Q

Bacterial abscess in brain most causative organism is

A

strep pneumo

37
Q

PML is infection of JC virus in immunocompromised. Will find inclusion bodies where

A

in oligodendrocyte nuclei therefore causing a demyelinating disease

38
Q

SSPE -characteristic CSF finding?

A

SSPE caused by reactivation of measles virus years later. CSF will show increased gamma-globulins, oligoclonal bands

39
Q

Cats scratch disease caused by bartonela hensalae is assoc with regional adenitis and what types of CNS symptoms

A

aseptic meningitis

status epilepticus

40
Q

Brain mets from which primary cancer can cause high likelihood of bleed

A

melanoma

41
Q

Parinaud syndrome

A

can be caused by problems of pineal gland (pineocytoma) –> loss of vertical gaze, loss of pupillary light reflex

42
Q

Symptoms of hypercalcemia

A

fatigue, letharge, weakness, areflexia

43
Q

Which abs are assoc with paraneoplastic cerebellar degeneration?

A

anti-purkinje abs aka anti-Yo abs

44
Q

Alcohol affects what types of neurons?

A

striatal neurons, purkinje cells

45
Q

Most common neurologic complication of chronic kidney disease?

A

peripheral neuropathy involving axonal degeneration

46
Q

Vitamin E deficiency can cause what type of CNS symptoms

A
  • spinocerebellar degeneration, polyneuropathy, pigmentary retinopathy
  • can see increased CPK, increased bilirubin
47
Q

Someone with NPH will have CSF results of

A

normal

48
Q

What are some complications of ventriculoperitoneal shunt?

A

complications like subdural hematoma 2/2 to decreased ICP causing brain to pull away from meninges stretching bridging veins; infections

49
Q

What are the language deficits assoc with AD

A

transcortical sensory aphasia, decreased fluency

50
Q

Coarse skin, macroglossia, delusions, ataxia can be due to

A

hypothyroidism

51
Q

MRI/CT of someone with HD

A

caudate atrophy –> lateral ventricles having a common boomerang shape

52
Q

What happens when you give someone with HD dopa-like drugs?

A

unmask corea

53
Q

Where do you find the substantia nigra?

A

midbrain

substantia nigra is a basal ganglia nuclei

54
Q

intoxification with MPTP drug can cause?

A

progressive damage to substantia nigra –> parkinsonism

55
Q

What is Meige syndrome?

A

focal dystonia with blepharospasm (involuntary tight closure of eyelids), forceful jaw opening, lip retraction, neck contractions and tongue thrusting

56
Q

What 4 conditions can show oligoclonal bands on CSF

A

MS
syphilis
SSPE
lyme

57
Q

Canavan disease

A

AR disorder: rapid regression of psychomotor function, loss of sight, increased urinary excretion of N-acetyl-L aspartic acid,

58
Q

Explain the bladder problems assoc with MS

A
  • bladder is spastic (UMN-corticospinal tract is involved)
  • little or no residual urine after voiding b/c contractility is good
  • bladder has POOR distensibility though leading to urinary urgency and incontinence
  • can treat with anti-cholinergics like oxybutynin
59
Q

What is Uhthoff phenomenon found in MS

A

heat sensitivity

-MS symptoms worsen when temperature is high

60
Q

Neuromyelitis optica (abs against aquaporin channels) characterized by

A

b/l optic neuritis

transverse myelitis

61
Q

Adrenoleukodystrophy is an X-linked d/o characterized by

A
limb ataxia
nystagmus
mental retardation
cerebellar involvement
decreased cortisol
62
Q

No arylsulfatase A –> schwann cells with sulfatides

A

metachromatic leukodystrophy

63
Q

Agenesis of corpus callosum leads to which characteristic imaging finding

A

batwing conformation of lateral ventricles

64
Q

VHL syndrome

A

microscopic hematuria, RCC, retinal angiomas, hemangioblastomas

65
Q

Tuberous sclerosis

A
AD d/o
shagreen patches
adenoma sebaceum
retinal phakomas
CNS calcifications
66
Q

Werdnig Hoffman

A

congenital weakness, hypotonia, muscle atrophy

67
Q

Someone with cancer with muscle weakness, worry about which paraneoplastic problems

A

lambert eaton

dermatomyositis

68
Q

Onset at age 12-30 with Early cataracts, testicular atrophy, baldness, increase stubborness, hostility, cardiac defects –> ? which is an AD d/o due to expansion of CTG repeats on chromosome 19

A

myotonic dystrophy

69
Q

Lead intoxication in adults can cause what nervous system effects?

A
  • death by brain herniation 2/2 to brain edema
  • radial nerve palsy
  • peripheral neuropathy
70
Q

Mercury poisoning can cause what types of nervous system effects

A
  • memory problems
  • depression
  • gait ataxia
  • limb and facial tremors
  • decreased pain and temp sensation
71
Q

Arsenic poisoning can cause what types of symtpoms

A
  • tonic clonic seizures
  • hemolysis
  • GI symptoms
  • headache
  • hallucinations
  • absent DTRs
72
Q

Ergot (found in rye) poisoning can cause what type of nervous system invovlement

A

-degeneration of posterior columns –> problems with sensory (vibratory and proprioception)

73
Q

What are some delayed neuro findings of CO poisoning

A

1-3 weeks after can cause parkinsonian gait

74
Q

Manganese inhalation causes neuro symptoms similar to which disease

A

wilsons’ disease, parksinons

75
Q

What type of poisoning can cause temperature reversal phenomenon (hot feels cold and cold feels hot)

A

-ciguatera poisoning

76
Q

Absent vs white relfex

A

absent reflex -congenital cataracts

white reflex -Retinitis pigmentosa

77
Q

Marcus Gunn pupil

A

afferent pupillary defect that can be assessed with swinging flashlight test; often develops in pts with MS

78
Q

of 3, 4, 6 -which CN palsy is most common

A

6

79
Q

Which nerve is most likely involved in VZV affection

A

CN 4

80
Q

Initial sign of CNIII compression

A

impaired constriction to light

81
Q

Medial longitudinal fasciculus syndrome

A

incomplete adduction ipsilateral to lesion in the MLF on conjugate gaze

82
Q

ocular bobbing is assoc with damage to

A

pons

83
Q

Cyclosporine and tacrolimus can cause nephrotoxicity and what on the brain?

A

hypertensive encephalopathy

84
Q

What is adie tonic pupil aka adie syndrome?

A

tonically dilated pupil that reacts slowly to light but shows a more definite response to accommodation. It is frequently seen in females with absent knee or ankle jerks and impaired sweating. It is caused by damage to the postganglionic fibers of the parasympathetic innervation of the eye, usually by a viral or bacterial infection which causes inflammation, and affects the pupil of the eye and the autonomic nervous system

85
Q

Most common cause of acute monocular blindness?

A

ischemic optic neuropathy caused by occlusion of posterior ciliary artery –> sudden painless loss of vision in one eye; opposite eye can be involved days later

86
Q

Presbycusis

A

most common cause of hearing loss in elderly. high frequency perception is impaired due to neuronal degeneration most likely of the spiral ganglion neurons of cochlea

87
Q

BC > AC signifies

A

conduction hearing loss -problems with middle ear

88
Q

explosion causing acoustic trauma leads to

A

high tone sensorineual loss; trauma is in the cochlea

89
Q

Characterize the sensorineural hearing loss found in Meniere’s

A

loss of lower tones first (differs from presbycusis when higher tones are lost)

90
Q

What are some drug induced causes of viral labyrinthitis

A

salicylates
alcohol
quinine
aminoglycosides

91
Q

drug induced tinnitus caused by

A

acetylsalicylate toxicity

92
Q

Where do you find olfactory cortex

A

in prepiriform gyrus/lateral olfactory gyrus

93
Q

Spinal fracture leading to spinal shock characterized by

A

1) areflexia and flaccidity
then days to weeks later
2) hypereflexia and spasticity

94
Q

In MVA, which movement causes lumbar vertebral body fracture

A

extreme flexion

95
Q

What’s the significance of artery of Adamkiewcz (aka arteria radiclaris magna or anterior medullary artery)

A

it is a major anterior radicular artery that supplies lower 2/3 of spinal cord. It’s at risk of occlusion during AAA repair. It enters at T10-L1

96
Q

Spinal cord ischemia is usu most severe in the distribution of which artery?

A

anterior spinal artery leading to probs with spinothalamic and corticospinal tracts.

97
Q

CSF findings in cerebral or spinal cord infarction

A

usu just increase CSF proteins

98
Q

Lyme neuropathy

A
  • facial nerve palsy

- can affect deep peroneal nerve that supplies anterior tibial muscle that is responsible for dorsiflexion –> foot drop

99
Q

Knee jerk level

A

L2, L3, L4

100
Q

Fredriechs ataxia

A

AR d/o
chromosome 9
gait ataxia
peripheral neuropathy 2/2 to degeneration of dorsal root ganglia
cardiomyopathy (EKG changes will show myocarditis)

101
Q

Parsonage-Turner syndrome

A

acute brachial plexopathy without known cause begins with acute onset of pain in neck, shouler, or upper arm followed by 3-10 days of proximal muscle weakness, resp dysfunction

102
Q

Familial Dysautonomia aka Riley day disease

A

AR d/o affecting jewish kids leading to impariment in pain and temp sensation, parasym and symp distrubances

103
Q

NO poisoning causes neuropathy similar to

A

vit b12 deficiency b/c also causes megaloblastic anemia and peripheral neuropathy

104
Q

Presence of raccoon eyes aka periorbital ecchymoses is evidence of

A

basillar skull racture

105
Q

What method that can be induced in someone with TBI assoc with decrease cerebral injury

A

induce hypothermia