Core Neurology: 10/15/2007

Front 1

for how long are subdural hematomas evident on CT? what happens after that?

Back 1

a few days -- after that, they are degraded into less dense fluid, similar in density to cerebral cortex

Front 2

emergent tx for pt with fluctuating consciousness due to elevated ICP from hematoma

Back 2

craniotomy (not VP shunt -- herniation risk)

Front 3

laterality of subdural vs epidural hematoma

Back 3

subdural: often bilateral; epidural: always unilateral

Front 4

which populations particular susceptible to chronic subdural hematoma?

Back 4

elderly and pts on renal dialysis

Front 5

wernicke's area and traumatic head injury

Back 5

not usually involved, even tho temporal lobes and frontal lobes most commonly damaged (wernicke's is too far back)

Front 6

immediate intervention following spinal cord injury

Back 6

high dose intravenous methylprednisolone

Front 7

CN most commonly affected by sarcoid

Back 7

VII -- seen in 50% of pts with neuro sarcoid

Front 8

CSF in polio vs guillain-barre

Back 8

polio has elevated WBC; both have elevated protein

Front 9

most common fungal cause of meningoencephalitis

Back 9

cryptococcus

Front 10

what kind of CNS disease process caused by aspergillus? In what pts?

Back 10

abscesses in immunocompromised pts

Front 11

at what level of nervous system is schistosoma mansoni lesion usually found?

Back 11

spinal cord (granulomatous lesions around cord cause compression)

Front 12

what parasite causes major brain cyst with multiple compartments in which smaller cysts are evident?

Back 12

echinoccocus

Front 13

what does the CSF look like in spongiform encephalitis? Whats the other name?

Back 13

creutzfeldt-jakob dz -- typically normal CSF

Front 14

what protein is highly sensitive and specific for prion dz?

Back 14

14-3-3 proteinase inhibitor protein released from neurons

Front 15

clinical findings of creutzfeldt jakob dz

Back 15

rapidly progressive DEMENTIA; other findings include PSYCH sx, EXTRAPYRAMIDAL signs, CEREBELLAR, and focal lesions anywehre else in CNS

Front 16

what does CSF leak predispose you to?

Back 16

recurrent meningitis

Front 17

most common cetiologies of rim-enhancing lesions in AIDS pts

Back 17

primary CNS lymphoma (PCNSL), toxo; bacterial, fungal abscess also possible

Front 18

what tests are highly sensitive and specific for PCNSL?

Back 18

CSF EBV PCR test

Front 19

cause and tx of PML in AIDS pt

Back 19

caused by JC virus; no direct tx, but HAART improves survival

Front 20

MCC encephalitis

Back 20

herpes

Front 21

main route of infection in amebic meningoencephalitis

Back 21

freshwater swimming (through cribriform plate), esp naegleria (also hartmanella or acanthamoeba)

Front 22

common histologic finding in both HIV and CMV brain infections

Back 22

microglial nodules (syncitial in HIV)

Front 23

EEG findings in HSV encephalitis

Back 23

bilateral, periodic epileptiform discharges (typically over temporal regions)

Front 24

1st and 2nd line tx of lyme meningitis

Back 24

1) IV PCN or ceftriaxone; 2) tetracycline

Front 25

most common location of brain abscess formation

Back 25

gray-white junction

Front 26

tx for rabies

Back 26

supportive; immunization after exposure is necessary but may not substantially improve outlook (almost invariably fatal)

Front 27

where does rabies virus establish itself for transmission after leaving the brain?

Back 27

salivary glands

Front 28

MCC CNS fungal abscess

Back 28

aspergillus

Front 29

MCC brain abscess in AIDS pts

Back 29

toxo (followed by fungal abscesses: cryptococcus, candida, mucor, aspergillus)

Front 30

how is polio acquired?

Back 30

enterovirus --> acquired by GI

Front 31

most common sx in brain abscess

Back 31

headache (75%)

Front 32

tx of choice for brain abscess? What can happen if you don’t?

Back 32

surgical resection; if perforation into ventricle, lethal

Front 33

most common bacterial cause of brain abscess

Back 33

strep, followed by enterics (ecoli, proteus, pseudomonas), followed by staph (esp in penetrating head trauma / neurosurg)

Front 34

what eeg findings in spongiform encephalitis?

Back 34

disorganized background with periodic sharp-wave dischrages at 1s intervals

Front 35

abx for listeria meningitis

Back 35

amp-gent

Front 36

in what dz do you see oligodendrocytes with inclusion bodies?

Back 36

JC virus --> PML

Front 37

how to dx PML?

Back 37

CSF PCR for JC virus -- don't need brain bx

Front 38

weakness vs sensory loss in guillain barre

Back 38

sensation usu preserved except for paresthesias of feet/lower legs; main finding is symmetric ascending weakness

Front 39

bladder function in tabes dorsalis

Back 39

profoundly disturbed -- hypotonic / flaccid

Front 40

which dz shares CSF findings with MS? What are the findings?

Back 40

SSPE (subacute sclerosing panencephalitis) -- elevated gamma globulin fraction with presence of oligoclonal bands