Core Neurology: 10/17/2007

Front 1

bony changes caused by brain tumors

Back 1

usually thinning (pituitary ADENOMA --> erodes floor of sella turcica; SCHWANNOMA / ASTROCYTOMA --> calcification but skull erosions where impinging); MENINGIOMA --> HYPEROSTOSIS (thickening of bone)

Front 2

what tumors a/w von Hippel-Lindau? where are they found?

Back 2

hemangioblastomas -- found in cerebellum / brainstem

Front 3

most common source of mets to brain

Back 3

lung (2/3 of brain mets)

Front 4

which source of mets to brain has the worst prognosis?

Back 4

malignant melanoma -- very likely to bleed

Front 5

where are CNS lymphomas usu found?

Back 5

periventricularly

Front 6

common effects of hypothalamic hamartomas (3)

Back 6

neuroendocrine dysfunction: PRECOCIOUS PUBERTY, ACROMEGALY (excess ghrh), GELASTIC SEIZURES (paroxysms of laughter)

Front 7

major risk of posterior fossa mass

Back 7

transforaminal herniation

Front 8

AIDS increases risk of what tumors? (2)

Back 8

1) Lymphoma; 2) Kaposi sarcoma

Front 9

most common location of medulloblastoma

Back 9

cerebellum (--> ataxia)

Front 10

which tumors can cause obstructive hydrocephalus? (2)

Back 10

medulloblastoma, ependymoma

Front 11

what tumors a/w NF1?

Back 11

optic gliomas

Front 12

where is the center for voluntary upward gaze?

Back 12

dorsal midbrain (area of superior colliculus)

Front 13

eye deviation in cortical vs pontine lesion

Back 13

pontine: eye deviates AWAY from lesion; cortilcal: eye deviates TOWARD lesion

Front 14

what kind of brain lesions can cause paralysis of voluntary upward gaze?

Back 14

pineocytomas --> impinge upon dorsal midbrain?

Front 15

another name for anti-purkinje cell antibodies

Back 15

anti-Yo antibodies (cerebellar)

Front 16

what tumor types a/w paraneoplastic cerebellar degeneration?

Back 16

lung, ovarian, lymphoma

Front 17

what sx with hypercalcemia (>14mg/dL)?

Back 17

decreased membrane excitability --> lethargy, fatigability, generalized weakness, areflexia

Front 18

characteristic diff between lambert-eaton and myasthenia gravis

Back 18

LE improves with use; also, LE spares oculobulbars

Front 19

what CNS disease a/w multiple myeloma?

Back 19

polyneuropathy (15% of mm pts) -- chronic distal symmetrical sensory or sensorimotor neuropathy

Front 20

which type of brain cells affected most by long-standing hepatic disease

Back 20

alzheimer's type II astrocytes

Front 21

what brain cells affected by alcohol toxicity?

Back 21

purkinje cells in cerebellum

Front 22

CSF changes in hypertensive encephalopathy

Back 22

elevation of CSF protein

Front 23

sx of hypertensive encephalopathy

Back 23

ENCEPHALOPATH, HEADACHE, vomiting, visual disturbances, seizures, focal neurologic deficits

Front 24

most common neurologic complication of chronic renal failure

Back 24

symmetric mixed sensorimotor peripheral neuropathy, sometimes a/w restless legs

Front 25

tx for restless legs syndrome

Back 25

gabapentin, dopamine AGONIST (eg L-dopa), opiates, clonazepam

Front 26

how to tx renal-failure-associated neuropathy?

Back 26

renal transplant

Front 27

in what pathways is vit B12 involved?

Back 27

methylmalonyl-CoA --> succinyl-CoA; AND homocysteine --> methionine

Front 28

how to diagnoses B12 deficiency from urine?

Back 28

measure methylmalonyl-CoA levels

Front 29

which spinal cord pathways disrupted in b12 deficiency?

Back 29

posterior (dorsal columns) AND lateral (corticospinals) -- demyelination, gliosis, and vacuolar degeneration

Front 30

what kind of visual deficit with b12 deficiency?

Back 30

enlarged blind spot (centrocecal scotoma)

Front 31

triad of wernicke's encephalopathy

Back 31

gait instability, oculomotor paresis, dementia

Front 32

what is deficiency ambylopia?

Back 32

aka nutritional optic neuropathy; centrocecal scotoma (enalargement of blindspot) a/w tobacco/etoh abuse

Front 33

what is pellagra? what causes it?

Back 33

niacin (b3) or tryptophan deficiency --> Dermatitis, Diarrhea, Dementia

Front 34

neurologic findings in b12 defiency

Back 34

SLOW EVOLUTION of: peripheral neuropathy and paresthesias + BLADDER DYSFUNCTION + gait difficulty

Front 35

sx of vit e defiency

Back 35

ATAXIA; also get polyneuropathy, pigmentary retinopathy

Front 36

what is pickwickian syndrome?

Back 36

morbid obesity + hypersomnia, likely 2/2 sleep apnea, hypoxemia, and pHTN

Front 37

first signs of herpes encephalitis in immunocompetetnt

Back 37

psychiatric (depression, irritability, labile affect) --> seizure

Front 38

one of the most common presenting sx of MS

Back 38

optic neuritis; ataxia, dysarthria usually dismissed by pt

Front 39

triphasic waves seen in what conditions?

Back 39

HEPATIC encephalopathy, uremia, other metabolic encephalopathies