Core Neurology First Aid Step I: Neuro Ii

Front 1

MCC viral meningitis

Back 1

enterovirus

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tx of CMV retinitis

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foscarnet

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deficit and finding in conduction aphasia

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arcuate fasciculus -- poor repitition with good comprehension, fluid speech

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what is kluver-bucy syndrome?

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bilateral amydala lesion ==> disinhibition (sexuality, touching, licking), bulemia, memory disorders, flattened emotions

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lesion in wernicke-korsakoff syndrome

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mammillary bodies (b/l)

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lesion of cerebellar hemisphere vs vermis

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HEMISPHERE: intention tremor, limb ataxia; VERMIS: truncal ataxia, dysarthria

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symptoms of basal ganglia lesion

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resting tremor, CHOREA (flailing dance-like mvmts) and ATHETOSIS (slow writhing snakelike movements)

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chromosomes implicated in alzheimer's

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1, 14 (presinilin 2 and 1 respectively), 19 (ApoE4), 21 (APP - amyloid precursor protein)

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MCC dementia in elderly (2)

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1) Alzheimer's; 2) multi-infarct dementia

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hemorrhagic consequence of alzheimer's

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amyloid angiopathy --> intracranial hemorrhage risk

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sx of pick's disease; where is the lesion?

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lesion in frontal/temporal lobes ==> dementia, aphasia, parkinsonian sx

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symptoms of parkinson's

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TRAP (resting Tremor, cogwheel Rigidity, Akinesia, Postural instability)

Front 13

what is werdnig-hoffmann disease?

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"floppy baby" syndrome -- AR dz a/w degeneration of anterior horns (LMN); median death by 7mo

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common findings in MS

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relapsing-remitting course, optic neuritis, MLF syndrome (INO), hemiparesis, hemisensory sx, bladder/bowel incontinence; TRIAD (SIN): Scanning speech, Intention tremor, Nystagmus

Front 15

CSF findings in MS

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elevated IgG (multiple oligoclonal bands)

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CSF findings in guillain-barre

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elevated CSF protein with normal cell count (albumino-cytologic dissociation)

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main symptom of guillain-barre

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ascending motor weakness (minimal sensory impact) with autonomic dysregulation

Front 18

mcc epidural hematoma

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rupture of middle meningeal artery, often 2/2 temporal bone fracture

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temporal progression of subdural hematoma

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slow, like tumor (b/c rupture of bridging veins --> venous bleeding

Front 20

MCC subarachnoid hemorrhage (2)

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berry aneurysms, AVM

Front 21

MCC parenchymal hemorrhage (5)

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HTN, amyloid angiopathy, diabetes mellitus, tumor, charcot-bouchard aneurysms

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with what dzs are berry aneurysms associated (3)

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adult PCKD, Ehlers-Danlos syndrome, Marfan's

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5 most common adult brain tumors

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1) GBM; 2) Meningioma; 3) Schwannoma; 4) Oligodendroglioma; 5) Pituitary adenoma

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characteristics of GBM

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poor prognosis, "butterfly glioma" b/c can cross corpus callosum, most common primary brain tumor

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characteristics of meningioma

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resectable; most often in convexities of hemispheres and parasagittal region (arachnoid cells)

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b/l schwannomas seen in what dz?

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neurofibromatosis type 2

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common consequence of medulloblastoma

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compression of 4th ventricle --> hydrocephalus

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most common location of ependymomas

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4th ventricle --> hydrocephalus

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common association, location and consequence of hemangioblastomas

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von hippel lindau (if retinal angiomas present) / cerebellum / EPO production --> 2' polycythemia

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findings in von hippel lindau syndrome

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a/w chromosome 3p; hemangioblastomas/cavernous hemangiomas, increased incidence of RCC, can see adenomas, cysts of liver/kidney/pancreas

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what diseases cause LMN lesion only? (2)

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polio, werdnig-hoffman ==> flaccid paralysis

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combined UMN/LMN lesions seen in what dz

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ALS

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whats spared in ASA occlusion?

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dorsal columns, tract of lissaeuer

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lesion in syringomyelia

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anterior commisure -- crossing fibers of spinothalamics ==> b/l loss of pain/temperature sensation in the upper extremities

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syringomyelia a/w what congenital defect?

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arnold-chiari malformation

Front 36

where are lesions in B12 deficiency / friedreich's ataxia?

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demyelination of dorsal columns, lateral corticospinals, spinocerebellars

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causes and findings of erb duchenne palsy

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caused by blow to shoulder or trauma during delivery; "waiter's tip:" limbs at side, medially rotated, forearm pronated

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role of common peroneal?

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PED: Peroneal Everts and Dorsiflexes --> if injured, foot gets dropPED

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role of tibial nerve?

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TIP: Tibial Inverts and Plantarflexes --> if injured, can't stand on TIPtoes

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role of femoral nerve?

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knee extension/jerk ("FEMales can't play KICK ball")