First Aid For Step 1 - Neurology Flashcards

Front 1

DESCRIBE:

Chiari II Malformation

Back 1

= an embryonic posterior fossa malformation

Cerebellar tonsillar and vermian herniated through foramen magnum ... causes aqueductal stenosis leading to hydrocephalus

Often see paralysis below the defect

Front 2

DESCRIBE:

Dandy-Walker Syndrome

Back 2

= an embryonic posterior fossa malformation

= agenesis of the cerebellar vermis (the middle area of cerebellum) ... instead have cystic enlargement of the 4th ventricle

Front 3

PRESENTATION & ASSOCIATIONS:

Syringomyelia

Back 3

Cystic enlargement of central canal of spinal cord - crossing fibers of spinothalamic tract are damaged giving "cape-like" bilateral loss of PAIN and TEMPERATURE

Associated with Chiari I malformation (congenital herniation of cerebellar tonsils, asymptomatic through childhood, but can see headaches and cerebellar symptoms

Front 4

WHAT:

Cell type is involved in Acoustic Neuroma

Back 4

Schwann cells, of CN VIII, in internal acoustic meatus

Front 5

WHAT:

Cell type is involved in MS vs. GBS

Back 5

MS = oligodendrocytes

GBS = Schwann cells

Front 6

NAME:

Inputs that travel through the thalamus

Back 6

Receives input from the following

Spinothalamic and dorsal columns and medial lemniscus (carry pain temp pressure touch vibration proprioception

Trigeminal/gustatory (carry face sensation and taste)

CNII (carries vision)

Superior olive/inferior colliculus of tectum (carry hearing)

Basal ganglia (carries motor control)

Front 7

WHAT:

Functions are facilitated by the lateral vs. medial cerebellum

Back 7

Lateral = voluntary movement of extremities

Medial = balance and truncal coordination

Front 8

WHAT:

Side does a patient with a lateral cerebellar lesion fall toward

Back 8

Ipsilateral

Front 9

STATE:

With regards to Huntington's Disease
1. Etiology
2. Neurotransmitter changes
3. S/Sx

Back 9

1. AD trinucleotide repeat expansion (CAG), demonstrating anticipation
2. CAG -- Caudate loses ACh and GABA
3. Chorea, aggression, depression, dementia

Front 10

WHAT:

Conditions are the following seen in, and what exacerbates/alleviates the following ...
Essential Tremor
Resting Tremor
Intention Tremor

Back 10

Essential = genetic predisposition; exacerbated by holding posture/limb position (aided by EtOH and beta-blockers)

Resting = Parkinson's; alleviated by intentional movement

Intention = cerebellar dysfunction; only appears when pointing/extending toward a target

Front 11

DESCRIBE:

The orientation of the homunculus

Back 11

Beginning at MEDIAL CORTEX ... toes progressing up to fingers ... to forehead through face to chin ... and finally to tongue and swallowing at the LATERAL CORTEX

Front 12

LOCALIZE:

Patient with hyperorality, hypersexuality, disinhibited behavior

Back 12

= bilateral lesion of amygdala
= AKA Kluver-Bucy syndrome, associated with HSV-1

Front 13

LOCALIZE:

Patient with disinhibition, deficits in concentration orientation judgment, reemergence of primitive reflexes

Back 13

= lesion in frontal lobe

Front 14

LOCALIZE:

Reduced levels of arousal and wakefulness (aka patient in a coma)

Back 14

= lesion in reticular activating system (the midbrain)

Front 15

LOCALIZE:

Spatial neglect syndrome

Back 15

= lesion in right parietal lobe

Front 16

LOCALIZE:

Confusion, ophthalmoplegia, ataxia, memory loss

Back 16

= bilateral lesions to mammillary bodies
= AKA Wernicke-Korsakoff syndrome, thiamine B1 deficiency of chronic alcoholism

Front 17

LOCALIZE:

Truncal ataxia, dysarthria

Back 17

= lesion to cerebellar vermis

Front 18

LOCALIZE:

Intention tremor and limb ataxia to one side of body

Back 18

= lesion to cerebellar hemisphere

Front 19

LOCALIZE:

Inability to make new memories

Back 19

= anterograde amnesia
= lesion to hippocampus

Front 20

LOCALIZE:

Locked-In Syndrome

Back 20

= central pontine myelinolysis
= massive axonal demyelination in pontine white matter tracts commonly due to overly rapid correction of hyponatremia

Front 21

DISTINGUISH:

Aphasia vs. Dysarthria

Back 21

Aphasia = higher order inability to speak (language deficit)
Dysarthria = motor inability to speak (motor deficit)

Front 22

LOCALIZE:

Nonfluent aphasia with intact comprehension

Back 22

= lesion to inferior frontal gyrus of frontal lobe
= Broca's aphasia with broken speech

Front 23

LOCALIZE:

Fluent aphasia with impaired comprehension

Back 23

= lesion to superior temporal gyrus of temporal lobe
= Wernicke's aphasia with word salad

Front 24

LOCALIZE:

Nonfluent aphasia with impaired comprehension

Back 24

= lesions to both Broca's and Wernicke's areas
= Global Aphasia

Front 25

LOCALIZE:

Poor repetition but fluent speech and intact comprehension

Back 25

= lesion to arcuate fasciculus
= Conduction Aphasia

Front 26

LOCALIZE:

Stroke resulting in contralateral paralysis of upper limb and face

Back 26

= MCA motor cortex

Front 27

LOCALIZE:

Stroke resulting in contralateral loss of sensation in upper limb and face

Back 27

= MCA sensory cortex

Front 28

LOCALIZE:

Stroke resulting in aphasia

Back 28

= MCA in dominant (usually left) hemisphere

Front 29

LOCALIZE:

Stroke resulting in hemineglect

Back 29

= MCA in non-dominant hemisphere

Front 30

LOCALIZE:

Stroke resulting in contralateral paralysis of lower limb

Back 30

= ACA in motor cortex

Front 31

LOCALIZE:

Stroke resulting in contralateral loss of sensation of lower limb

Back 31

= ACA in sensory cortex

Front 32

LOCALIZE:

Stroke resulting in contralateral hemiparesis/hemiplegia

Back 32

= lateral striate artery - which supply the striatum/internal capsule without much collateral circulation ... thus can be devastating

= can be from emboli off carotid to MCA to lateral striate ... or also seen secondary to HTN

= Lacunar Infarct

Front 33

LOCALIZE:

Aneurysm resulting in visual field defects

Back 33

= berry in anterior communicating artery

Front 34

LOCALIZE:

Aneurysm resulting in eye down and out

Back 34

= CN III palsy

= berry in posterior communicating artery

Front 35

LOCALIZE:

Stroke resulting in decreased pain and temperature sensation in limbs and face, Horner's syndrome, dysphagia, hoarseness, vomiting, vertigo, ataxia, dysmetria

Back 35

= Lateral medullary syndrome (stroke to lateral medulla)
= Wallenberg's syndrome
= PICA occlusion

Front 36

LOCALIZE:

Stroke resulting in contralateral hemiparesis of lower limbs, decreased contralateral proprioception, tongue deviates ipsilaterally

Back 36

= Medial medullary syndrome
= ASA occlusion

Front 37

NAME:

Most common complication of a berry aneurysm

Back 37

= subarachnoid hemorrhage

Front 38

WHAT:

Type of hemorrhage is NOT visible on CT

Back 38

= subarachnoid hemorrhage

Front 39

GIVE:

Mechanism of epidural vs. subdural vs. subarachnoid vs. intraparenchymal bleeds

Back 39

Epidural = secondary to fracture
Subdural = secondary to blunt trauma (shaken, whiplash)
Subarachnoid = aneurysm rupture
Intraparenchymal = secondary to systemic HTN

Front 40

EXPLAIN:

With regards to communicating hydrocephalus
1. Mechanism
2. S/Sx/Consequences
3. Potential etiology

Back 40

1. decreased CSF absorption by arachnoid granulations leading to increased intracranial pressure
2. can see papilledema (=optic disk swelling), risk herniation
3. can get scarring of arachnoid granulations post infection like meningitis

Front 41

STATE:

S/Sx of normal pressure hydrocephalus

Back 41

TRIAD:
1. urinary incontinence
2. ataxia
3. cognitive dysfunction

= wet, wobbly, wacky

Front 42

WHERE:

Does one perform spinal tap

Back 42

"keep cord alive between three and five"

L3/L4 or L4/L5

Front 43

WHERE:

Do vertebral disc herniations usually occur

Back 43

L4/L5 or L5/S1

Front 44

LOCALIZE:

Patient presenting with impaired sensation and proprioception and progressive sensory ataxia, with absent DTRs and positive Romberg

Back 44

= Tabes dorsalis
= tertiary syphilis mediated demyelination of dorsal columns and roots

Front 45

LOCALIZE:

Patient presenting with impaired position and vibration sense, ataxic gait, and paresthesia

Back 45

= vitamin B12 or E deficiency
= knocks out dorsal columns and lateral corticospinal tracts and spinocerebellar tracts

--> major difference from

Front 46

DISTINGUISH:

Partial vs. Generalized seizures

Back 46

Partial = focal, affects 1 are of brain, typically temporal lobe

Generalized = diffuse

***partial seizures can secondarily generalize

Front 47

DISTINGUISH:

Simple vs. Complex Partial seizures

Back 47

Simple = consciousness intact through seizure

Complex = impaired consciousness

Front 48

DEFINE:

The following types of seizures
Absence
Myoclonic
Tonic-Clonic
Tonic
Atonic

Back 48

Absence = 3 Hz, no postictal, blank stare
Myoclonic = quick, repetitive jerks
Tonic-Clonic = alternating stiffening and movement
Tonic = stiffening
Atonic = drop seizure, looks like fainting