Neuro

Front 1

cerebellar hemorrhage:
1. >est risk factor
2. typical presentation
3. Tx

Back 1

1. HTN
2. ataxia, vomiting, occipital headaches, gaze palsy, facial weakness. NO HEMIPARESIS
3. Qxical decompression

Front 2

putamen hemorrhage:
1. >est risk factor
2. presentation

Back 2

1. HTN and in fact the most common site of HTNsive hemorrhage is the putamen

2. hemiparesis, hemi-sensory loss, homonymous hemianopsia, stupor and coma

Front 3

Pontine hemorrhage
1. >est risk factor
2. presentation

Back 3

1. HTN, 2nd most common from this
2. coma and paraplegia that develop w/in minutes. pinpoint pupils, decerebrate rigidity, no horizontal eye movements

Front 4

lacunar infarct (post limb of internal capsule)

Back 4

motor impairment. no higher cortical dysfxn or visual problems

Front 5

MCA occlusion

Back 5

contralat hemiplegia, eye deviates toward side of infarct, hemianesthesia, homonymous hemianopia. *aphasia (dominant hemisphere) *hemineglect (nondom hemi)

Front 6

ACA occlusion

Back 6

contralat weakness affecting lower extremity, abulia (loss of will power, lack of motivation), mutism, emotional disturbance, eyes and head deviate towards side of lesion, sphincter incontinence

Front 7

vertebrobasilar system lesion (supplies brain stem)

Back 7

contralat hemiplegia, and ipsilat CN involvement

Front 8

lesion generalizations:
1. brainstem (medulla,midbrain, pons)
2. thalamus or cortex
3. cortical lesions (cortex)

Back 8

1. CNs, sensory loss of 1/2 of face and contralat loss of sensory body
2. sensory loss of 1/2 face and ipsi 1/2 of body
3. specific cortical findings: aphasia, neglect, stereognosis, etc.

Front 9

Metoclopramide use and SEs

Back 9

use: prokinetic used to tx nausea, vomiting and gastroparesis
SEs: drug-induced extrapyramidal symptoms (tardive dyskinesia, dystonic rxns and Parkinsonism)

Front 10

simple partial seizures

Back 10

- no LOC
- pt. remember the event

Front 11

complex partial seizure

Back 11

- LOC
- aura present = simple partial seizure
-automatisms present (=lip smacking , chewing, hand movements)

Front 12

Partial seizure w/ secondary generalization

Back 12

- LOC
- tonic clonic activity

Front 13

if neurofibromat type II is suspected in pt. w/ acoustic neuroma and cafe au lait spots what is the best method of diagnosing the acoustic neuroma?

Back 13

MRI w/ gadolinium enhancement

Front 14

resting tremor

Back 14

happens while sittin still. described as "pill rolling"
Assoc.d w/ Parkinson's

Front 15

Essential tremor

Back 15

presents as intention tremor. ex. trying to reach for a pen.
familial 50% of the time

Front 16

pronator drift
1. what is it/
2.when do you see it?

Back 16

1.pt.'s eyes are closed w/ arms outstretched and palms facing up. then one of palms turns inward and downward.
2. sensitive and specific for UMN damage.

Front 17

shy drager syndrome

Back 17

parkinsonism + autonomic dysfnxn

Front 18

CT scan showing white lesion on image. what is it?

Back 18

hemmorhagic

Front 19

pt w/ MG what do you do ?

Back 19

CT scan of chest

Front 20

tx of parkinson's tremor in younger pt.

Back 20

trihexphenidyl

Front 21

pt. only shaves right side of face.
1. what is this called
2. location of stroke

Back 21

1. hemineglect
2. right parietel cortex (nondom)

Front 22

PML (progressive multifocal leukoencephalopathy)
1. who should you suspect?
2. what will you see on CT?

Back 22

1. HIV infected w/ focal neuro signs (JC virus)
2. multiple non-enhancing lesions w/ no mass effect on CT scan

Front 23

subacute slcerosing panencephalitis
1. what is its antecedent
2. CT will show

Back 23

1. having had measles years ago
2. scarring and atrophy

Front 24

Primary CNS lymphoma
1. who has it?
2. what will you see on MRI?
3. specific for Dx

Back 24

1. 2nd most common cause of mass lesions in HIV infected pt.s
2. ring-enhancing lesion on MRI, periventicular
3. presence of EBV DNA in PCR of CSF

Front 25

Cerebral toxo
1 who has it
2. what do you see on CT
3. how common is it?

Back 25

1. MC ring-enhancing lesion in HIV
2. multiple ring lesions in basal ganglia (caudate, putamen, globus pallidus)
3. common in normal subjects in US

Front 26

Mult sclerosis Tx:
1. acute exacerbations
2. disabling symptoms
3. reducing frequency of acute exacerbations

Back 26

1. IV steroids
2. high dose IV steroids (methylprednisone)
3.interferon, plasmapheresis, cyclophosphamide, IV Igs, glatiramer

Front 27

craniopharyngioma
how does it present?

Back 27

benign suprasellar tumor (rathke's pouch) Presents with signs of hypopituitarism (->delayed growth in kids,or amenorrhea in women), headaches, and bitemporal blindness.

Front 28

how do you monitor resp funxn in GBS?

Back 28

serial measurements of bedside vital capacity

Front 29

Wernicke's enceph
1. triad
2. how can it be iatrogenically induced?
3. if chronic, what happens?

Back 29

1. encephalopathy, oculomotor dysfnx, gait ataxia
2. giving glucose w/o thiamine
3. chronic thiamine def -> korsakoff's sydrom = irreversible anmesia, confabulation, and apathy

Front 30

elderly pt. w/ dementia, urinary incontinence.
1. what is tx of choice?
2. what don't you ever give old people?

Back 30

1. haloperidol (or quietipine or risperidone) acute delirium (probably from UTI)
2. benzos

Front 31

stroke in ventral postero-lateral (VPL) nucleus of thalamus -> what presentation?

Back 31

contralat hemianesthesia that can be accompanied by transient hemiparesis, athetosis, or ballistic movements
(ex transient pain in right upper and lower limbs induced by even light touch and athetosis of right hand)

Front 32

Acute migraine tx

Back 32

prochlorperazine (or metoclopromide) as adjuvant and antiemetic + NSAIDs + triptans
(beta blocker as prophylaxis)

Front 33

common locations of hypertensive brain bleeds

Back 33

basal ganglia (MC), cerebellum, thalamus, and pons

Front 34

pt. with right sided hyperreflexia and conjugate gaze deviation to left .
what does this suggest?

Back 34

focal lesion involving left cerebral hemisphere (w/ cerebral lesions motor deficits happen opposite the site of the lesion whereas gaze deviation is usually towards the side of the lesion.)

Front 35

young female w/ bilateral trigeminal neuralgia. what could cause this?

Back 35

multiple sclrosis

Front 36

typical location for ulcers caused by:
1. arterial
2. venous stasis
3. diabetes
4. pressure ulcers

Back 36

1. distal body parts w/ lowest blood supply ex tip of toe
2. pretibial area, medial malleolus
3. soles of feet over metatarsal heads and tops of toes w/ charcot deformity
4. heel, sacrum, elbows, ears

Front 37

what dz.s is ptosis found in ?

Back 37

MG, diabetes, pancoast's tumor, and brain tumor

Front 38

thrombolytic therapy tPA requirements

Back 38

after CT scan, if pt. presents w/in 4.5 hours after onset of ischemic stroke

Front 39

how does cerebellar hemorrhage present?

Back 39

NO HEMIPARESIS, ataxia, vomiting, occipital headache, gaze palsy, facial weakness

Front 40

conjunctivitis (when):
1. gonococcal
2. chlamydial
3. chemical

Back 40

1. ~ 5 days
2. 5-15 days after birth
3. w/in 24 hours

Front 41

granulation tissue in external auditory canal in diabetic
-Dx
-complication
-Tx DOC

Back 41

- malignant otitis externa (MOE) = severe pseudo infxn
- osteomyelitis of skull base or TMJ
- cipro

Front 42

head CT vs MRI:
1. CT is best for:
2. MRI is best for:

Back 42

1. Noncontrast: head trauma w/ LOC or AMS, stroke, any intracranial bleeding
w/ contrast: CA and Infxn
2. demyelinating dz (MS), posterior fossa lesion on cerebellum, brainstem, pituitary lesion, spinal cord and vertebral lesions

Front 43

When not to use contrast

Back 43

-severe renal fail
- hydrate w/ saline and use bicarb or Nacetlycystein w/ mild renal insuff
-stop metformin prior to using contrast

Front 44

-Best way to confirm Dx of MG
-Tx

Back 44

- postive ACh receptor Abs
- Tx: antiAChesterase (neostig or pyridostig), plasmapheresis (gets rid of Abs), IVIg (for refractory cases)

Front 45

GB syndrome
Tx

Back 45

Tx plasmapheresis or IVIg to accelerate resolution

Front 46

normal cup to disc ratio

Back 46

0.3

Front 47

pt. w/ muscle strength redxn in lower extremities but well preserved in upper extremities. lower extrem sensation is <ed. stroking the soles of the feet elicits extension of the great toe.
1.Most likely Dx?
2.Cause?
3.best means of Dx?

Back 47

-spinal cord compression: isolated symmetric lower extremity symptoms including loss of sensation and signs of UMN dz (babs).
1-spinal cord compression (OSTEOPOROSIS), disc herniation, abscess, trauma, CA, epidural abscess in IVD abuser
2-medical emergency
3-MRI OF SPINE

Front 48

3 subdivisions of stroke:
1. SAH
2.Hemorrhagic
3. ischemic

Back 48

1. accompanied by severe headache
2. focal neuro signs that develop suddenly and worsen over minutes to hours. symptoms start during normal activity and are precipitated by sex or strenuous activity. as hemorrage expands, headache, vomiting and AMS develop. HTN is most important risk facto
3. ie embolic. Hx of previous transient ischemic attacks (amaurosis fugax) Don't have headache or impared consciousness

Front 49

what is the first step in pt.s suspected w/ stroke?

Back 49

CT w/o contrast
Confirms presence size and location of hemorrhage.
Ischemic changes may not appear in CT in first 24 hours