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27 Cards in this Set

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  • Back
A patient is brought in by her husband who claims his wife keeps putting things in her mouth or licking objects. She also acts "very horny," even in public. Where is the lesion?
bilateral amygdala - aka Kluver-Bucy syndrome (hyperoral, hypersexual, disinhibited)
A patient presents with slurred language, worsening balance and says he keeps falling over to one side. Yet he has no difficulty performing the finger-to-nose or heel-to-shin tests. Where is his lesion?
cerebellar vermis - truncal ataxia, dysarthria
Your patient who is a waiter comes in and complains he is unable to repeat his customers' orders, although he understands them perfectly. Where is the lesion?
arcuate fasciculus - connects Broca's and Wernicke's
What happens if you lesion the reticular activating system?
COMA. (don't do it)
A man presents in the ER and he seems to completely ignore you (and everything else including his own arm) when you stand at his left side. Where is the lesion?
right parietal lobe
What motor neuron disease presents at birth as floppy baby with tongue fasciculations?
Werdnig-Hoffmann disease - AR, death ~ 7 months, degeneration of anterior horn cells
A 40 y/o man presents with symmetric muscle atrophy and fasciculations, hyperreflexia, and spasticity. He has no sensory deficits. What do you suspect? What is his Px?
Amyotrophic Lateral Sclerosis (ALS) - motor neuron degeneration in lateral corticopinal tracts and anterior horns; prognosis poor (death from respiratory failure in a few years)
If a patient presents with ataxia, ophthalmoplegia, and confusion you would suspect the lesion to be where?
bilateral mamillary bodies (close to CN III)
A man comes into the ER saying his left arm has been acting on its own lately, suddenly flying out of control and accidentally hitting people around him. You know the lesion is in his:
right subthalamic nucleus - normally inhibits thalamus (thru the GPi)
A patient from a third world country presents with malaise, HA, fever, nausea, abdominal pain, sore throat. He also has marked muscle weakness and atrophy and hyporeflexia. What do you suspect?
poliomyelitis - fecal-oral, virus travels retrograde to CNS where destroys anterior horn cells --> LMN manifestations
A 28 y/o white female presents to the ER with sudden loss of vision and hemiparesis with bladder incontinence. Which cells in her body have a problem?
oligodendrocyte loss with axon preservation - see bilateral asymmetrical periventricular plaques
What do you suspect in a young woman who presents with scanning speech, intention tremor, and nystagmus?
multiple sclerosis - white women 20's - 30's
Patient presents with ascending symmetrical muscle weakness starting at the feet and legs. Lumbar puncture reveals markedly elevated proteins with near-normal cell count. You know it is:
Guillain-Barre syndrome (acute idiopathic polyneuritis) - highest incidence in young adults, preceded by infection --> autoimmune attack on peripheral myelin
Causes of seizures in kids: (5)
- genetic
- infection
- trauma
- congenital
- metabolic
Causes of seizures in adults: (4)
- tumor
- trauma
- stroke
- infection
Causes of seizures in eldery: (5)
- stroke
- tumor
- trauma
- metabolic
- infection
Fracture temporal bone --> rupture ___ ___ artery --> ___ hematoma
middle meningeal, epidural
Rupture bridging veins -->
subdural hematoma
Rupture aneurysm -->
subarachnoid hemorrhage (worst HA) - bloody spinal tap
Parenchymal hematoma can be due to: (4)
- amyloid angiopathy
- diabetes mellitus
- tumor
What are 7 risk factors for berry aneurysms?
- adult polycystic kidney
- Ehlers-Danlos
- Marfan's
- old age
- smoking
- blacks
What is the most common primary brain tumor?
Glioblastoma multiforme - found in cerebral hemispheres, very bad Px, stain astrocytes with GFAP
Which primary brain tumor is characterized by psamomma bodies and arises from arachnoid cells?
Meningioma - mostly in convexities of the hemispheres
What is the primary brain tumor associated with Neurofibromatosis 2?
acoustic Schwannoma
Which primary brain tumor looks like "fried eggs" with a perinuclear halo and round blue nuclei?
Oligodemdroglioma - relatively rare, slow growing
Which childhood primary brain tumor is associated with Rosenthal fibers? (eosinophilic corkscrew fibers)
Pilocytic astrocytoma - diffusely infiltrating but benign
Which highly malignant childhood primary brain tumor of the cerebellum that has a perivascular pseudorosette pattern and often compresses the 4th ventricle, leading to hydrocephalus?
Medulloblastoma - a form of PNET