Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/147

Click to flip

147 Cards in this Set

  • Front
  • Back
Aphasia(Dysphasia)
loss or impairment of language function as a result of damage to the language center
Dysarthria
disturbance in articulation of speech(pt knows what they want to say but can't)
Anomia
difficulty recalling names of objects
Brocca's Aphasia
disruption in FLUENCY of speech, with impairments in expression of speech and writing
Wernicke's Aphasia
inability to comprehend spoken or written word; speak fulently but meaningless
Conduction Aphasia
inability to repeate a spoke phrase-normal comprehension
Lesion in arcuate fasiculus connecting broca and wernicke
Global Aphasia
Large lesion in frontal lobe, all aspects of language are affected
Agnosia
Inability to recognize sensory stimulus despite preserved sensory function
Prosopagnosia
cant recognize familiar faces
Apraxia
inability to perform learned motor tasks despite sufficient memory and sensoriomotor function
Extinction
presented with bilateral stimuli responds to ipsilateral stimuuli
Anosognosia
lack of awareness of deficit
Amnesia
degeneration of hippocampus or its connections= inability to form new memories
Concussion injuries
retrograde amnesia and mild anterograde amnesia
Transient global amnesia
>65y/o, abrupt amnesia for <12hrs
cause:emotion, physical activity,sex, cold h2o
Korsakoff's syndrome
untreated or partially treated wernicke's encephalopathy from Thiamine deficiency
symptoms of Korsakoff's
1.)Confusion
2.)Gait ataxia
3.)nystagmus
4.)opthalmoparesis
If Korsakoff untreated
inability to form new memories
Chronic: confabulate freely
Psychogenic amnesia
affects long term memory as well as recent, unable to recall own name
Organic amnestic states
short term memory affected and disorientation greatest for time and place but never self
Dementia
progressive loss of intellectual function
Specific abnormalities of cognition
1.)language
2.)spatial processing
3.)Praxis
Cortical dementia symptoms
1.) change in memory
2.)language deficits
3.)perceptual deficits
4.)praxis
examples of cortical
Alzheimers
DLB
vascular dementia
Alzheimers
progressive loss of cortical neuronsand formation of amyloid plaques and neuro tangles
Alzheimers cause
deficiency of cortical acetylcholine
TX:acetylcholinesterase inhibitors
Clinical features of AD
1.)memory
2.)Orientation
3.)depression
5-15yrs progression
DLB
hallmark of Parkinsons when inclusion at brain stem
2nd most common
DLB treatment
Levadopa/carbidopa=motor
AchE inhib=psych
SSRI=depression
Vascular dementia
early incontinence, gait disturbances, flattening effect
Pick's disease
pts are irascible and socially disinhibited; progressive
Parkinson's disease
Tx:dopamine agonists=motor
Normal pressure hydrocephalus
CLINICALLY
1.)dementia
2.)gait instability
3.)urinary incontinence
Sx evolve over weeks to months
what does teh CT reveal in NPH?
ventricular enlargement
Creutzfeldt Jacob
subacute, dementing, transmissible
70% have myoclonus
PRION PROTEIN
when is the onset of C-J?
40-75y/o
what are the risk factors for CVA?
1.)Hypertension
2.)Heart Dz
3.)Previous stroke/TIA
4.)smoking
5.)Obesity
Vascular origin stroke
1.)thrombotic
2.)embolic
3.)Hypoxia
4.)Lacunar
5.)Hemorrhagic
Thombotic
most common in carotid or MCA
Occlusion of large blood vessel
Progress slowly
Embolic
Platlets, choles, fibrin break off arterial wall or heart
Abrupt onset
affects distal, small cortical vessels
Lacunar
small blockage in arterioles
Hemorrhagic
increase ICP
Stroke
neurologic defects that last at least 24hrs
Recurrent TIA with similar effects??
Thrombotic
Recurrent TIA w/ different?
embolic
Test for stroke
MRI
doppler
echo
ESR-inflammation
lupus, etc
Treatment of stroke?
Tpa within 3hrs onset
Heprin/asa-unclear
r-proUK:intra-arterial therapy 6hrs
Do you bring down BP with stroke?
slowly, but not to a normal range in first few days
Other TX for stroke
O2:mechanical vs supplemental
glucose needs managing
No oral feeding for 24hrs
check for Pneumonia
Cardiac status
DVT
Seizures
Cerebral edema
most common cause of deteriation and death, 24-96hrs
Cytotoxic
water and sodium with white matter
Vasogenic
salt and water with white and gray matter
Symptoms of cerebral edema
1.)drowsiness
2.)occular and abducen palsy
3.)breathinbg problems
4.)Babinski contralateral to hemiparesis
Tx of Cerebral edema
1.)intubation and hyperventilation to induce vasoconstriction & decreased ICP
2.)Mannitol
Prevention
1.)BP,120/80 with diuretics and ACE
2CEA:if ipsilateral severe stenosis
Hypertensive encephalopathy
cerebral effects not caused by infarction or hemorrhage
BP very high
MED EMERGENCY!!!
Symptoms of Hypertensive encephalopathy
1.)HA
2.)visual disturbances
3.)confusion
4.)drowsiness
Intracerebral Hemorrhage (ICH)
Diffuse or focal
Hypertensive ICH:lacunar infar
Charcot-Bouchard aneurysms
microaneurysims
Symptoms of ICH
WORST HEADACHE OF LIFE!!
seizures
LOC during first 24-48hrs
DX of ICH
CT scan
Management of ICH
manage mass effects
Fusiform aneurysms
dilation of large arteries, basilar or ICA
Rarly rupture but compress
Mycotic aneurysm
context of bacterial endocarditis
distal and multiple
septic emboli
Surgery if not treated with ABX
saccular aneurysm
form at arterial bifurcations
increaed in Marfans and PKD
Clinical Intercranial aneurysm
severe HA w/neck pain
LOC and vomiting
sentinal hemorrhage
less severe and HA resolves over 24-48hrs
TX of aneurysms
CT
LP
Cerebral angiography gold stand
Management
1.)reduce risk of bleed: bed rest, analgesics, sedation, laxatives
2.)Manage HTN
vascular malformations
Venous angiomas
MOST COMMON
close to brain surface
Capillary telangiectases
in brain stem
Cavernous angiomas
dialted sinus channels
found on CT
rarely bleed
Arteriovenous malformations
arteries connected directly to veins
HA, SEIZURES,HEMORRHAGE
TX AV malformations
age of pt and location
>55y/o=conservitativly
<55surgical
Acute transvere Myelitis
rapidly developing paraparesis or paralgia as result of spinal cord dysfunction
ATM
Urinary or fecal incon common
Progress from min to days
Disordes causing ATM
1.)lesions
2.)vascualr occlusion
3.)aortic disection
4.)AV malformation
5.)varicellar-zoster
Do pts ATM have any history of illness?
Yes, URI or flu
ADEM
Acute disseminated encephalomyelitis
after viral infections or immunizations
symptoms related to viral infection?
6-10days after infection
Clinical symptoms of ADEM
1.)HA, fever, neuro signs
severe-delerium, stupor, coma
TESTS for ADEM
CSF-pleocytosis and elevated gamma globulin with protein elevation
Vertigo
sensation of rotation
what is the sensation of vertigo?
rotation, pation sees room moving in direction opposite of slow nystagmus
Peripheral vertigo
pts has vertigo with nystagmus

fast phase directed away from affected ear
Central vertigo
vertigo with no nystagmus
Vestibular neuronitis
attacks of peripheral vertigo w/o auditory disfunction
Labryinthitis
acute vertigo with autonomic symptoms-otitis or viremia
peripheral vestibulopathy
recurrent attacks w/other neuro signs w/ normal exam
Nylen-Barany or Dix hallpike
seated forward-supine w/ head over edge of table
Peripheral nervous system disorder
weakness is proximal and prob climbing
Parkinsons DZ
premature death of pigmented dopaminergic neurons in substantia nigra
Risk factors for parkinsons DZ
1.)family Hx
2.)male gender
3.)head injury
4.)rural living
5.)well water
6.)pesticides
reduce incidence of PD
1.)smoking
2.)coffee
3.)NSAIDS
4.)estrogen
clinical features of PD
1.)hand tremmor
2.)foot drag
3.)decreased arm swing
4.)micrographia
5.)masked faces
6.)cogwheeling
7.)postural instability
Tx for PD
1.)Dopamine precursors(Carbidopa/levadopa)
2.) Dopamine agonist
(Bromocriptine)
3.)anticholenergics(last resort)
4.) MAOI
5.)COMT
unwanted SE of of Tx
1.)nausea
2.)orthostatic hypotension
3.)hallucinations
4.)Psychosis
5.)dyskinesias
Essential Tremor
MOST COMMON CAUSE TREMOR
Both sides of body
ETOH relieves
How do you treat ET
B-blocker
anti-seizure
Dystonia
sustained muscle contractions resulting in abnormal postures
Wilsons DZ
new onset of hyperkinesia or PD in young adult
Psycosis common
Testing for WD
24hr urine for copper
serum copper
Sydenham's chora
childhood-post infection complication of b-hemolytic strep
drug induced chorea
isonazid, lithium, OC
metabolic causes of hyperkinetic disorder
thyrotoxicosis
hypoparathyroidism
hypomagnesemia
ALS
degeneration of motor neurons at all levels of CNS
inital symptoms ALS
1.)weakness
2.)muscle wasting
3.)stiffness
4.)cramping
5.)muscle twitches hands and arms
6.)dysarthria and dysphagia
Ulnar Palsy symptoms
muscle weakness
atrophy of 1st dorsal interosseous muscle and pt notices difficulty performing fine movements
numbness of small finger
Meralgia paresthetica
compression of lateral cutaneous nerve of teh thigh as it passes through inguinal ligament
symptoms of Meralgia
numbness or burning sensations over lateral thigh provoked by walking or standing
lose weight
GBS
CSF:increase protein w/o pleocytosis
MOST COMMON CAUSE OF FLACID PARALYSIS
Name 5 infectious causes of GBS
1.)C. Jejuni
2.)mono
3.)CMV
4.) Herpes
5.)Mycoplasma
SX of GBS:
weakness in legs
reflex deminished
TX of GBS
plasmapheresis, Immunoglobulin
Myasthenia Gravis
acetylcholine deficiency at motor end plate
FEMALE
Clinical of MG
external occular muscles or voluntary muscle system
bilateral, assymetric PTOSIS and DIPLOPIA
SNARL b/c of loss of facial nerves
FATIGUE OF MUSCLES
Curtain sign
worsening pitosis w/upward gaze
DX of MG
1.)Anticholinesterase test-curse fatigue for a few min
2.)electromyography
3.)AChR antibody test
Tx for MG
1.)Anticholenesterase
2.)Thymectomy
3.)pred
Lambert-Eaton MG
AI disorder
autoantibodies to calcium channels in pre-synaptic motor nerve terminals
reduced AcH release
LOWER LIMBS MORE INVOLVED
causes of seizures
1.)stress
2.)sleep deprivation
3.)fever
4.)ETOH
are seizures higher in men?
yes
name 2 types of seizures
1.)focal or partial
2.)generalized
simple partial seizure
subjective sensory and psych phenom
Complex seizure
impair consciousness
generalized seizures
Tonic-clonic seizures lasting 90sec
GRAND MAL
Atonic seizures
Drop attack children with diffuse encephalopathies sudden loss of muscle tone
Rolandic epilepsy
Benign: partial epilepsy of childhood w/ central midtempral spikes
Onset 4-13y/o
occur at night
Cause of facial pain while eating
1.)TMJ
2.)GCA
3.)Tooth
4.)Trigeminal nerve
facial pain while swallowing
1.)glossopharyngeal
Atypical facial pain
nasal pharyngeal CA
Burning Facial pain
Tumor of 5th cranial nerve
what organisms linked w/ community aquired Meningitis
1.)S pneumonia
2.)N. Menin
3.)
classic triad for Meningitis
1.)fever
2.)HA
3.)rigidity
Kernig sign
supine positionbend knee and attempt to extend causes pain
focal seizures w/ meningitis
ischemia, infarction, edema
Generalized seizures w/ meningitis
fever, hyponatremia
Clinical Meningitis
ICP(LOC, papliodemapoor pupils, 6th nerve palsy)
How do you Dx
blood cultures and start meds
CSF-low glucose
latex agglutination
Tx of meningitis
60 min upon arrival with 3rd generation cephalosporin and vanco
add ampicillin for L.moncytogenes in ,3mo, .55, and cell mediated immunity
What is severe HA, stiff neck, no fever
ICH

need LP for dx if hemorrhage is small or below foramen magnum
what should you think is there is Hx of amenorrhea or Galactorrhea?
Pituitary adenoma
Temporal arteritis
causes blindness
in elderly
symptoms of TA
1.)HA
2.)polymyaligia rheumatica
3.)jaw claudication
4.)fever
5.)wt loss
Quality of head pain in TA
ice-pick, dull boring
scalp tenderness
worse at night
aggravated by cold
Labs for TA
Sed rate and C-reactive protein
Goals of Tx for migraine
1.)relief of attack
2.)prevention of recurring

KEEP MIGRAINE DIARY