Neurologic Disorder

Front 1

Aphasia(Dysphasia)

Back 1

loss or impairment of language function as a result of damage to the language center

Front 2

Dysarthria

Back 2

disturbance in articulation of speech(pt knows what they want to say but can't)

Front 3

Anomia

Back 3

difficulty recalling names of objects

Front 4

Brocca's Aphasia

Back 4

disruption in FLUENCY of speech, with impairments in expression of speech and writing

Front 5

Wernicke's Aphasia

Back 5

inability to comprehend spoken or written word; speak fulently but meaningless

Front 6

Conduction Aphasia

Back 6

inability to repeate a spoke phrase-normal comprehension
Lesion in arcuate fasiculus connecting broca and wernicke

Front 7

Global Aphasia

Back 7

Large lesion in frontal lobe, all aspects of language are affected

Front 8

Agnosia

Back 8

Inability to recognize sensory stimulus despite preserved sensory function

Front 9

Prosopagnosia

Back 9

cant recognize familiar faces

Front 10

Apraxia

Back 10

inability to perform learned motor tasks despite sufficient memory and sensoriomotor function

Front 11

Extinction

Back 11

presented with bilateral stimuli responds to ipsilateral stimuuli

Front 12

Anosognosia

Back 12

lack of awareness of deficit

Front 13

Amnesia

Back 13

degeneration of hippocampus or its connections= inability to form new memories

Front 14

Concussion injuries

Back 14

retrograde amnesia and mild anterograde amnesia

Front 15

Transient global amnesia

Back 15

>65y/o, abrupt amnesia for <12hrs
cause:emotion, physical activity,sex, cold h2o

Front 16

Korsakoff's syndrome

Back 16

untreated or partially treated wernicke's encephalopathy from Thiamine deficiency

Front 17

symptoms of Korsakoff's

Back 17

1.)Confusion
2.)Gait ataxia
3.)nystagmus
4.)opthalmoparesis

Front 18

If Korsakoff untreated

Back 18

inability to form new memories
Chronic: confabulate freely

Front 19

Psychogenic amnesia

Back 19

affects long term memory as well as recent, unable to recall own name

Front 20

Organic amnestic states

Back 20

short term memory affected and disorientation greatest for time and place but never self

Front 21

Dementia

Back 21

progressive loss of intellectual function

Front 22

Specific abnormalities of cognition

Back 22

1.)language
2.)spatial processing
3.)Praxis

Front 23

Cortical dementia symptoms

Back 23

1.) change in memory
2.)language deficits
3.)perceptual deficits
4.)praxis

Front 24

examples of cortical

Back 24

Alzheimers
DLB
vascular dementia

Front 25

Alzheimers

Back 25

progressive loss of cortical neuronsand formation of amyloid plaques and neuro tangles

Front 26

Alzheimers cause

Back 26

deficiency of cortical acetylcholine
TX:acetylcholinesterase inhibitors

Front 27

Clinical features of AD

Back 27

1.)memory
2.)Orientation
3.)depression
5-15yrs progression

Front 28

DLB

Back 28

hallmark of Parkinsons when inclusion at brain stem
2nd most common

Front 29

DLB treatment

Back 29

Levadopa/carbidopa=motor
AchE inhib=psych
SSRI=depression

Front 30

Vascular dementia

Back 30

early incontinence, gait disturbances, flattening effect

Front 31

Pick's disease

Back 31

pts are irascible and socially disinhibited; progressive

Front 32

Parkinson's disease

Back 32

Tx:dopamine agonists=motor

Front 33

Normal pressure hydrocephalus
CLINICALLY

Back 33

1.)dementia
2.)gait instability
3.)urinary incontinence
Sx evolve over weeks to months

Front 34

what does teh CT reveal in NPH?

Back 34

ventricular enlargement

Front 35

Creutzfeldt Jacob

Back 35

subacute, dementing, transmissible
70% have myoclonus
PRION PROTEIN

Front 36

when is the onset of C-J?

Back 36

40-75y/o

Front 37

what are the risk factors for CVA?

Back 37

1.)Hypertension
2.)Heart Dz
3.)Previous stroke/TIA
4.)smoking
5.)Obesity

Front 38

Vascular origin stroke

Back 38

1.)thrombotic
2.)embolic
3.)Hypoxia
4.)Lacunar
5.)Hemorrhagic

Front 39

Thombotic

Back 39

most common in carotid or MCA
Occlusion of large blood vessel
Progress slowly

Front 40

Embolic

Back 40

Platlets, choles, fibrin break off arterial wall or heart
Abrupt onset
affects distal, small cortical vessels

Front 41

Lacunar

Back 41

small blockage in arterioles

Front 42

Hemorrhagic

Back 42

increase ICP

Front 43

Stroke

Back 43

neurologic defects that last at least 24hrs

Front 44

Recurrent TIA with similar effects??

Back 44

Thrombotic

Front 45

Recurrent TIA w/ different?

Back 45

embolic

Front 46

Test for stroke

Back 46

MRI
doppler
echo
ESR-inflammation
lupus, etc

Front 47

Treatment of stroke?

Back 47

Tpa within 3hrs onset
Heprin/asa-unclear
r-proUK:intra-arterial therapy 6hrs

Front 48

Do you bring down BP with stroke?

Back 48

slowly, but not to a normal range in first few days

Front 49

Other TX for stroke

Back 49

O2:mechanical vs supplemental
glucose needs managing
No oral feeding for 24hrs
check for Pneumonia
Cardiac status
DVT
Seizures

Front 50

Cerebral edema

Back 50

most common cause of deteriation and death, 24-96hrs

Front 51

Cytotoxic

Back 51

water and sodium with white matter

Front 52

Vasogenic

Back 52

salt and water with white and gray matter

Front 53

Symptoms of cerebral edema

Back 53

1.)drowsiness
2.)occular and abducen palsy
3.)breathinbg problems
4.)Babinski contralateral to hemiparesis

Front 54

Tx of Cerebral edema

Back 54

1.)intubation and hyperventilation to induce vasoconstriction & decreased ICP
2.)Mannitol

Front 55

Prevention

Back 55

1.)BP,120/80 with diuretics and ACE
2CEA:if ipsilateral severe stenosis

Front 56

Hypertensive encephalopathy

Back 56

cerebral effects not caused by infarction or hemorrhage
BP very high
MED EMERGENCY!!!

Front 57

Symptoms of Hypertensive encephalopathy

Back 57

1.)HA
2.)visual disturbances
3.)confusion
4.)drowsiness

Front 58

Intracerebral Hemorrhage (ICH)

Back 58

Diffuse or focal
Hypertensive ICH:lacunar infar

Front 59

Charcot-Bouchard aneurysms

Back 59

microaneurysims

Front 60

Symptoms of ICH

Back 60

WORST HEADACHE OF LIFE!!
seizures
LOC during first 24-48hrs

Front 61

DX of ICH

Back 61

CT scan

Front 62

Management of ICH

Back 62

manage mass effects

Front 63

Fusiform aneurysms

Back 63

dilation of large arteries, basilar or ICA
Rarly rupture but compress

Front 64

Mycotic aneurysm

Back 64

context of bacterial endocarditis
distal and multiple
septic emboli
Surgery if not treated with ABX

Front 65

saccular aneurysm

Back 65

form at arterial bifurcations
increaed in Marfans and PKD

Front 66

Clinical Intercranial aneurysm

Back 66

severe HA w/neck pain
LOC and vomiting

Front 67

sentinal hemorrhage

Back 67

less severe and HA resolves over 24-48hrs

Front 68

TX of aneurysms

Back 68

CT
LP
Cerebral angiography gold stand

Front 69

Management

Back 69

1.)reduce risk of bleed: bed rest, analgesics, sedation, laxatives
2.)Manage HTN

Front 70

vascular malformations
Venous angiomas

Back 70

MOST COMMON
close to brain surface

Front 71

Capillary telangiectases

Back 71

in brain stem

Front 72

Cavernous angiomas

Back 72

dialted sinus channels
found on CT
rarely bleed

Front 73

Arteriovenous malformations

Back 73

arteries connected directly to veins
HA, SEIZURES,HEMORRHAGE

Front 74

TX AV malformations

Back 74

age of pt and location
>55y/o=conservitativly
<55surgical

Front 75

Acute transvere Myelitis

Back 75

rapidly developing paraparesis or paralgia as result of spinal cord dysfunction

Front 76

ATM

Back 76

Urinary or fecal incon common
Progress from min to days

Front 77

Disordes causing ATM

Back 77

1.)lesions
2.)vascualr occlusion
3.)aortic disection
4.)AV malformation
5.)varicellar-zoster

Front 78

Do pts ATM have any history of illness?

Back 78

Yes, URI or flu

Front 79

ADEM
Acute disseminated encephalomyelitis

Back 79

after viral infections or immunizations

Front 80

symptoms related to viral infection?

Back 80

6-10days after infection

Front 81

Clinical symptoms of ADEM

Back 81

1.)HA, fever, neuro signs
severe-delerium, stupor, coma

Front 82

TESTS for ADEM

Back 82

CSF-pleocytosis and elevated gamma globulin with protein elevation

Front 83

Vertigo

Back 83

sensation of rotation

Front 84

what is the sensation of vertigo?

Back 84

rotation, pation sees room moving in direction opposite of slow nystagmus

Front 85

Peripheral vertigo

Back 85

pts has vertigo with nystagmus

fast phase directed away from affected ear

Front 86

Central vertigo

Back 86

vertigo with no nystagmus

Front 87

Vestibular neuronitis

Back 87

attacks of peripheral vertigo w/o auditory disfunction

Front 88

Labryinthitis

Back 88

acute vertigo with autonomic symptoms-otitis or viremia

Front 89

peripheral vestibulopathy

Back 89

recurrent attacks w/other neuro signs w/ normal exam

Front 90

Nylen-Barany or Dix hallpike

Back 90

seated forward-supine w/ head over edge of table

Front 91

Peripheral nervous system disorder

Back 91

weakness is proximal and prob climbing

Front 92

Parkinsons DZ

Back 92

premature death of pigmented dopaminergic neurons in substantia nigra

Front 93

Risk factors for parkinsons DZ

Back 93

1.)family Hx
2.)male gender
3.)head injury
4.)rural living
5.)well water
6.)pesticides

Front 94

reduce incidence of PD

Back 94

1.)smoking
2.)coffee
3.)NSAIDS
4.)estrogen

Front 95

clinical features of PD

Back 95

1.)hand tremmor
2.)foot drag
3.)decreased arm swing
4.)micrographia
5.)masked faces
6.)cogwheeling
7.)postural instability

Front 96

Tx for PD

Back 96

1.)Dopamine precursors(Carbidopa/levadopa)
2.) Dopamine agonist
(Bromocriptine)
3.)anticholenergics(last resort)
4.) MAOI
5.)COMT

Front 97

unwanted SE of of Tx

Back 97

1.)nausea
2.)orthostatic hypotension
3.)hallucinations
4.)Psychosis
5.)dyskinesias

Front 98

Essential Tremor

Back 98

MOST COMMON CAUSE TREMOR
Both sides of body
ETOH relieves

Front 99

How do you treat ET

Back 99

B-blocker
anti-seizure

Front 100

Dystonia

Back 100

sustained muscle contractions resulting in abnormal postures

Front 101

Wilsons DZ

Back 101

new onset of hyperkinesia or PD in young adult
Psycosis common

Front 102

Testing for WD

Back 102

24hr urine for copper
serum copper

Front 103

Sydenham's chora

Back 103

childhood-post infection complication of b-hemolytic strep

Front 104

drug induced chorea

Back 104

isonazid, lithium, OC

Front 105

metabolic causes of hyperkinetic disorder

Back 105

thyrotoxicosis
hypoparathyroidism
hypomagnesemia

Front 106

ALS

Back 106

degeneration of motor neurons at all levels of CNS

Front 107

inital symptoms ALS

Back 107

1.)weakness
2.)muscle wasting
3.)stiffness
4.)cramping
5.)muscle twitches hands and arms
6.)dysarthria and dysphagia

Front 108

Ulnar Palsy symptoms

Back 108

muscle weakness
atrophy of 1st dorsal interosseous muscle and pt notices difficulty performing fine movements
numbness of small finger

Front 109

Meralgia paresthetica

Back 109

compression of lateral cutaneous nerve of teh thigh as it passes through inguinal ligament

Front 110

symptoms of Meralgia

Back 110

numbness or burning sensations over lateral thigh provoked by walking or standing
lose weight

Front 111

GBS

Back 111

CSF:increase protein w/o pleocytosis
MOST COMMON CAUSE OF FLACID PARALYSIS

Front 112

Name 5 infectious causes of GBS

Back 112

1.)C. Jejuni
2.)mono
3.)CMV
4.) Herpes
5.)Mycoplasma

Front 113

SX of GBS:

Back 113

weakness in legs
reflex deminished

Front 114

TX of GBS

Back 114

plasmapheresis, Immunoglobulin

Front 115

Myasthenia Gravis

Back 115

acetylcholine deficiency at motor end plate
FEMALE

Front 116

Clinical of MG

Back 116

external occular muscles or voluntary muscle system
bilateral, assymetric PTOSIS and DIPLOPIA
SNARL b/c of loss of facial nerves
FATIGUE OF MUSCLES

Front 117

Curtain sign

Back 117

worsening pitosis w/upward gaze

Front 118

DX of MG

Back 118

1.)Anticholinesterase test-curse fatigue for a few min
2.)electromyography
3.)AChR antibody test

Front 119

Tx for MG

Back 119

1.)Anticholenesterase
2.)Thymectomy
3.)pred

Front 120

Lambert-Eaton MG

Back 120

AI disorder
autoantibodies to calcium channels in pre-synaptic motor nerve terminals
reduced AcH release
LOWER LIMBS MORE INVOLVED

Front 121

causes of seizures

Back 121

1.)stress
2.)sleep deprivation
3.)fever
4.)ETOH

Front 122

are seizures higher in men?

Back 122

yes

Front 123

name 2 types of seizures

Back 123

1.)focal or partial
2.)generalized

Front 124

simple partial seizure

Back 124

subjective sensory and psych phenom

Front 125

Complex seizure

Back 125

impair consciousness

Front 126

generalized seizures

Back 126

Tonic-clonic seizures lasting 90sec
GRAND MAL

Front 127

Atonic seizures

Back 127

Drop attack children with diffuse encephalopathies sudden loss of muscle tone

Front 128

Rolandic epilepsy

Back 128

Benign: partial epilepsy of childhood w/ central midtempral spikes
Onset 4-13y/o
occur at night

Front 129

Cause of facial pain while eating

Back 129

1.)TMJ
2.)GCA
3.)Tooth
4.)Trigeminal nerve

Front 130

facial pain while swallowing

Back 130

1.)glossopharyngeal

Front 131

Atypical facial pain

Back 131

nasal pharyngeal CA

Front 132

Burning Facial pain

Back 132

Tumor of 5th cranial nerve

Front 133

what organisms linked w/ community aquired Meningitis

Back 133

1.)S pneumonia
2.)N. Menin
3.)

Front 134

classic triad for Meningitis

Back 134

1.)fever
2.)HA
3.)rigidity

Front 135

Kernig sign

Back 135

supine positionbend knee and attempt to extend causes pain

Front 136

focal seizures w/ meningitis

Back 136

ischemia, infarction, edema

Front 137

Generalized seizures w/ meningitis

Back 137

fever, hyponatremia

Front 138

Clinical Meningitis

Back 138

ICP(LOC, papliodemapoor pupils, 6th nerve palsy)

Front 139

How do you Dx

Back 139

blood cultures and start meds
CSF-low glucose
latex agglutination

Front 140

Tx of meningitis

Back 140

60 min upon arrival with 3rd generation cephalosporin and vanco
add ampicillin for L.moncytogenes in ,3mo, .55, and cell mediated immunity

Front 141

What is severe HA, stiff neck, no fever

Back 141

ICH

need LP for dx if hemorrhage is small or below foramen magnum

Front 142

what should you think is there is Hx of amenorrhea or Galactorrhea?

Back 142

Pituitary adenoma

Front 143

Temporal arteritis

Back 143

causes blindness
in elderly

Front 144

symptoms of TA

Back 144

1.)HA
2.)polymyaligia rheumatica
3.)jaw claudication
4.)fever
5.)wt loss

Front 145

Quality of head pain in TA

Back 145

ice-pick, dull boring
scalp tenderness
worse at night
aggravated by cold

Front 146

Labs for TA

Back 146

Sed rate and C-reactive protein

Front 147

Goals of Tx for migraine

Back 147

1.)relief of attack
2.)prevention of recurring

KEEP MIGRAINE DIARY