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97 Cards in this Set

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  • Back
encephalopathy + ophthalmoplegia + ataxia = ?? treatment??
Wernicke's encephalopathy; treat with IV thiamine
encephalopathy + ophthalmoplegia + ataxia + amnesia = ?? treatment??
Korsakoff's dementia; damage is irreversible
how does closed-angle glaucoma present and what temporizing measures can be done?
usually unilateral, fast onset, intraocular pressure increases; give them acetazolamine to temporarily lower pressure; laser treatment is definitive
how is open-angle glaucoma different than closed angle on presentation?
it is usually slower onset, always getting new prescription glasses, bilaterl
what is the leading cause of permanent blindness in the elderly?
macular degeneration
how does macular degeneration present?
painless loss of central vision
sudden, painless, unilateral blindness with cherry-red spot on fovea = ??
central retinal artery occlusion
rapid onset, painless vision loss on one side = ??
central vein retinal occlusion; arterial occlusions are sudden onset as opposed to venous are rapid onset
treatment for Guillain-Barre sx
plasmapheresis and IVIG; do not give steroids
what disease affects both upper and lower motor neurons?
ALS
are most CNS tumors primary or metastatic?
metastatic
most common primary CNS tumors in adults
glioblastoma multiforme
most common primary CNS tumors in children
medulloblastomas and astrocytomas
where are most brain tumors in adults located?
2/3 are supratentorial
where are most brain tumors in children located?
2/3 are infratentorial
what disease is associated with bilateral acoustic neuromas and a defective gene on chromosome 22?
neurofibramatosis 2
ashleaf spots (hypopigmented lesions) + shagreen patch + lesions enhance under Woods lamp = ??
tuberous sclerosis
what tumor is tuberous sclerosis associated with?
rhabdomyoma of heart
cafe-au-lait spots + freckles on axilla/groin + optic glioma + lisch nodules = ??
neurofibromatosis 1, aka von Recklinghausens syndrome
what causes aphasia?
an insult to the dominant hemisphere
blockage of which artery is typically associated with Brocas aphasia?
left superior MCA
blockage of which artery is typically associated with Wernickes aphasia?
inferior/posterior MCA
what is Broca's aphasia?
disorder of language production but intact comprehension; expressive aphasia
what is Wernicke's aphasia?
disorder of language comprehension with intact but non-sensical production
what test is the gold standard for a subarachnoid hemorrhage?
4-vessel angiography
what causes a subdural hematoma?
rupture of the bridging veins
how does a subdural hematoma present on CT?
crescent-shaped, concave hyperdensity on CT
how does a epidural hematoma present on CT?
lens-shaped, convex hyperdensity limited by sutures
how does a intraparchenchymal hematoma present on CT?
irregular-shaped hyperdensity with midline shift of choroid plexus
what is Todd's paralysis?
focal weakness in a part of the body after a partial seizure
how does an absence seizure present on EEG?
3 second per spike and wave discharges
what do you see on autopsy with Alzheimers?
neurofibrally tangles, neuritic plaques, amyloid deposition
what is the most common cause of death in an Alzheimer's patient?
death due to aspiration pneumonia
what do you see on MRI with Huntingtons?
atrophy of caudate and putamen
what causes Parkinsons?
dopamine depletion in the substantia nigra
scanning speech + intranuclear ophthalmoplegia + nystagmus = ??
triad for multiple sclerosis
muscular weakness that resolves with rest is classic for what?
myasthenia gravis
what can pseudotumor cerebri lead to if untreated?
blindness
afebrile patient with rapidly ascending paralysis without sensory abnormalities = ??
tick-borne illness
ipsilateral oculomotor nerve injury with trauma indicates what?
uncal herniation
absence versus complex partial seizure...

EEG does not respond to hyperventilation
complex partial seizure
what defines brain death?
1. absent cranial nerve reflexes
2. fixed and dilated pupils
3. no spontaneous breaths for 10 minutes
4. 2 physicians in agreement
intense retro-orbital pain with sudden onset that awakes someone from sleep
cluster headache
best long-term treatment for myasthenia gravis
thymectomy
treatment for essential tremor
beta-blocker or primidone
what may primidone cause?
acute intermittent porphyria
hemi-sensory loss with severe dysthesia of affected area = what type of stroke?
thalamic stroke
personality changes + compulsive behaviors + impaired memory = ?? (typically in older person)
Picks dementia (frontal-temporal dementia)
ipsilateral ataxia + nystagmus + intention tremors + loss of coordination = ??
cerebellar tumor
how is neurofibromatosis transmitted?
autosomal dominant
What is Brown-Sequard syndrome?
occurs due to damage to the lateral spinothalamic tract causing contralateral loss of pain and temperature sensation 2-segments below the lesion
what do you see on MRI with multiple sclerosis?
bilateral, multifocal, asymmetric contrast enhancement in periventricular white matter
uncontrolled HTN + focal neurological signs = what must you rule out?
parenchymal hemorrhage
hyperreflexia + fasciculations = ??
ALS
multiple sclerosis causes what ophthalmic problem and what is the reason for it?
internuclear ophthalmoplegia due to demyelination of medial longitudinal fasciculations
what electrolyte abnormality occurs with a subarachnoid hemorrhage?
cerebral salt-wasting syndrome, hyponatremia, SIADH
a 6 year old girl should be able to do what things for development?
ride bike, copy triangle, knows right from left
what level of stenosis is an indication for a carotid endartectomy?
60-99% blockage
most common cause of non-traumatic SAH
rupture of saccular aneurysm
areflexic weakness in the upper extremities with cape-like anesthesia
must rule out syringomyelia
treatment for trigeminal neuralgia
carbamazepine
what is the number one risk factor for amaurosis fugax?
atherosclerosis
what is the best test to determine carotid flow?
carotid doppler or MRA
what genetic mutation is association with Alzheimers?
alternation of apolipoprotein E4 allele
what do you look for on MRI with Alzheimers?
look for hippocampal and medial temporal lobe assymetry
antidote for mercury poisoning
dimercaprol
treatment for organophosphate toxicity
atropine or pralidoxine
treatment for post-dural headache
epidural blood patch
treatment for deep aching associated with post-herpetic neuralgia
amitriptyline
most common cause of syringomyelia
Arnold-Chiari malformation
what is Becks syndrome?
occlusion of the anterior spinal artery
transient hearing loss in one ear + tinnitus + vertigo = ??
Meniere's disease
what is amaurosis fugax?
transient monocular blindness due to carotid emboli occluding the ophthalmic artery
what do you see histologically with Alzheimers?
neurofibrillary tangles and beta-amyloid plaques
what do you see on imaging with dementia?
enlarged lateral ventricles
treatment for heat stroke
cover patient in ice-water soaked sheets
most common location for cerebral venous thrombosis
superior saggital sinus
horrible headache + vomiting + papilledema + focal neurological signs without changes in mental status = ?? what increases risk for this?
must r/o CVT, higher risk if patient is on OCPs
first line treatment for cerebral venous thrombosis
heparin and warfarin
treatment for anti-cholinergic toxicity
physostigmine
ataxia + hallucinations + seizures + "sweet breath" = ??
ethylene glycol toxicity
treatment for ethylene glycol
treat with competitive binding via ethanol and formepizole
name the alternate term for the vitamins B1, B2, B3, B6, B12
B1 = thiamine
B2 = riboflavin
B3 = niacin
B6 = pyridoxine
B12 = cobalamin
what do you see on LP with Guillain-Barre syndrome for protein, pressure and glucose?
increased protein
normal pressure
normal glucose
what symptoms does salicylate toxicity initially present with?
tinnitus and dizziness
what do you see on ABG with salicylate toxicity?
mixed metabolic and respiratory acidosis
most common artery ruptured with an epidural hematoma?
middle meningial artery
what do you see histologically with Parkinsons?
Lewy bodies in the substantia nigra
how does a cluster headache present?
typically a young male with pain localized behind/around one eye
what type of drug is clonidine and what is a common side effect?
alpha-2 blocker; orthostatic hypotension
definition of orthostatic hypotension
decrease in blood pressure by 20/10 after going from seated to standing over 3 minutes
antidote for methanol toxicity
fomepizole
antidote for ethylene glycol toxicity
fomepizole
treatment for black widow spider bite
treat with calcium gluconate
empiric treatment for bacterial meningitis
vanco and ceftriaxone
LE weakness + finger dysethesias + 2-4 weeks post-URI/GI infection = ??
Guillain-Barre syndrome
treatment for Guillain-Barre syndrome
plasmapheresis and IVIG