Neurology Board Review - Syndromes And Symptoms

Front 1

Kleine-Levin

Back 1

- "sleeping beauty"
- Hypersomnolence
- Hyperphagia
- Hypersexuality
- Mood and behavior changes

Front 2

Kluver-Bucy

Back 2

- Bilateral medial temporal lobes (amygdala)
- Docility
- Hyperorality
- Hyperphagia
- Hypersexuality
- Visual agnosia

Front 3

Thallium toxicity

Back 3

- Axonal peripheral neuropathy, ascending
- Alopecia
- Pain and paresthesias starting with soles of feet
- Distal>proximal weakness
- MRI normal

Front 4

Serotonin syndrome

Back 4

- Site of disorder: CNS
- Caused by SSRIs with or without MAOi, TCA, meperidine
- Tachycardia/HTN, diaphoresis/shivering, nausea/diarrhea, myoclonus, hyperreflexia, hyperthermia, seizures, coma
- Treatment is supportive

Front 5

Bechet's disease

Back 5

- Mucocutaneous, ocular, cardiovascular, renal, GI, pulmonary, and CNS
- Presence of oral aphthous ulcers and 2 other ulcers or vasculitidities

Front 6

Sturge-Weber disease

Back 6

- Neurocutaneous disorder involving leptomeninges, skin of face in V1 and V2
- Port-wine stain
- Ocular manifestations include ocular choroidal angiomas and glaucoma

Front 7

Organophosphate poisoning

Back 7

- Cholinergic syndrome
- Pinpoint pupils
- SLUDGE: salivation, lacrimation, urination, diaphoresis, GI motility, emesis
- Otherwise known as "fluid coming out of everywhere"

Front 8

Lead

Back 8

- Peripheral neuropathy

Front 9

Giant cell arteritis

Back 9

- Systemic symptoms are protective against CNS involvement
- Visual loss occurs in 8%
- Stroke occurs in 7%

Front 10

Toxins: Botulism

Back 10

- Presynaptic membrane (SNARE protein cleavage, no Ach release)
- Nausea, vomiting, diarrhea -> constipation, generalized weakness.
- Foodborne develops over 12-36 hours
- Wound borne develops over days to weeks.

Front 11

Toxins: Tick paralysis

Back 11

- Block NMJ transmission, or block Na channels at Nodes of Ranvier
- Rapidly ascending weakness
- Remove tick

Front 12

Toxins: Tetrodotoxin

Back 12

- Presynaptic Na+ channel blocker
- Found in pufferfish

Front 13

Toxins: Saxitoxin

Back 13

- Presynaptic Na+ channel blocker
- Dinoflagellates (red tide), shellfish that feed on them

Front 14

Toxins: Ciguatoxin

Back 14

- Presynsaptic Na+ channel blocker
- Dinoflagellates, reef fish
- Abdominal pain, oral and acral paresthesias, altered temperature sensation

Front 15

Toxins: Aminopyradines (dalfampridine)

Back 15

- Presynaptic K+ channel blocker
- Slows repolarization and promotes Ach release
- Used in treatment of Lambert Eaton syndrome

Front 16

Toxins: Dendrotoxin

Back 16

- Presynaptic K+ channel blocker
- Black or green mamba snake

Front 17

Toxins: Notexin

Back 17

- Presynaptic K+ channel blocker
- Australian tiger snake

Front 18

Medications which worsen myasthenia

Back 18

- Ca2+ blockers
- Antibiotics (aminoglycosides)
- Mg2+

Front 19

Toxins: Conotoxins

Back 19

- Presynaptic Ca2+ channel blocker
- Found in marine snails

Front 20

Toxins: Organophosphates

Back 20

- Include weaponized nerve agents such as soman, sarin, VX
- Insecticides
- Hypercholinergic state
- Treat with atropine

Front 21

Toxins: Curare

Back 21

- Postsynaptic AchR blocker
- Vec, pancuronium have similar mech of action

Front 22

Toxins: alpha bungarotoxin

Back 22

- Postsynaptic AchR blocker
- Banded krait (cobratoxin by siamese cobra)

Front 23

Manganese toxicity

Back 23

- Bilateral basal ganglia and midbrain lesions on MRI

Front 24

Neuroleptic malignant syndrome

Back 24

- Site of disorder: CNS
- Antipsychotics, especially depot
- Rigidity, encephalopathy, autonomic instability, dystonia, tremor, chorea, hyperthermia
- Treat with dantrolene, dopaminergic agents, withdraw medication

Front 25

Malignant hyperthermia

Back 25

- Site of disorder: muscle
- Halogenated anesthetics or depolarizing anesthetics in patients with ryanodine receptor mutation
- Jaw clenching, respiratory acidosis, cyanosis, myoglobinuria
- Withdraw medication, dantrolene, bicarbonate

Front 26

Acute lethal catatonia

Back 26

- Site of disorder: CNS
- Exacerbated psychotic disorder
- Psychosis, dyskinesia, waxy flexibility (not true rigidity)
- treat with ECT

Front 27

Neuroleptic malignant syndrome

Back 27

- Site of disorder: CNS
- Antipsychotics, especially depot
- Rigidity, encephalopathy, autonomic instability, dystonia, tremor, chorea, hyperthermia
- Treat with dantrolene, dopaminergic agents, withdraw medication

Front 28

Malignant hyperthermia

Back 28

- Site of disorder: muscle
- Halogenated anesthetics or depolarizing anesthetics in patients with ryanodine receptor mutation
- Jaw clenching, respiratory acidosis, cyanosis, myoglobinuria
- Withdraw medication, dantrolene, bicarbonate

Front 29

Acute lethal catatonia

Back 29

- Site of disorder: CNS
- Exacerbated psychotic disorder
- Psychosis, dyskinesia, waxy flexibility (not true rigidity)
- treat with ECT

Front 30

Causes of head drop

Back 30

myasthenia
ploymyositis
ALS

Front 31

Causes of head drop

Back 31

myasthenia
ploymyositis
ALS

Front 32

Causes of head drop

Back 32

myasthenia
ploymyositis
ALS

Front 33

Spastic paraplegia

Back 33

Focal spinal cord disease
SCD
tethered cord
DOPA responsive dystonia
Leukodystrophies
SCA-3
Friedreich's ataxia

Front 34

Episodic ataxia I

Back 34

- voltage gated K+ channel
- Onset 20-30 years
- Ataxia only lasting 1-2 minutes, emotion or change in position
- without nystagmus
- Treat with antiepileptics, avoid acetozolamide

Front 35

Episodic ataxia II

Back 35

- mutations of p/q type voltage gated ca2+ channel (CACNA1A)
- lasts more than 10 minutes to hours
- triggered by exercise or stress
- with nystagmus
- Treat with acetazolamide