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65 Cards in this Set
- Front
- Back
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•Unilateral, throbbing, aura, nausea/vomiting/photophobia |
•Migraines; treat with triptans, NSAIDs |
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•Bilateral, band-like, worse as the day goes on |
Tension headache |
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•Unilateral, brief HA, male, periorbital pain, Horner’s Sx, lacrimation |
•Cluster headache, treat with triptans or oxygen |
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•Worst headache of patient's life |
•Subarachnoid hemorrhage |
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•Overweight young woman, bilateral papilledema |
•Pseudotumor cerebri, idiopathic intracranial HTN, treat with LP, acetolazamide |
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•Chronic daily headaches, daily analgesic use |
•Rebound headaches (medication overuse headache) |
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•Contralateral face, arm weakness and sensory loss, eyes deviated to lesion Which blood vessel is affected? |
MCA |
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•contralateral foot and leg weakness, behavioral change, confusion, impairment of gait and stance (apraxia), akinetic mutism (lack of initiative), urinary incontinence, grasp and suck Which blood vessel is affected? |
•ACA |
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•Vomiting, vertigo, ataxia, dysarthria, CN palsies, diplopia, hemiparesis or hemisensory loss Which blood vessel is affected? |
•Posterior circulation (vertebrobasilar) |
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Part of brain: •CN 3,4 |
•Midbrain |
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Part of brain: •CN 5, 6, 7, 8 |
•Pons |
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Part of brain: •CN 9,10,11, 12 |
•Medulla |
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Which blood vessel? •Headache, one pupil not reactive to light (CN III) |
•Post. Communicating Artery Aneurysm |
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Hematoma: Rapid onset after lucid interval, temporal skull fracture |
•Epidural hematoma; middle meningeal artery |
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Hematoma: Slow onset, at risk persons (elderly with falls; alcoholics) |
•Subdural hematoma; torn bridging veins from shear stress |
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•Worst headache of life, blood in CSF |
Subarachnoid hemorrhage; Assoc. with aneurysms; remember Berry aneurysm with Adult Polycystic Kidney Disease |
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•Ptosis, diplopia, dysarthria, dysphagia, worse with fatigue |
•Myasthenia Gravis, antibodies vs. Ach receptor, Rx with Acetylcholinesterase Inhibitor: pyridostigmine; thymoma |
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•Smoker, lung mass, prox muscle weakness, autonomic sx, BETTER with exertion/repeated effort |
•Lambert-Eaton; antibodies vs. voltage gate calcium channel; associated with small cell lung cancer |
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•Ascending polyneuropathy, sensory, absent reflexes, preceded by infection (URI, Campylobacter diarrhea) |
•Guillain-Barre; Rx with plasmapharesis or IVIg |
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•Weakness, UMN signs (hyperreflexia, Babinski, spasticity) and LMN (atrophy, weakness, FASCICULATIONS) |
•ALS; Rx with riluzole (unclear mechanism; reduces glutamate-induced excitotoxicity) |
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•Young woman, visual sx (loss; ophthalmoplegia), other neuro sx, periventricular white matter changes |
•MS; Rx with interferon-beta |
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•Floppy baby, neonatal hypotonia, fasciculations |
•Werdnig-Hoffman; spinal muscular atrophy type 1 (AR, congenital degeneration of anterior horn cells) |
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•Paresthesias of first 3.5 digits, repetitive motion, Phelan’s |
•Median nerve; carpal tunnel, RX with wrist splints |
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•Paresthesias of last 1.5 digits, Hx prolonged elbow flexion |
•Ulnar nerve; if at wrist, claw hand 4th/5th digit, bicyclists, Hamate hook fracture |
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•Weakness of wrist extensors/wrist drop, hx of crutches or passing out with arm over back of chair |
•Radial nerve; also fracture of mid-humerus, spiral groove |
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•Winging of scapula, post radical mastectomy |
•Long thoracic nerve (from C5,6,7) |
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•Acute foot drop after compression of fibular neck (cast) |
•Peroneal nerve |
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•Numbness/pain lateral aspect of thigh, overweight |
•Lateral cutaneous nerve of thigh; “meralgia paresthetica” |
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•Shoulder dystocia, “waiter’s tip” sign |
•Erb’s palsy, C5,C6; |
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total claw hand with loss of lumbricals, |
Klumpke’s sign, C8, T1 |
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•HIV, low CD 4, visual sx (hemianopia), gait ataxia, non-enhancing white matter lesions |
•Progressive multifocal leukoencephalopathy, JC virus |
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•HIV, low CD4, heachache, multiple ring enhancing lesions |
•Toxoplasmosis |
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•Encephalitis, fever, muscle weakness, flaccid paralysis, Parkinson features, tremors |
•West Nile Virus |
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•Cranial nerve palsy, posterior column signs, general paresis, dementia, pupil accommodates but doesn’t react |
•Neurosyphilis |
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•Encephalitis, MRI with temporal lobe findings; RBC, lymphs in CSF |
•Herpes (Rx with acyclovir, inhibits viral thymidine kinase) |
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What medication causes these side-effects: |
•Valproic acid |
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What medication causes these side-effects:•Aplastic anemia; hepatic failure |
•Felbamate (only for intractable szs, like Lennox Gastaut) |
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What medications causes these side-effects:•Ataxia, hepatic dysfunction, gingival hyperplasia |
•Phenytoin |
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What medications causes these side-effects:•Hyponatremia, hepatic dysfunction |
•Carbamazepine |
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What medications causes these side-effects:•Stevens-Johnson |
•Ethosuximide (for absence); phenytoin, lamotrigine, carbamazepine |
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What medications causes these side-effects:•Kidney stones, weight loss, glaucoma, metabolic acidosis |
•Topiramate |
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What medications causes these side-effects:•Irritability, depression |
•Levetiracetam |
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Visual field defect: •Bitemporal hemianopia |
•Optic chiasm |
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•Right upper quadrantic anopia (pie in the sky) |
•Left temporal lobe |
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•Left lower quadrantic anopia |
•Right Parietal lobe |
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•Left homonymous hemianopia with macular sparing |
•Right occipital lobe |
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•Central scotoma |
•Macular degeneration |
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•No light perception in left eye |
•Left optic nerve |
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•Diplopia, dysphonia, dysarthria, dysphagia, descending flaccid paralysis, baby eating honey |
•Botulism |
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•Sprained ankles, calf atrophy, hammer toes, sensory loss, palpable peripheral nerves |
•Charcot-Marie-Tooth (Hereditary Motor Sensory Neuropathy) |
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•Myasthenia Gravis, anterior mediastinal mass |
•Thymoma |
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•~4 year old, awakens screaming, inconsolable, no memory of it |
•Night terrors/sleep terrors |
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•Slow growing, midline tumor |
•Meningioma |
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•Rapid dementia, startle myoclonus, hypokinesia, cerebellar (ataxia, nystagmus) |
•Creutzfeld-Jacob; prion; spongiform changes, 14-3-3 protein in CSF, MRI with flare in putamen and head of caudate |
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•Pediatric cerebellar tumor |
•Medulloblastoma |
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•Boy, self mutilating, MR, chorea, high uric acid |
•Lesch-Nyhan; mutation in hypoxanthine-guanine phosphoribosyltransferase |
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•Port wine stain in V1, seizures, MR, hemiparesis, glaucoma |
•Sturge Weber |
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•Hamartomas in skin and CNS, adenoma sebaceum, retardation, Ash leaf spot (hypopigmented macules), MR, AD |
•Tuberous sclerosis |
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•Cavernous hemagiomas in skin, bilateral renal cell (clear cell), hemangioblastoma in retina, brainstem, cerebellum, pheo |
•Von Hippel-Lindau (AD, VHL gene on chromosome 3) |
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•Sudden onset, floater, peripheral vision first affected, days to weeks |
•Retinal detachment |
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•Acute visual loss, PAIN, headache, red eye, mid-dilated fixed pupil |
•Acute angle-closure glaucoma |
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•Abrupt onset of painless visual loss, hemorrhages, cotton wool spots |
•Central retinal vein occlusion |
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•Sudden onset of vertigo triggered by specific positions |
•Benign positional vertigo, otoliths in semi-circularcanal, treat with Epley maneuver |
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•Tinnitus, hearing loss, vertigo |
•Meniere’s disease; increase in endolymphatic fluid damaging hair cells |
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•Unilateral hearing loss, vertigo, tinnitus |
•Acoustic neuroma (vestibular schwannoma); bilateral in NF 2 |
