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143 Cards in this Set

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Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: ASA, NSAIDs, sumatriptans, ergot alkaloids, and opiates may be used as abortive therapy.
Migraine
Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: associated with N/V, photophobia, phonophobia.
Migraine
Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: beta-blockers, calcium-channel blockers, ergots, antidepressants, and depakote are used for prophylaxis
Migraine
Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: Classic symptoms include unilateral frontotemporal cephalgia (e.g. scintillating scotoma)
Migraine
Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: course is characterized by periods of multiple headaches of the same character alternating with symptom-free intervals.
Cluster
Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: Findings include ipsilateral tearing, conjuctival injection, Horner's syndrome, and rhinorrhea.
Cluster
Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: Headaches described as pulsatile or throbbing
Migraine
Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: Headaches may be precipitated by hormonal factors (e.g. OCPs or menses), emotional or metabolic stress.
Migraine
Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: history of allergies
Sinus
Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: localized tenderness over sinuses
Sinus
Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: Most common type of headache in adults.
tension
Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: pathophysiology may relate to the effect of serotonin on cephalic blood vessels
Migraine
Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: patients often have a family history of headaches
migraine
Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: symptoms are often eradicated by 100% O2 by facemask
Cluster
Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: unilateral boring periorbital headache worst in the temporal-orbital region
Cluster
Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: vise-like, tightening bilateral pain assoacted with photophobia, phonophobia, neck tightness
Tension
What are the seven red flags of headache?
1. Sudden onset of severe headache
2. Headache beginning after straining, valsalva, sexual activity, or awakens patient from sleep.
3. Headache that is persistent and worsening over a period of weeks or months
4. Headache associated with focal neurologic findings or a change in mental status
5. Headache associated with meningeal signs (including nuchal rigidity, Brudzinski's or Kernig's sign)
6. Headache associated with fever
7. Headache in a patient who has never experienced a headache before.
Name the type of seizure associated with the following clinical findings: brief lapses of consciousness with or without rapid eye blinking, slight head, and limb jerking in a child.
Absence
Name the type of seizure associated with the following clinical findings: first line of therapy may include valproate, phenytoin, carbamazepine, phenobarbital, or newer agents (levetiracetam, oxcarbazepine, lamotrigine)
Tonic-clonic seizure
Name the type of seizure associated with the following clinical findings: sudden, brief muscle contractions; first line of therapy includes valproate and clonazepam
myoclonic seizures
Name the type of seizure associated with the following clinical findings: commonly mistaken as daydreaming in a young child
absence seizures
Name the type of seizure associated with the following clinical findings: first line of therapy includes ethosuximide and valproate
absence
Name the type of seizure associated with the following clinical findings: loss of consciousness followed by loss of postural control, a tonic phase of muscle contraction, and clonic phase of limb jerking
tonic-clonic
Name the type of seizure associated with the following clinical findings: motor, sensory, visual, psychic, or autonomic phenomena with preserved level of consciousness
simple partial
Name the type of seizure associated with the following clinical findings: three Hz spike-and-wave pattern on EEG
Absence
Name the type of seizure associated with the following clinical findings: may be associated with cyanosis and urinary or fecal incontinence; increased serum prolactin during postictal period
tonic-clonic
Name the type of seizure associated with the following clinical findings: motor, sensory, visual, psychic, or autonomic phenomena with diminished level of consciousness and/or postictal confusion
complex partial
Name the type of seizure associated with the following clinical findings: seizure interferes with a single neurologic modality (motor, sensory, or autonomic function) but does not cause LOC
simple partial
Name the type of seizure associated with the following clinical findings: seizure commonly involves the temporal lobe
complex partial
Describe the artery that has been occluded in the following stroke syndrome: paresis and sensory loss of contralateral lower extremity
anterior cerebral artery
Describe the artery that has been occluded in the following stroke syndrome: hemiparesis, contralateral hemisensory loss, homonymous hemianopsia, aphasia
middle cerebral artery supplying the dominant hemisphere
Describe the artery that has been occluded in the following stroke syndrome: altered mental status, memory deficits, hemisensory loss, homonymous hemianopsia with macular sparing
posterior cerebral artery
Describe the artery that has been occluded in the following stroke syndrome: amaurosis fugax
opthalmic artery
Describe the artery that has been occluded in the following stroke syndrome: vertigo, cranial nerve palsies, impaired level of consciousness, dysarthria
basilar artery
Describe the artery that has been occluded in the following stroke syndrome: sensory neglect and apraxia
partial occlusion of the MCA supplying the nondominant hemisphere
Describe the artery that has been occluded in the following stroke syndrome: urinary incontinence, suck and grasp reflex
MCA or ACA supplying the frontal lobe
Describe the artery that has been occluded in the following stroke syndrome: wernicke's aphasia (fluent speech without meaning; poor comprehension and word repetition)
dominant inferior MCA
Describe the artery that has been occluded in the following stroke syndrome: Broca's aphasia (nonfluent speech with poor repetition and normal comprehension)
superior dominant MCA
What is the most common source of emboli that result in stroke?
Carotid atheroma
Name the term used to describe the infarction of white matter commonly associated with hypertension, diabetes, and carotid atherosclerosis
Lacunar infarction
Name the term used to describe the infarction of gray matter commonly associated with sustained hypotension
Watershed infarction
cerebral edema may cause dangerous elevations in ICP how long after stroke?
two to five days
What interventions are available for lowering ICP?
Head elevation in bed, IV mannitol/diuretics, hyperventilation, sedation, CSF drainage (aka ventriculostomy)
Name the term used to describe a neurologic deficit caused by ischemia that resolves within 24 hours
transient ischemic attack
What is the primary radiologic study necessary in the workup of stroke?
CT scan of the head WITHOUT contrast
What radiologic study may be useful in determining the etiology of an ischemic stroke?
cerebral angiography
What radiologic study can provide useful information about the etiology of a stroke if angiography is contraindicated?
MRA
What oral medications have been shown to improve outcome in patients with acute ischemic stroke?
ASA, clopidogrel, ticlodipine, and aggrenox
What type of therapy is indicated in a patient at risk for cardioembolic stroke?
Anticoagulation with heparin followed by coumadin
What medical intervention has been shown to improve outcome in embolic stroke patients when they are treated within 3 hours?
tissue plasminogen activator (tPA)
What surgical intervention is indicated for patients with carotid atherosclerosis causing >70% compromise of the carotid lumen?
carotid endarterectomy
What primary preventative measures are recommended in a patient at risk for ischemic stroke?
smoking cessation, antihypertensive therapy, glycemic control in diabetes, cholesterol lowering therapy
Name the type of intracranial hemorrhage associated with the following features: associated with cerebral arteriovenous malformations
subarachnoid and intraparenchymal hemorrhage
Name the type of intracranial hemorrhage associated with the following features: commonly caused by ruptured berry aneurysm; classically presents as "the worst headache of my life."
Subarachnoid hemorrhage
Name the type of intracranial hemorrhage associated with the following features: Commonly presents with headache and lethargy in a patient with focal motor and sensory defects
Intraparenchymal hemorrhage
Name the type of intracranial hemorrhage associated with the following features: hematoma following the contour of a cerebral hemisphere on CT; due to laceration of bridging cerebral veins
Subdural hematoma
Name the type of intracranial hemorrhage associated with the following features: lens-shaped hematoma on CT scan; due to laceration of middle meningeal artery due to fracture of the temporal bone
Epidural hematoma
Name the type of intracranial hemorrhage associated with the following features: Lumbar puncture must be performed in a patient with suspected intracranial hemorrhage even if CT scan is negative
subarachnoid hemorrhage
Name the type of intracranial hemorrhage associated with the following features: Lucid interval followed by rapid decline in mental status
Epidural hematoma
Name the type of intracranial hemorrhage associated with the following features: may present with meningeal signs, CN palsies, seizures, and focal neurologic signs; bloody or xanthrochromic CSF on LP
Subarachnoid hemorrhage (secondary to ruptured aneurysm)
Name the type of intracranial hemorrhage associated with the following features: Most common type of intracranial hemorrhage from trauma
Subdural hematoma (commonly seen in alcoholics and the elderly)
Name the type of intracranial hemorrhage associated with the following features: treated with emergent neurosurgical evacuation
epidural hematoma (and subdural hematoma > 1cm or with midline shift)
Name the type of intracranial hemorrhage associated with the following features: type of intracranial hemorrhage seen in patients with long-standing, poorly controlled hypertension
Intraparenchymal hemorrhage
What is the central principle in the management of hemorrhagic stroke?
Management of ICP
What is the fasted nonsurgical method for lowering ICP
Hyperventilation
What are the most common types of intracranial tumors?
metastatic tumors
Name the primary brain tumor associated with the following clinical or pathologic finding(s): five year survival of less than 4 - 5%
GBM
Name the primary brain tumor associated with the following clinical or pathologic finding(s): benign tumor derived from arachnoid cap cells with well-dilineated margins
Meningioma
Name the primary brain tumor associated with the following clinical or pathologic finding(s): EBV positive b-cell tumor of the CNS in AIDS patients
CNS lymphoma
Name the primary brain tumor associated with the following clinical or pathologic finding(s): malignant pediatric tumor found exclusively in the posterior fossa
medulloblastoma (metastasizes through CSF pathways)
Name the primary brain tumor associated with the following clinical or pathologic finding(s): most common pediatric intracranial tumor
Juvenile pilocytic astrocytoma
Name the primary brain tumor associated with the following clinical or pathologic finding(s): most common pediatric supratentorial tumor
craniopharyngioma
Name the primary brain tumor associated with the following clinical or pathologic finding(s): most common pituitary adenoma
prolactinoma
Name the primary brain tumor associated with the following clinical or pathologic finding(s): most common pituitary tumor
pituitary adenoma
Name the primary brain tumor associated with the following clinical or pathologic finding(s): most common primary brain tumor
GBM
Name the primary brain tumor associated with the following clinical or pathologic finding(s): multiple lesions at presentation
CNS lymphoma
Name the primary brain tumor associated with the following clinical or pathologic finding(s): small round blue cell tumor
medulloblastoma
Name the primary brain tumor associated with the following clinical or pathologic finding(s): tumor arising from ependymal lining of ventricular system
Ependymoma
Name the primary brain tumor associated with the following clinical or pathologic finding(s): Tumor characterized by highly malignant cells bordering necrotic areas
GBM
Name the primary brain tumor associated with the following clinical or pathologic finding(s): tumor derived from Rathke's pouch
Craniopharyngioma
Name the primary brain tumor associated with the following clinical or pathologic finding(s): tumor of the dorsal root that may grow in a dumbbell configuration through a vertebral foramen
Schwannoma
Name the primary brain tumor associated with the following clinical or pathologic finding(s): tumor which originates from the vestibular division of CN VIII
Schwannoma
Name the primary brain tumor associated with the following clinical or pathologic finding(s): two tumors often presenting with bitemporal hemianopia
pituitary adenoma and craniopharyngioma
Name the primary brain tumor associated with the following clinical or pathologic finding(s): type of tumor that may be found bilaterally in patients with NF2
acoustic neuroma/Schwannoma
Name the primary brain tumor associated with the following clinical or pathologic finding(s): vascular tumor of the cerebellum and retina in patients with von Hippel-Lindau syndrome
Hemangioblastoma
What are the three modalities used in the treatment of brain tumor?
Surgery, Chemo, Radiation
Delirium or dementia? waxing and waning level of consciousness
delirium
Delirium or dementia? usually a rapid onset
delirium
Delirium or dementia? characterized by memory loss
Dementia
Delirium or dementia? Associated with disturbances in the sleep-wake cycle
delirium
Delirium or dementia? often irreversible
dementia
Delirium or dementia? associated with changes in sensorium (hallucinations and illusions)
Delirium
Name four major causes of delirium.
"HIDE" Hypoxia, Infection (often UTIs) and ICU psychosis, Drugs (anticholinergics, opioids, steroids, barbituates), Electrolyte and Endocrine causes
List four important steps in the evaluation of a patient with new-onset delirium.
1. Check vitals (including O2 saturation) 2. Check med list 3. Check lab values 4. Check for occult infection
What is the treatment course for delirium?
Address underlying cause; neuroleptics for agitation
What cognitive disorder is characterized by progressive, global intellectual impairment?
Dementia
What is the most common etiology for dementia?
Dementia of Alzheimer Type (DAT) = 70 - 80% of cases
Name common etiologies for dementia other than Alzheimer's.
"DEMENTIASS" Degenerative diseases (Parkinson's, Huntington's) Endocrine (thyroid, pituitary, parathyroid) Metabolic (electrolytes, glucose, hepatorenal dysfunction, ethanol) Exogenous (CO poisoning, drugs, heavy metals), Neoplastic, Traumatic, Infectious (encephalitis, meningitis, cerebral abscess, syphilis, prions, HIV, Lyme), Affective disorders (depression may mimic dementia), Stroke (multiinfarct dementia, ischemia, vasculitis); Note: Vascular causes account for 10% of dementias; Structural (normal pressure hydrocephalus; Note: NPH is one of the few reversible causes of dementia
Name the type of dementia associated with the following feature(s): Associated with ApoE4, amyloid precursor protein, presenilin, and alpha2-macroglobulin genes
Alzheimer's
Name the type of dementia associated with the following feature(s): Risk for this type of dementia reduced with appropriate antihypertensive and antiplatelet medications
Vascular or multiinfarct
Name the type of dementia associated with the following feature(s): Cognitive impairment, extrapyramidal signs, and early visual hallucinations.
Dementia with Lewy bodies
Name the type of dementia associated with the following feature(s): Insidious onset of difficulties with the activities of daily living and cognitive decline in the absence of other neurologic deficits
Alzheimer's
Name the type of dementia associated with the following feature(s): stepwise dementia in a patient with focal neurologic deficits
Vascular or multiinfarct
Name the type of dementia associated with the following feature(s): Death occurs 5 - 10 years after the onset of cognitive decline
Alzheimer's
Name the type of dementia associated with the following feature(s): Dementia accompanied by changes in personality, speech disturbance, and extrapyramidal signs
Pick's
Name the type of dementia associated with the following feature(s): Triad of chorea, behavioral changes, and dementia
Huntington's
Name the type of dementia associated with the following feature(s): Most common cause of dementia; Donzepil may be helpful
Alzheimer's
Name the type of dementia associated with the following feature(s): risk factors are idential to those of cerebrovascular disease
Vascular or multiinfarct
Name the type of dementia associated with the following feature(s): difficulty with vertical gaze
Progressive supranuclear palsy
Name the type of dementia associated with the following feature(s): Rapidly progressive dementia associated with pyramidal, extrapyramidal and cerebellar motor decline, myoclonus, and increased startle response
Creutzfeld-Jakob
Name the movement disorder associated with the following feature(s): resting tremor, bradykinesia, rigidity, and postural instability-->treat with dopamine replacement therapy
Parkinson's disease
Name the movement disorder associated with the following feature(s): pediatric onset of sudden vocal or motor tics
Tourette's syndrome
Name the movement disorder associated with the following feature(s): chorea, behavioral changes, and dementia
Huntington's disease
Name the movement disorder associated with the following feature(s): postural tremor in the absence of other neurologic deficits
essential tremor
Name the movement disorder associated with the following feature(s): paroxysmal unilateral flailing limb movements
Hemiballism (secondary to lesion of the subthalamic nucleus)
Name the movement disorder associated with the following feature(s): atrophy of the caudate and putamen
Huntington's disease
Name the movement disorder associated with the following feature(s): tremor, ataxia, dysarthria, facial dystonia, parkinsonian signs, cognitive decline secondary to abnormal copper metabolism
Wilson's disease
Name the movement disorder associated with the following feature(s): associated with schizophreniform changes
Huntington's disease
What are the common symptoms of ALS?
Asymmetric, slowly progressive limb, bulbar weakness with fasciculations (i.e., difficulty swallowing)
What are the classic signs of ALS?
UMN signs (spasticity, hyperreflexia, clonus, upgoing toes, frontal reflexes) AND LMN signs (flaccid paralysis, fasciculations)
What are the common EMG abnormalities in ALS?
Denervation potentials in at least three limbs
What is the common presentation of multiple sclerosis?
"Symptoms separated in time and space"; may include limb weakness, spasticity, optic nerve dysfunction, internuclear ophthalmoplegia, parasthesias, tremor, urinary retention, and vertigo
What are the classic radiologic abnormalities on MRI in a patient with MS?
periventricular white matter lesions
What are the classic CSF abnormalities in a patient with MS?
Oligoclonal bands and mononuclear pleocytosis
What class of medications can be used during exacerbations of MS?
Steroids
What class of medications can be used to prolong periods of remission of MS?
Immunosuppressants (cyclophosphamide, azathioprine, methotrexate) and immunomodulators (beta-interferon and copaxone)
Name the demyelinating disorder associated with the following clinical and pathologic feature(s): most common demyelinating disorder
MS
Name the demyelinating disorder associated with the following clinical and pathologic feature(s): ascending paralysis, facial diplegia, and autonomic dysfunction
Guillain-Barre syndrome
Name the demyelinating disorder associated with the following clinical and pathologic feature(s): Loss of myelin from globoid and peripheral neurons
Krabbe's disease
Name the demyelinating disorder associated with the following clinical and pathologic feature(s): charcot's triad (intention tremor, scanning speech, and nystagmus)
MS
Name the demyelinating disorder associated with the following clinical and pathologic feature(s): autosomal recessive disease-->progressive paralysis, dementia, ataxia; fatal in early childhood
Metachromic leukodystrophy
Name the demyelinating disorder associated with the following clinical and pathologic feature(s): spinal lesions typically occur in the white matter of the cervical cord
MS
Name the demyelinating disorder associated with the following clinical and pathologic feature(s): post-viral autoimmune syndrome causing demyelination of peripheral nerves, especially motor fibers
Guillain-Barre syndrome
Name the demyelinating disorder associated with the following clinical and pathologic feature(s): may present with intranuclear ophthalmoplegia (medial longitudinal fasciculus syndrome) or sudden visual loss due to optic neuritis
MS
Name the demyelinating disorder associated with the following clinical and pathologic feature(s): Albuminocytologic dissociation (increased CSF protein with normal cell count)
Guillain-Barre syndrome
Name the demyelinating disorder associated with the following clinical and pathologic feature(s): rapidly fatal autosomal recessive disease of childhood associated with globoid bodies in the white matter due to deficiency of beta-galactocerebrosidase
Krabbe's disease
Name the demyelinating disorder associated with the following clinical and pathologic feature(s): genetic disorder causing accumulation of very long chain fatty acids resulting in behavioral and a diverse array of neurological deficits
Adrenoleukodystrophy
Name the virtiginous disorder associated with the following feature(s): associated with popping sensation in the middle ear after sneezing, coughing, or straining
endolymphatic fistula
Name the virtiginous disorder associated with the following feature(s): caused by head injury, may be associated with hearing loss
labyrinthine concussion
Name the virtiginous disorder associated with the following feature(s): episodes of vertigo triggered by sudden changes in position; may be associated with recent trauma
benign positional paroxysmal vertigo
Name the virtiginous disorder associated with the following feature(s): progressive hearing loss, episodic vertigo accompanied by nausea and vomiting and sense of fullness in the ear
Meniere's disease
Name the virtiginous disorder associated with the following feature(s): sudden onset nausea, vomiting, and vertigo; self-limited disorder
Vestibular neuronitis
Name the virtiginous disorder associated with the following feature(s): vertical nystagmus, weakness, ataxia, CN palsies
Infarction of the vestibular system