Neuroscience Dejareview

Front 1

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.

Back 1

Migraine

Front 2

Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: associated with N/V, photophobia, phonophobia.

Back 2

Migraine

Front 3

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

Back 3

Migraine

Front 4

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)

Back 4

Migraine

Front 5

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.

Back 5

Cluster

Front 6

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.

Back 6

Cluster

Front 7

Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: Headaches described as pulsatile or throbbing

Back 7

Migraine

Front 8

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.

Back 8

Migraine

Front 9

Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: history of allergies

Back 9

Sinus

Front 10

Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: localized tenderness over sinuses

Back 10

Sinus

Front 11

Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: Most common type of headache in adults.

Back 11

tension

Front 12

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

Back 12

Migraine

Front 13

Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: patients often have a family history of headaches

Back 13

migraine

Front 14

Name the type of headache (migraine, tension, cluster, or sinus) associated with the following features: symptoms are often eradicated by 100% O2 by facemask

Back 14

Cluster

Front 15

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

Back 15

Cluster

Front 16

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

Back 16

Tension

Front 17

What are the seven red flags of headache?

Back 17

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.

Front 18

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.

Back 18

Absence

Front 19

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)

Back 19

Tonic-clonic seizure

Front 20

Name the type of seizure associated with the following clinical findings: sudden, brief muscle contractions; first line of therapy includes valproate and clonazepam

Back 20

myoclonic seizures

Front 21

Name the type of seizure associated with the following clinical findings: commonly mistaken as daydreaming in a young child

Back 21

absence seizures

Front 22

Name the type of seizure associated with the following clinical findings: first line of therapy includes ethosuximide and valproate

Back 22

absence

Front 23

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

Back 23

tonic-clonic

Front 24

Name the type of seizure associated with the following clinical findings: motor, sensory, visual, psychic, or autonomic phenomena with preserved level of consciousness

Back 24

simple partial

Front 25

Name the type of seizure associated with the following clinical findings: three Hz spike-and-wave pattern on EEG

Back 25

Absence

Front 26

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

Back 26

tonic-clonic

Front 27

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

Back 27

complex partial

Front 28

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

Back 28

simple partial

Front 29

Name the type of seizure associated with the following clinical findings: seizure commonly involves the temporal lobe

Back 29

complex partial

Front 30

Describe the artery that has been occluded in the following stroke syndrome: paresis and sensory loss of contralateral lower extremity

Back 30

anterior cerebral artery

Front 31

Describe the artery that has been occluded in the following stroke syndrome: hemiparesis, contralateral hemisensory loss, homonymous hemianopsia, aphasia

Back 31

middle cerebral artery supplying the dominant hemisphere

Front 32

Describe the artery that has been occluded in the following stroke syndrome: altered mental status, memory deficits, hemisensory loss, homonymous hemianopsia with macular sparing

Back 32

posterior cerebral artery

Front 33

Describe the artery that has been occluded in the following stroke syndrome: amaurosis fugax

Back 33

opthalmic artery

Front 34

Describe the artery that has been occluded in the following stroke syndrome: vertigo, cranial nerve palsies, impaired level of consciousness, dysarthria

Back 34

basilar artery

Front 35

Describe the artery that has been occluded in the following stroke syndrome: sensory neglect and apraxia

Back 35

partial occlusion of the MCA supplying the nondominant hemisphere

Front 36

Describe the artery that has been occluded in the following stroke syndrome: urinary incontinence, suck and grasp reflex

Back 36

MCA or ACA supplying the frontal lobe

Front 37

Describe the artery that has been occluded in the following stroke syndrome: wernicke's aphasia (fluent speech without meaning; poor comprehension and word repetition)

Back 37

dominant inferior MCA

Front 38

Describe the artery that has been occluded in the following stroke syndrome: Broca's aphasia (nonfluent speech with poor repetition and normal comprehension)

Back 38

superior dominant MCA

Front 39

What is the most common source of emboli that result in stroke?

Back 39

Carotid atheroma

Front 40

Name the term used to describe the infarction of white matter commonly associated with hypertension, diabetes, and carotid atherosclerosis

Back 40

Lacunar infarction

Front 41

Name the term used to describe the infarction of gray matter commonly associated with sustained hypotension

Back 41

Watershed infarction

Front 42

cerebral edema may cause dangerous elevations in ICP how long after stroke?

Back 42

two to five days

Front 43

What interventions are available for lowering ICP?

Back 43

Head elevation in bed, IV mannitol/diuretics, hyperventilation, sedation, CSF drainage (aka ventriculostomy)

Front 44

Name the term used to describe a neurologic deficit caused by ischemia that resolves within 24 hours

Back 44

transient ischemic attack

Front 45

What is the primary radiologic study necessary in the workup of stroke?

Back 45

CT scan of the head WITHOUT contrast

Front 46

What radiologic study may be useful in determining the etiology of an ischemic stroke?

Back 46

cerebral angiography

Front 47

What radiologic study can provide useful information about the etiology of a stroke if angiography is contraindicated?

Back 47

MRA

Front 48

What oral medications have been shown to improve outcome in patients with acute ischemic stroke?

Back 48

ASA, clopidogrel, ticlodipine, and aggrenox

Front 49

What type of therapy is indicated in a patient at risk for cardioembolic stroke?

Back 49

Anticoagulation with heparin followed by coumadin

Front 50

What medical intervention has been shown to improve outcome in embolic stroke patients when they are treated within 3 hours?

Back 50

tissue plasminogen activator (tPA)

Front 51

What surgical intervention is indicated for patients with carotid atherosclerosis causing >70% compromise of the carotid lumen?

Back 51

carotid endarterectomy

Front 52

What primary preventative measures are recommended in a patient at risk for ischemic stroke?

Back 52

smoking cessation, antihypertensive therapy, glycemic control in diabetes, cholesterol lowering therapy

Front 53

Name the type of intracranial hemorrhage associated with the following features: associated with cerebral arteriovenous malformations

Back 53

subarachnoid and intraparenchymal hemorrhage

Front 54

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."

Back 54

Subarachnoid hemorrhage

Front 55

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

Back 55

Intraparenchymal hemorrhage

Front 56

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

Back 56

Subdural hematoma

Front 57

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

Back 57

Epidural hematoma

Front 58

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

Back 58

subarachnoid hemorrhage

Front 59

Name the type of intracranial hemorrhage associated with the following features: Lucid interval followed by rapid decline in mental status

Back 59

Epidural hematoma

Front 60

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

Back 60

Subarachnoid hemorrhage (secondary to ruptured aneurysm)

Front 61

Name the type of intracranial hemorrhage associated with the following features: Most common type of intracranial hemorrhage from trauma

Back 61

Subdural hematoma (commonly seen in alcoholics and the elderly)

Front 62

Name the type of intracranial hemorrhage associated with the following features: treated with emergent neurosurgical evacuation

Back 62

epidural hematoma (and subdural hematoma > 1cm or with midline shift)

Front 63

Name the type of intracranial hemorrhage associated with the following features: type of intracranial hemorrhage seen in patients with long-standing, poorly controlled hypertension

Back 63

Intraparenchymal hemorrhage

Front 64

What is the central principle in the management of hemorrhagic stroke?

Back 64

Management of ICP

Front 65

What is the fasted nonsurgical method for lowering ICP

Back 65

Hyperventilation

Front 66

What are the most common types of intracranial tumors?

Back 66

metastatic tumors

Front 67

Name the primary brain tumor associated with the following clinical or pathologic finding(s): five year survival of less than 4 - 5%

Back 67

GBM

Front 68

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

Back 68

Meningioma

Front 69

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

Back 69

CNS lymphoma

Front 70

Name the primary brain tumor associated with the following clinical or pathologic finding(s): malignant pediatric tumor found exclusively in the posterior fossa

Back 70

medulloblastoma (metastasizes through CSF pathways)

Front 71

Name the primary brain tumor associated with the following clinical or pathologic finding(s): most common pediatric intracranial tumor

Back 71

Juvenile pilocytic astrocytoma

Front 72

Name the primary brain tumor associated with the following clinical or pathologic finding(s): most common pediatric supratentorial tumor

Back 72

craniopharyngioma

Front 73

Name the primary brain tumor associated with the following clinical or pathologic finding(s): most common pituitary adenoma

Back 73

prolactinoma

Front 74

Name the primary brain tumor associated with the following clinical or pathologic finding(s): most common pituitary tumor

Back 74

pituitary adenoma

Front 75

Name the primary brain tumor associated with the following clinical or pathologic finding(s): most common primary brain tumor

Back 75

GBM

Front 76

Name the primary brain tumor associated with the following clinical or pathologic finding(s): multiple lesions at presentation

Back 76

CNS lymphoma

Front 77

Name the primary brain tumor associated with the following clinical or pathologic finding(s): small round blue cell tumor

Back 77

medulloblastoma

Front 78

Name the primary brain tumor associated with the following clinical or pathologic finding(s): tumor arising from ependymal lining of ventricular system

Back 78

Ependymoma

Front 79

Name the primary brain tumor associated with the following clinical or pathologic finding(s): Tumor characterized by highly malignant cells bordering necrotic areas

Back 79

GBM

Front 80

Name the primary brain tumor associated with the following clinical or pathologic finding(s): tumor derived from Rathke's pouch

Back 80

Craniopharyngioma

Front 81

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

Back 81

Schwannoma

Front 82

Name the primary brain tumor associated with the following clinical or pathologic finding(s): tumor which originates from the vestibular division of CN VIII

Back 82

Schwannoma

Front 83

Name the primary brain tumor associated with the following clinical or pathologic finding(s): two tumors often presenting with bitemporal hemianopia

Back 83

pituitary adenoma and craniopharyngioma

Front 84

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

Back 84

acoustic neuroma/Schwannoma

Front 85

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

Back 85

Hemangioblastoma

Front 86

What are the three modalities used in the treatment of brain tumor?

Back 86

Surgery, Chemo, Radiation

Front 87

Delirium or dementia? waxing and waning level of consciousness

Back 87

delirium

Front 88

Delirium or dementia? usually a rapid onset

Back 88

delirium

Front 89

Delirium or dementia? characterized by memory loss

Back 89

Dementia

Front 90

Delirium or dementia? Associated with disturbances in the sleep-wake cycle

Back 90

delirium

Front 91

Delirium or dementia? often irreversible

Back 91

dementia

Front 92

Delirium or dementia? associated with changes in sensorium (hallucinations and illusions)

Back 92

Delirium

Front 93

Name four major causes of delirium.

Back 93

"HIDE" Hypoxia, Infection (often UTIs) and ICU psychosis, Drugs (anticholinergics, opioids, steroids, barbituates), Electrolyte and Endocrine causes

Front 94

List four important steps in the evaluation of a patient with new-onset delirium.

Back 94

1. Check vitals (including O2 saturation) 2. Check med list 3. Check lab values 4. Check for occult infection

Front 95

What is the treatment course for delirium?

Back 95

Address underlying cause; neuroleptics for agitation

Front 96

What cognitive disorder is characterized by progressive, global intellectual impairment?

Back 96

Dementia

Front 97

What is the most common etiology for dementia?

Back 97

Dementia of Alzheimer Type (DAT) = 70 - 80% of cases

Front 98

Name common etiologies for dementia other than Alzheimer's.

Back 98

"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

Front 99

Name the type of dementia associated with the following feature(s): Associated with ApoE4, amyloid precursor protein, presenilin, and alpha2-macroglobulin genes

Back 99

Alzheimer's

Front 100

Name the type of dementia associated with the following feature(s): Risk for this type of dementia reduced with appropriate antihypertensive and antiplatelet medications

Back 100

Vascular or multiinfarct

Front 101

Name the type of dementia associated with the following feature(s): Cognitive impairment, extrapyramidal signs, and early visual hallucinations.

Back 101

Dementia with Lewy bodies

Front 102

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

Back 102

Alzheimer's

Front 103

Name the type of dementia associated with the following feature(s): stepwise dementia in a patient with focal neurologic deficits

Back 103

Vascular or multiinfarct

Front 104

Name the type of dementia associated with the following feature(s): Death occurs 5 - 10 years after the onset of cognitive decline

Back 104

Alzheimer's

Front 105

Name the type of dementia associated with the following feature(s): Dementia accompanied by changes in personality, speech disturbance, and extrapyramidal signs

Back 105

Pick's

Front 106

Name the type of dementia associated with the following feature(s): Triad of chorea, behavioral changes, and dementia

Back 106

Huntington's

Front 107

Name the type of dementia associated with the following feature(s): Most common cause of dementia; Donzepil may be helpful

Back 107

Alzheimer's

Front 108

Name the type of dementia associated with the following feature(s): risk factors are idential to those of cerebrovascular disease

Back 108

Vascular or multiinfarct

Front 109

Name the type of dementia associated with the following feature(s): difficulty with vertical gaze

Back 109

Progressive supranuclear palsy

Front 110

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

Back 110

Creutzfeld-Jakob

Front 111

Name the movement disorder associated with the following feature(s): resting tremor, bradykinesia, rigidity, and postural instability-->treat with dopamine replacement therapy

Back 111

Parkinson's disease

Front 112

Name the movement disorder associated with the following feature(s): pediatric onset of sudden vocal or motor tics

Back 112

Tourette's syndrome

Front 113

Name the movement disorder associated with the following feature(s): chorea, behavioral changes, and dementia

Back 113

Huntington's disease

Front 114

Name the movement disorder associated with the following feature(s): postural tremor in the absence of other neurologic deficits

Back 114

essential tremor

Front 115

Name the movement disorder associated with the following feature(s): paroxysmal unilateral flailing limb movements

Back 115

Hemiballism (secondary to lesion of the subthalamic nucleus)

Front 116

Name the movement disorder associated with the following feature(s): atrophy of the caudate and putamen

Back 116

Huntington's disease

Front 117

Name the movement disorder associated with the following feature(s): tremor, ataxia, dysarthria, facial dystonia, parkinsonian signs, cognitive decline secondary to abnormal copper metabolism

Back 117

Wilson's disease

Front 118

Name the movement disorder associated with the following feature(s): associated with schizophreniform changes

Back 118

Huntington's disease

Front 119

What are the common symptoms of ALS?

Back 119

Asymmetric, slowly progressive limb, bulbar weakness with fasciculations (i.e., difficulty swallowing)

Front 120

What are the classic signs of ALS?

Back 120

UMN signs (spasticity, hyperreflexia, clonus, upgoing toes, frontal reflexes) AND LMN signs (flaccid paralysis, fasciculations)

Front 121

What are the common EMG abnormalities in ALS?

Back 121

Denervation potentials in at least three limbs

Front 122

What is the common presentation of multiple sclerosis?

Back 122

"Symptoms separated in time and space"; may include limb weakness, spasticity, optic nerve dysfunction, internuclear ophthalmoplegia, parasthesias, tremor, urinary retention, and vertigo

Front 123

What are the classic radiologic abnormalities on MRI in a patient with MS?

Back 123

periventricular white matter lesions

Front 124

What are the classic CSF abnormalities in a patient with MS?

Back 124

Oligoclonal bands and mononuclear pleocytosis

Front 125

What class of medications can be used during exacerbations of MS?

Back 125

Steroids

Front 126

What class of medications can be used to prolong periods of remission of MS?

Back 126

Immunosuppressants (cyclophosphamide, azathioprine, methotrexate) and immunomodulators (beta-interferon and copaxone)

Front 127

Name the demyelinating disorder associated with the following clinical and pathologic feature(s): most common demyelinating disorder

Back 127

MS

Front 128

Name the demyelinating disorder associated with the following clinical and pathologic feature(s): ascending paralysis, facial diplegia, and autonomic dysfunction

Back 128

Guillain-Barre syndrome

Front 129

Name the demyelinating disorder associated with the following clinical and pathologic feature(s): Loss of myelin from globoid and peripheral neurons

Back 129

Krabbe's disease

Front 130

Name the demyelinating disorder associated with the following clinical and pathologic feature(s): charcot's triad (intention tremor, scanning speech, and nystagmus)

Back 130

MS

Front 131

Name the demyelinating disorder associated with the following clinical and pathologic feature(s): autosomal recessive disease-->progressive paralysis, dementia, ataxia; fatal in early childhood

Back 131

Metachromic leukodystrophy

Front 132

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

Back 132

MS

Front 133

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

Back 133

Guillain-Barre syndrome

Front 134

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

Back 134

MS

Front 135

Name the demyelinating disorder associated with the following clinical and pathologic feature(s): Albuminocytologic dissociation (increased CSF protein with normal cell count)

Back 135

Guillain-Barre syndrome

Front 136

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

Back 136

Krabbe's disease

Front 137

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

Back 137

Adrenoleukodystrophy

Front 138

Name the virtiginous disorder associated with the following feature(s): associated with popping sensation in the middle ear after sneezing, coughing, or straining

Back 138

endolymphatic fistula

Front 139

Name the virtiginous disorder associated with the following feature(s): caused by head injury, may be associated with hearing loss

Back 139

labyrinthine concussion

Front 140

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

Back 140

benign positional paroxysmal vertigo

Front 141

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

Back 141

Meniere's disease

Front 142

Name the virtiginous disorder associated with the following feature(s): sudden onset nausea, vomiting, and vertigo; self-limited disorder

Back 142

Vestibular neuronitis

Front 143

Name the virtiginous disorder associated with the following feature(s): vertical nystagmus, weakness, ataxia, CN palsies

Back 143

Infarction of the vestibular system