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40 Cards in this Set

  • Front
  • Back
what imaging study is often used in the dx of dementia?
SPECT
tertiary neurosyphilis causes what neurological sx?
tabes dorsalis:destruction of dorsal roots, impaired sensation and ataxia, absent DTRs
what percentage of people die of encephalitis?
35%, sx of worsening HAs with systemic signs and sx
Most common primary brain tumor in adults?
glioblastoma multiforme(grade 4=astrocytoma)
Sx of brain tumor?
personality changes, HAs, drowsiness, lethargy, psychosis, vomiting, papilledema
4 peripheral nerve tumors?
neurofibromatosis=autosomal dominant with mutations
Shwannoma/acoustic neuroma= CN8, benign <1% malignant
sx of optic neuritis, glove and stocking parasthesias, higher risk in the northern latitudes, autoimmune demylenation in the CNS?
Multiple Sclerosis
2/3 preceded by flu, ascending paralysis, DTR's absent, sensation intact, acute onset (polyradiculopathy), PNS
Guillian-Barre syndrome
alcoholic with short term memory loss and confabulations
wernicke-korsakoff syndrome (B1 deficiency)
dementia, dermatitis, diarrhea leading to death; what nutritional deficiency?
niacin deficiency
macrocytic anemia, degeneration of the spinal cord:spasticity, weakness, loss of proprioception,dementia; not cured with folate deficiency
B12 deficiency
New HAs in pt over 50 should be evaluated b/c of what dx?
ischemic cerebrovascular dz; 25% of pt with carotid or middle cerebral vascular dz or 50% of pt with vertebrobasilar insufficiency
Hydrocephalus is an increase in what fluid? and what ventricles swell?
CSF, lateral 3rd and 4th
atrophy of hypothenar eminence and interosseous mm. of hand; also parasthesias of 1/2 of ring finger and 5th finger on palm surface
Ulnar palsy
problems with the brachial plexus; radiculopathy,numbness and tingling of the arm d/t compression by cervical rib, lymphoma, vascular malformation
thoracic outlet syndrome
viral infx of 7th nerve leading to unilateral facial paralysis, no sensory loss,
bells palsy
dry mouth, diplopia, ptosis, loss of accomadation and pupillary reflex--GI sx precede, descending paralysis
Botulism
severe, unilateral HA with nasal congestion, less than 4 hrs long q weekly
cluster HA; more common in men no fam HX
nausea and vomiting; photophobia with HA; hibernates; females more common
migraine; fam hx
dull HA; steady; daily and worse with stress
tension HA
HA after 50 yrs of age
temporal arteritis; vertebral/carotid insufficiency
difference b/t classic and common migraine
prodrome with classic
tx for migraines? and works how?
triptans; sumatriptan; causes vasoconstriction by binding (5HT1)
Ergonavine-vasoconstriction, can cause hypertension/seizures
HA can occur 6-8x/day; alcohol can trigger;unilateral and periorbital; more in men; no n/v
cluster HA
shooting pain from 5th trigeminal nerve;can be triggered by touch, drafts, brushing teeth
trigeminal neuralgia
malaise; proximal mm. pain; jaw claudication; tender scalp arteries
giant cell arteritis; 50% can progress to blindless; ESR >100
MRI shows plaques and periventricular white matter; demyelination of brain and spinal cord
MS
dx of muscular dystrophy?
mm. biopsy is definative; CK greater than 2000 in duchenes
progressive non-inflammatory mm. fiber degeneration
muscular dystrophy
stiffness, inability to release grasp, thick speech, mm. atrophy in face and neck, onset 20, slowly progressive (cataract, testicular atrophy, intelectual changes)
myotonic dystrophy; autosomal dominant
motor manifestations of non-progressive brain damage during prenatal/postpartum period;spasticity (70%); quadrapalegic (low IQ, dysarthria, poor feeding); hemiplegic or diplegic (bilat spasticity, clumsy norm IQ)
cerebral palsy
progressive degeneration of corticospinal tract and/or ant. horn cells; dz of later or mid life; decrease DTRs; fasiculations of mm. weakness of arms/legs;bulbar involvement: dysarthria, dysphagia, tongue atrophy
ALS; 50% die in 3 yrs, 90% in 6 yrs
autoimmune d.o. affecting acetylcholine receptors; women in 20s and men in 40-50s; weakness on exertion; weakness of ocular, proximal, pharyngeal and respiratory mm.
myasthenia gravis
test for myasthenia gravis?
tensilon test; better when an acetylcholinesterase inhibitor
most common movement d.o.; tremor not present at rest
benign essential tremor
slow movement; muscular rigidity; resting tremor; postural instability; shuffling instability; pill rolling; masked facies?
Parkinson's dz
movement d.o. manifesting in the 3rd or 4th decade; fidgetign or restlessness progressing to writhing movements; dementia follows
Huntington's dz; child has 50% chance of inheriting
most common cause of dementia; clinical exam shows greater than 2 deficits; progressive worsening
alzheimer's dz
alzheimers dz dx
SPECT
depression; simple delusions; behavioral change; wandering; screaming
alzheimer's dz