Ppal99 Dissecting The Usmle 1,2,3 Neurology

Front 1

DDx: Ring-Enhancing Lesions: (4)

Back 1

• Toxo
• Lymphoma
• Abscess
• Metastasis

Front 2

when does the brain develop?

Back 2

Brain has developed by 8 wks

Front 3

how is spinal cord made?

Back 3

Primitive streak~> Notochord ~> Spinal cord (nucleus pulposus)

Front 4

Spinal cord: plates are divided by sulcus limitans. what are its two parts?
which one is for motor? sensory? ventral? dorsal spinal cord?

Back 4

Basal plate (motor) => ventral spinal cord "boob side"
• Alar plate (sensory) => dorsal spinal cord "anus side"

Front 5

how does the vertebral arch develops?

Back 5

Vertebral arch develops ventral ~> dorsal

Front 6

how does the fusion of the spinal cord happend?

Back 6

Fusion of spinal cord starts in cervical region, zips up bidirectionally

Front 7

Anencephaly:

Back 7

notochord (day 17) did not make contact with brain=> only have medulla => high AFP

Front 8

Encephalocele:

Back 8

pocket at the base of the brain

Front 9

Dandy Walker malformation:

Back 9

no cerebellum, distended 4'th ventricle, big head, separated sutures

Front 10

arnold-Chiari malformation: define and what are its two types?

Back 10

herniation of cerebellum through foramen magnum
arnold chiari I and II

Front 11

arnold chiari Type I:

Back 11

cerebellar tonsils (scoliosis)=> less sx
• an early finding

Front 12

arnold chiari Type II:

Back 12

cerbellar vermis/medulla => hydrocephalus, syrngomyelia (loss of pain/temp)
inward herniation to the spinal canal

Front 13

Sacral Problems: test

Back 13

do MRI

Front 14

Spina bifida occulta:

Back 14

covered by skin w/ tuft of hair


·

Front 15

Spina bifida aperta:

Back 15

opening (high AFP)

Front 16

Meningocele:

Back 16

sacral pocket w/ meninges in it

Front 17

Meningomyelocele:
what is the problem with this

Back 17

sacral pocket w/ meningies and nerves, problems with bowel and bladder control

Front 18

CSF Production:
what vitamin and enzyme it needs to be made
how does it drain

Back 18

>>Needs Vit A, carbonic anhydrase
>>Drainage: subarachnoid dural sinuses ~> plasma

Front 19

CSF Production:
how many choroid plexus are there?
where does it lead to?

Back 19

Each ventricle has its own choroid plexus = > CSF

Front 20

CSF Production:
what kind of problems can affect the CSF and why?

Back 20

>>C02 can diffuse into your brain
>>Bicarb and H+ cannot diffuse into brain=> resp. problems affect CSF (Not metabolic acidosis)

Front 21

Vomiting centers: what is its function?
define and what are the two centers?

Back 21

responds to increased intracranial pressure, toxic smells
>>Chemotactic Trigger Zone - on floor of 4th ventricle
>>Area Postrema- in BBB

Front 22

CSF vs Sweat

Back 22

CSF: ⇩Bicarb, ⇧Cl
Sweat: ⇧Bicarb, ⇧K

Front 23

Communicating Hydrocephalus:
Newborns:
Kids:
Elderly:

Back 23

Ventricle Problems: ⇧CSF production
Newborns: Intraventricular hemorrhage
Kids: Pseudotumor cerebri High Vit A)
Elderly: Normal pressure hydrocephalus-

Front 24

what is the most common cause of normal hydrocephalus in the elderly

Back 24

due to cortical atrophy with age

Front 25

Non-communicating Hydrocephalus:
adult and kids

Back 25

obstruction
Newborns:
#1: Aqueductal stenosis
#2: Dandy Walker Cyst (in 4th ventricle)
Adults: Tumors (Ependymoma.)

Front 26

Neurocutaneous Tumors: (5)
mode of inheritance
what do they have in common (3)
and name them

Back 26

(AD) => mental retardation, cerebral calcification, seizures
Sturge-Weber
Osler-Weber-Rendu
Tuberous Sclerosis
Von Hippel-Lindau
Neurofibromatosis

Front 27

Sturge-Weber: describe, what should you check for? and tx

Back 27

port wine stain (big purple spot) on forehead, angioma of retina
Tx: pulsed dye laser

Front 28

Osler-Weber-Rendu:

Back 28

AVM in lung, gut, CNS =>sequester platelets=> telangiectasias

Front 29

Tuberous Sclerosis: mode of inheritance, chromosome, tumors, spots, presentation

Back 29

(AD, Chr#9): Ashen leaf spots hypopigmentation; seen better under Wood's
lamp), Brain Ependymomas, Heart Rhabdomyomas, Renal cell CA, Shagreen spots (leathery), bumpy
nose, mental retardation

Front 30

Von Hippel-Lindau:
increase risk

Back 30

AVM in head, retina=> renal cell CA
"risk you can only see the head and eyes of a hippo"

Front 31

Neurofibromatosis: describe
what do the cafe au lait spots lead to?
if the cafe au lait spots become painful or get bigger, what should you worry about?

Back 31

>6 Cafe au lait spots hyperpigmentation) =>peripheral nerve tumors
- If cafe au lait spots are painful or get bigger, think malignant transformation

Front 32

Neurofibromatosis Type 1
name
ch
clues

Back 32

"Von Recklinghausen's ":
Peripheral (Chr#17), optic glioma
Lisch nodules (iris hamartoma), scoliosis

Front 33

Neurofibromatosis Type 2
name
chromosome
clues (3)

Back 33

"Acoustic Neuroma.": Central (Chr#22), cataracts, bilateral deafness, proliferation of Schwanoma cells

Front 34

Pseudotumor Cerebri: signs and symptoms, etiology and tx

Back 34

• HA worse when lying down
see spots when straining
tinnitus, CN6 palsy, optic disc edema
• Caused by Isotretinoin
• Tx: Acetazolamide

Front 35

Budd-Chiari vs Arnold-Chiari:

Back 35

Budd-Chiari: Hepatic vein obstruction
Arnold-Chiari: Foramen magnum obst.

Front 36

where does the thalamus, basal ganglia and cerebrum develop from?

Back 36

Forebrain= Prosencephalon "Pro Die & Tell"
• Diencephalon => Thalamus, Basal ganglia
• Telencephalon=> Cerebrum

Front 37

from what part of the primitive brain does the Midbrain develop from?
what are the CN in it?

Back 37

= Mesencephalon (CN 3-4)

Front 38

where does the Hindbrain grow from (primitive brain)?
what are the two parts of the this primitive brain?

Back 38

= Rhombencephalon ''meet my Rhomb"
metencephalon and myencephalon

Front 39

where does cerebellum, medulla, pons arises from?
what crainal nerves a rise with them?

Back 39

• Metencephalon=> Pons (CN 5-8), Cerebellum
• Myencephalon =>Medulla (CN 9-12)

Front 40

Vision Lesions:
CN that innervates supeiror oblique and lateral rectus?
Nasal fibers
Temporal fibers

Back 40

"SO4LR6 "
• Nasal fibers - cross over
• Temporal fibers- go straight back

Front 41

Ipsilateral blindness: Dx

Back 41

Optic nerve lesion

Front 42

Ipsilateral blindness:
Newborns:
Kids:

Back 42

Newborns: cataract or Rb (light must hit retina by 3mo or child will be blind)
Kids: optic nerve glioma

Front 43

Ipsilateral blindness: (5)
Adults: emboli

Back 43

Adults: emboli
TIA
Temporal arteritis
Optic neuritis
Central retinal artery occlusion
Central retinal vein occlusion

Front 44

TIA

Back 44

blind in one eye for< 1 hr

Front 45

Temporal arteritis: describe and tx

Back 45

HA, blind in one eye
(Tx: steroids)

Front 46

Optic neuritis: describe and tx

Back 46

painful, blind in one eye, change in color perception
(Tx: steroids)

Front 47

Central retinal artery occlusion; describe and tx

Back 47

=>pale retina and cherry red macula
(Tx: thrombolytics)

Front 48

Central retinal vein occlusion

Back 48

=> blue retina

Front 49

Bitemporal Hemianopsia: define and 2 causes

Back 49

Optic chiasm lesion
• Pituitary tumor => high PRL
• Pineal tumor=> precocious puberty

Front 50

Homonymous Hemianopsia:

Back 50

Optic tract lesion
Lose nasal same side, temporal other side

Front 51

Quadranopsia:

Back 51

Calcarine fissure lesion
• Lose opposite side

Front 52

Central Scotoma:

Back 52

Macula lesion

Front 53

Acute Loss:
Retinal detachment tx

Back 53

flashes of light (Tx: surgery)

Front 54

Vitreous hemorrhage:
tx

Back 54

floaters
(Tx: photocoagulate)

Front 55

Amaurosis Fugax:
what is it due to, signs and symptoms

Back 55

Retinal emboli => painless loss of vision, looks like a "curtain falling down"

Front 56

Cerebellum: function

Back 56

depth perception, balance

Front 57

what are the 3 things that attack the cerebellum

Back 57

Romberg
• EtOH:
• All else: attacks hemispheres=> intention tremor, dysmetria, dysdiodokinesis, pronator drift

Front 58

Romberg

Back 58

lose unconscious proprioception (signal doesn't go to cortex)

Front 59

EtOH

Back 59

attacks vermis => ataxia

Front 60

what other things that can attact the cerebellum?

Back 60

All else: attacks hemispheres=> intention tremor, dysmetria, dysdiodokinesis, pronator drift

Front 61

3 parts of the Brainstem:

Back 61

1) Midbrain
2) Pons
3) Medulla: sets stuff

Front 62

which part of the brainstem most sensitive to shifts in osmolarity?

Back 62

pons

Front 63

Frontal Lobe: functions, which one is responsible for expressive aphasia? short-term memory?

Back 63

Abstract reasoning, Personality, Broca's area (expressive aphasia) , Hippocampus (short-term memory)

Front 64

Abstract reasoning: test, disease

Back 64

=> Schizophrenia (test: interpret proverbs)

Front 65

Personality: disease

Back 65

=> Pick's disease (inhibition loss)

Front 66

Broca's area: disease

Back 66

(expressive aphasia) => broken speech "say babababa"

Front 67

Hippocampus
function
examples

Back 67

(short-term memory) Ex: early Alzheimer's, drowning victims

Front 68

Dominant Lobe
location
type of memory
disease

Back 68

(99% population: left side -- regardless of what hand you write with)
• Everything you learned in kindergarden: all long-term memory => late Alzheimer's

Front 69

what part of the brain is Non-dominant lobe? how is it tested? and what happens if it is lesioned?

Back 69

right side, Apraxia: finger function (test: trace a letter), Hemineglect =>inability to recognize 1 side of body (usually left side)

Front 70

what is in the Corpus Callosum?

Back 70

fibers cross from right to left side of brain (and vice versa)

Front 71

what kind of brain connection do left handed people have?

Back 71

ipsilateral connections

Front 72

what kind of neuronal connections do absent corpus callosum have?

Back 72

ipsilateral connections => ambidextrous

Front 73

what kind of connections do right handed people have?

Back 73

contralateral connections

Front 74

Temporal Lobe: what parts of the brain does it involve?

Back 74

includes hippocampus, amygdala, and limbic lobes

Front 75

what is the temporal lobe responsible for?
give 2 diseases?

Back 75

Hearing
Balance
Hallucinations
Wernicke's area (receptive aphasia)
kluver bucy

Front 76

Temporal lobe "partial complex" seizures:

Back 76

have olfactory hallucinations before seizure

Front 77

Hypnopompic hallucinations:

Back 77

occur when waking up

Front 78

Hypnogogic hallucinations:

Back 78

occur when going to sleep

Front 79

Wernicke's area (receptive aphasia)

Back 79

=> can't understand speech or writing "Wordy''

Front 80

Kluver-Bucy: presentation and where is the lesion in the brain?

Back 80

bilateral temporal lesion, hypersexual,

Front 81

Occipital Lobe:
note in answering eye lesion problems
what to look for in the eye and management for neonates vision

Back 81

>>Make sure and flip ALL the words in eye lesion problems
>>Vision: light must hit the retina by 3 mo
or child is permanently blind => look for red reflex

Front 82

Nerve Tests:
Thumbs up:
Finger circle:
Spread fingers:

Back 82

Thumbs up: radial nerve
Finger circle: median nerve
Spread fingers: ulnar nerve

Front 83

Epithalamus:

Back 83

no known function

Front 84

Thalamus:
Medial:
Lateral:

Back 84

"The Secretary" All sensory info must stop here
Medial: Leg fibers
Lateral: Arm fibers

Front 85

Anterior nucleus

Back 85

Hypothalamic nucleus. Temp regulation (dissipates heat) ''AC: Anterior"or Cools"

Front 86

what drug is affectes the anterior nucleus?

Back 86

Acetaminophen

Front 87

Posterior nucleus:
autonomic system that regualtes it

Back 87

Hypothalamic nucleus. Temp regulation (conserves heat), parasympathetics

Front 88

Lateral nucleus:

Back 88

Hypothalamic nucleus. Hunger
''grab food with hands, which are lateral"

Front 89

Medial nucleus:

Back 89

Hypothalamic nucleus. Satiety

Front 90

Suprachiasmatic nucleus:

Back 90

Hypothalamic nucleus. Circadian rhythms "the time keeper"

Front 91

Supraoptic nucleus

Back 91

Hypothalamic nucleus. ADH production

Front 92

Paraventricular nucleus

Back 92

Hypothalamic nucleus. Thirst center

Front 93

Basal Ganglia:
location
function
what are its three parts?

Back 93

lateral wall of internal capsule, controls gross movement
straitum, corpus staitum and lenticular nucleus

Front 94

Striatum of the basal ganglia

Back 94

caudate nucleus+ putamen

Front 95

Corpus striatum of the Basal Ganglia

Back 95

globus pallidus + striatum

Front 96

Lenticular nucleus of the Basal Ganglia

Back 96

globus pallidus + putamen

Front 97

Huntington's: nucleus, etiology(2), hormone, movements

Back 97

>>atrophy of the Caudate nucleus
>>triplet repeats, anticipation, no GABA, choreiform movements

Front 98

Huntington's: most common cause of death

Back 98

Cause of death: suicide (30 y/o), insurance will drop them upon diagnosis

Front 99

function of Globus Pallidus of the basal ganglia

Back 99

inhibits movement by sending Ach or GABA to substantia nigra

Front 100

Tick:

Back 100

Movement Disorder
involuntary movement of one muscle

Front 101

Dystonia

Back 101

Movement Disorder
sustained contraction of muscle groups

Front 102

Tardive Dyskinesia:

Back 102

Movement Disorder
facial grimace, tongue thrusting

Front 103

Akathesia:

Back 103

Movement Disorder
non-stop restless movements

Front 104

Tourette's Syndrome; risk

Back 104

Tics ⇧OCD and ADHD risk

Front 105

Tourette's Syndrome: signs and symptoms, define echolalia and coprolalia?

Back 105

Motor tics, Vocal tics, Echolalia: repeats everything, Coprolalia: constant swearing

Front 106

tx for motor tics of tourett's syndrome

Back 106

Tx: Clonidine or Haloperidol

Front 107

most common site of HTN hemorrhage

Back 107

Putamen:

Front 108

Wilson's: pathogenesis, location

Back 108

ceruloplasmin def. => Cu deposits in liver, eye (KF rings), brain (lenticular nucleus), putamen

Front 109

Substantia Nigra: location, function and how does it do this?
what happens when there is a lesion in this area?

Back 109

medial wall of internal capsule=> initiates movements (sends DA to basal ganglia), parkinson's (decrease dopamine)

Front 110

Parkinson's: pathogenesis, location

Back 110

can't initiate movement (no DA)
basal ganglia

Front 111

Subthalamic Nucleus: what happens if there is a lesion to this area?

Back 111

"The Final Relay Station for Fine Motor Coordination"=> ballismus

Front 112

Internal Capsule:

Back 112

All info going in & out of brain must come through here

Front 113

Reticular Activating System:

Back 113

"Gatekeeper of the Internal Capsule", maintains your focus

Front 114

Attention Deficit Disorder.

Back 114

>>can't ignore any thought
>>lesion of the RAS

Front 115

Stress Response: what autonomic system response first? give examples?

Back 115

1st response: Parasympathetic
• Ex: Erection, diarrhea

Front 116

Cushing's triad:

Back 116

increased intracranial pressure, HTN, Bradycardia, Irregular respirations

Front 117

2ndary sympathetic stress response: GI, GU, what problem this causes? (4), define cushing's ulcer? curling's ulcer?

Back 117

Sympathetic, Ejaculation/constipation, increased GI acid output =>Stress ulcer, Curling's ulcer (burn pts) "Burn pts have a curling scream", Cushing's ulcer (intracranial pressure ulcer), IBS: constipation ⇨ diarrhea ⇨ repeat

Front 118

Nerve Reflexes:
L4:
L5:

Back 118

L4: knee jerk, foot dorsiflex
L5: big toe dorsiflex, foot drop

Front 119

Nerve Reflexes:
S1:
S2-4:

Back 119

S1: ankle jerk, foot eversion
S2-4: anal wink

Front 120

Sleep Waves:
Increased by:
Decreased by:

Back 120

Sleep Waves:
Increased by: ACh, 5-HT
Decreased by: DA, NE

Front 121

Watershed Areas:
Brain:
GI:

Back 121

First to lose, last to recover
Brain: Hippocampus
GI: Splenic flexure

Front 122

Wide awake:
Eyes closed awake:

Back 122

Wide awake: β waves
Eyes closed awake: α waves

Front 123

Light sleep: waves/complexes, stage
Deep sleep: waves/complexes, stage

Back 123

Light sleep: θ waves "Stage 1-2"/ K-complexes
Deep sleep: δ (huge) waves "Stage 3-4"

Front 124

REM sleep:

Back 124

β waves - every 90 min

Front 125

Deep sleep:
examples
tx

Back 125

o teeth grinding, sleepwalking
o BZ, Imipramine inhibit this

Front 126

REM sleep ie., what factors inhibit it? what factors increases this?

Back 126

dreams, penile erections, NE, EtOH, Barbs, Age, inhibit this 5-HT, ACh increase this.

Front 127

Nightmare:

Back 127

remember dreams, occurs in REM sleep

Front 128

Sleep Terror: what part of sleep cycle does this occur?

Back 128

don't remember dreams, occurs in non-REM sleep

Front 129

Dysomnia:

Back 129

quality of sleep

Front 130

Parasomnia:

Back 130

sleep behavior (nightmares)

Front 131

Narcolepsy:

Back 131

fall asleep during day, pathognomonic cataplexy, sleep paralysis, hallucinations

Front 132

Sleep Apnea

Back 132

fall asleep during day, wake up exhausted

Front 133

Kleine-Levin syndrome

Back 133

teenage boys eat and sleep a lot

Front 134

Fasciculus

Back 134

Brain Tracts:
= few fibers

Front 135

Tractus

Back 135

Brain Tracts:
= lots of fibers

Front 136

Gracilus

Back 136

Brain Tracts:
= legs ''gracellus legs"

Front 137

Cuneatus

Back 137

Brain Tracts:
= arms

Front 138

Glasgow Coma Scale:

Back 138

<8=severe
Eye opening (max=4)
Verbal response (max=5)
Motor response (max=6)

Front 139

UMN: "upper" /LMN: "downer"
CS/non-CS tract
type of paralysis

Back 139

UMN: "upper" /LMN: "downer"
CS tract/ non-CS tracts
Spasticity /Flaccid paralysis

Front 140

UMN "upper" /LMN: "downer"
reflex
contraction

Back 140

UMN: "upper" /LMN: "downer"
Hypereflexia/ Hyporeflexia
Clonus /Atrophy

Front 141

Descending Tracts

Back 141

Corticospinal (CS) tract
Corticorubral tract
Hypothalamospinal tract

Front 142

Corticospinal (CS) tract:
function
crosses
sx
how to find the level of injury

Back 142

motion
Crosses in medulla => sx are contralateral,
pyramidal decussation,
use CN to find level of injury

Front 143

Corticorubral tract:

Back 143

contains red nucleus, runs right below CN3 => flexion

Front 144

Hypothalamospinal tract Lesion

Back 144

=> ipsilateral Homer's syndrome: miosis, ptosis, anhydrosis, enophthalmos

Front 145

Ascending Tracts

Back 145

Dorsal Column Medial Lemniscus (DCML) tract
Spinocerebellar (SC) tract
Spinothalamic (ST) tract

Front 146

Dorsal Column Medial Lemniscus (DCML) tract:
where does it cross?

Back 146

vibration, position, 2-point discrimination
Crosses in medulla,

Front 147

Spinocerebellar (SC) tract

Back 147

balance, depth perception
The only pathway that crosses twice=> ipsilateral symptoms

Front 148

Spinothalamic (ST) tract: how does it travel

Back 148

>>pain & temp
>>Crosses in spinal cord (ant. white commissure) =>lose stuff 2 levels lower on contralateral side
All sensory .fibers come in through dorsal root ganglia, go up two dermatomes, then cross

Front 149

Anterior white commissure lesion

Back 149

Syringomyelia=> lose pain/temp in "cape" distribution

Front 150

Spinal cord lesions

Back 150

pain & temp loss on opposite side of all other losses

Front 151

how is the DMCL tract travel name the steps and where it crosses

Back 151

Crosses in medulla,
1st synapse: Dorsal root ganglion
2nd synapse: Nucleus cuneatus and nucleus gracilis (crosses here)
3rd synapse: Thalamus
4th synapse: Post-central gyrus

Front 152

Pernicious anemia
what tracts does it affects?
how does it affect these tracts?

Back 152

anti-IF Ab (affects DCML and Spinothalamic tracts)

Front 153

Friedreich's ataxia
clues
what tracts does it attacts?

Back 153

scoliosis, retinitis pigmentosa (attacks DCML and Spinocerebellar)

Front 154

3° Syphilis

Back 154

obliterative endarteritis, lancinating stabbing pain (attacks DCML)

Front 155

Spinocerebellar (SC) tract:

Back 155

balance, depth perception
The only pathway that crosses twice=> ipsilateral symptoms

Front 156

CPP = MAP - ICP

Back 156

CPP =cerebral perfusion pressure
ICP = intracranial pressure
MAP = mean arterial pressure

Front 157

⇧Intracranial pressure: signs and symptoms

Back 157

Sx: Headache
sign
1) Papilledema
2) Esotropia
3) Dilated pupils
4) Decorticate rigidity
5) Decerebrate rigidity

Front 158

which of the ff factors of the equation ( CPP = MAP - ICP) would increase on a head injury?
contraindications and management

Back 158

HTN +head injury=> ⇧CCP
No Nitroprusside! Treat ICP and BP will follow

Front 159

which of the ff factors of the equation would increase on a HTN?
CPP = MAP - ICP

Back 159

MAP

Front 160

Papilledema: management
mass/ no mass management

Back 160

(check CT first)
• Mass => don't do a lumbar puncture!
• No Mass=> do LP for meningitis

Front 161

Esotropia + ⇧ ICP

Back 161

eye moves in due to CN6 compression

Front 162

1st sign of herniation
what is this due to?

Back 162

Dilated pupils (due to CN3 compression)

Front 163

2nd sign of herniation

Back 163

Decorticate rigidity:
herniation above red nuc. => flex arms

Front 164

Decerebrate rigidity

Back 164

herniation below red nucleus=> extend arms => dead

Front 165

Head Injury Tx:
CI procedure

Back 165

"VMAB"
1) Ventilator (100% 02 to ⇩C02 ⇨ ⇩flow ⇨ ⇩ICP)
2) Mannitol - suck fluid out of brain cells to shrink brain
3) Acetazolamide - inhibits CA (which makes CSF)
4) Burr a hole in top of head to relieve pressure, No LP!

Front 166

what are LP Barriers: how do we do a lumbar puncture

Back 166

Skin ⇨ Ligaments ⇨ Dura ⇨ Arachnoid (Note: CSF is in subarachnoid space)
Do LP at L4-L5'
"L4-L5 keep the spinal cord alive"

Front 167

CN 3-4
location and what sign when it is compressed?

Back 167

Midbrain ⇨ blown pupils

Front 168

CN 5-8
location, test and sign

Back 168

Pons ⇨ no doll's eyes, (+) ice water calories
(doll's eyes = symmetrical deviation of the eyes when the head is moved in different positions, always returning to center),

Front 169

CN 9-12
location, signs of injury (2)

Back 169

Medulla ⇨ tongue deviation to injured side, irregular breathing

Front 170

Eye Reflexes (2)

Back 170

Blink/corneal reflex: CN 5 ⇨ 7 ⇨ 3
Pupillary light reflex: CN 2 ⇨ 3

Front 171

Cranial Nerve Lesions: how to find the lesion

Back 171

Put the lesion at the level of the highest CN affected

Front 172

Cranial Nerve Lesions:
CN 1:
CN 2:

Back 172

CN 1: Olfactory=> can't smell
CN 2: Optic => blind

Front 173

Cranial Nerve Lesions:
CN 3:
CN 4:

Back 173

CN 3: Occulomotor =>no response to light, ptosis, look down and out
CN 4: Trochlear=> see double when they look down

Front 174

Cranial Nerve Lesions:
CN 5:
CN 6:

Back 174

CN 5: Trigeminal => can't chew
CN 6: Abducens=> eye points toward nose

Front 175

Cranial Nerve Lesions:
CN 7:
CN 8:

Back 175

CN 7: Facial => facial paralysis
CN 8: Acoustic=> can't hear

Front 176

Cranial Nerve Lesions:
CN 9:
CN 10:

Back 176

CN 9: Glossopharyngeal => dry mouth, dysphagia, ⇩gag
CN 10: Vagus =>hoarse voice, uvula deviation, palate does not rise with "ahh"

Front 177

Cranial Nerve Lesions:
CN 11:
CN 12:

Back 177

CN 11: Spinal Accessory=> can't shrug shoulders or turn head ·
CN 12: Hypoglossal=> tongue deviates to weak side, difficulty speaking

Front 178

Sports Concussions: mngmt
No LOC:
LOC <5 min:
LOC > 5min:

Back 178

No LOC: 15 min observation
LOC <5 min: 1 week observation
LOC > 5min go to ER with C-collar

Front 179

Rabies:
exposure
presentation
pathogenesis

Back 179

>>exposure to raccoon, skunk, fox, bat, dog, cat
>>Negri bodies, hydrophobia, laryngospasm
>>Virus~> unmyelinated nerves~> CNS hippocampus) ~> salivary glands, peripheral nerves

Front 180

HSV-2:
what does it cause and management

Back 180

temporal lobe hemorrhagic encephalitis, need C/S prophylaxis

Front 181

Polio: presentation, onset and pathogenesis

Back 181

asymetric Fasciculations in a child
• 2 wks after gastroenteritis
• Trendelenburg gait (superior gluteal nerve ~> gluteus mm.)

Front 182

JC virus: name of diesease and pathogenesis

Back 182

progressive multifocal leukoencephalopathy, brain demyelination

Front 183

Toxoplasma: what part of the brain does it like to live?
what would be seen of a CT?
how can one acquire it?

Back 183

multiple ring-enhancing lesions
cat urine
parietal lobe

Front 184

CMV: ulcers, presentation

Back 184

>>shallow big esophagus ulcers, yellow-white retina opacification, bloody diarrhea, tenesmus,
>>spastic diplegia of legs, hepatosplenomegaly, blindness, central calcifications

Front 185

Measles = Rubeola
virus, cells

Back 185

(paramyxovirus): multinucleated giant cells (lymphocytes)

Front 186

Complications of measels

Back 186

otitis media
pneumonia
demyelinating disease = "Subacute Sclerosing Panencephilitis

Front 187

presentation of measels

Back 187

1) Cough, Coryza (thick rhinorrhea), Conjunctivitis
2) Koplik spot (white spot on buccal mucosa) - 24 hrs before rash
3) Morbilliform blotchy rash - spreads from head

Front 188

Echinococcus: describe and tx

Back 188

raw lamb/dog poop=> hydatid cyst/ eggshell calcifications
• Tx: Mebendazole +surgery

Front 189

Taenia Solium:
how is it acquired?
cystercercosis
tx

Back 189

raw pork (cysticercosis= larva swims in aqueous humor)
• Tx: Praziquental + steroids

Front 190

Syphilis: in children or neonates

Back 190

Rhagade's (lip fissure)
Hutchison's razor teeth
saber shin legs
mulberry molars

Front 191

Acanthamoeba:

Back 191

in contact lenses, eats through cornea

Front 192

Naegleria Fowleri:

Back 192

swamp diving trauma
• fulminant meningoencephalitis - eats through cribiform plate into brain => die in 48 hrs

Front 193

Creutzfeldt-Jacob:

Back 193

prion induced, die within 1 year, post-cornea transplant

Front 194

Rubella: neonate

Back 194

cataracts, hearing loss, PDA, meningoencephalitis, pneumonia, "blueberry muffin" rash

Front 195

Ramsay-Hunt: CN, signs and symptoms

Back 195

CN 7 herpes zoster ⇨ hearing loss, vertigo, Bell's palsy (facial nerve palsy)

Front 196

Most Common CNS Infections
Frontal Lobe

Back 196

Rubella "rub the front"

Front 197

Most Common CNS Infections: temporal

Back 197

"wish Herpes was Temporary"

Front 198

Most Common CNS Infections: Parietal Lobe

Back 198

Toxoplasma
"The Toxic Pariah"

Front 199

Most Common CNS Infections: Hippocampus

Back 199

Rabies 'The Hippo with Rabies"

Front 200

Most Common CNS Infections: Posterior Fossa

Back 200

TB
"Posterior is The Back"

Front 201

Most Common CNS Infections: DCML

Back 201

Treponema Pallidum
"Don't Trip on The Colunms"

Front 202

Delirium: define

Back 202

loss of consciousness
lucid intervals
sundowning
abnormal EEG (Check UA/ CMP)

Front 203

causes of delirium

Back 203

"DELIRIUM"
Dementia
Epilepsy, Epidural hematoma
Lungs, Liver
Infxn
Rx: NPH
Injury
Unfamiliar environment
Metabolic: vitamin deficiency

Front 204

Pick's disease is what kind of disorder?
what should be checked?

Back 204

Dementia/Degenerative
Check: TSH/Vit B12
fontal lobe atrophy, disinhibition

Front 205

Normal pressure hydrocephalus:
define
tx

Back 205

TrIAD =Incontinence, Ataxia, Dementia (reversible w/ LP)

Front 206

Alzheimer's:
neurotransmitter and nucleus
amyloid

Back 206

⇩ACh in nucleus basalis of Meynert
bad ApoE
neurofibrillary tangles of tau

Front 207

Alzheimer's tx

Back 207

>>Acetyl Cholinesterase Inhibitors:
>>NMDA-receptor antagonist: Memantine

Front 208

best tx for alzheimer's

Back 208

Acetyl Cholinesterase Inhibitor: Donepazil

Front 209

tx for alzheimer's with liver toxicity

Back 209

Acetyl Cholinesterase Inhibitor: Tacrine

Front 210

tx for alzheimer's with liver and kidney toxicity

Back 210

Acetyl Cholinesterase Inhibitor: Galantamine

Front 211

alzheimer's disease tx (NMDA)

Back 211

NMDA-receptor antagonist: Memantine

Front 212

Parkinson's: location, presentation, brain biopsy

Back 212

decrease dopamine in substantia nigra
bradykinesia
pill-rolling tremor
shuffling gait
Lewy bodies

Front 213

parkinsons Pathway: DA ⇨ ACh ⇨ GABA

Back 213

⇩DA ⇨ ⇧ACh ⇨ ⇧GABA

Front 214

drugs that ⇧DA: parkinson's
SE

Back 214

>>Raynaud's, Visual Hallucinations
L-DOPA
Pergolide
Bromocriptine
Pramipexole
Ropinirole

Front 215

what two drugs are a tx for restless leg syndrome and parkinson's

Back 215

Pramipexole
Ropinirole

Front 216

drugs that ⇩DA Metabolism: (3)

Back 216

• Carbidopa/Levodopa
• Selegiline
• Amantidine

Front 217

which parkinson tx causes purple skin?

Back 217

amantidine

Front 218

⇩ACh: tx
treatment for parkinsonian tremors

Back 218

• Benztropine
• Trihexyphenidyl- tx tremor

Front 219

COMT Inhibitors:
which one is hepatotoxic

Back 219

• Entacapone
• Tolcapone - hepatotoxic

Front 220

Lewy body dementia

Back 220

stiff
visual hallucinations
dementia within 1 yr of NM dysfunction

Front 221

Huntington's (AD):

Back 221

in caudate/ putamen
triplet repeat disorder
choreiform movements

Front 222

Amyotrophic Lateral Sclerosis (ALS) = Lou Gehrig disease
presentation, tx

Back 222

Descending paralysis, fasciculations in middle aged male
• Only motor nerves are affected (Corticospinal tract and ventral horn)
• Tx: Riluzole (decreases pre-synaptic Glu)

Front 223

Friedreich's ataxia:

Back 223

Retinitis pigmentosa, scoliosis

Front 224

Vascular "multi-infarct" dementia:

Back 224

sudden onset, stepwise progression of deficits

Front 225

Multiple Sclerosis: type of disease, presentation and ab

Back 225

Demyelinating Diseases:
anti-myelin Ab, symptoms come and go

Front 226

Multiple Sclerosis:
vision complaints

Back 226

Demyelinating Diseases:
middle aged woman with vision problems
• Optic neuritis => halo vision (can't see directly)

Front 227

what is Internuclear ophthalmoplegia?

Back 227

Demyelinating Diseases: MS
Internuclear ophthalmoplegia: opposite eye won't go past midline

Front 228

complications of MS

Back 228

Demyelinating Diseases:MS
MLF lesion (connects CN 3 and CN 6)
Bilateral trigeminal neuralgia

Front 229

test
LP, MRI
and tx for MS
treatment side effects

Back 229

LP: myelin basic proteins, MRI: plaques
• Tx: Glucocorticoids, INF-β => depression, Plasmapheresis

Front 230

Central Pontine Myelinolysis:

Back 230

if you correct osmolarity too fast
• Increase glucose 100mL/ dL = > decrease Na 1.6mEq/L
• Never correct Na faster than O.5mEq/ hr

Front 231

Guillain-Barre: type of paralysis

Back 231

ascending paralysis "Ground-to-Butt"

Front 232

Guillain-Barre: onset, bug, ab

Back 232

2 wks after URI or C. jujuni infection
Anti-ganglioside Ab

Front 233

Guillain-Barre: pathogenesis

Back 233

>>MP eat myelin off nerve axons ⇨ ⇧CSF protein
>>Polyradiculoneuropathy-many dermatomes involved
>>Same presentation as tick bites, resolves spontaneously like MS

Front 234

Guillain-Barre: tx

Back 234

Tx: Intubate if needed, IV Ig Plasmapheresis

Front 235

Wilson's disease: pathogenesis, mode of inheritance and tx

Back 235

(AR): Ceruloplasmin deficiency
• Cu in basal ganglia, hepatitis, Kaiser-Fleischer eye rings
• Tx: Penicillamine (chelates Cu2+)

Front 236

Kernicterus: who is at risk

Back 236

sulfa exposure, Hemolytic Disease of the Newborn

Front 237

Wernicke's encephalopathy:

Back 237

ophthalmoplegia, ataxia, psychosis

Front 238

Korsakoff psychosis

Back 238

mamillary bodies => anterograde amnesia, confabulation

Front 239

Acute Intermittent Porphyria:

Back 239

increased porphyrin production, urine δ-ALA, porphobilinogen

Front 240

Acute Intermittent Porphyria: presentation and triggers

Back 240

Sx: Abdominal pain, neuropathy, red urine (hemolytic anemia)
• Can be set off by stress (menses, Drugs: Barbs, Sulfas)

Front 241

Tx:Acute Intermittent Porphyria (4)

Back 241

Tx: 1. Fluids - wash away porphyrin ring
2. Sugar - break down bilirubin
3. Opiates- stop pain (use Meperidine for abdominal pain)
4. Hematin - inhibits δ-ALA synthase

Front 242

Brain Tumor vs Migraine HA

Back 242

Brain Tumor: immediate vomiting
Migraine HA: vomit hours later

Front 243

Comatose Tx:

Back 243

"DONT"
Dextrose
02
Naloxone
Thiamine

Front 244

Migraines: presentation

Back 244

aura
photophobia
nunbness and tingling ⇨ throbbing Headache (HA), nausea

Front 245

Migraines Prophylaxis:

Back 245

Amitriptyline, Propanolol

Front 246

Migraines Tx
contraindications

Back 246

Tx: NSAIDs, Sumatriptan (5-HT agonist), Ergotamine (not if CAD)

Front 247

Tension Headache

Back 247

bilateral "band-like" pain, worse as day progresses, sleep disturbance

Front 248

Tension Headache Prophylaxis and tx

Back 248

Prophylaxis: Amitriptyline
Tx: ASA

Front 249

Cluster Headache: (5)

Back 249

unilateral retro-orbital pain
suicidal
facial flushing
lacrimation
Honer's syndrome

Front 250

Cluster Headache: acute and chronic tx

Back 250

• Acute Tx: 02 inhalation, Glucocorticoid, Sumatriptan
• Chronic Tx: Li, Verapamil, β-blocker

Front 251

Temporal (Giant cell) Arteritis: tx

Back 251

pain with chewing, blind in one eye
• Tx: Prednisone

Front 252

Trigeminal Neuralgia: describe and tx

Back 252

sharp, shooting face pain
• Tx: Carbamazepine

Front 253

Chronic Daily Headache: define and prophylaxis

Back 253

bilateral, diffuse, pressure-like
• Prophylaxis: Nortriptyline

Front 254

causes of altered mental status

Back 254

"MENTAL"
Meds: BZ, Opioids
Electrolytes: DKA
Neuro disorders: Status epilepticus
Temperature
Alcohol: Vit B12, folate deficiency
Liver/ kidney dz: Hepatic encephalopathy

Front 255

BZ, Opioids cause of altered mental status tx

Back 255

Tx: Naloxone+ Flumazenil

Front 256

DKA is the cause of altered mental status tx

Back 256

Tx: Insulin ⇨ Fluid ⇨ K+

Front 257

status epilepticus is the cause of altered mental state of consciousness. Tx

Back 257

Tx: Diazepam

Front 258

treatment for vit B12 and folate deficiency cause of altered state of consciousness

Back 258

Tx: Thiamine ⇨ Glucose

Front 259

hepatic encephalopathy cause of delirium, what is the treatment?

Back 259

Nitroprusside + Lactulose