Sus2 - Neurologic Disorders: Facts

Front 1

What region of the brain is supplied by the anterior cerebral artery (ACA)?

Back 1

Medial and superior surfaces and frontal lobes

Front 2

What region of the brain is supplied by the middle cerebral artery (MCA)?

Back 2

Lateral surfaces and temporal lobes

Front 3

What region of the brain is supplied by the posterior cerebral artery (PCA)?

Back 3

Inferior surfaces and occipital lobes

Front 4

What region of the brain is supplied by the basilar artery?

Back 4

Midbrain and brainstem (pons)

Front 5

What region of the brain is supplied by the anterior inferior cerebellar artery (AICA)?

Back 5

Brainstem (pons) and parts of the cerebellum

Front 6

What region of the brain is supplied by the posterior inferior cerebellar artery (PICA)?

Back 6

Brainstem (medulla) and parts of the cerebellum

Front 7

Where are the dorsal columns located in the spinal cord?

Back 7

Posterior spinal cord

Front 8

Where is the spinothalamic tract located in the spinal cord?

Back 8

Anterior spinal cord

Front 9

Where is the corticospinal tract located in the spinal cord?

Back 9

Lateral spinal cord

Front 10

Describe the first order neuron and synapse in the dorsal columns

Back 10

Enters at the ipsilateral dorsal horn, ascends in fasciculus gracilis and cuneatus, and synapses in the nucleus gracilis and cuneatus

Front 11

How is the homunculus arranged in the dorsal columns?

Back 11

Lower body and extremities medial, upper body and extremities lateral

Front 12

Describe the first order neuron and synapse in the spinothalamic tract

Back 12

Originate in the dorsal root ganglion an synapse in the dorsolateral tract of Lissauer

Front 13

Describe the first order neuron and synapse in the corticospinal tract

Back 13

Descend from the internal capsule and midbrain, decussate in the medullary pyramids, descend in the corticospinal tract and synapse in the ventral horn through interneurons

Front 14

Describe the second order neuron in the dorsal columns

Back 14

Decussate at the medulla and ascend as the medial lemniscus

Front 15

Describe the second order neuron in the spinothalamic tract

Back 15

decussate in the ventral white commissure, and ascend in the lateral spinothalamic tract

Front 16

Describe the second order neuron in the corticospinal tract

Back 16

exit the cord through the ventral horn

Front 17

Describe the function of the dorsal columns

Back 17

Two point discrimination, vibration sense, proprioception

Front 18

Describe the function of the spinothalamic tract

Back 18

Pain and temperature sensation

Front 19

Describe the function of the corticospinal tract

Back 19

voluntary movement of striated mscle

Front 20

Which parts of the cord are affected in amyotrohic lateral sclerosis?

Back 20

Corticospinal tract and ventral horn

Front 21

Which parts of the cord are affected in poliomyelitis?

Back 21

ventral horn

Front 22

Which parts of the cord are affected in tabes dorsalis?

Back 22

Dorsal columns

Front 23

Which parts of the cord are affected in Spinal artery syndrome?

Back 23

Corticospinal tract, spinothalamic tract, ventral horn, lateral gray matter

Front 24

Which parts of the cord are affected in vitamin B12 deficiency?

Back 24

Dorsal columns, corticospinal tract

Front 25

Which parts of the cord are affected by syringomyelia?

Back 25

Ventral horn, ventral white commissure

Front 26

Which parts of the cord are affected in Brown-Sequard syndrome?

Back 26

All tracts on one side of the cord

Front 27

What symptoms result from the spinal cord defect in amyotrophic lateral sclerosis?

Back 27

spastic and flaccid paralysis

Front 28

What symptoms result from the spinal cord defect in poliomyelitis?

Back 28

Flaccid paralysis

Front 29

What symptoms result from the spinal cord defect in tabes dorsalis?

Back 29

impaired proprioception and pain sensation

Front 30

What symptoms result from the spinal cord defect in spinal artery syndrome?

Back 30

Bilateral loss of pain and temperature sensation (one level below the lesion)
Bilateral spastic paresis below the lesion
Bilateral flaccid paralysis at the level of the lesion

Front 31

What symptoms result from the spinal cord defect in vitamin B12?

Back 31

Bilateral loss of vibration and discrimination
Bilateral spastic paresis affecting legs before arms

Front 32

What symptoms result from the spinal cord defect in syringomyelia?

Back 32

Bilateral loss of pain and temperature sensation one level below the lesion
Bilateral flaccid paralysis at the level of the lesion

Front 33

What symptoms result from the spinal cord defect in brown-sequard syndrome?

Back 33

ipsilateral loss of vibration and discrimination sensation below the lesion
Ipsilateral spastic paresis below the lesion
Ipsilateral flaccid paralysis at the level of the lesion
Contralateral loss of pain and temperature sensation below the lesion

Front 34

Name of CN I

Back 34

Olfactory

Front 35

Name of CN II

Back 35

Optic

Front 36

Name of CN III

Back 36

Oculomotor

Front 37

Name of CN IV

Back 37

Trochlear

Front 38

Name of CN V

Back 38

Trigeminal

Front 39

Name of CN VI

Back 39

Abducens

Front 40

Name of CN VII

Back 40

Facial

Front 41

Name of CN VIII

Back 41

Vestibulocochlear

Front 42

Name of CN IX

Back 42

Glossopharyngeal

Front 43

Name of CN X

Back 43

Vagus

Front 44

Name of CN XI

Back 44

Accessory

Front 45

Name of CN XII

Back 45

Hypoglossal

Front 46

Function of Olfactory nerve

Back 46

Smell

Front 47

Function of Optic nerve

Back 47

Sight

Front 48

Function of oculomotor nerve

Back 48

Medial, superior, inferior rectus muscles, inferior oblique muscle, ciliary muscle, sphincter of the eye

Front 49

Function of trochlear nerve

Back 49

Superior oblique muscle

Front 50

Function of trigeminal nerve

Back 50

sensation of the face, muscles of mastication

Front 51

Function of abducens nerve

Back 51

lateral rectus muscel

Front 52

Function of facial nerve

Back 52

Taste to the anterior 2/3 of the tongue
Muscles of facial expression, stapedius, stylohyoid, and proximal belly of digastric muscles
Lacrimal, submandibular and sublingual glands

Front 53

Function of vestibulocochlear nerve

Back 53

hearing, balance

Front 54

Function of glossopharyngeal nerve

Back 54

Taste to the posterior 1/3 of the tongue
Pharyngeal sensation
Stylopharyngeus muscle
Parotid gland

Front 55

Function of the vagus nerve

Back 55

Sensation of the trachea, esophagus, viscera
Laryngeal, pharyngeal muscles
Visceral autonomics

Front 56

Function of the accessory nerve

Back 56

Sternocleidomastoid and trapezius muscles

Front 57

Function of the hypoglossal nerve

Back 57

Tongue

Front 58

What is the most common cause of bacterial meningitis in the newborn period?

Back 58

Group b-streptococci

Front 59

What is the most common cause of bacterial meningitis between 1 month and 2 y.o.?

Back 59

Streptococcus pneumoniae and Neisseria meningitidis

Front 60

What is the most common cause of bacterial meningitis between the ages of 2 - 18 y.o.?

Back 60

Neisseria meningitidis

Front 61

What is the most common cause of bacterial meningitis between the ages of 18 - 60 y.o.?

Back 61

Streptococcus pneumoniae

Front 62

What is the most common cause of bacterial meningitis after the age of 60 y.o.?

Back 62

Streptococcus pneumoniae

Front 63

Area injured in Broca's aphasia

Back 63

Inferior frontal gyrus, dorsolateral frontal cortex, anterior parietal cortex

Front 64

Area injured in Wernicke's aphasia

Back 64

posterior superior temporal gyrus, inferior parietal lobe

Front 65

Area injured in conduction aphasia

Back 65

supramarginal gyrus, angular gyrus

Front 66

Area injured in global aphasia

Back 66

large infarcts of the left cerebral hemisphere

Front 67

Characteristics of Broca's aphasia

Back 67

Expressive aphasia: nonfluent, difficulty producing words. Good comprehension.
Face and arm hemiparesis, loss of oral coordination

Front 68

Characteristics of Wernicke's aphasia

Back 68

Receptive aphasia: Fluent, with word substitutions, meningless words, meaningless phrases (word salad) and poor comprehension

Front 69

Characteristics of conduction aphasia

Back 69

Fluent speech, word substitutions, frequent attempts to correct words, word-finding pauses

Front 70

Characteristics of global aphasia

Back 70

Difficulty producing words, nonfluent speech, poor comprehension limb ataxia

Front 71

Area of involvement of a simple partial seizure

Back 71

Focal cortical region of the brain

Front 72

Area of involvement of a complex partial seizure

Back 72

Focal cortical region (most commonly temporal lobe)

Front 73

Area of involvement of generalized convulsive seizure

Back 73

Bilateral cerebral cortex

Front 74

Area of involvement of absence seizure

Back 74

Bilateral cerebral cortex

Front 75

Signs/symptoms of simple partial seizure

Back 75

Focal sensor or motor deficits, no loss of consciousness

Front 76

Signs/symptoms of complex partial seizure

Back 76

Hallucinations, automatisms, deja vu, or impaired consciousness with postictal confusion

Front 77

SIgns/symptoms of generalized convulsive seizure

Back 77

Sustained contractions, repetitive muscle contractions and relaxations, or loss of tone (or a combination of these).
Loss of consciousness, incontinence, significant postictal confusion

Front 78

Define Todd paralysis

Back 78

Unilateral weakness lasting several hours - days after a generalized convulsive seizure

Front 79

Signs/symptoms of absence seizure

Back 79

brief impairment of consciousness, normal muscle tone, possible eye blinking. No postictal confusion

Front 80

Presentation of Argyll Robertson pupil

Back 80

Accomodation to near objects, nonreactive to light

Front 81

Presentation of Marcus Gunn pupil

Back 81

Light in affected pupil causes minimal bilateral constriction, but light in the normal pupil causes normal bilateral constriction

Front 82

What are the three most common primary CNS tumors in adults?

Back 82

Glioblastoma, meningioma, and schwannoma

Front 83

What are the three most common primary CNS tumors in children?

Back 83

Astrocytoma (benign), medulloblastoma (malignant), and ependymoma (may be malignant)

Front 84

Presentation of Horner syndrome

Back 84

Ptosis, miosis, anhidrosis

Front 85

Presentation of an Adie pupil

Back 85

Minimally reactive dilated pupil

Front 86

Presentation of MLF syndrome

Back 86

With lateral gaze, there is absent contralateral eye adduction

Front 87

Cause of an Argyll Robertson pupil

Back 87

Syphilis, SLE, DM

Front 88

Cause of a MArcus Gunn Pupil

Back 88

Afferent nerve defect

Front 89

Cause of Horner syndrome

Back 89

Sympathetic trunk lesion (e.g. Pancoast tumor)

Front 90

Cause of an Adie pupil

Back 90

abnormal innervation of the iris

Front 91

Cause of MLF syndrome

Back 91

Intracranial lesion, MS

Front 92

Define myopia

Back 92

Refracting power of the eye is too great, causing image focal point to be anterior to the retina

Front 93

Define hyperopia

Back 93

Refracting power of the eye is insufficient, causing image focal point to be posterior to the retina

Front 94

Define astigmatism

Back 94

asymmetric corneal surface, causing inconsistent refraction of light

Front 95

Define strabismus

Back 95

Deviation of the eye unable to be overcome by normal motor control

Front 96

Define Amblyopia

Back 96

Developmental defect in neural pathways of the eye, resulting in poor visual acuity and spatial differentiation in the affected eye

Front 97

What kind of white blood cells are found in the CSF of a patient with bacterial meningitis?

Back 97

PMNs - Neutrophils

Front 98

What kind of white blood cells are found in the CSF of a patient with fungal meningitis?

Back 98

Lymphocytes

Front 99

What kind of white blood cells are found in the CSF of a patient with tuberculous meningitis?

Back 99

Lymphocytes

Front 100

What kind of white blood cells are found in the CSF of a patient with Viral meningitis?

Back 100

Lymphocytes

Front 101

What are the three most common bacterial causes of meningitis in a patient under the age of 1 month old?

Back 101

1. Group B Streptococcus
2. E. coli
3. Listeria (occasionally)

Front 102

Generally, what are the two most common bacterial causes of meningitis in a patient between the ages of 1 - 60 y.o.?

Back 102

1. Streptococcus Pneumoniae
2. Neisseria Meningitidis

Front 103

What is the most common cause of bacterial meningitis between the ages of 10 - 19 y.o.?

Back 103

Neisseria meningitidis

Front 104

What additional bacterial cause of meningitis can occur in patients age 50 - 60 y.o.?

Back 104

Listeria monocytogenes

Front 105

What are the four most common bacterial causes of meningitis in patients aged 60 y.o. or older, as well as alcoholics and patients with debilitating comorbidities?

Back 105

1. Streptococcus Pneumoniae
2. Listeria Monocytogenes
3. Neisseria Meningitidis
4. Gram negative bacilli

Front 106

What is the empiric antibiotic coverage for suspected bacterial meningitis under 1 month of age?

Back 106

1. Ampicillin +
2. Cefotaxime or Gentamycin

Front 107

What is the empiric antibiotic coverage for suspected bacterial meningitis from 1 month of age - 60 y.o.?

Back 107

1. Cefotaxime or Ceftriazone
2. Vancomycin

Front 108

What is the empiric antibiotic coverage for suspected bacterial meningitis over 60 y.o, as well as alcoholics and patients with debilitating comorbidities?

Back 108

1. Ampicillin
2. Cefotzxime or Ceftriaxone
3. Vancomycin

Front 109

What medication should be added to patients over the age of 6 weeks old at the beginning of antibiotic therapy for bacterial meningitis, and what effect does it have?

Back 109

Dexamethasone

Reduces long-term neurologic sequelae in children, and reduces morbidity and mortality in adults

Front 110

Headache that is made worse by foods containing tyramine

Back 110

Migraine headache

Front 111

Headache in an obese woman with papilledema

Back 111

Pseudotumor cerebri

Front 112

Headache with jaw muscle pain when chewing

Back 112

Temporal arteritis

Front 113

Headache associated with periorbital pain with ptosis and miosis

Back 113

Cluster headache

Front 114

Headache with photophobia and/or phonophobia

Back 114

Migraine headache

Front 115

Headache with bilateral frontal/occipital pressure

Back 115

Tension headache

Front 116

Headache with lacrimation and/or rhinorrhea

Back 116

Cluster headache

Front 117

Headache with elevated ESR

Back 117

Temporal arteritis

Front 118

Headache described as the "worst headache of my life"

Back 118

Subarachnoid hemorrhage

Front 119

Headache with extraocular muscle palsies

Back 119

Cavernous sinus thrombosis

Front 120

Headache preceded by scintilating scotomas

Back 120

Migraine headache with aura

Front 121

Headache occurring either before or after orgasm

Back 121

Post-coital cephalagia

Front 122

Headache that is responsive to 100% oxygen supplementation

Back 122

Cluster headache

Front 123

Headache beginning days after a trauma to the head, and persists for over a week

Back 123

Subdural hematoma

Front 124

Which artery is most commonly involved in an embolic ischemic stroke?

Back 124

Middle cerebral artery

Front 125

What two diseases are associated with formation of berry aneurysms?

Back 125

Autosomal dominant (adult onset) polycystic kidney disease, and Ehler's-Danlos syndrome

Front 126

What are the five most common lacunar stroke syndromes?

Back 126

1. Pure motor hemiparesis (most common)
2. Pure sensory stroke
3. Ataxic hemiparesis
4. Sensorimotor stroke
5. Dysarthria-clumsy hand syndrome

Front 127

Define tonic seizure

Back 127

Sustained contraction of the extremities andback

Front 128

Define clonic seizure

Back 128

Repetitive muscle contraction and relaxation

Front 129

Define tonic-clonic seizure

Back 129

Brief contraction period, followed by repetitive contraction-relaxation pattern

Front 130

Define myoclonic seizure

Back 130

Brief repetitive contractions

Front 131

Define atonic seizure

Back 131

Complete loss of tone ("drop" seizures)

Front 132

What EEG pattern will be seen in an absence seizure?

Back 132

Generalized three-cycle/second spike and wave pattern

Front 133

What intracranial hemorrhage is associated with a classic "lucid interval"?

Back 133

Epidural Hematoma

Front 134

What are the two most common locations of berry aneurysms?

Back 134

Anterior communicating artery
Posterior communicating artery

Front 135

Arterial location of a stroke presenting with contralateral extremity an trunk weakness:

Back 135

Anterior Cerebral artery

Front 136

Arterial location of a stroke presenting with contralateral face and upper extremity weakness and decreased sensation, bilateral visual abnormalities, aphasias or neglect syndromes:

Back 136

Middle Cerebral Artery

Front 137

Arterial location of a stroke presenting with Contralateral visual abnormalities or blindness:

Back 137

Posterior cerebral artery

Front 138

Arterial location of a stroke presenting with cranial nerve abnormalities, contralateral full body weakness and decreased sensation, vertigo, loss of coordination, difficulty speaking, visual abnormalities, or coma:

Back 138

Basilar artery

Front 139

Arterial location of a stroke presenting with weakness of the face, arm, and leg on one side of the body without sensory or cortical signs:

Back 139

Lacunar arteries

Front 140

Name of syndrome presenting with weakness of the face, arm, and leg on one side of the body without sensory or cortical signs:

Back 140

Pure motor hemiparesis (Lacunar stroke)

Front 141

Arterial location of a stroke presenting with sensory defect of the face, arm and leg on one side of the body without motor or cortical signs:

Back 141

Lacunar arteries

Front 142

Name of syndrome presenting with sensory defect of the face, arm and leg on one side of the body without motor or cortical signs:

Back 142

Pure sensory stroke (Lacunar Stroke)

Front 143

Arterial location of a stroke presenting with ipsilateral weakness and limb ataxia out of proportion to the motor defect, possible gait deviation to the side of the lesion without cortical signs:

Back 143

Lacunar arteries

Front 144

Name of syndrome presenting with ipsilateral weakness and limb ataxia out of proportion to the motor defect, possible gait deviation to the side of the lesion without cortical signs:

Back 144

Ataxic hemiparesis (Lacunar stroke)

Front 145

Arterial location of a stroke presenting with weakness and numbness of the face, arm and leg on one side of the body without cortical signs:

Back 145

Lacunar arteries

Front 146

Name of syndrome presenting with weakness and numbness of the face, arm and leg on one side of the body without cortical signs:

Back 146

Sensorimotor stroke (Lacunar stroke)

Front 147

Arterial location of a stroke presenting with facial weakness, dysarthria, dysphagia, and slight weakness and clumsiness of one hand without sensory or cortical signs:

Back 147

Lacunar arteries

Front 148

Name of syndrome presenting with facial weakness, dysarthria, dysphagia, and slight weakness and clumsiness of one hand without sensory or cortical signs:

Back 148

Dysarthria-clumsy hand syndrome (Lacunar stroke)

Front 149

What are the unique features of dementia caused by Pick disease?

Back 149

Behavior and personality changes
Progressive Aphasia

Front 150

What is another name for Pick Disease?

Back 150

Frontotemporal dementia

Front 151

What are the unique features of Lewy body dementia?

Back 151

Bradykinesia, Parkinsonian Gait, Cogwheel Rigidity
Visual Hallucinations

Front 152

Cause of syncope associated with emotional stress, trauma, pain, the sight of blood, or prolonged standing:

Back 152

Vasovagal Syncope (a type of Reflex Syncope)

Front 153

Cause of syncope associated with micturition, defecation, coughing, and GI stimulation:

Back 153

Situational syncope (a type of Reflex Syncope)

Front 154

Cause of syncope associated with head-turning, shaving or a tight collar:

Back 154

Carrotid-sinus hypersensitivity

Front 155

Cause of syncope associated with exertion, palpitations, chest pain, or shortness of breath:

Back 155

Cardiogenic syncope

Front 156

Cause of syncope associated with BP medications, that will have a positive tilt table test:

Back 156

Orthostatic syncope

Front 157

Cause of syncope associated with prolonged loss of consciousness, seizures or neurologic deficits:

Back 157

Cerebrovascular syncope

Front 158

Define a Chalazion:

Back 158

Inflammation of internal Meibomian sebaceous glands resulting in the entire eyelid swelling

Front 159

Define a Hordeolum:

Back 159

Stye
Infection of external sebaceous glands of Zeiss or Mol; tender, red welling at the lid margin

Front 160

Define anterior blepharitis:

Back 160

Infection of the eyelids and lashes secondary to seborrhea; red, swollen lid margins with dandruff on lashes

Front 161

Treatment of a chalazion:

Back 161

Usually self-limited
Surgical excision and/or intralesional steroid injection

Front 162

Treatment of a hordeolum:

Back 162

Hot compress 3-4 times per day for 10-15 minutes
I&D if not resolved within 24 hours

Front 163

Treatment of anterior blepharitis:

Back 163

wash lid margins daily with shampoo
Remove scales with cotton ball
Antibiotic ointment daily applied to the lid margin

Front 164

Diagnosis in a patient presenting with acute onset of vertigo, nausea, vomiting and nystagmus with preserved hearing:

Back 164

Vestibular neuritis

Front 165

Diagnosis in a patient presenting with acute onset of vertigo, nausea, vomiting and nystagmus with hearing loss:

Back 165

Acute labrynthitis

Front 166

What is the most common cause of conductive hearing loss?

Back 166

Otosclerosis

Front 167

What is the most common cause of sensorineural hearing loss?

Back 167

Presbycusis

Front 168

Describe the Rinne Test. In what type of disorder will it be abnormal?

Back 168

Tuning fork is held against the mastoid process until it is no longer head, and is then moved just outside of the ear. Normally the patient will be able to hear the fork outside the ear.

Normally, air conduction is greater than bone conduction. An abnormal Rinne test (i.e. the patient cannot hear the tuning fork when it is moved), indicating conducive hearing loss

Front 169

What is the pathogenesis of Parkinson disease?

Back 169

Idiopathic dopamine depletion, loss of dopaminergic striated neurons in the substantia nigra and Lewy body formation, leading to abnormal cholinergic input to the cortex

Front 170

What is a Lewy body?

Back 170

Eosinophilic cytoplasmic inclusions in neurons

Front 171

Are Anterior Horn cells UMN or LMN?

Back 171

LMN

Front 172

Are corticospinal tract cells UMN or LMN?

Back 172

UMN

Front 173

What is the result of destruction of anterior horn cells?

Back 173

Flaccid paralysis

Front 174

What is the result of destruction of corticospinal tract cells?

Back 174

Spastic paralysis

Front 175

Pathophysiology of Myasthenia gravis:

Back 175

Autoantibodies that bind to ACh receptors at the neuromuscular junction preventing normal neuromuscular transmission, resulting in easy fatigability

Front 176

Pathophysiology of Lambert-Eaton syndrome:

Back 176

Autoantibodies to presyntamtic calcium channels, preventing calcium release, resulting in weakness that improves with continued use

Front 177

How is Myasthenia gravis distenguished from Lambert-Eaton syndrome?

Back 177

The weakness in myasthenia gravis worsens with use, while the weakness in Lambert-Eaton syndrome improves with continued use

Front 178

What are the three most common primary CNS tumors in adults?

Back 178

Glioblastoma
Meningioma
Schwannoma

Front 179

What are the three most common primary CNS tumors in children?

Back 179

Astrocytoma
Medulloblastoma
Ependymoma

Front 180

What is the most common malignant primary CNS tumor in children?

Back 180

Medulloblastoma

Front 181

What CNS damage causes spasticity in cerebral palsy?

Back 181

Damage to the pyramidal tracts

Front 182

What CNS damage causes dyskinesis in cerebral palsy?

Back 182

Extrapyramidal damage

Front 183

What are three causes of a cherry red spot on the macula?

Back 183

Retinal Artery occlusion
Neimman Pick Disease
Tay-Sach's disease

Front 184

What are the three most common causes of acute otitis media?

Back 184

Streptococcus pneumoniae
Haemophilys influenzae
Moraxella catarrhalis