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32 Cards in this Set
- Front
- Back
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young woman with diplopia?
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- myasthenia gravis, ddx primary muscular problem by normal CPK 2/2 Ab agianst ACh receptor
- only affects motor, can also rpesent with jaw fatigue - CT SCAN FOR THYMOMA |
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when do you scan for thymoma?
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- dx of myasthenia gravis
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severe red eye, pain halos around light?
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- acute angle glaucoma, also HA!
- check for ESR if < 50 then not giant cell temporitis - also pt with fixed non-reactive eye! |
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neuro defects not explained by single lesion?
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- MS
- also presents with internuclear ophthalmoplegia = lesion in MLS |
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LESIONS:
optic nerve optic chiasm optic radiation occulomotor nerve abducens frontal lobe |
- blindness in that eye
- bitemoral hemianopsia - contralateral hemianopic - ptosis and eye looking down and out 2/2 unopposed lateral rectus and superior oblique - convergent strabismus, horizontal diplopia - ipsilateral deviation of eye |
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absence of forehead furrows?
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- bells palsy = peripheral CN 7 lesion
- central CN7 = dysarthria, drooped R corner mouth, facial spasm |
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motor and sensory deficits greater in lower than upper? if upper greater than lower?
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- anterior cerbral artery stroke
- middle cerebral atery |
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vertigo, tinnitus, decreased hearing?
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- meniere
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central vision loss
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- scotomas = optic neuritis
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creutzfeldt-Jakob
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- rapidly progressive dementia, myoclojnos, high voltage complexes on EEG, death in 12 wks
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ALS
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- both UMN and LMN lesions
- spasticity, increased DTR - fasciulations = LMN |
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acute stroke
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- do CT => if not acute hemorrhage and within 4.5 hrs => TPA; if hemorrhage then c/i to asa and tpa
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tx of SAH?
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- nimodipine = dilator to reduce vessel spasm
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**pt with GBS how to monitor resp status?
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- vital capacity
- intubate if < 15 |
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don't feel pain from corneal abrasion?
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- trigeminal V1 branch
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anisocoria?
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- unequal size of pupils = CN III
- also ptosis, eye adduction |
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myasthenia gravis crisis
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- respiratory and pharyngeal muscle weakenss => intubate and anticholinesterase (pyridostigmine) withdrawal b/c can also precipitate
- MCC is infx |
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steppage gait
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- can't dorsiflex foot => high step, foot slaps down
- due to L5 radiculopathy, trauma or congenital (charcot-Marie tooth) |
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basal ganglia dz
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- parkinson, huntington, wilson, kernicterus, hemiballismus
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MC site hypertensive hemorrhage?
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-1. putaman => hemiparesis, eyes deviate away from paralytic side
-2. cerebellar hemorrhage: ataxia, vomiting, HA, gaze palsy, facial weakness - 3. pontine: coma, pinpoint pupils reactive to light |
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anticholinergix sx
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- red, dry, hot, blind, mad, full = flusing, dry mouth/eye, hyperthermia, mydriasis, vision changes, delirium, urinary retention, constipation
- seen in tx of parkinsons with anticholinergics = trihexyphenidyl and bromocriptine |
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CT findings
- caudate - cerebral cortex - lenticular nucleus - frontal/temporal |
- huntingtons
- alz - wilsons -picks |
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word finding difficulty but intact language comprehension?
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- broca's aphasia = left frontal temporal lobe
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disease of posterior spinal colums?
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- syphillis (tabes dorsalis) and vit B12 deficiency
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vagal nerve
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- hoarseness, dysphagia, tachy
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eye problem in cerebellar dysfx
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- nystagmus
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tx trigeminal neuralgia
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- carbamazepine
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electrolyte abnormality in subarachnoid hemorrhage?
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- hypoNa2+ = cerebral salt wasting syndrome 2/2 vasopressin release => water rentention and increased BNP => salt wasting
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SE metoclopramide
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- DA receptor agonist for tx N/V, gastroparesis
- EPS: TD, dystonic rxn, parkinsonisms, NMS |
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hyperdense vs hypodense CT?
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- hyper = hemorrhage
- hypo- infacrt |
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max sinusitis + neuro deficits
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- anaerobic brain abscess from lung, max infx, etc
- 80% streptococcus, 20% bacteroides - ring enhancing lesion |
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strongest RF in stroke
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HTN
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