Em Neurology

Front 1

Motor Reflexes
a. Biceps
b. Triceps
c. Knee Jerk
.d Achilles Tendon

Back 1

a. C5-6
b. C7
c. L4
d. S1

Front 2

Nexus criteria (5)

Back 2

No posterior Midline tenderness
No altered mental status
No Distracting injury
Normal level of alertness
No focal neurologic deficits

Front 3

Stable cervical fractures (5)

Back 3

1. Anterior subluxation (<3mm)
2. Clay shoveler's fractures (avulsion fracture of C2)
3. Posterior arch C1 fracture
4. Unilateral facet dislocation
5. Wedge fracture <25 mm)

Front 4

Unstable Cervical Fracture (5)

Back 4

"Jefferson Bit Off A Hangmans Tit"
Jefferson fracture (burst of C1)
Bilateral facet dislocation +/- fracture
Odontoid (type II and type III)
Any Fracture/Dislocaiton
Hagman's Fracture (posterior C2)
Tear Drop Fracture

Front 5

Posterior Columns

Back 5

Vibration and position (propioception) sense

Front 6

Lateral Corticospinal

Back 6

Upper motor neurons

Front 7

Anterior Horn Cells

Back 7

Lower motor neurons

Front 8

Anterior Spinothalamic Tract

Back 8

Pain and Temperature

Front 9

Anterior Cord Syndrome

Back 9

Complete motor paralysis below the lesion
Vibration/Propioception intact
Loss of pain/temperature below the injury

Front 10

Brown Sequard Segment

Back 10

Crossed findings below the level
Ipsilateral weakness, loss of position and vibration sense
Contralateral loss of pain/temperature sense

Front 11

Central Cord Syndrome

Back 11

Hyperextension injury (older patients)
Some loss of bladder control
Some decreased sensation (distal pain and temperature)
Sacral/rectal tone sparing

Front 12

Transverse Cord Syndrome

Back 12

Trauma, tumors, transverse myelitis
Complete loss of all sensory and motor
Pathway below a certain level
No sacral Sparing

Front 13

Posterior Cord Syndrome

Back 13

Extension injury, B12, Tertiary syphallis
Loss of position and vibratory sensation only

Front 14

Neurogenic shock

Back 14

Flaccid paralysis below the lesion
Hypotension (treat w fluids)
Loss of reflexes
Warm, flished skin

Front 15

Spinal Shock

Back 15

Loss of sensation, motor paralysis
Day 0-1 loss of reflex below level of injury
Day 1-3 Initial return of reflex
Week 1-4 Hyperreflexia
1-12 months Hyperreflexia

Front 16

Pediatric hip problems
a. 4-8 years of age
b. 4-10 years of age
c. 10-16 years of age
d. Any age

Back 16

a. Legg-Calve- erthes
b. Toxic Synovitis
c. SCFE
d. Septic Arthritis

Front 17

Causes of bilateral miosis (5)

Back 17

Pontine Stroke
Opiates
Cholinergics
Clonidine
Phenothiazine

Front 18

Cold Calorics (occulovestibular reflex)

Back 18

COWS: Cold Opposite Warm Same
Brainstem+ cortex intact: nystagmus with fast component direct to opposite ear
Brainstem: injury: no deviation
Cortex injured: Eyes deviate to cold side but dont snap back

Front 19

Doll's Eyes (Occulocephalic reflex)

Back 19

brainstem intact: eyes move opposite direction as head movement
brainstem injured: eyes stay fixed

Front 20

What side is the lesion on in a blown pupil?

Back 20

85% represent large ipsilateral bleed or uncal herniation

Front 21

Trigeminal neuralgia treatment

Back 21

Carbamazepine and surgical decompression

Front 22

Migraine - preventative therapy

Back 22

TCA's, beta-blocker, Calcium Channel blockers, Methysergine

Front 23

Migraine - abortive therapy

Back 23

1. Ergotamine, DHE
2. Sumatriptan
3. Antiemetics

Front 24

Contraindications to Ergotamine

Back 24

CAD, PVD, HTN, Renal Failure, and pregnancy

Front 25

Contraindication for Sumatriptan

Back 25

Heart disease, hypertension, ergotaine, migraines with focal findings

Front 26

Treatment for cluster headaches?

Back 26

100% oxygen, pain mediation, 4% lidocaine, nasal drops, and prophylactic verapamil

Front 27

Idiopathic Intracranial Hypertension
(Pseudotumor Cerebri)

Cause

Back 27

Cause: impaired CSF absorption and elevated CSF pressure (no mass or obstruction)

Front 28

Idiopathic Intracranial Hypertension
(Pseudotumor Cerebri)

CT/LP findings

Back 28

CT :Slit like or normal ventricles
LP: High opening Pressure

Front 29

Idiopathic Intracranial Hypertension
(Pseudotumor Cerebri)

Treatment

Back 29

Repeated LPs, acetazolamide
Surgical shunt if severe and refractory

Front 30

Subarachnoid Hemorrhage - most specific finding

Back 30

Xanthrocromia (LP fluid)

Front 31

SAH treatment

Back 31

Nimodipine (decreases vasospasm and decreases risk of rebleed that may occur weeks later)
Neurosurgery consult
Blood pressure control

Front 32

Normal Pressure Hydrocephalus

Back 32

Wet, wobbly, wacky
Urinary incontinence
Ataxia
Progressive ataxia

Front 33

Subdural hematoma -lesion?

Back 33

bridging veins
(has a worse prognosis)

Front 34

Epidural Hematoma - lesion?

Back 34

Middle Meningeal Artery
'Talk and die"

Front 35

Most common CNS lesion in AIDs

Back 35

Toxoplasmosis
(ring enhancing lesions on CT)

Front 36

LP Findings in bacterial meningitis
Opening Pressure, WBC, PMN, Protien, Glucose

Back 36

INC OP, INC WBC, INC PMN, INC Protein, DEC Glucose

Front 37

Treatment order for bacterial meningitis?

Back 37

Steroids first THEN antibiotics

Front 38

Bacterial Meningitis
<1 month age

Back 38

Group B strep
E Coli
Listeria
(Amp/ Gent or Amp/ 3rd G cepalosporine)

Front 39

>1 month (Bacterial meningitis)

Back 39

pnuemococcus/ meningococcus

3G ceph + Vanc

Front 40

VP shunt (Bacterial meningitis)

Back 40

Staph Epi

3G ceph + vanc

Front 41

Guillaine Barre Syndrome
+ bugs (2)

Back 41

Progressive ascending muscle weakness; Hallmark: loss of DTRs
- Campylocator/ Flu vaccine

Front 42

bilateral internuclear opthalmoplegia is pathognemonic for what disease?

Back 42

multiple sclerosis

Front 43

MS has what findings on LP

Back 43

high protein, high IgG, and oligoclonal bands

Front 44

Disease that have pure motor disease but normal sensation (7)

Back 44

1. Hypokalemic periodic paralysis
2. Myastenia gravis
3. Tick Paralysis
4. Lambert- Eaton Syndrome
5. Botulism
6. ALS
7. Polio

Front 45

Hallmark for Myastinia gravs?

Back 45

Auto-immune antibiody against the ACH receptor
Muscle weakness and fatiguability
Diplopia
Ptosis

Front 46

Anterior Cerebral Artery Stroke

Back 46

Contralateral paresis
legs> Arms and Face
Sensory deficit in same distribution
Gait disturbance

Front 47

Middle Cerebral Artery

Back 47

Contralateral paralysis
Arms and face> Legs
Sensory (same distribution)
Aphasia (if dominant hemisphere) or hemineglect
Homonymous hemianopsia

Front 48

Posterior Cerebral Artery

Back 48

Occipital cortex
Homonymous hemianopsia (contralateral)
Visual Agnosia (can't recognize objects)
Cortical blindness (post CPR)

Front 49

Vertebral Basilar

Back 49

(Brainstem, cerebellum, visual cortex)
Vertigo, nystagmus,
Visual field deficits, diplopia,
Dysarthria, dysphagia
Quadriplegia
Coma and Syncope

Front 50

Wallenberg Syndrome

Back 50

Vertebral Artery stenosis
* Ataxia, Vertigo, Nystagmus, N/V
* Decreased pain/temperature sensation (ipsilateral face/ contralateral body)
* Ipsilateral Horner's (ptosis, miosis, anhydrosis)

Front 51

Locked in Syndrome

Back 51

Basilar Artery Occlusion (pons)
* Patient awake and lucid
* No motor activity except diaphragmatic breathing
* Verticle eye movement spared

Front 52

Cerebellar Infarct

Back 52

Sudden inability to stand or walk
* Headache, dizziness nystagmusm ataxia, N/V

Front 53

Neuro Deficits:
Cerebral/ Cortex

Back 53

Contralateral motor and sensory
Contralateral CN palsy

Front 54

Neuro Deficits:
Brainstem

Back 54

Ipsilateral facial weakness
Contralateral extremity weakness

Front 55

Neuro Deficits:
Pontine

Back 55

Coma, miosis, gaze paresis
Altered respiratory

Front 56

Neuro Deficits:
Cerebellar

Back 56

Nystagmus, N/V
Dizziness/ Ataxia