Neuro Exam 3

Front 1

Sharp burning groin pain

Back 1

Ilioinguinal n

Front 2

Weakness in abduction, rotation of hip

Back 2

Gluteal n

Front 3

Lateral thigh pain with weakness; pt with heavy, tight belt

Back 3

Lateral femoral cutaneous n

Front 4

Quad and psoas weakness; abnormal sensory at anterior thigh and medial calf

Back 4

Femoral n

Front 5

Cardiopathy, peripheral nerve weakness/sensory, anemia, encephalopathy; hemorrhage and necrosis at 3rd ventricle

Back 5

Thiamine deficiency (B1)

Front 6

Hx chemotherapy exposure, loss of 2pv, hearing loss, NO analgesia

Back 6

Cisplatin neuropathy

Front 7

Ataxia, motor spasticity, ± seizures

Back 7

Cerebral palsy

Front 8

Adolescent w h/a, neck pain, incr urinary frequency, progressive ataxia & LE spasticity

Back 8

Chiari type 1

Front 9

Infant w resp distress, stridor, apnea, facial weakness, ± myelomeningocele, SHORT occiput

Back 9

Chiari type 2

Front 10

Incr ICP, ataxia, progr head enlargement, LARGE occiput

Back 10

Dandy-Walker syndrome

Front 11

Kids, h/a, fever, focal neuro s/s, can have incr ICP w lesion expansion

Back 11

Brain abscess

Front 12

Café au-lait spots, dermal lesions, glioma on optic n, pigmented nodules on iris (PERIPHERAL)

Back 12

Neurofibromatosis type 1 - chr 17 neurofibromin (on RAS tumor-supr pathway)

Front 13

B/L CN 8 schwannomas, multiple menigniomas, ependymomas, nodular schwann cell growths (CENTRAL)

Back 13

Neurofibromatosis type 2 - chr 22 merlin (cytoskeleton)

Front 14

Unable to raise arm overhead, scapular winging

Back 14

Long thoracic n (serratus anterior m)

Front 15

Scapular winging during arm abduction, C5-6 pain distribution

Back 15

Dorsal scapular n (rhomboids & levator scap)

Front 16

Weak initiation of arm abduction and external rotation

Back 16

Suprascapular n ( supraspinatus & infraspinatus)

Front 17

Diff deviation to pinky side, sensory deficit at 4th and 5th digits

Back 17

Ulnar n

Front 18

Weak forearm flexion

Back 18

Musculocutaneous n

Front 19

Inability to pronate forearm, diff deviation to thumb side, sensory loss at palm, can't hold thumb-forefinger circle

Back 19

Median n

Front 20

Weakness during middle of arm abduction, sensory loss at outer shoulder

Back 20

Axiallary n (teres major & deltoid)

Front 21

Rapid progression memory loss, behavioral change; myoclonus, ataxia, akinetic mutism

Back 21

Prion disease

Front 22

Hyperreflexia, EARLY incontinence, upper and lower motor neuron signs, B/L sensory and motor deficits, saddle anesthesia

Back 22

Conus medullaris syndrome

Front 23

Hearing loss; Mm of mastication/facial sensory loss

Back 23

Schwannoma (Benign, adheres to nerve, non-penetrative)

Front 24

Kids, sweating, HTN b/c present at adrenal glands; opsomyoclonus (dancing feet/eyes)

Back 24

Neuroblastomas

Front 25

Infant w abn head enlargment; child w incr DTR, spasticity, clonus; older kid w irritability, lethargy, poor appetite, vomiting, h/a

Back 25

Hydrocephalus

Front 26

Clouding of lens with slowly progressive image blur and increased near vision, NORMAL pupil response

Back 26

Cataracts

Front 27

Buildup of drusden in Bruch's membrane; slowly progressive vision loss

Back 27

Macular degeneration

Front 28

Changes in optic cup and changes in intraocular pressure leading to loss of vision

Back 28

Glaucoma

Front 29

Increased vascularity of retina disrupts ability of light to penetrate retina; progressive loss of vision

Back 29

Diabetic retinopathy

Front 30

Rare infection between dura and bone

Back 30

Epidural abscess

Front 31

Truncal ataxia w atrophy of cerebellar vermis

Back 31

Ethanol toxicity

Front 32

Change in consciousness, confusion, incr psychomotor activity; progresses to coma, abn reflexes, seizures

Back 32

Hepatic encephalopathy (assoc w incr ammonia)

Front 33

Recurring U/L face, head, neck, jaw pain, lasting 4-72h, photophobia, nausea, ± aura

Back 33

Migraine h/a (due to small afferent fibers of CN 5)

Front 34

Nystagmus, lateral gaze or rectus palsy, gait ataxia, confusion, learning/memory deficit, confabulation

Back 34

Wernicke-Korsakoff syndrome

Front 35

20-30's, EPISODIC sensory loss, optic neuritis, weakness, paresthesias; demyelination

Back 35

Multiple sclerosis (plaques on imaging w/in white matter at angle of lat ventricles)

Front 36

Afebrile, h/a, neck stiffness, incr ICP, incr lymphocytes and protein, normal glucose in CSF, mass effect on surrounding structure

Back 36

Subdural empyema

Front 37

Adults w h/a, no n/v, no photophobia, pain lasts 30m - 7d

Back 37

Tension h/a

Front 38

Rapid onset periobital h/a, U/L pain, I/L lacrimation, congestion, partial Horner's

Back 38

Cluster h/a

Front 39

Facial nevus on U/L V1 dist'n, I/L glaucoma, seizures, some MR

Back 39

Sturge-Weber syndrome

Front 40

Infants w rapid onset fever to >39, gen tonic-clonic seizure for seconds-minutes

Back 40

Febrile seizures

Front 41

Trauma w rapid velocity changes; chg in consciousness, h/a, hemiparesis, aphasia, HTN, U/L pupil dilation & motor palsy

Back 41

Subdural hematoma (crescent shape, don't cross midline, can cross suture lines)

Front 42

Hx falls, MVC, violence; h/a, syncope, n/v, diff concentrating, blurred vision

Back 42

Traumatic brain injury

Front 43

Hx previous viral illness, fever, malaise; s/s spinal cord transection

Back 43

Myelitis

Front 44

Saddle anesthesia, motor/sensory loss LE, sciatica, LATE incontinence, areflexia, lower motor neuron signs

Back 44

Cauda equina syndrome

Front 45

Discomfort at trapezius ridge, supraclavicular & infraclavicular fossa, pain/numb at C8-T1 dist'n

Back 45

Thoracic outlet syndrome

Front 46

Hepatitis/cirrhosis, dystonia, ataxia, tremor, autonomic dysfxn, memory loss, migraines, seizures, behav disturbance

Back 46

Wilson's disease

Front 47

Kids, tumor in cerebellum, ataxia, incr ICP, visual deficit, CN deficit

Back 47

Pilocytic astrocytoma

Front 48

Tumor of 4th ventricle; < 3yo, vomiting, ataxia, h/a, lethargy, incr head circumf; older kids, ataxia, nystagmus, gaze palsy, hemiparesis

Back 48

Ependymoma

Front 49

Acute onset back pain w radiation to legs, LE weakness, incontinence, analgesia

Back 49

Anterior spinal syndrome

Front 50

Mass in abdomen near adrenals with calcification, elevated homovanillic acid and vanillylmandelic acid in urine

Back 50

Neuroblastomas

Front 51

Insidious slow loss of visual fields, painless, often increased intraocular pressure

Back 51

Open angle glaucoma

Front 52

Acute, painful red eye with progressive loss of visual fields from periphery to fovea

Back 52

Closed angle glaucoma

Front 53

Diffuse bruising of eye

Back 53

Subconjunctival hemorrhage

Front 54

Highly visible veins/arteries in sclera

Back 54

Conjunctival hyperemia

Front 55

Redness extending from around iris

Back 55

Ciliary flush

Front 56

White opacities of cornea caused by scar tissue

Back 56

Corneal leukomata

Front 57

Procedure allows detection of irregularities in corneal epithelium

Back 57

Flourescein staining

Front 58

Layered pus in anterior chamber of eye

Back 58

Hypopeon

Front 59

Layered blood in anterior chamber of eye

Back 59

Hyphema

Front 60

Most common source of decreased vision in US

Back 60

Cataracts

Front 61

Monocular diplopia

Back 61

Cataracts

Front 62

p53 mutations

Back 62

Glioblastoma, Fibrillary astrocytoma

Front 63

Glial tumors w/in CNS, contrast-enhancing on imaging due to leaky vessels

Back 63

Glioblastoma

Front 64

Late childhood, diff running, ankle sprains, foot slap, high arches, hammer toes

Back 64

Charcot-Marie-Tooth

Front 65

Infant, hypotonia, atrophy, decr DTR, bulbar signs

Back 65

SMA type 1 (auto recess w degen alpha motor neurons)

Front 66

6-12 m/o, can't walk, weakness, NO bulbar involvement, ± scoliosis

Back 66

SMA type 2 (auto recess w degen alpha motor neurons)

Front 67

>12 m/o, do walk, proximal weakness, slow progression

Back 67

SMA type 3 (auto recess w degen alpha motor neurons)

Front 68

Previous injury, paresis, burning pain, altered skin temp/color, edema

Back 68

Complex regional pain syndrome

Front 69

Elderly, sudden severe U/L episodic pain at lips, gums, cheek, chin

Back 69

Trigemina neuralgia (CN 5 root compression by SCA)

Front 70

Fatigue, flu-like s/s, h/a, n/v, aseptic meningitis, hx of outdoor exposure

Back 70

Lyme disease

Front 71

Oligoarticular arthritis or synovitis, neuritis incl facial palsy

Back 71

Lyme disease

Front 72

Sharp burning groin pain

Back 72

Ilioinguinal n

Front 73

Dermatomal itch, burning, pain, vesicular eruption

Back 73

Varicella Zoster - Shingles

Front 74

Rapidly progressing weakness from legs up, arthralgia, back pain, hyporeflexia

Back 74

Guillan-Barre syndrome (axon demyelination, self-limited)

Front 75

Kids 3-5 y/o, delayed motor devel w loss of strength, Gower's sign, limited ROM, calf pseudohypertrophy

Back 75

Duchenne's MD (X-linked, dystrophin - connects contractile elements to ECM)

Front 76

Weakness in abduction, rotation of hip

Back 76

Gluteal n

Front 77

Subacute or chronically evolving mononeuropathy multiplex, or symmetric polyneuropathy

Back 77

Vasculitic neuropathy

Front 78

Lateral thigh pain with weakness; pt with heavy, tight belt

Back 78

Lateral femoral cutaneous n

Front 79

Kids 5-15 y/o, SLOW progression of weakness, proximal LE weakness, calf pseudohypertrophy

Back 79

Becker's MD (X-linked, dystrophin - connects contractile elements to ECM)

Front 80

Quad and psoas weakness; abnormal sensory at anterior thigh and medial calf

Back 80

Femoral n

Front 81

Increased mitochondrial iron levels, defect on chromosome 9

Back 81

Freidrich's ataxia (frataxin, auto rec GAA repeats)

Front 82

Early closure of sagittal suture

Back 82

Schizencephaly

Front 83

Cardiopathy, peripheral nerve weakness/sensory, anemia, encephalopathy; hemorrhage and necrosis at 3rd ventricle

Back 83

Thiamine deficiency (B1)

Front 84

Early closure of metopic suture

Back 84

Trigonocephaly

Front 85

Hx chemotherapy exposure, loss of 2pv, hearing loss, NO analgesia

Back 85

Cisplatin neuropathy

Front 86

Early closure of coronal suture

Back 86

Frontal plagiocephaly

Front 87

Ataxia, motor spasticity, ± seizures

Back 87

Cerebral palsy

Front 88

Adolescent w h/a, neck pain, incr urinary frequency, progressive ataxia & LE spasticity

Back 88

Chiari type 1

Front 89

Early closure of lambdoid suture

Back 89

Occipital plagiocephaly

Front 90

Infant w resp distress, stridor, apnea, facial weakness, ± myelomeningocele, SHORT occiput

Back 90

Chiari type 2

Front 91

Deformity of head based on positioning/resting/weight bearing

Back 91

Positional plagiocephaly

Front 92

Proximal LE weakness, ptosis, diplopia, ABSENT DTRs, dry mouth

Back 92

Eaton-Lambert syndrome (Ca channel defect at presynaptic neuron)

Front 93

Incr ICP, ataxia, progr head enlargement, LARGE occiput

Back 93

Dandy-Walker syndrome

Front 94

Fatigueable weakness starting at face, ocular, cranial muscles, B/L or U/L, NORMAL DTRs, NORMAL sensory function

Back 94

Myasthenia Gravis (Ach receptor shortage due to antibody attack)

Front 95

Kids, h/a, fever, focal neuro s/s, can have incr ICP w lesion expansion

Back 95

Brain abscess

Front 96

Adolescent/adult onset of exercrise intolerance, especially brief exercise of high intensity; rhabdomyolysis and dark urine

Back 96

McArdle's disease (defect in glycogen storage in muscle)

Front 97

Café au-lait spots, dermal lesions, glioma on optic n, pigmented nodules on iris (PERIPHERAL)

Back 97

Neurofibromatosis type 1 - chr 17 neurofibromin (on RAS tumor-supr pathway)

Front 98

B/L CN 8 schwannomas, multiple menigniomas, ependymomas, nodular schwann cell growths (CENTRAL)

Back 98

Neurofibromatosis type 2 - chr 22 merlin (cytoskeleton)

Front 99

Late childhood gait abnormalities, sustained muscle contractions, weakness hands then face, elongated face w open mouth

Back 99

Myotonic dystrophy (DMPK for cell communication, auto dominant CTG repeat at chr 19)

Front 100

Unable to raise arm overhead, scapular winging

Back 100

Long thoracic n (serratus anterior m)

Front 101

Hx trauma w brief LOC and "lucid interval", increasing h/a, n/v, drowsiness, focal signs progressing to B/L and posturing

Back 101

Epidural hematoma (lens shape on CT, rapidly expand, injury to meningeal a, can cross midline, not cross suture lines)

Front 102

Scapular winging during arm abduction, C5-6 pain distribution

Back 102

Dorsal scapular n (rhomboids & levator scap)

Front 103

Progressive ataxia, numb/tingling LE, weak/spastic/incr DTR, diffuse and symmetric, dementia, pernicious anemia

Back 103

Subacute combined degeneration (B12 deficiency, degen of lat and posterior spinal cord)

Front 104

Increased pain and suffering out of proportion to injury, refractory to treatment

Back 104

Chronic pain

Front 105

Weak initiation of arm abduction and external rotation

Back 105

Suprascapular n ( supraspinatus & infraspinatus)

Front 106

Diff deviation to pinky side, sensory deficit at 4th and 5th digits

Back 106

Ulnar n

Front 107

U/L cramping hand muscles progress to B/L, can have upper and lower motor neuron signs with bulbar involvement; NO sensory defects

Back 107

Amyotrophic Lateral Sclerosis (death of motor neurons at ventral horn, brainstem nuclei, bulbospinal and corticospinal tracts)

Front 108

Weak forearm flexion

Back 108

Musculocutaneous n

Front 109

Confusion, seizures, fever and U/L edema on a scan

Back 109

Herpes HSV-1

Front 110

Inability to pronate forearm, diff deviation to thumb side, sensory loss at palm, can't hold thumb-forefinger circle

Back 110

Median n

Front 111

Kids, h/a, bitemporal hemianopsia, diabetes insipidus, incr ICP, growth retardation

Back 111

Craniopharyngioma (usually at sella turcica)

Front 112

Weakness during middle of arm abduction, sensory loss at outer shoulder

Back 112

Axiallary n (teres major & deltoid)

Front 113

I/L motor loss, proprioceptive and vibratory loss, C/L pain and temp loss

Back 113

Brown-Sequard syndrome (hemisection of spinal cord)

Front 114

Rapid progression memory loss, behavioral change; myoclonus, ataxia, akinetic mutism

Back 114

Prion disease

Front 115

Very rare tumor, presents before 30 y/o w focal neuro s/s (3rd ventricle, hypothal, temporal lobe)

Back 115

Ganglion cell tumor

Front 116

Hyperreflexia, EARLY incontinence, upper and lower motor neuron signs, B/L sensory and motor deficits, saddle anesthesia

Back 116

Conus medullaris syndrome

Front 117

Older adult, cognitive/behavioral problems, speech and motor problems; NO initial memory problems

Back 117

Fronto-temporal dementia ( atrophy of frontal/temporal lobes on CT/MRI, buildup of tau protein deposits)

Front 118

Hearing loss; Mm of mastication/facial sensory loss

Back 118

Schwannoma (Benign, adheres to nerve, non-penetrative)

Front 119

Flaccid paralysis x4, hx of alcoholism, inability to chew/swallow/speak, long term spasticity

Back 119

Central pontine myelinolysis (rapid increase in Na)

Front 120

Kids, sweating, HTN b/c present at adrenal glands; opsomyoclonus (dancing feet/eyes)

Back 120

Neuroblastomas

Front 121

Adults, slow onset of uncontrolled jerky movement, behavior/cognitive disturbance

Back 121

Huntington's disease (auto dom, CAG repeats on chr 4, degen caudate nucleus)

Front 122

Infant w abn head enlargment; child w incr DTR, spasticity, clonus; older kid w irritability, lethargy, poor appetite, vomiting, h/a

Back 122

Hydrocephalus

Front 123

Weak shoulder girdle, upper arm, incomplete sensory loss on dermatomes, waiter's tray position

Back 123

Cervical plexopathy, Erb's palsy (C5-C7)

Front 124

Distal arm weak/atrophy, sensory deficit at forearm and hand, flexor posturing

Back 124

Cervical plexopathy, Klumpke's palsy (C8-T1)

Front 125

Clouding of lens with slowly progressive image blur and increased near vision, NORMAL pupil response

Back 125

Cataracts

Front 126

Common site of cervical radiculopathy due to disk herniation

Back 126

C5/6 then C6/7

Front 127

Buildup of drusden in Bruch's membrane; slowly progressive vision loss

Back 127

Macular degeneration

Front 128

Common site of lumbar radiculopathy due to disk herniation

Back 128

L5/S1 then L4/L5

Front 129

Changes in optic cup and changes in intraocular pressure leading to loss of vision

Back 129

Glaucoma

Front 130

Progressive limb ataxia, impaired gait/equilibrium, IMPAIRED sensory fxn, dysarthria, nystagmus, head/neck tremor

Back 130

Spinocerebellar ataxia

Front 131

Increased vascularity of retina disrupts ability of light to penetrate retina; progressive loss of vision

Back 131

Diabetic retinopathy

Front 132

± head trauma, rapid change in mental status, h/a, star sign on CT, s/s of meningeal irritation

Back 132

Subarachnoid hemorrhage (berry aneurysm, use CT to find)

Front 133

Rare infection between dura and bone

Back 133

Epidural abscess

Front 134

Truncal ataxia w atrophy of cerebellar vermis

Back 134

Ethanol toxicity

Front 135

Acute focal neuro s/s, h/a, nausea, rapid progression, midline shift on imaging

Back 135

Intraparenchymal hemorrhage (assoc w HTN, cocaine use, Charcot-Bouchard aneurysms)

Front 136

Papilledema, h/a, n/v

Back 136

Hydrocephalus (obstructive, non-obstructive, ex vacuo)

Front 137

Change in consciousness, confusion, incr psychomotor activity; progresses to coma, abn reflexes, seizures

Back 137

Hepatic encephalopathy (assoc w incr ammonia)

Front 138

Aching/creepy feeling in calves/thighs relieved by movement

Back 138

Restless leg syndrome

Front 139

Recurring U/L face, head, neck, jaw pain, lasting 4-72h, photophobia, nausea, ± aura

Back 139

Migraine h/a (due to small afferent fibers of CN 5)

Front 140

Adults 40-50's, seizures, h/a, incr ICP, can see calcification at fronto-temporal region

Back 140

Oligodendroma (highly infiltrative, better prognosis than astrocytomas)

Front 141

Nystagmus, lateral gaze or rectus palsy, gait ataxia, confusion, learning/memory deficit, confabulation

Back 141

Wernicke-Korsakoff syndrome

Front 142

Hypomelanotic macules, sebaceous adenomas, shagreen patches at lumbar, retinal mulberry tumor, hamartomas, seizures, MR

Back 142

Tuberous sclerosis (hamartin at chr 9, tuberin at chr 16 - both involved in Golgi app)

Front 143

20-30's, EPISODIC sensory loss, optic neuritis, weakness, paresthesias; demyelination

Back 143

Multiple sclerosis (plaques on imaging w/in white matter at angle of lat ventricles)

Front 144

Visual hallucinations, parkinson-like tremor, fluctuating alertness, freq falls

Back 144

Lewy Body dementia (neurofilaments surrounded by ubiquitin and a-synuclein, seen in cortex, amygdala, SN)

Front 145

Afebrile, h/a, neck stiffness, incr ICP, incr lymphocytes and protein, normal glucose in CSF, mass effect on surrounding structure

Back 145

Subdural empyema

Front 146

Adults w h/a, no n/v, no photophobia, pain lasts 30m - 7d

Back 146

Tension h/a

Front 147

Dementia, gait disturbance, pseudobulbar signs (dysphagia, diff chewing, dysarthria)

Back 147

Vascular dementia

Front 148

Rapid onset periobital h/a, U/L pain, I/L lacrimation, congestion, partial Horner's

Back 148

Cluster h/a

Front 149

Brief, repetitive purposeless actions

Back 149

Tourette's syndrome (overactive dopa pthwys, D2 to corpus striatum)

Front 150

Head/neck/back pain, cape analgesia, flaccidity at level, spasticity below level, ± incontience

Back 150

Syringomyelia (dx w MRI)

Front 151

Facial nevus on U/L V1 dist'n, I/L glaucoma, seizures, some MR

Back 151

Sturge-Weber syndrome

Front 152

Infants w rapid onset fever to >39, gen tonic-clonic seizure for seconds-minutes

Back 152

Febrile seizures

Front 153

Diff walking, B/L sensory and cerebellar ataxia, early loss of 2pv, later loss pain/temp

Back 153

Freidrich's ataxia (frataxin, auto rec GAA repeats on chr 9)

Front 154

Trauma w rapid velocity changes; chg in consciousness, h/a, hemiparesis, aphasia, HTN, U/L pupil dilation & motor palsy

Back 154

Subdural hematoma (crescent shape, don't cross midline, can cross suture lines)

Front 155

Child/adolescent w fever, h/a, nuchal rigidity, photophobia, irritability

Back 155

Meningitis (N. meningitidis, Strep pneumoniae)

Front 156

LP with purulent fluid, increased ICP, + cultures, incr PMNs, incr protein, decr glucose

Back 156

Bacterial meningitis

Front 157

Hx falls, MVC, violence; h/a, syncope, n/v, diff concentrating, blurred vision

Back 157

Traumatic brain injury

Front 158

LP with nl pressure, nl glucose, incr lymphocytes, mod incr protein

Back 158

Viral meningitis (most enteroviruses)

Front 159

Hx previous viral illness, fever, malaise; s/s spinal cord transection

Back 159

Myelitis

Front 160

Saddle anesthesia, motor/sensory loss LE, sciatica, LATE incontinence, areflexia, lower motor neuron signs

Back 160

Cauda equina syndrome

Front 161

Child-young adult w h/a, n/v, trunk ataxia/spasticity, papilledema, nystagmus

Back 161

Medulloblastoma (v. malignant, cerebellum, lg enhancing mass blocking 4th ventricle on imaging)

Front 162

Discomfort at trapezius ridge, supraclavicular & infraclavicular fossa, pain/numb at C8-T1 dist'n

Back 162

Thoracic outlet syndrome

Front 163

Fever, h/a, photophobia, nuchal rigidity, confusion, behavior chg, altered consciousness, seizures

Back 163

Encephalitis/menigoencephalitis

Front 164

50-60's, more females, extracerebral, focal neuro deficits at brain, seizures, hemiparesis, gait disturbances

Back 164

Meningioma (usually arachnoid,BENIGN, mass effects, incidental imaging finding, whorling w psammoma bodies)

Front 165

Hepatitis/cirrhosis, dystonia, ataxia, tremor, autonomic dysfxn, memory loss, migraines, seizures, behav disturbance

Back 165

Wilson's disease

Front 166

70-90's, slow decline in memory and orientation, cortical atrophy on imaging

Back 166

Alzheimer's disease (a-beta-amyloid plaques, neurofib tangles w tau protein, familial type on chr 21)

Front 167

Kids, tumor in cerebellum, ataxia, incr ICP, visual deficit, CN deficit

Back 167

Pilocytic astrocytoma

Front 168

Tumor of 4th ventricle; < 3yo, vomiting, ataxia, h/a, lethargy, incr head circumf; older kids, ataxia, nystagmus, gaze palsy, hemiparesis

Back 168

Ependymoma

Front 169

4-6hz tremor, cog-wheel rigidity, bradykinesia, loss of facial expression

Back 169

Parkinson's disease (degen of SN, nigrostriatal fibers of basal ganglia, atrophy of frontal lobes, can have lewy bodies)

Front 170

Acute onset back pain w radiation to legs, LE weakness, incontinence, analgesia

Back 170

Anterior spinal syndrome

Front 171

Hx DM, numb/tingling/pain at night in toes and calves, progresses to fingers/hands, B/L symmetric; non-healing ulceration

Back 171

Diabetic neuropathy (chronic axonal degeneration)

Front 172

Focal neuro s/s of white matter tracts (IC, CC, ML, cerebellum), multiple hypodense non-enhancing lesions

Back 172

Progressive multifocal leukoencephalopathy (pt immunocomp, JC virus infection)

Front 173

Mass in abdomen near adrenals with calcification, elevated homovanillic acid and vanillylmandelic acid in urine

Back 173

Neuroblastomas

Front 174

Focal or diffuse neuro s/s, multiple ring enhancing lesions w protozoan abscesses

Back 174

Toxoplasmosis (pt immunocomp)

Front 175

Insidious slow loss of visual fields, painless, often increased intraocular pressure

Back 175

Open angle glaucoma

Front 176

Ring enhancing lesions on imaging, needle biopsy shows B cells

Back 176

Primary brain lymphoma (pt immunocomp, tumors often w EBV)

Front 177

Acute, painful red eye with progressive loss of visual fields from periphery to fovea

Back 177

Closed angle glaucoma

Front 178

Impaired attention, global confusional state, waxing and waning

Back 178

Encephalopathy (aka delirium)

Front 179

Diffuse bruising of eye

Back 179

Subconjunctival hemorrhage

Front 180

Highly visible veins/arteries in sclera

Back 180

Conjunctival hyperemia

Front 181

Deterioration of intellectual function with no disturbance of consciousness or perception

Back 181

Dementia (general definition)

Front 182

Redness extending from around iris

Back 182

Ciliary flush

Front 183

Young adult 20-30's, seizures, h/a, focal neuro s/s; vague hypodensity obscuring gray-white jct on CT

Back 183

Fibrillary astrocytoma

Front 184

White opacities of cornea caused by scar tissue

Back 184

Corneal leukomata

Front 185

Progression of fibrillary astrocytoma w edema, incr ICP and more severe deficits

Back 185

Anaplastic astrocytoma

Front 186

Hormone disturbances in adults

Back 186

Pituitary adenoma

Front 187

Procedure allows detection of irregularities in corneal epithelium

Back 187

Flourescein staining

Front 188

Sharp burning groin pain

Back 188

Ilioinguinal n

Front 189

Patchy sensory neuropathy w loss of touch sensation, skin ulcers, secondary infection

Back 189

Leprosy (M. Leprae invades superficial nerves)

Front 190

Weakness in abduction, rotation of hip

Back 190

Gluteal n

Front 191

Layered pus in anterior chamber of eye

Back 191

Hypopeon

Front 192

SOD-1, on chr 21

Back 192

Amyotrophic Lateral Sclerosis (death of motor neurons at ventral horn, brainstem nuclei, bulbospinal and corticospinal tracts)

Front 193

Layered blood in anterior chamber of eye

Back 193

Hyphema

Front 194

Lateral thigh pain with weakness; pt with heavy, tight belt

Back 194

Lateral femoral cutaneous n

Front 195

Merlin, on chr 22

Back 195

Schwannoma

Front 196

Most common source of decreased vision in US

Back 196

Cataracts

Front 197

Quad and psoas weakness; abnormal sensory at anterior thigh and medial calf

Back 197

Femoral n

Front 198

Monocular diplopia

Back 198

Cataracts

Front 199

Chr 20, PRP -> PRPSC , alpha chains to beta sheets which are undigestible

Back 199

Prion disease

Front 200

Chr 13, ATP7B

Back 200

Wilson's disease

Front 201

p53 mutations

Back 201

Glioblastoma, Fibrillary astrocytoma

Front 202

Cardiopathy, peripheral nerve weakness/sensory, anemia, encephalopathy; hemorrhage and necrosis at 3rd ventricle

Back 202

Thiamine deficiency (B1)

Front 203

Hx chemotherapy exposure, loss of 2pv, hearing loss, NO analgesia

Back 203

Cisplatin neuropathy

Front 204

CTG repeats

Back 204

Myotonic dystrophy

Front 205

Glial tumors w/in CNS, contrast-enhancing on imaging due to leaky vessels

Back 205

Glioblastoma

Front 206

Ataxia, motor spasticity, ± seizures

Back 206

Cerebral palsy

Front 207

Late childhood, diff running, ankle sprains, foot slap, high arches, hammer toes

Back 207

Charcot-Marie-Tooth

Front 208

Ragged red fibers in mitochondria, weakness/poor endurance, tachycardia

Back 208

Mitochondrial myopathy

Front 209

Adolescent w h/a, neck pain, incr urinary frequency, progressive ataxia & LE spasticity

Back 209

Chiari type 1

Front 210

ETOH use, infection or warfarin in first trimester can lead to

Back 210

Dandy-Walker syndrome

Front 211

Infant, hypotonia, atrophy, decr DTR, bulbar signs

Back 211

SMA type 1 (auto recess w degen alpha motor neurons)

Front 212

Infant w resp distress, stridor, apnea, facial weakness, ± myelomeningocele, SHORT occiput

Back 212

Chiari type 2

Front 213

Hamartin on Chr 9, Tuberin on Chr 16

Back 213

Tuberous sclerosis

Front 214

6-12 m/o, can't walk, weakness, NO bulbar involvement, ± scoliosis

Back 214

SMA type 2 (auto recess w degen alpha motor neurons)

Front 215

Incr ICP, ataxia, progr head enlargement, LARGE occiput

Back 215

Dandy-Walker syndrome

Front 216

>12 m/o, do walk, proximal weakness, slow progression

Back 216

SMA type 3 (auto recess w degen alpha motor neurons)

Front 217

17q and 1p

Back 217

Charcot-Marie-Tooth

Front 218

Previous injury, paresis, burning pain, altered skin temp/color, edema

Back 218

Complex regional pain syndrome

Front 219

Kids, h/a, fever, focal neuro s/s, can have incr ICP w lesion expansion

Back 219

Brain abscess

Front 220

Chr 4

Back 220

Huntington's disease

Front 221

CAG repeats

Back 221

Huntington's disease

Front 222

Elderly, sudden severe U/L episodic pain at lips, gums, cheek, chin

Back 222

Trigemina neuralgia (CN 5 root compression by SCA)

Front 223

Café au-lait spots, dermal lesions, glioma on optic n, pigmented nodules on iris (PERIPHERAL)

Back 223

Neurofibromatosis type 1 - chr 17 neurofibromin (on RAS tumor-supr pathway)

Front 224

GAA repeats

Back 224

Friedrich's ataxia

Front 225

B/L CN 8 schwannomas, multiple menigniomas, ependymomas, nodular schwann cell growths (CENTRAL)

Back 225

Neurofibromatosis type 2 - chr 22 merlin (cytoskeleton)

Front 226

Fatigue, flu-like s/s, h/a, n/v, aseptic meningitis, hx of outdoor exposure

Back 226

Lyme disease

Front 227

Oligoarticular arthritis or synovitis, neuritis incl facial palsy

Back 227

Lyme disease

Front 228

Unable to raise arm overhead, scapular winging

Back 228

Long thoracic n (serratus anterior m)

Front 229

Most common form of progressive motor neuron disease

Back 229

Amyotrophic Lateral Sclerosis

Front 230

Dermatomal itch, burning, pain, vesicular eruption

Back 230

Varicella Zoster - Shingles

Front 231

Most common inherited peripheral neuropathy

Back 231

Charcot-Marie-Tooth

Front 232

Scapular winging during arm abduction, C5-6 pain distribution

Back 232

Dorsal scapular n (rhomboids & levator scap)

Front 233

Rapidly progressing weakness from legs up, arthralgia, back pain, hyporeflexia

Back 233

Guillan-Barre syndrome (axon demyelination, self-limited)

Front 234

Most common cause of acute generalized weakness

Back 234

Guillan-Barre syndrome

Front 235

Weak initiation of arm abduction and external rotation

Back 235

Suprascapular n ( supraspinatus & infraspinatus)

Front 236

Most common adult muscular dystrophy

Back 236

Myotonic muscular dystrophy

Front 237

Kids 3-5 y/o, delayed motor devel w loss of strength, Gower's sign, limited ROM, calf pseudohypertrophy

Back 237

Duchenne's MD (X-linked, dystrophin - connects contractile elements to ECM)

Front 238

Diff deviation to pinky side, sensory deficit at 4th and 5th digits

Back 238

Ulnar n

Front 239

Most common childhood-onset muscular dystrophy

Back 239

Duchenne's MD

Front 240

Subacute or chronically evolving mononeuropathy multiplex, or symmetric polyneuropathy

Back 240

Vasculitic neuropathy

Front 241

Weak forearm flexion

Back 241

Musculocutaneous n

Front 242

Most common presentation of meningiomas

Back 242

Seizures

Front 243

Inability to pronate forearm, diff deviation to thumb side, sensory loss at palm, can't hold thumb-forefinger circle

Back 243

Median n

Front 244

Kids 5-15 y/o, SLOW progression of weakness, proximal LE weakness, calf pseudohypertrophy

Back 244

Becker's MD (X-linked, dystrophin - connects contractile elements to ECM)

Front 245

Most common chronic motor disability in children

Back 245

Cerebral palsy

Front 246

Weakness during middle of arm abduction, sensory loss at outer shoulder

Back 246

Axiallary n (teres major & deltoid)

Front 247

Increased mitochondrial iron levels, defect on chromosome 9

Back 247

Freidrich's ataxia (frataxin, auto rec GAA repeats)

Front 248

Most common sites which metastasize to brain

Back 248

Lung, Breast, Skin, Kidney

Front 249

Early closure of sagittal suture

Back 249

Schizencephaly

Front 250

Rapid progression memory loss, behavioral change; myoclonus, ataxia, akinetic mutism

Back 250

Prion disease

Front 251

Least likely sites to metastasize to brain

Back 251

Ovary, Testicles, Prostate, Pancreas

Front 252

Hyperreflexia, EARLY incontinence, upper and lower motor neuron signs, B/L sensory and motor deficits, saddle anesthesia

Back 252

Conus medullaris syndrome

Front 253

Early closure of metopic suture

Back 253

Trigonocephaly

Front 254

Most common neuro presentation in adults, especially women

Back 254

Multiple sclerosis

Front 255

Hearing loss; Mm of mastication/facial sensory loss

Back 255

Schwannoma (Benign, adheres to nerve, non-penetrative)

Front 256

Early closure of coronal suture

Back 256

Frontal plagiocephaly

Front 257

Most common familial neurodegenerative disease

Back 257

Parkinson's disease

Front 258

Kids, sweating, HTN b/c present at adrenal glands; opsomyoclonus (dancing feet/eyes)

Back 258

Neuroblastomas

Front 259

Early closure of lambdoid suture

Back 259

Occipital plagiocephaly

Front 260

Infant w abn head enlargment; child w incr DTR, spasticity, clonus; older kid w irritability, lethargy, poor appetite, vomiting, h/a

Back 260

Hydrocephalus

Front 261

Most common form of demential in Asia

Back 261

Vascular dementia

Front 262

Most common site of primary thrombosis

Back 262

Middle cerebral artery

Front 263

Deformity of head based on positioning/resting/weight bearing

Back 263

Positional plagiocephaly

Front 264

Clouding of lens with slowly progressive image blur and increased near vision, NORMAL pupil response

Back 264

Cataracts

Front 265

Most common seizure disorder of children

Back 265

Febrile seizures

Front 266

Buildup of drusden in Bruch's membrane; slowly progressive vision loss

Back 266

Macular degeneration

Front 267

Proximal LE weakness, ptosis, diplopia, ABSENT DTRs, dry mouth

Back 267

Eaton-Lambert syndrome (Ca channel defect at presynaptic neuron)

Front 268

Changes in optic cup and changes in intraocular pressure leading to loss of vision

Back 268

Glaucoma

Front 269

Most frequent brain tumor in infants

Back 269

Pilocytic astrocytoma

Front 270

Fatigueable weakness starting at face, ocular, cranial muscles, B/L or U/L, NORMAL DTRs, NORMAL sensory function

Back 270

Myasthenia Gravis (Ach receptor shortage due to antibody attack)

Front 271

Increased vascularity of retina disrupts ability of light to penetrate retina; progressive loss of vision

Back 271

Diabetic retinopathy

Front 272

Most common adult headache

Back 272

Tension h/a

Front 273

Adolescent/adult onset of exercrise intolerance, especially brief exercise of high intensity; rhabdomyolysis and dark urine

Back 273

McArdle's disease (defect in glycogen storage in muscle)

Front 274

Rare infection between dura and bone

Back 274

Epidural abscess

Front 275

Most common childhood headache

Back 275

Migraine h/a

Front 276

Late childhood gait abnormalities, sustained muscle contractions, weakness hands then face, elongated face w open mouth

Back 276

Myotonic dystrophy (DMPK for cell communication, auto dominant CTG repeat at chr 19)

Front 277

Truncal ataxia w atrophy of cerebellar vermis

Back 277

Ethanol toxicity

Front 278

Type of varicella zoster; affects pain and vesicles of external auditory canal, facial palsy, loss of taste

Back 278

Ramsey-Hunt syndrome

Front 279

Change in consciousness, confusion, incr psychomotor activity; progresses to coma, abn reflexes, seizures

Back 279

Hepatic encephalopathy (assoc w incr ammonia)

Front 280

Hx trauma w brief LOC and "lucid interval", increasing h/a, n/v, drowsiness, focal signs progressing to B/L and posturing

Back 280

Epidural hematoma (lens shape on CT, rapidly expand, injury to meningeal a, can cross midline, not cross suture lines)

Front 281

Translocation of 1p and 19q

Back 281

Oligodendroma

Front 282

Progressive ataxia, numb/tingling LE, weak/spastic/incr DTR, diffuse and symmetric, dementia, pernicious anemia

Back 282

Subacute combined degeneration (B12 deficiency, degen of lat and posterior spinal cord)

Front 283

Recurring U/L face, head, neck, jaw pain, lasting 4-72h, photophobia, nausea, ± aura

Back 283

Migraine h/a (due to small afferent fibers of CN 5)

Front 284

Increased pain and suffering out of proportion to injury, refractory to treatment

Back 284

Chronic pain

Front 285

Sympathetic ganglion tumors

Back 285

Neuroblastomas

Front 286

Nystagmus, lateral gaze or rectus palsy, gait ataxia, confusion, learning/memory deficit, confabulation

Back 286

Wernicke-Korsakoff syndrome

Front 287

U/L cramping hand muscles progress to B/L, can have upper and lower motor neuron signs with bulbar involvement; NO sensory defects

Back 287

Amyotrophic Lateral Sclerosis (death of motor neurons at ventral horn, brainstem nuclei, bulbospinal and corticospinal tracts)

Front 288

Lherette's sign - electric shock pain down spinal cord with neck flexion

Back 288

Cisplatin neuropathy

Front 289

20-30's, EPISODIC sensory loss, optic neuritis, weakness, paresthesias; demyelination

Back 289

Multiple sclerosis (plaques on imaging w/in white matter at angle of lat ventricles)

Front 290

Confusion, seizures, fever and U/L edema on a scan

Back 290

Herpes HSV-1

Front 291

Most commonly a sequela of sinusitis

Back 291

Subdural empyema

Front 292

Afebrile, h/a, neck stiffness, incr ICP, incr lymphocytes and protein, normal glucose in CSF, mass effect on surrounding structure

Back 292

Subdural empyema

Front 293

Most likely agent for brain abscess following brain surgery

Back 293

Staph aureus

Front 294

Adults w h/a, no n/v, no photophobia, pain lasts 30m - 7d

Back 294

Tension h/a

Front 295

Mature appearing neurons w/in tumor on biopsy

Back 295

Gliocytoma (ganglion cell tumor)

Front 296

Rapid onset periobital h/a, U/L pain, I/L lacrimation, congestion, partial Horner's

Back 296

Cluster h/a

Front 297

Buildup of myocilin causes increased intraocular pressure

Back 297

Open angle glaucoma

Front 298

Facial nevus on U/L V1 dist'n, I/L glaucoma, seizures, some MR

Back 298

Sturge-Weber syndrome

Front 299

Bupthalmos (diffuse enlargment of eye in infants/children) or megalocornea is associated with

Back 299

Glaucoma

Front 300

Infants w rapid onset fever to >39, gen tonic-clonic seizure for seconds-minutes

Back 300

Febrile seizures

Front 301

Pulsatile tinnitus

Back 301

Very rare, usually vascular origin

Front 302

Most common disease of vestibular system

Back 302

Vertigo

Front 303

Trauma w rapid velocity changes; chg in consciousness, h/a, hemiparesis, aphasia, HTN, U/L pupil dilation & motor palsy

Back 303

Subdural hematoma (crescent shape, don't cross midline, can cross suture lines)

Front 304

Hx falls, MVC, violence; h/a, syncope, n/v, diff concentrating, blurred vision

Back 304

Traumatic brain injury

Front 305

Meckle's cave contains ganglion for trigeminal nerve due to

Back 305

Meningioma

Front 306

Hx previous viral illness, fever, malaise; s/s spinal cord transection

Back 306

Myelitis

Front 307

Saddle anesthesia, motor/sensory loss LE, sciatica, LATE incontinence, areflexia, lower motor neuron signs

Back 307

Cauda equina syndrome

Front 308

Discomfort at trapezius ridge, supraclavicular & infraclavicular fossa, pain/numb at C8-T1 dist'n

Back 308

Thoracic outlet syndrome

Front 309

Hepatitis/cirrhosis, dystonia, ataxia, tremor, autonomic dysfxn, memory loss, migraines, seizures, behav disturbance

Back 309

Wilson's disease

Front 310

Kids, tumor in cerebellum, ataxia, incr ICP, visual deficit, CN deficit

Back 310

Pilocytic astrocytoma

Front 311

Tumor of 4th ventricle; < 3yo, vomiting, ataxia, h/a, lethargy, incr head circumf; older kids, ataxia, nystagmus, gaze palsy, hemiparesis

Back 311

Ependymoma

Front 312

Acute onset back pain w radiation to legs, LE weakness, incontinence, analgesia

Back 312

Anterior spinal syndrome

Front 313

Mass in abdomen near adrenals with calcification, elevated homovanillic acid and vanillylmandelic acid in urine

Back 313

Neuroblastomas