Term
| What is the major cause of morbidity and mortality in patients with subarachnoid hemorrhage? |
|
Definition
| - Vasospasm of the arteries at the base of the brain. Signs of ischemia usually appear in about 7 days. Calcium channel blockers like nimodipine are used to prevent vasospasm. |
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Term
| frequency of the Parkinson's tremor? |
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Definition
|
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Term
|
Definition
| - an anticholinergic medication sometimes used in the treatment of Parkinson's, generally in younger patients where tremor is the primary symptom. |
|
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Term
| Of all the risk factors, which has the strongest association with stroke? |
|
Definition
Hypertension
- HTN increases the risk of all types of stroke
- ppl with HTN are 4 times more likely to have a stroke |
|
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Term
| Characteristic features of NF1: |
|
Definition
- cafe-au-lait spots
- macrocephaly
- feeing problems
- short stature
- learning disablities.
- patients may later develop fibromas, neurofibromas, or different tumors. |
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Term
| 7 contraindications for triptans: |
|
Definition
1. familial hemiplegic migraine
2. uncontrolled hypertension
3. CAD
4. Prinzmetal angina
5. pregnancy
6. ischemic stroke
7. basilar migraine |
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Term
| Nerve affected in an anterior shoulder dislocation? |
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Definition
| axillary nerve in the quadrangular space. This will cause paralysis of the deltoid and teres minor muslces as well as los of sensation on the lateral upper arm. |
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Term
| What does + pronator drift mean? |
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Definition
| - Upper motor neuron lesion; the naturally stronger pronators is exaggerated in pts c upper motor neuron dysfunction. |
|
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Term
| wtf is progressive multifocal leukoencephalopathy? |
|
Definition
- an opportunistic infection seen in immunocompromised patients. It is caused by the JC virus, and mode of transmission is unkown.
- PML predominantly involves the cortical white matter, with brainstem and cerebellum seen too.
- The MC presenting symptoms are hemiparesis and disturbances in speech, vision, and gait. CNs too. |
|
|
Term
| wtf is multiple system atrophy? |
|
Definition
- the same as Shy Drager syndrome
- a degenerative process characterized by:
1. parkinsonism
2. autonomic disfunction
3. widespread neurological signs |
|
|
Term
| What is the treatment of choice for absence seizures? |
|
Definition
| ethosuximide or valproic acid |
|
|
Term
| What characterizes a complex partial seizure? |
|
Definition
- a brief episode of impaired consciousness, failure to respond to various stimuli during the episode, staring spells, automatisms (lip smacking, swallowing, picking movements) and post-ictal confusion.
- The EEG is usually normal or may show brief discharges. NB: hyperventilation will not simulate the seizures. |
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|
Term
| What is Lennox-Gastaut syndrom? |
|
Definition
| - usually presents in childhood with seizures of multiple types, impaired cognitive function, and slow spike-and-wave activity on EEG. |
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Term
| Pt presents with acute motor and sensory loss in his legs, loss of rectal tone, and urinary retention. |
|
Definition
| Cauda equina syndrome. = surgical emergency. |
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Term
| drug that has long term disease modifying effects in MS: |
|
Definition
- Glatiramer acetate
- beta interferon |
|
|
Term
| What is the treatment for acute exacerbations of MS? |
|
Definition
|
|
Term
| What cranial nerve is affected in uncal herniation? |
|
Definition
Oculomotor
- compression causes loss of parasympathetic innervation early, with loss of motor innervation later. |
|
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Term
| Senior patient comes for evaluation of "decreased memory." On further evaluation she has urinary incontinence, and broad-based shuffling gait. What is the next step? |
|
Definition
| - MRI. The classic presentation of normal pressure hydrocephalus is dementia, urinary reteniton, and gait disturbance. Lumbar puncture reveals normal CSF pressure, and MRI shows enlarged ventricles. |
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|
Term
| What is a common neurological finding after years of chronic alcoholism? |
|
Definition
| - Cerebellar disfunction. Watch for gait instability and intention tremor in addition to classical cerebellar findings. |
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Term
| Young female with bilateral trigeminal neuralgia: |
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Definition
|
|
Term
| I say myasthenia, you say: |
|
Definition
|
|
Term
| How do you treat Guillain-Bare? |
|
Definition
| - IVIG and plasmapheresis |
|
|
Term
| MCC of brain abscess in an immunocompetant patient with known extracranial bacterial infection? |
|
Definition
| - Aerobic and anaerobic streptococci, bacteroides spp (anaerobes). |
|
|
Term
| Four cardinal symptoms of restless leg syndrome: |
|
Definition
1. an uncomfortable sensation or urge to move the legs
2. discomfort which worsens in the evening or during sleep
3. discomfort which worsens at rest
4. discomfort alleviated by movement of the affected limbs |
|
|
Term
| What does treatment for restless leg focus on? |
|
Definition
| - increasing dopamine with dopaminergic agonists like pramipexole and ropinerole. |
|
|
Term
| Pt presents with weakness and broad, flat T waves: |
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Definition
|
|
Term
| Stroke: motor impairment without any higher cortical dysfunction and visual field abnormalities. |
|
Definition
| - posterior limb of the internal capsule |
|
|
Term
| Contralateral hemiplegia, conjugate eye deviation toward the side of infarct, hemianesthesia, homonymous hemianopia, *aphasia or hemineglect* |
|
Definition
|
|
Term
| Contralateral weakness that predominantly affects the LE, abulia, akinetic mutism, emotional diturbances, deviation of head and eyes toward the lesion, sphincter incontinence. |
|
Definition
|
|
Term
| 'alternate' syndromes, with contralateralhemiplegia and ipsilateral CN involement. |
|
Definition
| - Vertebrobasilar system (brainstem) |
|
|
Term
| Pt with Huntington's, where is the lesion? |
|
Definition
| - atrophy of the caudate nucleus |
|
|
Term
| MCC of fatal sporadic encephalitis in the US? |
|
Definition
| - HSV encephalitis. Which is also 10-20% of all viral encephalitis. |
|
|
Term
| Why do you see increased RBCs in the CSF in HSV encephalitis? |
|
Definition
| - hemorrhagic destruction of the temporal lobes |
|
|
Term
| What are the most common early side effects of beginning treatment for Parkinsons? |
|
Definition
| - hallucinations, confusion, agitation, dizziness, somnolence, nausea |
|
|
Term
| DDx of seeing halos around lights: |
|
Definition
- acute angle closure glaucoma
- dig toxicity
- migraine? |
|
|
Term
|
Definition
| - a glutamate inhibitor that has been approved for patients with ALS. |
|
|
Term
| - What is the most powerful modifiable risk factor for pancreatic cancer? |
|
Definition
|
|
Term
| NOT risk factors for pancreatic cancer: |
|
Definition
1. alcohol
2. gallstones
3. coffee intake |
|
|
Term
| What are the CSF findings in HSV encephalitis? |
|
Definition
- increased lymphocytes
- increased protein
- elevated RBCs (hemorrhage)
- normal glucose |
|
|
Term
| I say humoral mid-shaft fracture, you say: |
|
Definition
|
|
Term
| "Crossed paralysis," or hemiparalysis with contralateral facial weakness in a stroke patient: |
|
Definition
| - the lesion is most likely the facial nerve nucleus in the pons. |
|
|
Term
| Adolescent patient has a seizure after sleep deprivation: |
|
Definition
- Juvenile mioclonic epilepsy. These usually present in their teenage years with a progression from absence to myoclonic to generalized tonic-clonic seizures. The seizures typically occur upon awakening, and symptoms can be worsened by sleep deprivation.
- JME is genetic |
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