Term
| 22 yo man presents to ER with 2-hr h/o SEVERE DIFFUSE HEADACHE. The worst HA ever for him. Preceded by brief LOC. NO visual disturbance. Vomited x3. H/o three prior episodes of HA that were unilateral and throbbing associated with N/V in the last two ye |
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Definition
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| 70 yo male pt with h/o DM x 20 yrs. H/o of diplopia x 2 days. Can NOT move left eye outward and diplopia on looking to the left side. Diplopia disappears by covering either eye. Fundus exam with MILD diabetic retinopathy and NO papilledema. WHATs the D |
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Definition
| Left 6th nerve paralysis due to infarction of the nerve. |
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Term
| 76 yo male c/o recurrent episodes of left sided visual loss assocated with weakness of right arm and leg. 4 similar episodes ove the last 6 months. Each one lasting about 5-10 min. Physical exam non contributory. Carotid Duplex = 60% narrowing of left |
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Definition
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| Whats the DX?...60 yo male, slowly progressive weakness arms and legs and occasional difficulty in swallowing...+fasciculation for the muscles of upper ext. and weakness, spasticity, HYPERactive DTR and + extensor plantar. NO pain or parathesia |
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Definition
| Amyotrophic Lateral Sclerosis |
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Term
| Where is the lesion? > Sudden Severe HA and diplopia. Ptosis of R-eye. Fixed, dilated R-pupil. Paralysis of ADDuction and elevation of R-eye... |
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Definition
| THIRD NERVE NUCLEUS, Leaking posterior communicating aneurysm with compression of the third nerve nucleus. |
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Term
| DX?...56 yo male; parathesias of hands and feet; poor memory and unsteady gait; Spasticity and Weakness of Legs; (+) ankle clonus; (+)plantar; (+) Rhomberg |
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Definition
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| What is this?...(the presence of a cavity in the spinal cord due to breakdown of gliomatous new formations, presenting clinically with pain and paresthesias followed by muscular atrophy of the hands) |
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Definition
Syringomyelia (Syringomyelia, ie, cord cavitation)There is a characteristic clinical picture, with segmental atrophy and areflexia and loss of pain and temperature appreciation in a "cape" distribution owing to the destruction of fibers crossing in front of the central canal. Syringomyelia, ie, cord cavitation, may also occur in association with an intramedullary tumor or following severe cord injury, and the cavity then does not communicate with the central canal.
In patients with Arnold-Chiari malformation, there are commonly skeletal abnormalities on plain x-rays of the skull and cervical spine. |
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Term
| Where is the lesion?...Loss of hearing in L-ear. Rinne's = hears better with tuning fork placed on L-mastoid process than in front of ear. Tuning Fork is loudest in L-ear when place over center of forehead... |
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Definition
| External auditory canal or middle ear. Wax or fluid in middle ear. |
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Term
| What is the Tx?...42yo man; L-retro-orbital severe HA. Awakes him from sleep. Recurrent lasting for about 2 hours. Associated tearing of left eye, stuffiness of left side of nose and drooping of the left eyelid. |
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Definition
| Start high dose oral prednisone for one week. |
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Term
| 60 yo female; episodes of INTENSE PAIN lasting only A FEW SECONDS. To Lips; Cheek; and the Chin on the LEFT side. What do you treat this with? |
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Definition
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Term
| Does or Does Not the forehead wrinkle in Bell Palsy? (7th Nerve Paralysis) |
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Definition
| (NOT) Paralysis of the seventh nerve immobilizes the muscles of facial expression: The eye fails to close, the forehead does not wrinkle (as opposed to central or supranuclear facial paralysis with forehead sparing), and the angle of the mouth droops, so the patient drools. Peripheral seventh nerve paralysis suggests serious disease, such as tumor of the cerebellopontine angle, acoustic neuroma, facial nerve neuroma, neoplasm of the middle ear, or parotid gland neoplasm. Acute otitis media, temporal bone fracture, and chronic otitis media with or without cholesteatoma may produce facial paralysis. Other causes include surgical trauma, Guillain-Barré syndrome, Lyme disease, AIDS, and herpes zoster oticus (Ramsay Hunt's syndrome). When the cause is unknown, the condition is known as Bell's palsy. Although Bell's palsy is the commonest cause of peripheral seventh nerve paralysis, the pathogenesis is mysterious. Current theories implicate vascular ischemia and compressive edema within the facial canal as the cause of neurapraxia and cessation of axoplasmic flow. |
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Term
* Asymmetric (unilateral) sensorineural hearing loss, tinnitus, or both.
* Disproportionate speech discrimination score relative to pure-tone average.
* Vestibular complaints unlikely.
WHAT IS THE DX? |
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Definition
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| Where is the vascular occlusion most likely? 55 yo pt. Chronic HTN. Presents with sudden weakness of RIGHT arm and leg with aphasia. PMH for several episodes of transient loss of vision for the LEFT eye in the last 3 months. Each episode lasted 5-10 mi |
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Definition
| Left Internal Carotid Artery. |
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Term
| 72 yo male with history of HTN and DM is brought to you for progressive memory loss. CVA 4 yrs ago. BP = 170/100. Brisk Tendon Reflexes and Extensor Plantar Response. What will the CT show? |
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Definition
| Multiple HYPO dense lesions in WHITE and GRAY matter. |
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Term
| Which of the following OD can cause seizures: A)Phenothiaznes B)Barbiturates C)Cocaine D)Codeine |
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Definition
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| 50 yo female consults you because of tremors of both hands and difficulty in writing.Tremors disappear at rest and after drinking alcohol. Which of the following do you want to Rx? A)Amitriptyline; B)Propranolol; C)Carbidopa-levodopa; D)Diazepam |
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Definition
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| Where is the lesion? Right-sided Visual Loss. RIGHT HOMOnymous HEMIanopsia. Rest of exam is normal. |
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Definition
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| What is the DX? 70 yo. Poor Memory and Unsteady Gait. Urinary Incontinence. Gait is SHUFFLING, BROAD BASED and UNSTEADY. Dilated Ventricles on CT with NORMAL SULCI. |
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Definition
| NPH (Normal Pressure Hydrocephalus) |
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Term
| Select the most important INITIAL test: 76 yo with HA, intermittent blurring of vision for past 2-weeks. Normal Neuro exam: A) CT; B)MRI; C)LP; D)ESR |
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Definition
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| Which is NOT associated with Contrast ENHANCING CNS lesions in AIDS? A)Multifocal leucoencephalopathy; B)Toxoplasmosis; C)CNS lymphoma; D)Brain abscess. |
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Definition
| Multifocal leucoencephalopathy is NOT. Toxo,Lymphoma,Abcess ARE ENHANCING LESIONS. |
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Term
| Do you find elevated levels of protein in a LP from an Alzheimers patient? |
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Definition
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| Pt. with HYPOmetabolism of the parietal lobes on PET scan implies: |
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Definition
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| Enlarged ventricles and sulci with non-enhancing HYPOdense areas in the white matter implies: |
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Definition
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| CT scan or MRI in active disease shows contrast enhancing white matter lesions in the paraventricular and subcortical area for... |
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Definition
| Multiple Sclerosis (contrast enhancing WHITE matter lesions for PARAventricular and SUBcortical areas.) |
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Term
| Does a identical twin of a pt. with MS have an increased risk of developing active disease? |
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Definition
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Term
| Which type of MS has the worst prognosis? |
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Definition
| Chronic Progressive Disease |
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Term
| If you get MS after the age of 40 do you have a better prognosis? |
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Definition
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Term
| Name what must be present to confirms the Dx. of Myasthenia Gravis? |
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Definition
| Antibodies: The presence of acetylcholine receptor antibodies confirms the diagnosis of myasthenia gravis. |
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Term
| What is the major cause of death in patients with Duchenne Muscular Dystrophy? |
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Definition
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Term
| True or False: Myotonic Dystrophy may be complicated by Cardiac Conduction Defects? |
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Definition
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Term
| What surgery should be done on all pts. with generalized myasthenia gravis who are under the age of 55? |
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Definition
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| List three complications of Status Epilepticus... |
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Definition
| Hyperpyerexia; Irreversible brain damage; CSF and peripheral Leukocytosis |
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