Neuro - Misc/stop forgetting

Question 1

syringomyelia

Answer 1

• lesion in ventral white commisure
• affects pain/temp
• SUSPENDED at level of lesion
• next: anterior horn cells affected (LMN signs)

Question 2

Brown-Sequard Syndrome

Answer 2

• hemisection
• ipsilateral: position/vibration, paralysis
• contralateral: pain/temp sensation

Question 3

Amyotrophic lateral sclerosis (ALS)

Answer 3

• COMBINED UMN and LMN
• affects long tract CST (UMN) – babinski
• affects anterior horn cells (LMN) – fasciculations
• sensory pathways normal
• progressive, slow

Question 4

spinal muscular atrophy

Answer 4

ALS variant

-LMN

Question 5

primary lateral sclerosis

Answer 5

ALS variant

• UMN
• steven hawking

Question 6

bulbar ALS

Answer 6

ALS variant

-LMN cranial nerves

Question 7

tabes dorsalis

Answer 7

• dorsal column affected
• loss of pain/temp in suspended areas (spreads to ventral white commisure!!)
• loss of position/vibration sense
• Romburg sign

Question 8

subacute combined degeneration posterolateral sclerosis

Answer 8

• posterior column (Romberg)
• CST (UMN signs)
• vit D deficiency
• pernicious anemia

Question 9

B12 deficiency

Answer 9

posterior column and corticospinal tracts

Question 10

spinocerebellar degeneration (Friedrich’s ataxia)

Answer 10

• posterior column
• spinocerebellar tract
• corticospinal tract

Question 11

Guillan-Barre Syndrome

Answer 11

• acute demyelinating syndrome
• autoimmune
• after viral/bacterial illness
• motor>sensory

Tx: plasma exchange, IVIG

Question 12

Charcot-Marie-Tooth Syndrome

Answer 12

• chronic demyelinating myopathy

- hereditary

Question 13

CIDP (chronic inflammatory demyelinating nueropathy)

and Tx

Answer 13

-chronic demyelinating neuropathy

Tx: steroid, IVIG, plasma exchange

Question 14

mysasthenia gravis is associated with

Answer 14

thymoma

Question 15

weird symptom associated with LEMS

Answer 15

dry mouth

Question 16

LEMS is associate with what tumor

Answer 16

SCLC

Question 17

think NEUROPATHY when…

Answer 17

• proximal weakness
• SYMMETRIC weakness
• normal/enlarged muscles
• deep tendon reflex reduction parallels muscle strength

Question 18

polymyositis

Answer 18

• same as dermatomyositis but w/o rash
• proximal
• elevated CK
• correllates with malignancy

Question 19

inclusion body myositis

Answer 19

• DISTAL hand involvement
• elevated CK
• does NOT respond to steroids

Question 20

drugs that can cause myopathies

Answer 20

• steroids

- statins

Question 21

mutation associated with Beckers

Answer 21

in frame mutation

• partially functional protein
• less severe than duchenne’s

Question 22

mutation associated with Duchenne’s

Answer 22

• framshift mutation
• nonfunctional protein
• more severe
• shorter life

Question 23

myotonic dystrophy

Answer 23

• autosomal dominant
• trinucleotide repeats
• facial, DISTAL weakness
• temporal wasting, frontal balding
• myotonia - delayed relaxation

Question 24

cerebellopontine angle

Answer 24

• extrinsic compression (tumors)
• begins with cranial nerve signs
• –vestibular before cochlear
• –later involvement of V and VII
• late occurrence of long tract signs
• -ataxia (MCP)
• -hemiparesis (CST)

Question 25

if III, IV, and VI are involved, think __________

Answer 25

if III, IV, and VI are involved, think cavernous sinus

Question 26

basilar artery occlusion

Answer 26

- bilateral hemiparesis (both CSTs) - bilateral sensory loss (ascending systems) - variable cranial nerve signs - reticular system

Question 27

lesion of PPRF

Answer 27

- complete lateral gaze palsy - neither eye can look toward the side with the lesion (PPRF cannot communicate to contralateral MLF for opposite eye to follow either)

Question 28

internuclear ophthalmoplegia

Answer 28

MLF lesion - PPRF can still tell ipsilateral eye to look laterally - contralateral MLF cannot communicate with CN III to move medial rectus to follow other eye - medial nystagmus

Question 29

one and a half syndrome

Answer 29

PPRF and MLF lesions - complete impairment of lateral gaze on side of lesion - --PPRF cannot move eye lateral, and cannot communicate to contralateral MLF to have other eye follow -when trying to move eye contralateral to lesion laterally, PPRF (intact) can move that eye, but when it tries to communicate with the contralateral MLF (lesioned) it cannot and the other eye doesn't follow

Question 30

Parkinson's - asymmetric or symmetric??

Answer 30

asymmetric

Question 31

main 2 symptoms of huntingtons

Answer 31

- chorea | - dementia

Question 32

schwanoma on cerebelopontine angle

Answer 32

5, 7, 8