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51 terms

11. DIT Day 12 Neuro III

STUDY
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Weber test conductive hearing loss; sound lateralizes to?
side of affected ear
Weber test sensorineural hearing loss; sound lateralizes to?
side opposite of the affected ear
Rinne Test Normal Vs conductive hearing loss?
Normal AC greater than BC
Conductive hearing loss BC greater than AC
Pt with Weber test result of midline; Rinne left ear AC > BC & right ear AC > BC; dx?
Normal
Pt with weber test result of right lateralization; Rinne left ear AC > BC & right ear BC > AC; dx?
Conductive hearing loss of Right Ear
Pt with weber test result of left lateralization; Rinne left ear AC > BC & right ear AC > BC; dx?
Right Sensorineural hearing loss
Pt with Weber test result of midline lat; Rinne Left ear BC > AC & Right BC > AC; dx?
Bilateral conductive hearing loss
Describe the light reflexes seen in both eyes if the right optic nerve is damaged prior to the pretectal nucleus (afferent defect)?
No constriction of either pupil when light is shined in right eye.
Both pupils constrict if light is shined in left eye.
Describe light reflexes in both eyes if the right occulomotor nerve is damaged (efferent defect)?
Right eye will not respond to light shone in either R or L eye.
Left eye will constrict when light is shined in either eye.
MS and internuclear ophthalmoplegia; what eye abnormality?
Internuclear Ophthalmoplegia
A pt cannot adduct her left eye on lateral gaze but convergence is normal; what structure is damaged?
Medial Longitudinal Fasciculus (MLF in internuclear ophthalmoplegia)
A light stimulus in pt's right eye produces bilateral pupillary constriction; when the lgiht is shown in the left eye there is a paradoxical bilateral pupillary dilation; what is the defect?
Afferent defect
What are the components of a dementia work up?
Cranial CT or MRI to rule out multi infarcts or stroke and to rule out normal pressure hydrocephalus.
Screen for B12; TSH; HIV; and syphilis.
Mini Mental Status Exam
Which neurodegenerative disease is a/w Lou Gehrig's disease?
ALS
Which neurodegenerative disease is a/w senile plaques and neurofibrillary tangles?
Alzheimers
Which neurodegenerative disease is a/w presenting at birht as a "floppy baby"?
W Hoffman Disease
Which neurodegenerative disease is a/w Lewy bodies?
Parkinsons
Lewy body dementia (Diffuse lewy bodies)
Alzheimers Diffuse lewy body type
Which neurodegenerative disease is a/w frequent falls and syncope?
Lewy Body Dementia
Which neurodegenerative disease is a/w atrophy of caudate nucleus leading to chorea?
Huntingtons
Which neurodegenerative disease is a/w depigmentation of the substantia nigra?
Parkinsons
Which neurodegenerative disease is a/w both upper and lower motor neuron signs (spasticity and weakness)?
ALS
Which neurodegenerative disease is a/w dementia and visual hallucinations?
Lewy Body Dementia
Which neurodegenerative disease is a/w Dementia and personality changes and/or aphasia?
Picks Disease
What neural pigment/inclusion is an intranuclear inclusion seen in herpes simplex encephalitis?
Caudry type A
What neural pigment/inclusion is a cytoplasmic inclusion pathognomonic of rabies?
Negri bodies
What neural pigment/inclusion is a neuronal inclusion characteristic of parkinsons?
Lewy body
What neural pigment/inclusion is a cytoplasmic inclusion body associated with aging?
Lipofuscin Granules
What neural pigment/inclusion is a dark cytoplasmic pigment in neurons of the substantia nigra and locus coeruleus; not seen in pts with parkinsons?
Melanin
What neural pigment/inclusion is eosinophilic, rodlike inclusions in hippocampus of Alzheimers pts?
Hirano Bodies
What neural pigment/inclusion is diagnostic of alzheimers?
Neurofibrillary plaques and tangles
What neural pigment/inclusion stain with silver, but do not survive neuronal death?
Pick Bodies
What neural pigment/inclusion stain with PAS and ubiquitin?
Lewy Bodies
What brain tumor is a/w polycythemia?
Hemangioblastoma
What brain tumor is a/w Neurofibromatosis II?
Schwanoma
What brain tumor is a/w Prolactinemia leading to galactorrhea, amenorrhea and anovulation?
Pituitary Adenoma
What brain tumor is a/w Psammoma bodies?
Meningioma
What brain tumor is a/w perivascular pseduorosettes?
Ependymoma
What brain tumor is a/w loss of peripheral vision or bitemporal hemianopia?
Pituitary Adenoma
Craniopharyngioma
What brain tumor is a/w worst prognosis of any brain tumor?
Glioblastoma Multiforme
Differentiate partial, simple, complex and complete seizures?
Partial - localized to specific area of the brain
Simple - no alteration of consciousness
Complex - Alteration of consciousness
Generalized - entire brain is affected
What are the most common causes of seizures in children?
Genetic
Infection
Trauma
Congenital
Metabolic disturbances
What is the classic triad in Multiple Sclerosis?
Charcot's Triad:
Scanning Speech
Intention Tremor
Nystagmus
Distinguish between a migrane, cluster and tension headache?
Migrane - Aura; nausea; vomiting; photophobia; 24 hr
Cluster - 30 - 3 hrs; Tearing; Rhinorrhea; daily basis
Tension - Frontal to Occipital lobe pain; band like pain
What allele is a/w Alzheimer's?
APP
Apo E4
Why is Alzheimers common in pts with Down Syndrome?
Bc chromosome 21 so these pts usually have three copies of APP gene
A woman presents with headache, visual distrubance and amenorrhea; what is the dx?
Pituitary Adenoma
43 yo man presents with symptoms of dizziness and tinnitus; CT shows enlarged internal acoustic meatus; what is the dx?
Acoustic Schwanoma
A child exhibits proximal muscle weakness and enlarged calves; dx and how is it inherited?
Duchennes Muscular Dystrophy
X linked recessive
A 25 yo female presents with a sudden uniocular vision loss and slightly slurred speech. She has a hx of weakenss and paresthesia that have resolved; dx?
Multiple Sclerosis
A 10 yo child "spaces out" in class (stops talking midsentence and then continues as if nothing happened). During the spells the child has slight quivering of lips; dx?
Absence Seizure
A pt presents with vertigo, tinnitus and hearing loss; dx?
Meniere's Disease