Neuro 1
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Which tract conveys motor from cortex to head & neck? | Corticobulbar
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| Which tract conveys postural adjustments and head movements? | Vestibulospinal
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| Which CN is responsible for: eyelid opening? | Oculomotor (CN III)
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| Which CN is responsible for: taste from anterior 2/3 of tongue? | Facial (CN VII)
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| Which CN is responsible for: carotid body? | Glossopharyngeal (CN IX)
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| A LESION to which area of brain causes: Contralateral hemiballismus? | Subthalamic nucleus (use this for Parkinson's Rx)
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| A LESION to which area of brain causes: Eyes look towards lesion? | Frontal eye field
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| A LESION to which area of brain causes: Eyes look away from lesion? | PPRF
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| A LESION to which area of brain causes: Coma? | Reticular Activating System
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| A LESION to which 3 areas of brain causes: poor repetition, poor comprehension, poor vocal expression? | Repetition: arcuate fasciculus; Comprehension: Wernicke's; Vocalization: Broca's
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| A LESION to the non-dominant Parietal lobe (usually Right) causes what? | Hemispatial neglect syndrom
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| A LESION to the dominant Parietal lobe (usually Left) causes what? | Agraphia & Acalcula
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| What LESIONS cause resting tremor vs. intention tremor? | Resting: Basal ganglia (Parkinson); Intention: Cerebellar
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| What LESION to the brain causes dysarthria? | Cerebellar vermis
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| Top 3 causes of bacterial meningitis in <1mo baby? What's the Rx? | E Coli, GBS, Listeria. Rx: amp + ceft/gent
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| Top 3 causes of bacterial meningitis in 1mo-60yo? Rx of these causes? | Strept Pneumo, N. Meningitidis, Staph Aureus. Rx: ceft/cefo, vanco, dexamethosone
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| Top 4 causes of bacterial meningitis in 60yo+ and alcoholics? Rx for these causes? | Strept Pneumo, Listeria, N. Meningitidis, Gram (-) bacteria. Rx: amp, cefo/ceft, vanco, dexamethosone
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| Why give dexomethosone with or before ABx when treating bacterial meningitis? | Helps improve neurological sequelae. For kids, helpful in HiB and NM infections. For adults, helpful in Strept Pneumo infections.
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| For suspected bacterial meningitis, in what order do you do labs/radiology? | Neuro exam > LP > CT. If showing severe defecits, skip LP (may cause uncal herniation) and go straight to CT.
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| Rifampin is given to contacts of bacterial meningitis patient to protect from what infectious agents? | N. Meningitidis and HiB
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| MCC of fungal meningitis? How do you stain? How do you Rx? | Cryptococcus in HIV patients. Stain with India Ink. Rx with ampho B intrathecally.
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| Complications of bacterial meningitis in children (list of 4)? | 1) Hearing loss 2) Seizures 3) Spastic paralysis 4) Mental retardation
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| MCC of asceptic (viral) meningitis? | Enterovirus (Coxsackie and Human enterovirus)
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| 3 labs for viral meningitis? | LP, viral culture, viral Ag panel
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| Four components of Rx for viral meningitis? | Acetominophen (pain), IV fluids, Empiric ABx (until bacterial r/o), Acyclovir (until HSV r/o)
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| Presentation of West Nile Virus encephalitis? | Maculopapular rash w/ flaccid paralysis
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| Hallmark of viral encephalitis presentation? | Change in mental status
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| HSV encephalitis typically seen in which brain area on CT? | Parietal lobe
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| Reye's syndrome in kids causes decreased _________ on blood labs. | Glucose (d/t liver damage)
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| Six step mgmt of Reye's syndrome? | 1) Discontinue ASA 2) ICU admission for C/P monitoring 3) maintain normal Glucose levels [very impt!] 4) maintain isovolemia 5) Reduce brain swelling 6) Phenytoin [if seizures, NOT prohpylactically]
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| Rhomberg test checks function of __________. | Vestibular (CN VIII) apparatus, NOT cerebellum.
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| T/F: culturing in viral encephalitis is recommended. | False. Definitive Dx is by biopsy (but not practical). CT/MRI may show lesion.
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| ALS has what type of paralysis? | Both spastic and flaccid
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| Poliomyelitis affects what tract? What type of paralysis does it cause? | Affects ventral horn (motor neurons), causing flaccid paralysis.
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| Tabes Dorsalis is a sequela of what infection? What tract does it affect, leading to what symptoms? | D/T tertiary syphilis. Affects Dorsal columns, causing pain and proprioception (gait) impairment.
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| Spinal artery syndrome spares what region of spinal cord? | Dorsal columns
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| B12 deficiency damages what tracts? | Dorsal columns, corticospinal tract (b/l loss of vibration, etc and b/l spastic paralysis of legs then arms)
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| Syringomyelia affects what region of spinal cord? Causes what symptoms? | Affects ventral white commissure, then ventral (motor) horn. Causes b/l loss of pain/temp 1 level below, then flaccid paralysis @ level of lesion
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| Brown-Sequard syndrome affects what part of spinal cord? | One entire half.
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| What lab do you do to confirm brain abscess? | Culture during biopsy by needle aspiration. Biopsy is CT guided
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| What radiology do you do for brain abscess? What does it look like? | MRI (more detailed than CT). Shows ring-enhancing lesion d/t capsule.
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| Brain abscess is treated with ABx, ________, and surgical drainage. | Corticosteroids
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| LP picture of poliomyelitis resembles that of ________________. | Viral meningitis
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| Labs for polio? | Polio-specific AB, LP, viral culture (throat, stool, or CSF)
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| What is the benefit of I/M polio vaccine over oral? | I/M vaccine is killed, so no risk of infection with virus.
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| Rabies causes hydrophobia due to _____________. | Laryngospasm
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| CSF picture of viral meningitis (WBCs, Pressure, Glc, Protein)? | WBCs: lymphocytes; Pressure: slightly increased; Glc: normal; Protein: normal
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| CSF picture of bacterial meningitis (WBCs, Pressure, Glc, Protein)? | WBC: PMNs; Pressure: greatly increased; Glc: low; Proteins: high
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| CSF picture of fungal meningitis (WBCs, Pressure, Glc, Protein)? | WBC: lymphocytes; everything else same as bacterial
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| 3 steps after Rabies is suspected? | 1. catch and observe suspected causative animal 2. if appearing infected, kill animal and test brain for Negri bodies 3. viral testing in patient (CSF, skin, serum)
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| Rx of Rabies? | Clean wound well, rabies immunoglobulin AND vaccine patient if animal is infected/suspected of carrying rabies
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