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ICM IV - Neurology Exam 2
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ICM IV - Neurology Exam 2 ICM IV - Neurology Exam 2 ICM IV - Neurology Exam 2
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ICM IV - Neurology Exam 2What neurologic disease is this?
dyemyelinating and axonal autoimmune disease that is characterized by episodes of focal disorder of
the CNS.
this disease mainly affects (white/grey) matter - MS
white
MS Epidemiology
(young/old)
(white/non-white)
(women/men) - young
white
women
MS is predominantly due to (t/b) cell response - T
Dysfunction in the BBB allows the activated cells to cross into the CNS attacking myelin
match the types of MS: primary progressive, and relapsing-remitting MS
a. deficits or symptoms come and go like flares, most amendable to treatment
b. 10%, associated with spastic gait - a. relapsing-remitting MS
b. primary progressive
A patient comes in and says "one time i got really tingly and then it got better, but I still feel it!"
which of the following would you not see on an neurologic exam
,-hyperreflexia
-spasticity
-Lhermittes
- RAPD
-optic disc edema
- flexor plantar responses - flexor plantar responses --> extensor
the highest yield for diagnosis of MS is (CT/MRI) (with/without) contrast - MRI
with
(MS/NMO) is a b-cell mediated disease - NMO
match the following: neuromyelitis optica, acute disseminated encephalomyelitis
a febrile illness in pediatrics that leads to a demyelination change
b. transverse myelitis and often bilateral optic neuritis - a. ADEM
b. NMO
a patient presents with vision changes and paresthesias, you do an MRI and it is normal. Next you do
a lumbar puncture and find Aquaporin-4 ab. What disease is this - Neuromyelitis Optica (NMO)
Devic's Disease
wernicke-korsakoff syndrome is associated with deficiency of what d/t what? - B1 (thiamine)
alcohol use
AMS, hallucinate (confabulation), gait disturbances, ophthalmoplegia is associated with.... -
wernicke-korsakoff syndrome
a patient has autoimmune gastritis, what deficiency will they develop?
their neurologic symptoms
(proximal/distal) (motor/sensory) loss
,(LMN/UMN) myelopathy and MS - b12
distal sensory
UMN
a patient on isonazid for TB is have some sensory ataxia problems, what nutrient might be depleted -
b6
Dementia, dermatitis, and diarrhea are related with what nutrient deficiency? - Niacin
true/false: vitamin K causes neurologic symptoms and neuropathy - false
No neurologic symptoms, but coagulopathy may result in ICH
true/false: hypokalemia does not have CNS manifestations but can cause weakness - true
both hypernatremia and hyponatremia cause MS changes and seizures, but (hyper/hypo)natremia
can result in osmotic demyelination - hypo
a pregnant patient is being treated for eclampsia, what neurological symptoms might she have due
to her treatment? - reduced reflexed, lethargy
-mg is tx
what electrolyte disturbance resembles hypocalcemia - hypomagnesium
(hyper/hypo)calcemia causes tetany
-chvostek sign, carpopedal, stridor (larynx), opithotonas (trunk) - hypo
hyperparathyroidism ---> (hyper/hypo)calcemia - hyper
(MS changes, cramps, weakness)
(hyper/hypo)glycemia can cause seizures - hypo
, true/false: asterixis is called liver flap due to the beating of the hands and/or feet, and it is only seen
in liver disease - false, seen in renal disease too
what CNS infection are patients with renal disease ML to get? - listeria monocytogenes
what is posterior reversible encephalopathy syndrome - Accelerated HTN
MRI will show parieto-occipital white matter changes
Headache, seizure, MS changes, papilledema
what organ dysfunction causes radiculopathy? - adrenal (crisis)
a patient comes in with MS change, upon history you find they are prescribed levothyroxine but dont
take it, what could this possible be - Hashimoto encephalopathy
if WBC get too (low/high) they can cause a CNS infection - low
a patient presents with fever and MS changes, upon history they have recently started taking an
anti-psychotic
what test would you run?
What is the diagnosis?
they would be (spastic/rigid) - muscle enzymes (be high)
neuroleptic malignant syndrome
rigid
match: takaysau arteritis, kawasaki, polyarthritis neuritis, wegener's
a. lungs and kidney, mononeuritis multiplex (peripheral nerve)
b. infants and children, seizures, strokes, facial weakness
c. mostly neuromuscular disorder
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