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First Aid for the USMLE Step 2 CK (8th Ed.)
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10 - Neurology - Page 241

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First Aid for the USMLE Step 2 CK (8th Ed.) | Medicine (MD/DO) School Study Aid

10 - Neurology - Page 241
62 Picmonics to Learn | 1 hr 48 mins
Vitamin B12 (Cobalamin) Deficiency Causes
Causes
Vegans
Pernicious Anemia
Gastric Bypass Surgery
Malabsorption
Sprue
Enteritis
Crohn's Disease
Diphyllobothrium latum
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4 mins
Folate Deficiency
Clinical Features
Macrocytic Anemia
Megaloblastic Anemia
Etiologies
Malabsorption
Dietary
Tea and Toast
Alcoholics
Medication-induced
Methotrexate
Trimethoprim
Increased Requirement
Hemolytic Anemia
Pregnancy
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2 mins
CN I
Olfactory Nerve
Sensory
Smell
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36 secs
CN II
Optic Nerve
Sensory
Vision
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35 secs
CN III
Oculomotor Nerve
Motor
Eye Movement
Accommodation
Eyelid Opening
Pupillary Constriction
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1 min
CN IV
Trochlear Nerve
Motor
Abducts, Depresses, Internally Rotates
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48 secs
CN V
Trigeminal Nerve
Sensory
Facial Sensation
Motor Function (Via Mandibular Nerve)
Mastication Muscles
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1 min
CN VI
Abducens Nerve
Motor
Abducts Eye
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48 secs
CN VII
Facial Nerve
Lacrimation
Salivation
Sensory
Taste from Anterior 2/3 of Tongue
Motor
Facial Movement
Stapedius Muscle
Eyelid Closing
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1 min
CN VIII
Vestibulocochlear Nerve
Sensory
Hearing
Balance
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55 secs
CN IX
Glossopharyngeal Nerve
Sensory
Taste from Posterior 1/3 of Tongue
Monitoring Carotid Body and Sinus
Motor
Stylopharyngeus
Swallowing
Salivation
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1 min
CN X
Vagus Nerve
Sensory
Aortic Arch Chemoreceptors and Baroreceptors
Taste from Epiglottic Region
Motor
Swallowing
Palate Elevation
Talking
Coughing
Midline Uvula
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1 min
CN XI
Accessory Nerve
Motor
Head Turning
Shoulder Shrugging
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36 secs
CN XII
Hypoglossal Nerve
Motor
Tongue Movement
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34 secs
Cranial Nerve Function
Sensory
CN I
CN II
CN VIII
Motor
CN III
CN IV
CN VI
CN XI
CN XII
Both
CN V
CN VII
CN IX
CN X
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1 min
Posterior Column (Dorsal Column)
Ascending Pathway (Sensory)
Sensations
Proprioception
Fine Touch
Pressure
Vibration Sensation
Anatomy
Dorsal Root
Fasciculus Cuneatus
Arms
Fasciculus Gracilis
Lower Limbs
Lesions
Vitamin B12 Deficiency
Tabes Dorsalis
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2 mins
Spinothalamic Tracts
Ascending Pathway (Sensory)
Lateral
Temperature
Pain
Anterior
Crude Touch
Pressure
Decussates at Anterior White Commisure
Lesion
Contralateral Anesthesia
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2 mins
Types of Strokes
Warning Signs
Transient Ischemic Attack (TIA)
Reversible Ischemic Neurologic Deficit (RIND)
Types
Ischemic
Thrombotic
Atherosclerosis
Embolic
Atrial Fibrillation
Hemorrhagic
Severe Hypertension
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3 mins
Left Hemisphere Stroke Assessment
Opposite Side Weakness (Hemiplegia)
Side to Side Discrimination
Aphasia
Agraphia
Slow Performance
Aware of Deficits
Anxiety
Depression
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2 mins
Right Hemisphere Stroke Assessment
Opposite Side Weakness (Hemiplegia)
Poor Proprioception
Disoriented to Person, Place, Time
Can't Recognize Faces (Prosopagnosia)
Loss of Judgement and Awareness
Impulsiveness
Personality Changes
Tonal Hearing Loss
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2 mins
Anterior Cerebral Artery
Contralateral paralysis of lower limb
Contralateral loss of sensation in lower limb
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1 min
Middle Cerebral Artery
Contralateral paralysis upper limb and face
Contralateral loss of sensation of upper limb and face
Affects Wernicke's area and Broca's area
Aphasia if Lesion in Dominant (Left) Hemisphere
Hemineglect if lesion in nondominant (right) hemisphere
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1 min
Subarachnoid Hemorrhage
Bleeding into Subarachnoid Space
Mechanisms
Trauma
Aneurysm Rupture
AVM Rupture
Vasospasm causes Ischemia
Signs & Symptoms
"Worst Headache Of My Life"
Diagnosis
Noncontrast Head CT
Lumbar Puncture
Angiography
Considerations
Surgery
Blood Pressure Control
Intracranial Pressure Control
Nimodipine for Vasospasm Prophylaxis
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3 mins
Subdural Hematoma
Mechanism
Tear of Bridging Veins
Slow Bleeding, Over Time
Imaging
Subdural Space
Crescent-shaped on CT
Crosses Suture Lines
Midline Shift
Causes
Elderly
Whiplash
Abusive Head Trauma (Shaken Baby Syndrome)
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2 mins
Types of Seizures
Tonic-Clonic
Tonic
Clonic
Absence (Petit Mal)
Myoclonic
Atonic
Partial (Focal) Seizure
Focal Aware (Formerly Called Simple Partial)
Focal Impaired Awareness (Formerly Called Complex Partial)
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3 mins
Barbiturates
Barb- Drug Names
Indications
Seizure Treatment
Anesthesia Induction
Mechanism of Action
Increased Duration of Cl- Channel Opening
Decrease Neuron Firing
Side Effects
Sedation
Cardiovascular and Respiratory Depression
CNS Depression
P450 inducer
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2 mins
Phenobarbital (Barbiturates)
Mechanism
Barbiturate
Indications
Seizures
Side Effects
Ataxia
Paradoxical Excitement
Fatigue/Drowsiness
Considerations
Monitor Plasma Levels
High Potential for Abuse
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1 min
Benzodiazepine Antidote
Antidote
Flumazenil
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40 secs
Benzodiazepines Overview
Indications
First Line for Status Epilepticus
Anesthesia Induction
Anxiety
Eclampsia
Detoxification
Mechanism of Action
'-zepam' and '-zolam" Suffix
Increase Frequency of Cl- Channel Opening
Side Effects
Decrease REM Sleep
CNS Depression
Dependence
Antidote
Flumazenil for Overdose
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2 mins
Meniere's Disease
Mechanism
Excess Endolymph
Signs and Symptoms
Tinnitus
One-sided Sensorineural Hearing Loss
Vertigo
Nausea and Vomiting
Considerations
Meclizine (Antivert)
Low Salt Diet
Surgery
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2 mins
Indirect Cholinomimetics
Acetylcholinesterase Inhibitors
Doesn't Cross BBB
Edrophonium
Myasthenia Gravis (Diagnosis)
Pyridostigmine and Neostigmine
Myasthenia Gravis (Tx)
Ileus
Crosses BBB
Physostigmine
Atropine Overdose
Glaucoma
Donepezil
Alzheimer's
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2 mins
Myasthenia Gravis
Mechanism
Antibodies to Acetylcholine Receptor
Symptoms
Ptosis
Diplopia
Weakness with Muscle Use
Respiratory Death
Thymus Associated
Treatment
Acetylcholinesterase Inhibitors
Plasmapheresis
Thymectomy
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1 min
Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
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2 mins
Multiple Sclerosis Features and Mechanisms
Features
More Common in Women
Presents in 20's and 30's
Northern Europeans
Mechanism
Unknown mechanism, genetic factor
HLA-DRB1
Autoimmune Demyelination of CNS
White Matter of Brain and Spinal Cord
T Cell Mediated Inflammation
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2 mins
Multiple Sclerosis Symptoms and Diagnosis
Symptoms
Optic Neuritis
Internuclear Ophthalmoplegia
Scanning Speech
Urinary and Fecal Incontinence
Motor Issues (Intention Tremor, Paresis)
Numbness and Pain
Depression
Relapsing Symptoms
Diagnosis
Gold Standard = Plaques on MRI
Increased CSF Immunoglobulins (IgG)
Oligoclonal Bands
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4 mins
Guillain-Barre Syndrome Assessment
Assessment
Ascending Paralysis
Muscle Weakness
Paresthesias (Pins and Needles)
Diplopia
Difficulty Speaking
Dysphagia
Labile Blood Pressure
Loss of Bowel and Bladder Control
Considerations
Aggressive Airway Management
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2 mins
Amyotrophic Lateral Sclerosis (ALS)
Assessment
Progressive Muscle Weakness
Systemic Muscle Wasting
Fasciculations
Spasticity
Fatigue
Considerations
Riluzole (Rilutek)
Stretching
Little to No Cognitive Decline
Respiratory Support
Palliative Care
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2 mins
5 A's of Alzheimer's Disease
Agnosia
Anomia
Aphasia
Apraxia
Amnesia
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1 min
Huntington's Disease
Pathophysiology
Autosomal Dominant
Trinucleotide Repeat
CAG Repeats
Chromosome 4
Anticipation
Caudate
Decrease of ACh
Decrease of GABA
Signs and Symptoms
Chorea
Dementia
Depression
Glutamate Toxicity
Neuronal Death via NMDA Binding
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3 mins
Parkinson's Disease Assessment
Assessment
Decreased Dopamine
Older Adult
Cogwheel Rigidity
Bradykinesia
Shuffling Gait
Resting Tremor
Pill-Rolling
Mask-Like Face
Cognitive Decline
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2 mins
Parkinson's Disease Interventions
Medications
Levodopa/Carbidopa (Sinemet)
Entacapone (Comtan)
Selegiline (Eldepryl)
Amantadine (Symmetrel)
Bromocriptine (Parlodel)
Benztropine (Cogentin)
Considerations
Allow Extra Time
Ensure Patient Safety
Surgery As Last Resort
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2 mins
Parkinson's Drugs
Parkinsons Characteristics
Decreased Dopamine
Increased Acetylcholine
Drug Names
BALSA Acronym
Bromocriptine
Amantadine
Levodopa
Selegiline
Antimuscarinics
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2 mins
Levodopa/Carbidopa (Sinemet)
Indications
Parkinson's Disease
Mechanism of Action
Increase Dopamine in Brain
Cross blood-brain barrier
Increase bioavailability
Side Effects
Arrhythmias
Dyskinesia
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1 min
Craniopharyngioma
Hypopituitarism
Remnants of Rathke's Pouch
Tooth-enamel Like Calcification
Cholesterol Crystals
Yellow Viscous Fluid
Headache
Bitemporal Hemianopsia
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1 min
Ependymoma
Occur in Children
Fourth Ventricle
Hydrocephalus
Perivascular Pseudorosettes
Rod Shaped Blepharoplasts
Cauda Equina in Adults
Poor Prognosis
Neurofibromatosis Type II
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2 mins
Glioblastoma Multiforme
Most Common Malignant Primary Brain Tumor
Grade 4 Astrocytoma
Can Cross Corpus Callosum
Butterfly Glioma
Pseudo-palisading Tumor Cells
Areas of Necrosis and Hemorrhage
Stain Astrocytes for Glial Fibrillary Acidic Protein (GFAP)
Grave Prognosis
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2 mins
Medulloblastoma
Pathophysiology
Occurs in Children
Cerebellum
Fourth Ventricle
Diagnosis
Small Blue Cells
Lots of Mitotic Figures
Homer Wright Rosettes
Signs and Symptoms
Hydrocephalus
Ataxia
Wide-based Gait
Treatment
Radiosensitive
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2 mins
Meningioma
Epidemiology
Most Common Adult Primary Brain Tumor
pathology
Benign
Originate from Arachnoid Villi
Dural Attachment
Parasagittal
Clinical Manifestations
Contralateral Leg Weakness
Seizures
Diagnosis
Psammoma Bodies
Calcifications
Increased Bone Density
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3 mins
Pilocytic Astrocytoma
Occurs Most Commonly in Kids
Posterior Fossa
Cerebellum
Well Circumscribed
GFAP
Rosenthal Fibers
Eosinophilic Corkscrew Fibers
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1 min
Schwannoma
Characteristics
Acoustic Schwannoma
Cranial Nerve VIII
Cerebellopontine Angle
S100 Positive
Bilateral Schwannoma in Neurofibromatosis Type 2
Tinnitus
Cranial Nerve V
Affects Corneal Reflex
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2 mins
Neurofibromatosis Type 1
Pathophysiology
Autosomal Dominant
Chromosome 17
Signs and Symptoms
Neurofibromas
Optic Glioma
Lisch Nodules
Hamartomas
Cafe Au Lait Spots
Scoliosis
Pheochromocytoma
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4 mins
Neurofibromatosis Type 2
Pathophysiology
Autosomal-Dominant
Chromosome 22
Signs and Symptoms
Vestibular Schwannoma
Meningioma
Ependymoma
Cafe Au Lait Spots
Cataracts
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2 mins
Tuberous Sclerosis
Characteristics
Autosomal Dominant
Signs and Symptoms
Hamartomas in CNS and Skin
Phakoma
Subependymal Giant Cell Astrocytoma
Seizures
Intellectual Disability (Mental Retardation)
Adenoma Sebaceum
Shagreen Patch
Ash-leaf Spots
Renal Angiomyolipoma
Cardiac Rhabdomyoma
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2 mins
Beriberi (Thiamine Deficiency)
Thiamine Deficiency
Dry Beriberi
Polyneuritis
Muscle Wasting
Wet Beriberi
Dilated Cardiomyopathy
Edema
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51 secs
Wernicke-Korsakoff Syndrome
Thiamine deficiency
Confusion
Ophthalmoplegia
Ataxia
Korsakoff
Confabulation
Personality Changes
Memory loss
Alcoholics
Damage to medial dorsal nucleus
Damage to mammillary bodies
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2 mins
Closed-Angle Glaucoma
Primary
Lens causes pupillary obstruction
Aqueous humor builds behind iris
Iris bends forward, obstructing trabecular mesh
Secondary
Hypoxia Causes Neovascular Proliferation
Contraction and obstruction of trabecular mesh
Chronic disease (Crone)
Asymptomatic
Acute Disease
Eye pain and blindness
Rock-hard eye
Headache
Emergency
Epinephrine contraindicated
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2 mins
Age-Related Macular Degeneration (AMD)
Mechanism
Dry (nonexudative)
Wet (exudative)
Signs and Symptoms
Scotomas
Blurred, Darkened Vision
Loss of Central Vision
Distortion of Vision
Considerations
Drug Therapy
Surgery
Low-vision Assistive Devices
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2 mins
Cataract
Mechanism
Age-related
Assessment
No Pain
Cloudy Opaque Lens
Decreased Visual Acuity
Occurs Gradually
Treatment
Surgery
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1 min
Open-Angle Glaucoma
Humor Has Access to Trabecular Meshwork
Presentation
Painless
African American
Elderly
Positive Family History
Primary Open-Angle Glaucoma
Most Common Form of Glaucoma
Unknown Mechanism
Secondary Open-Angle Glaucoma
Blocked Trabecular Meshwork (With Open-Angle)
WBCs
Red Blood Cells (RBC)
Retinal Products
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2 mins
Central Retinal Vein Occlusion
Etiologies
Hypercoagulability
Hypertension
Diabetes Mellitus
Clinical Features
Non-Ischemic
Mild to Moderate Vision Loss
Sparse Dot-blot and Flame Hemorrhages
Ischemic
Sudden, Painless Vision Loss
"Blood and Thunder" Appearance
Cotton Wool Spots
Papilledema
Interventions
Observation if Non-Ischemic
Laser Photocoagulation
VEGF Inhibitors
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3 mins
Tremor Types
Resting Tremor
Postural Tremor
Essential Tremor
Physiologic Tremor (Reversible)
Intention Tremor
Asterixis (Flapping Tremor)
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1 min
Pick's Disease (Frontotemporal Dementia)
Epidemiology
Affects People Aged 45 to 65.
Pathophysiology
Frontal and Temporal Lobes
Occipital and Parietal Lobes are Spared
Tauopathy
Neuronal Apoptosis
Clinical Features
Dementia
Personality Changes, Impaired Judgment, Apathy, and Disinhibition
Behavioral Variant
Primary Progressive Aphasia
Diagnosis Based on Clinical Features and Imaging
Management
Supportive Care
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5 mins

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