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