Which of these tumors can metastasize to the CNS?
thyroid
bronchus
breast
stomach
kidney
prostate
melanoma
ovarian
mouth
liver
Which of these is not a common CNS tumor in children?
astrocytoma
ependyoma
medullablastoma
schwannoma
Meninngioma is more common in women
Primary Brain Trauma crashes Falls wounds
Secondary Brain Trauma Brain Meningitis
Which of these are potential complications of meningitis?
sepsis
hearing loss
epilepsy
vision loss
death
learning difficulties
partial paralysis
loss of taste
anaphylaxis
psychogenic behaviors
What are the contraindications to lumbar puncture?
brain herniation
convulsions
shock
extensive purpura
infection over site
coagulation abnormalities
meningitis
anticoagulation abnormalities
cluster headache
partial blindness
What is of clinical relevance regarding meningitis?
headache
fever
neck stiffness
photophobia
non-blanching rash
caused by virus, bacteria, or fungus
Kernig's sign
affects patient's balance/stability
in elderly cases, will resolve itself usually
blanching rash
Treat all suspected meningitis with: IM in community IV / cefotaxime
If meningococcal meningitis, close contacts give prophylaxis
If it's a meningitis medical emergency, treatment order:
1. ABCDE
2. Ceftriaxone 4mg IV stat
3. Lumbar puncture
4. Blood culture
3. Blood culture
2. Blood culture
3. Ceftriaxone 4mg IV stat
4. Lumbar puncture
5. Bedside observations
Alzheimer's disease is inevitable in Down's syndrome
What is not a type of dementia?
Alzheimer's disease
Vascular dementia
Lewy body dementia
Fronto-temporal dementia
Cerebellar dementia
In dementia, the patient presents with fluctuating cognitive impairment, detailed visual hallucinations, and later . Histology is characterized by in brainstem and neocortex.
dementia is when there is frontal and temporal atrophy without Alzheimer histology.
Symptoms: and personality change preservation of memory and orientation emotional unconcern
dementia is due to the cumulative effects of many small strokes, thus sudden onset and stepwise deterioration is characteristic. Look for evidence of pathology.
Management: Manage disease risk factors with changes +
is the acquired deficits of cognition, visual spatial skill, memory and verbal abilities. Histology: characterised by neuritic and tangles (distinguishes from other dementias). Results in progressive neuronal damage and loss of .
Management: approach Medication: 1st line: (an inhibitor)
What is not a major component of idiopathic parkinson's disease?
tremor
bradykinesia
rigidity
aphasia
Idiopathic parkinson's disease is due to the destruction of neurones in the where is produced.
Management: -
The afferent light reflex is due to the occulomotor nerve (CN3)
is when the sympathetic nervous system to the eye is compromised.
What can cause Horner's syndrome?
CNS infarctions
CNS tumors
Carotid artery dissection
Neck malignancies
Cluster headaches
Tension-type headaches
Blindness
Vertebral artery dissection
Presentation of Horner's Syndrome:
Classic triad: Unilateral (constricted pupil) Unilateral (eyelid drooping) Unilateral apparent (sunken eye)
and Unilateral (inability to sweat)
palsy presents as down and out pupil with a drooping eyelid.
Majority of the extrinsic eye muscles is controlled by the oculomotor nerve.
palsy presents as difficulty looking down in an adducted position.
Trochlear nerve is very susceptible to trauma.
palsy presents as difficulty with abduction of eyes.
Abducens nerve is rarely injured but trauma can cause compression of it.
- is a persistent nerve pain that occurs at the site of a previous attack of shingles. It is difficult to treat but can be managed via neuropathic pain agents such as or gabapentin.
Ramsey Hunt Syndrome includes facial nerve palsy and hearing may be affected as a result.
What are unilateral causes for facial nerve palsy?
hemispheric stroke
cerebellopontine angle tumor
bell's palsy
trauma
middle ear infection
ramsey hunt syndrome
ischemic stroke
saturday night palsy
inner ear infection
cushing's syndrome
Vestibulocochlear nerve palsy causes hearing loss.
is the sensation of the room spinning
nerve damage can lead to ipsilateral diminished taste sensation
nerve is a branch of the vagus nerve which supplies muscles of . It is commonly injured in surgeries, which can lead to a voice
Damage to the vagus nerve can manifest as failure to raise soft palate with deviation to the opposite side
Damage to the accessory nerve will manifest as weakness in the head to side of lesion and the weakness in shoulders.
Hypoglossal nerve:
A unilateral lesion causes: tongue weakness and tongue in the of nerve lesion
What are the bulbar nerves, which all arise in the medulla and as a result, are commonly injured together.
CN 9-12
CN 4-7
CN 8 - 11
CN 2-6
Bulbar nerves all have similar pathologie that leads to dysphagia and dysarthria.
palsy: bilateral UMN lesion: Spastic tongue (not wasted) no fasciculations jaw jerk liability Traumatic brain injury or
palsy: bilateral LMN lesion: Wasting of tongue with fasciculations jaw jerk
What is not a trigger for trigeminal neuralgia?
washing
shaving
wind
chewing
sunlight
ften caused by at angle
Trigeminal neuralgia presents as severe (paroxysms of knife-like or electric shock). These pain spasms last for with multiple episodes before a remission for or even years before reoccurrence
Treatment: , surgical , or
