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[h] Neurology System Flashcards

[i] Master this session in just 5 minutes.

[q] What is the most likely diagnosis?

70 years old female patient presenting with her husband complaining of repetitive loss in her neighbourhood, word finding difficulty, trouble performing everyday tasks like shopping, cooking + MRI shows diffuse brain atrophy that is most prominent in Hippocampus + Biochemical changes in her brain shows decline in acetylcholine levels is most notable in basal nucleus of meynert (participates in memory & cognition) and hippocampus?

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[f]IEFsemhlaW1lciBkaXNlYXNlLg==

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[q] Advanced Alzheimer’s disease is associated with diffuse brain atrophy. …………. is evident even in the early stages of the disease and can be detected by brain MRI?

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[f]IFRoZSBoaXBwb2NhbXB1cyAoQSkgaXMgdGhlIGFyZWEgb2YgdGhlIGJyYWluIGRlbW9uc3RyYXRpbmcgdGhlIGdyZWF0ZXN0IGRlZ3JlZSBvZiBhdHJvcGh5IGluIEFsemhlaW1lcuKAmXMgZGlzZWFzZS4=[Qq]

[q] In Alzheimer disease, tau protein is disturbed and hyperphosphorylated, causing microtubule structures to collapse into …………… that contribute to global neuronal dysfunction.

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[f]IE5ldXJvZmlicmlsbGFyeSB0YW5nbGVzLg==

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[q] In Alzheimer disease, amyloid precursor protein (APP) is not properly cleared and forms amyloid fragments, these then harden into insoluble plaques and accumulate in brain tissue forming ……………. , and vessel wall causing ………………. which ↑ Risk of spontaneous lobar hemorrhage, particularly in the elderly. The most common sites of hemorrhage include the occipital and parietal lobes.

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[f]IEHOsiAoQW15bG9pZCDOsikgcGxhcXVlcywgYW15bG9pZCBhbmdpb3BhdGh5Lg==

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[q] All amyloids form extracellular deposits that stain with Congo red. When seen under polarized light, it gives ……………..?

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[f]IGFwcGxlLWdyZWVuIGJpcmVmcmluZ2VuY2Uu

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[q] Early onset familial Alzheimer disease (onset < 60 years old) is associated with mutation in ……………..?

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[f]

Cg==

MS0gQW15bG9pZCBwcmVjdXJzb3IgcHJvdGVpbiAoQVBQKSBnZW5lIG9uIGNocm9tb3NvbWUgMjEu
CjItIFByZXNlbmlsaW4gMSBnZW5lIG9uIGNocm9tb3NvbWUgMTQu
CjMtIFByZXNlbmlsaW4gMiBnZW5lIG9uIGNocm9tb3NvbWUgMS4=[Qq]

[q] Apolipoprotein E4 genotype is thought to (decrease or increase) the risk of Sporadic Alzheimer disease, but ApoE2 (decrease or increase) Risk.

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[f]IGluY3JlYXNlLCBkZWNyZWFzZS4=[Qq]

[q] What is the most likely diagnosis?

55 years old patient presenting with disinhibited behaviour, change in personality, poor judgement, non-fluent aphasia + MRI shows  pronounced atrophy of frontal and temporal lobes + Brain biopsy shows cytoplasmic inclusions of hyperphosphorylated microtubule associated tau protein?

 

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[q] What is the most likely diagnosis?

57 years old patient presenting with dementia and visual hallucinations, dyskinesia, and rigidity. It started with dementia followed by parkinsonian features after a few months + brain biopsy shows eosinophilic intracytoplasmic inclusions representing accumulations of alpha synuclein protein in the cortex?

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[f]IExld3kgYm9keSBkZW1lbnRpYS4=[Qq]

[q] What is the most likely diagnosis?

54 years old patient presenting with ) dementia with myoclonus (startle myoclonus), CSF showing high level of 14-3-3 protein + the patient after a few days of admission, postmortem brain autopsy shows spongiform transformation of the gray matter?

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[q] …………. is the 2nd most common cause of dementia in elderly.

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[Qq]

[q] What is the most likely diagnosis?

25 years old female presenting with unilateral visual loss associated, pain with ocular movement, diplopia, intension tremor, scanning speech, ataxia, vertigo, hemiparesis, spasticity, and hemisensory loss + she feel particularly fatigued after taking hot shower or after strenuous activity in heated environments + CSF gel electrophoresis shows oligoclonal bands + MRI shows periventricular white plaques?

 

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[q] ………….. is a chronic autoimmune demyelinating disease affecting the white matter of the central nervous system (brain and spinal cord), most often affects women in their 20s and 30s, and it should be suspected in a patient with neurological deficits that cannot be explained by a single lesion.

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[q] ………… is characterized by perivenular inflammatory infiltrates made up primarily of autoreactive T lymphocytes and macrophages directed against myelin components and depletion of oligodendrocytes with patchy demyelination and glial scarring.

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[q]…………….. is highly myelinated fiber bundle, it is affected in MS leading to internuclear ophthalmoplegia

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[f]IE1lZGlhbCBsb25naXR1ZGluYWwgZmFzY2ljdWx1cyAoTUxGKS4=[Qq]

[q] What is the most likely diagnosis?

26 years old patient presenting with symmetric ascending flaccid muscle weakness and + loss of reflexes that starts after recovery of gastroenteritis + CSF finding: ↑ CSF protein with normal cell count (albuminocytologic dissociation)?

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[f]IEd1aWxsYW4tQmFycmUgc3luZHJvbWUu[Qq]

[q] ………… is characterized by segmental demyelination and endoneural inflammatory infiltrate are seen on the light microscopy of motor fibers, sensory fibers, peripheral nerves.

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[q] …………. results from rapid correction of chronic hyponatremia osmotic demyelination of the axons in the central part of the pons. The typical clinical features include quadriplegia (due to demyelination of corticospinal tracts) and pseudobulbar palsy (due to demyelination of the corticobulbar tracts of CN IX, X, XI).

 

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[f]IGNlbnRyYWwgcG9udGluZSBteWVsaW5vbHlzaXMu

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[q] …………… is multifocal periventricular inflammation and demyelination after infection (commonly measles or varicella zoster virus) or certain vaccinations (rabies, smallpox). Occurs usually in children. Presents with rapidly progressive multifocal neurologic symptoms, altered mental status.

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[q] What is the most likely diagnosis?

9 years old immigrant child presenting with seizures, myoclonus, spasticity + MRI shows inflammation, demyelination, gliosis in many cerebral areas + CSF finding: shows RNA virus in CSF?

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[q] What is the most likely diagnosis?

32 years old child presenting with aphasia, olfactory hallucination, and personality change + Macroscopic brain examination reveals edema and hemorrhagic necrosis of the temporal lobes + CSF finding: viral DNA in CSF?

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[q] What is the most likely diagnosis?

HIV positive patient with CD count less than 50 presenting with progressive dementia, motor deficits, and visual impairment + CSF finding: JC virus DNA in CSF?

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[q] What is the most likely diagnosis?

10 years old child presenting with distal weakness and sensory loss, wasting in the legs. The legs look like inverted champagne bottles, decreased deep tendon reflexes, foot drop, pes cavus, and hammer toe?

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[q] ……………. is an accumulation of blood between the skull bone and dura mater due to fracture of the temporal bone and subsequent rupture or tear of the middle meningeal artery (branch of Maxillary artery). Presents with Lucid interval, followed by Loss of consciousness. CT without contrast reveals hyperdense biconvex mass located between the brain and the skull not crossing suture lines.

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[q] ………….. is an accumulation of blood between the dura mater and arachnoid due to shearing stress of cortical bridging veins after acceleration – deceleration injury. Presents with gradual onset of headache and slow decline in mental function. CT without contrast reveals crescent-shaped hemorrhage that crosses suture lines.

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[q] What is the most likely diagnosis?

44 years old patient presenting with severe headache, the patient describes it as “the worst headache in my life”, confusion, fever, and nuchal rigidity + CT scan without contrast is shown below + Lumbar puncture reveals gross blood or xanthochromia?

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[q] …………… occurs due to rupture of saccular (berry) aneurysm or arteriovenous malformation.

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[q] More than half of the Subarachnoid hemorrhage patients develop  in the vessels surrounding the ruptured aneurysm most probably due to impaired brain autoregulation, this vasospasm causes cerebral ischemia, which presents as new-onset confusion and focal neurological deficits 4-12 days after the initial insult. ……………… is often prescribed to prevent this vasospasm?

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[q] ………… is the most common cause of intraparenchymal hemorrhage due to rupture of ……………… charcot-Bouchard microaneurysms. Hypertensive hemorrhages (Charcot-Bouchard microaneurysm) most often occur in ………….?

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[q] …………… causes recurrent lobar hemorrhagic stroke in Alzheimer patient especially parietal and occipital lobes.

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[q] What is the most likely diagnosis?

Premature infant with low birth weight presenting with altered level of consciousness, bulging fontanelle, hypotension, and seizures + ultrasound of the head is shown below?

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[q] Neonatal intraventricular hemorrhage occurs due to hemorrhage from ………………..?

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[q]

[x][restart]

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