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Neurology Shelf Exam Review - Part 3.new

Treat underlying cause, supportive care, avoid restraints, reassurance, orientation

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83 views

Neurology Shelf Exam Review - Part 3.new

Treat underlying cause, supportive care, avoid restraints, reassurance, orientation

Uploaded by

yogurt
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
You are on page 1/ 12

I hope you find this file helpful for student

preparation for the Neurology Shelf Exam. 


I apologize for the intermittent beeps during the
audio clips (these will be recorded again soon).
Use of the accompanying transcriptions is
advisable.
Sincerely,
Heather Anderson, MD
Director, Neurology Clerkship
Associate Professor of Neurology
Localization
• Caudate nucleus • Medial longitudinal fasciculus
– Huntington’s disease, Wilson’s – Internuclear ophthalmoplegia
• Cerebellar hemisphere • Medullary pyramid
– Ataxia, dyscoordination – Hemiparesis
• Cerebellar vermis • Pons
– Truncal ataxia – Hemiparesis, ataxia, dysarthria-
• Cerebral peduncle clumsy hand, 1½ syndrome
– Hemiplegia • Subthalamic nucleus
• Medial lemniscus Hemiballismus
– Contralateral dec • Thalamus
vibration/proprioception – Sensory, motor, memory,
visuospatial
Neurotransmitter Systems Originate In
Which Part of the Brain?
• Acetylcholine – Nucleus basalis of Meynert
• Dopamine – Substantia nigra
• GABA – Nucleus accumbens
• Norepinephrine – Locus coeruleus
• Serotonin – Raphe nucleus
Herniation Syndromes
Types of brain herniation
1) Uncal
2) Central
3) Cingulate
4) Transcalvarial
5) Upward
6) Tonsillar

Smith, Julian; Joe J. Tjandra; Gordon J. A. Clunie; Kaye, Andrew H. (2006).


Textbook of Surgery. Wiley-Blackwell. pp. 446.
http://en.wikipedia.org/wiki/File:Brain_herniation_types-2.svg
Herniation Syndromes
• Uncal herniation (a common type of
transtentorial herniation)
• Cerebellar tonsillar herniation
• Central herniation
• Subfalcine herniation
Neuropathy
• Treatable causes
– Check fasting blood glucose, hgbA1c, vitamin
B12, TSH, RPR
– Consider other testing such as SPEP, IFE,
copper, etc.
• EMG/NCS
Neuropathy Syndromes
• Lead poisoning
• Guillain-Barré syndrome
• Acute intermitten porphyria
• Porphyria variegate
• Diptheria
• Vitamin B12 deficiency
• Diabetic amyotrophy
Neurologic Sleep Disorders (other
than sleep apnea)
• Narcolepsy
– Excessive daytime sleepiness
– Cataplexy
– Hypnagogic and hypnopompic hallucinations
– Sleep paralysis
Neurologic Sleep Disorders (other
than sleep apnea)
• Restless legs syndrome
– Evaluation
– Treatment
Evaluation of Memory Loss
• Depression
• Delirium
• Dementia
– Normal aging
– Mild Cognitive Impairment
– Dementia
Evaluation of Memory Loss
• Think about all of the different causes of
dementia
– Alzheimer’s disease
– Vascular
– Frontotemporal dementia
– Dementia with Lewy bodies
– CJD
– Normal pressure hydrocephalus
Evaluation and Treatment for
Mental Status Change/Delirium

• Overdose • Seizure
• Anticholinergic use • Hyponatremia/glycemia,
• Infection etc.
• Herniation • Hypoxia

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