Medical-Surgical
Nursing
Exam 5 - Neurology
** 100% Guaranteed Pass
** Expert-Verified Explanation
** Questions with Verified Answer
** Latest Edition | Updated
,where is the vomiting and swallowing center? medulla-pons
obstruction of _____________ leads to Horner syndrome the posterior inferior cerebellar artery
hunger, food and water intake, circadian rhythm, hypothalamus
autonomic control - located where in the brain?
seeing "flashing lights" is a sign of? occipital lobe epilepsy
What encephalopathy causes ocular palsies, confusion, Wernicke's encephalopathy
and gait abnormalities related to a lesion in the
mammillary bodies and/or the dorsomedial nuclei of the
thalamus?
a lesion of what tract will result in loss of pain- spinothalamic
temperature sensation contralaterally?
A lesion of the _____________ results in a decrease in posterior columns
proprioception-sterognosis ipsilaterally below the level of
the lesion
upper motor lesion
weakness, increased reflexed, increased tone - upper or upper
lower?
weakness, atrophy, fasciculations, decreased reflexes lower
and tone - upper or lower?
Sudden onset of facial paresis caused by an Bell Palsy
inflammatory response involving the facial nerve
Idiopathic, although theorized to be caused by
reactivation of HSV type 1 or varicella virus
More common in patients with DM and in pregnancy
Abrupt facial paralysis that gradually worsens Bell Palsy
Ear pain on the affected side
Numbness sensation
Difficulty eating
Excessive tearing
difficulty closing ipsilateral eye
Poor fine facial movements
inability to wrinkle forehead Bell Palsy
forehead AND lip droop Bell Palsy
,lip droop, forehead spared central lesion (stroke)
Bell's palsy diagnosis and treatment dx: clinical
tx:
Acyclovir/Valacyclovir +/- Prednisone
Prevent corneal damage (eye drops/patches)
Facial exercises
Most common cause of neuralgic pain in the face Trigeminal Neuralgia
Patients are typically 40 or older
Pain is most often unilateral and generally involves the
second, third or both branches of the trigeminal nerve
Attacks occur with sudden onset, severe facial pasting Trigeminal Neuralgia
lasting seconds
Described as sharp, stabbing, or burning
Precipitated by touch or movement of trigger regions
(eating, speaking, brushing teeth, wind)
Attacks typically occur daily for periods of weeks to
months and then resolve spontaneously, but a subset of
patients (up to nearly half in some case series, report
chronic, constant pain)
where is usually the location of pain in Trigeminal cheek, jaw, mouth
Neuralgia?
dx and treatment trigeminal neuralgia` dx: MRI
tx: Carbamazepine or Oxcarbazepine
Reactivation of dormant varicella zoster virus in herpes zoster
individuals who had chicken pox virus previously
Painful vesicular rash occurring in dermatomal
distribution
Stereotypical rash is preceded by 2-3 days of burning, herpes zoster
tingling, or pain occurring in a dermatomal distribution
May be followed by fatigue, malaise, low-grade fever,
and headache
The most characteristic finding is the vesicular rash
occurring in a unilateral, dermatomal distribution
Thorax is the most common location
The lesions progress from vesicles to pustules to
crusting lesions
rash that does not cross midline herpes zoster
what complication of herpes zoster warrants herpes zoster ophthalmicus
opthalmology consult?
diagnosis and treatment herpes zoster dx: clinical
tx:
Acyclovir, valacyclovir or famciclovir
+/-
NSAIDs
anticonvulsants (Gabapentin)
TCAs (Amitriptyline)
+/-
PT, topical treatments, CBT
, what complication of herpes zoster warrants ENT Ramsay Hunt
consult?
Creutzfeldt-Jakob Disease (CJD) spongiform encephalopathies
Variant CJD (vCJD or BSE)
Gerstmann-Sträussler-Scheinker Syndrome (GSS)
Fatal Familial Insomnia (FFI)
Kuru
No known cause spongiform encephalopathies
Genetic: Mutations in the PRNP gene
Acquired: Exposure to infected tissue (e.g., through
contaminated medical equipment or consumption of
infected beef)
Clinical presentation: spongiform encephalopathy
Rapidly progressive dementia
Myoclonus
Visual disturbances
Cerebellar dysfunction (ataxia)
Behavioral change
Mutations in the PRNP gene exist in those with inherited prion diseases (missense, insertion, deletion, or
nonsense), leading to conformational change in the prion protein
diagnosis and treatment spongiform encephalopathy dx: clinical
tx: palliative
Autoimmune disorder linked to anti-thyroid Hashimoto encephalopathy
antibodies (anti-thyroperoxidase and anti-thyroglobulin)
Cognitive impairment (memory loss, confusion)
Seizures
Myoclonus
Psychosis
Ataxia
Stroke-like episodes
diagnosis Hashimoto encephalopathy (6) diagnosis:
1. encephalopathy with seizures, hallucinations, stroke-like episodes
2. subclinical or overt thyroid disease
3. normal brain MRI
4. serum thyroid antibodies
5. absence of neuronal antibodies in serum and CSF
6. exclusion of alternative causes
elevated anti-thyroid antibodies (anti-TPO, anti-Tg) Hashimoto encephalopathy
normal or mildly abnormal thyroid function tests
response to corticosteroid treatment
treatment Hashimoto encephalopathy high-dose prednisone or IV methylprednisolone
Acute neuropsychiatric syndrome resulting from thiamine Wernicke encephalopathy
(vitamin B1) deficiency
Chronic alcoholism (most common cause)
Malnutrition or malabsorption (e.g., bariatric surgery, Wernicke encephalopathy
eating disorders).
Hyperemesis gravidarum.
Prolonged intravenous feeding without thiamine
supplementation.
can cause?
Nursing
Exam 5 - Neurology
** 100% Guaranteed Pass
** Expert-Verified Explanation
** Questions with Verified Answer
** Latest Edition | Updated
,where is the vomiting and swallowing center? medulla-pons
obstruction of _____________ leads to Horner syndrome the posterior inferior cerebellar artery
hunger, food and water intake, circadian rhythm, hypothalamus
autonomic control - located where in the brain?
seeing "flashing lights" is a sign of? occipital lobe epilepsy
What encephalopathy causes ocular palsies, confusion, Wernicke's encephalopathy
and gait abnormalities related to a lesion in the
mammillary bodies and/or the dorsomedial nuclei of the
thalamus?
a lesion of what tract will result in loss of pain- spinothalamic
temperature sensation contralaterally?
A lesion of the _____________ results in a decrease in posterior columns
proprioception-sterognosis ipsilaterally below the level of
the lesion
upper motor lesion
weakness, increased reflexed, increased tone - upper or upper
lower?
weakness, atrophy, fasciculations, decreased reflexes lower
and tone - upper or lower?
Sudden onset of facial paresis caused by an Bell Palsy
inflammatory response involving the facial nerve
Idiopathic, although theorized to be caused by
reactivation of HSV type 1 or varicella virus
More common in patients with DM and in pregnancy
Abrupt facial paralysis that gradually worsens Bell Palsy
Ear pain on the affected side
Numbness sensation
Difficulty eating
Excessive tearing
difficulty closing ipsilateral eye
Poor fine facial movements
inability to wrinkle forehead Bell Palsy
forehead AND lip droop Bell Palsy
,lip droop, forehead spared central lesion (stroke)
Bell's palsy diagnosis and treatment dx: clinical
tx:
Acyclovir/Valacyclovir +/- Prednisone
Prevent corneal damage (eye drops/patches)
Facial exercises
Most common cause of neuralgic pain in the face Trigeminal Neuralgia
Patients are typically 40 or older
Pain is most often unilateral and generally involves the
second, third or both branches of the trigeminal nerve
Attacks occur with sudden onset, severe facial pasting Trigeminal Neuralgia
lasting seconds
Described as sharp, stabbing, or burning
Precipitated by touch or movement of trigger regions
(eating, speaking, brushing teeth, wind)
Attacks typically occur daily for periods of weeks to
months and then resolve spontaneously, but a subset of
patients (up to nearly half in some case series, report
chronic, constant pain)
where is usually the location of pain in Trigeminal cheek, jaw, mouth
Neuralgia?
dx and treatment trigeminal neuralgia` dx: MRI
tx: Carbamazepine or Oxcarbazepine
Reactivation of dormant varicella zoster virus in herpes zoster
individuals who had chicken pox virus previously
Painful vesicular rash occurring in dermatomal
distribution
Stereotypical rash is preceded by 2-3 days of burning, herpes zoster
tingling, or pain occurring in a dermatomal distribution
May be followed by fatigue, malaise, low-grade fever,
and headache
The most characteristic finding is the vesicular rash
occurring in a unilateral, dermatomal distribution
Thorax is the most common location
The lesions progress from vesicles to pustules to
crusting lesions
rash that does not cross midline herpes zoster
what complication of herpes zoster warrants herpes zoster ophthalmicus
opthalmology consult?
diagnosis and treatment herpes zoster dx: clinical
tx:
Acyclovir, valacyclovir or famciclovir
+/-
NSAIDs
anticonvulsants (Gabapentin)
TCAs (Amitriptyline)
+/-
PT, topical treatments, CBT
, what complication of herpes zoster warrants ENT Ramsay Hunt
consult?
Creutzfeldt-Jakob Disease (CJD) spongiform encephalopathies
Variant CJD (vCJD or BSE)
Gerstmann-Sträussler-Scheinker Syndrome (GSS)
Fatal Familial Insomnia (FFI)
Kuru
No known cause spongiform encephalopathies
Genetic: Mutations in the PRNP gene
Acquired: Exposure to infected tissue (e.g., through
contaminated medical equipment or consumption of
infected beef)
Clinical presentation: spongiform encephalopathy
Rapidly progressive dementia
Myoclonus
Visual disturbances
Cerebellar dysfunction (ataxia)
Behavioral change
Mutations in the PRNP gene exist in those with inherited prion diseases (missense, insertion, deletion, or
nonsense), leading to conformational change in the prion protein
diagnosis and treatment spongiform encephalopathy dx: clinical
tx: palliative
Autoimmune disorder linked to anti-thyroid Hashimoto encephalopathy
antibodies (anti-thyroperoxidase and anti-thyroglobulin)
Cognitive impairment (memory loss, confusion)
Seizures
Myoclonus
Psychosis
Ataxia
Stroke-like episodes
diagnosis Hashimoto encephalopathy (6) diagnosis:
1. encephalopathy with seizures, hallucinations, stroke-like episodes
2. subclinical or overt thyroid disease
3. normal brain MRI
4. serum thyroid antibodies
5. absence of neuronal antibodies in serum and CSF
6. exclusion of alternative causes
elevated anti-thyroid antibodies (anti-TPO, anti-Tg) Hashimoto encephalopathy
normal or mildly abnormal thyroid function tests
response to corticosteroid treatment
treatment Hashimoto encephalopathy high-dose prednisone or IV methylprednisolone
Acute neuropsychiatric syndrome resulting from thiamine Wernicke encephalopathy
(vitamin B1) deficiency
Chronic alcoholism (most common cause)
Malnutrition or malabsorption (e.g., bariatric surgery, Wernicke encephalopathy
eating disorders).
Hyperemesis gravidarum.
Prolonged intravenous feeding without thiamine
supplementation.
can cause?
