Iraqi Board Neurology flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Lateral corticospinal decussation

Corticospinal fibers cross in the medullary pyramids; the lateral tract carries limb motor control, while the anterior tract supplies axial muscles.

Rule of 4 brainstem

Mid-pons lesions affect cranial nerves 6 and 7 with contralateral hemiparesis; medullary lesions affect cranial nerves 9-12 with contralateral spinothalamic sensory loss.

Red neurons

Eosinophilic neurons with pyknotic nuclei appearing 12-24 hours after ischemic injury; they mark irreversible neuronal damage in the infarct core.

Lewy body composition

Eosinophilic intracytoplasmic inclusions composed of alpha-synuclein; loss of substantia nigra neurons produces parkinsonism and cognitive fluctuations.

DWI in acute stroke

Diffusion-weighted MRI shows hyperintensity from cytotoxic edema within minutes of infarction; it is the most sensitive early sequence for acute ischemia.

Demyelinating NCS pattern

Prolonged distal latency, slowed conduction velocity below 70 percent of normal, conduction block, and prolonged F waves indicate acquired or inherited demyelination.

tPA eligibility window

Intravenous alteplase is given within 4.5 hours of ischemic stroke onset when blood pressure is below 185/110 mmHg and CT excludes hemorrhage.

Lacunar syndrome

Pure motor, pure sensory, sensorimotor, ataxic hemiparesis, or dysarthria-clumsy hand caused by a single deep perforator infarct without cortical signs.

Absence seizure EEG

Generalized 3 Hz spike-and-wave discharges with abrupt staring and immediate recovery; hyperventilation provokes attacks and ethosuximide is first-line therapy.

Status epilepticus sequence

Give a benzodiazepine first, then a second-line agent such as levetiracetam, fosphenytoin, or valproate, then an anesthetic infusion for refractory cases.

Migraine aura criteria

Fully reversible visual, sensory, or speech symptoms that develop over at least 5 minutes, last 5-60 minutes, and are followed by headache within 60 minutes.

Cluster headache treatment

Severe unilateral periorbital pain with ipsilateral autonomic signs; high-flow oxygen and subcutaneous sumatriptan are first-line acute therapies.

Progressive supranuclear palsy

Tauopathy with vertical supranuclear gaze palsy, early falls, and axial rigidity; MRI shows midbrain atrophy with the hummingbird sign.

Essential tremor

Bilateral postural and action tremor of hands and head that improves with alcohol; propranolol and primidone are first-line treatments.

Guillain-Barre syndrome

Ascending symmetric weakness with areflexia and albuminocytologic dissociation, reaching nadir within four weeks; treat with IVIG or plasma exchange.

Myasthenia gravis

Fatigable ptosis and diplopia with bulbar weakness, anti-acetylcholine receptor antibodies, and decrement on repetitive nerve stimulation; treat with pyridostigmine and immunosuppression.

McDonald MRI criteria

Dissemination in space requires lesions in at least two of four regions: periventricular, cortical or juxtacortical, infratentorial, and spinal cord.

Neuromyelitis optica spectrum

Anti-aquaporin-4 antibody disease with longitudinally extensive transverse myelitis, optic neuritis, and area postrema syndrome; attacks require acute immunotherapy.

HSV encephalitis

Fever, confusion, and seizures with temporal lobe involvement on MRI; CSF PCR confirms HSV and intravenous acyclovir is the treatment.

Tuberculous meningitis CSF

Subacute meningitis with basilar meningeal enhancement, hydrocephalus, lymphocytic pleocytosis, low glucose, and high protein; treat with four drugs plus steroids.

Glioblastoma treatment

Maximal safe resection followed by radiotherapy with temozolomide; MGMT promoter methylation predicts better response to temozolomide.

Pituitary adenoma visual field

Bitemporal hemianopia from compression of the optic chiasm; prolactinomas are treated first with dopamine agonists rather than surgery.

Simple febrile seizure

A generalized seizure lasting under 15 minutes in a child aged 6 months to 5 years with fever, occurring once in 24 hours without CNS infection.

Duchenne muscular dystrophy

X-linked dystrophin deficiency in boys with Gowers sign, calf pseudohypertrophy, and elevated creatine kinase; corticosteroids slow progression.

Mitochondrial inheritance

Maternal transmission with heteroplasmy; examples include MELAS, MERRF, and Leber hereditary optic neuropathy from mitochondrial DNA mutations.

Neurofibromatosis type 2

NF2 gene mutation causing bilateral vestibular schwannomas, meningiomas, and ependymomas; hearing loss and tinnitus are common presenting symptoms.

Broca aphasia

Nonfluent, effortful speech with relatively preserved comprehension from a lesion in the dominant inferior frontal gyrus; repetition is impaired.

Gerstmann syndrome

Agraphia, acalculia, finger agnosia, and left-right confusion from a lesion of the dominant angular gyrus in the parietal lobe.

Lambert-Eaton syndrome

Proximal weakness with autonomic symptoms and anti-voltage-gated calcium channel antibodies; high-frequency repetitive stimulation shows an incremental response, often paraneoplastic.

Juvenile myoclonic epilepsy

Morning myoclonic jerks with generalized tonic-clonic seizures and 4-6 Hz polyspike-wave discharges; valproate is effective but teratogenic.

Cerebral malaria

Plasmodium falciparum infection with impaired consciousness, seizures, and retinal whitening; intravenous artesunate is the treatment of choice.

Frontotemporal dementia

Behavioral variant with disinhibition and apathy, or primary progressive aphasia, from frontal and temporal atrophy; memory is relatively preserved early.