Sask Neurons- Jeopardy

Optic Neuropathies

100

4 Signs of Optic Nerve Dysfunction

1. decreased visual acuity

2. Color vision impairment

3. Relative afferent pupillary defect in the affected eye

4. visual field deficits

200

4 Characteristics of vision loss in NAION (Non-arteritic ischemic optic Neuropathy 

sudden, unilateral, painless, and often worsens over 1 to 2 weeks

300

painful red eye, corneal clouding, and vision loss attributed to optic nerve ischemia

Acute angle closure Glaucoma

400

List 5 non-demyelinating/autoimmune causes of optic Neuropathies

Giant cell arteritis 
Toxins (methanol, ethambutol, amiodarone)

Metabolic (vitamin b12, thiamine, folate, thiamine, copper)

Neoplasm

Infections(syphilis)

Hereditary

500

The most common cause of Hereditary optic Neuropathy

And which structure is affected in the eye

Leber Optic hereditary neuropathy

Papillo macular bundle of axons

(usually binocular symmetrical visual acuity loss, central or centrocaecal scotomas, and eventually temporal disc pallor)

TB

100

4 common complications of TB meningitis

Stroke (basal ganglia)

Seizures

focal deficits from tuberculomas

Hydrocephalus

200

Abbreviation of IRIS and what is it

Immune reconstitution inflammatory syndrome

Paradoxical worsening in people with HIV initiating antiretroviral therapy

300

Most common CSF pattern in TB meningitis

mononuclear (ie, lymphocytic or monocytic) pleocytosis, low glucose, and markedly elevated protein.

400

Treatment of TB meningitis

 (1) the intensive phase: rifampicin, isoniazid, pyrazinamide, and ethambutol for 2 months, followed by 

(2) the continuation phase: rifampicin and isoniazid for an additional 7 to 10 months (9 to 12 months of total treatment)

500

Image

circumscribed lesion with an area of central calcification and a surrounding hyperdense ring. Marked associated vasogenic edema is seen with resultant compression of the right lateral ventricle. Of note, post-contrast images had been obtained, they would have likely demonstrated central enhancements surrounded by a ring of enhancement

ALS &MND

100

Diagnostic Criteria for ALS

Progressed motor impairment documented by history or repeated clinical assessment preceded by previous normal motor function AND presence of both upper and lower motor neuron findings in at least one body region AND exclusion of other disease

200

Tofersen - MOA

antisense oligonucleotide to SOD1

300

SBMA (Kennedy disease)

Inheritance and genetics ?

X-linked and CAG trinucleotide expansion in androgen receptor gene

400

List 4 causes of head drop

ALS

Myasthenia gravis

MSA

IBM

Congenital myopathy

500

Differential diagnosis for lower motor neuron predominant ALS - list 4

MMN

Spinal muscular atrophy

Kennedy disease

Post-Polio syndrome

CIDP 

IBM

Lyme Disease

100

What causes Lyme disease in North America

Borrelia burgdoferi (sprichete)

200

Initial sign of infection with borrelia ?

Erythema migrans

300

How do we know intrathecal production of Borrelia antibodies has occurred

CSF to serum antibody index

anti-Borrelia IgG in CSF/anti-Borrelia IgG in serum DIVIDED BY total IgG in CSF/total IgG in serum

400

What is considered high risk bite

high-risk tick bite is defined as a bite from an Ixodes species tick that was attached for 36 hours or longer in an area highly endemic for Lyme disease

500

List 3 neurological complications of Lyme

cranial neuritis (most often cranial nerve VII), meningitis, and raduculoneurits

Headache

100

Spontaneous intracranial hypotension 

CSF pressure

<6

200

Name 4 symptoms/signs of IIH

• Headache – worse w/ Valsalva, worse in am, better on sitting

• Pulsatile tinnitus

• Transient Visual obscurations

Papilledema or 6th nerve palsy (visual field loss)/no venous pulsations

300

List 4 causes and predisposing factors for SIH

CTD (ehlers danlos, marfan, ADPKD)

Trauma (history of previous LP, spinal surgery, whiplash trauma, nerve root sheeth avulsion)

Bariatric surgery

400

Name one main pharmacologic treatment for IIH and MOA

Acetazolamide (carbonic anhydrase inhibitors)

500

Poor prognosis for IIH (list 4)

• Grade 4 papilledema

• Frequent visual obscurations

• Decreased VA at baseline

• Anemia, renal failure, hypertension, elevated inflammatory markers

• Optic neuropathy +/- retinal changes  

• Weight gain