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1
Q

What is goal BP in ischemic stroke

A

< 220/120

<185/110 with thrombotic

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2
Q

What is TX for BP in ischemic stroke

A

Labetolol

Nicardipine

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3
Q

What drugs are CI in ischemic stroke

A

Nitroprusside

Nitroglycerin

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4
Q

What drugs are CI in SAH

A

Nitroprusside

Nitroglycerin

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5
Q

TX for ALS

MOA?

A

Riluzole
Increases survival time
MOA - increases glutamate induced cytotoxicity

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6
Q

EMG of ALS

A

Widespread muscular denervation and motor block

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7
Q

Dopamine Antagonists used in Huntington’s

A

Neuroleptics - esp hi potency typical, Haloperidol, Risperidone
Tetrabenazine

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8
Q

Visual abnormalities seen with MS

A 
1. Unilateral Optic Neuritis
May seen afferent pupillary defect
2. Central vision loss
3. Internuclear ophthalmoplegia
- Damage to MLF- Loss of adduction on lateral gaze + nystagmus
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9
Q

Colored halos ?

A

Acute angle closure glaucoma

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10
Q

Shallow Anterior Chamber

A

Acute angle closure glaucoma

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11
Q

TX for orbital cellulitis

A

IV Vanco
IV Ceftriaxone/Cefotaxime
Until afebrile or 3-5 days, THEN
Oral Abx for 2-3 weeks

Consult Ophthalmo and ENT for debridement

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12
Q

DDX for Cherry Red Spot

A

Neiman Pick
Tay Sacchs
Retinal artery Occlusion

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13
Q

Eye abnormalities seen in Vitamin A deficiency

A

Night blindness
Complete blindness
Xerophthalmia = dryness
Bitot spots

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14
Q

Presentation of Bullous Myringitis

A

Bullous/vesicular inflammation of TM

Ass’d with Acute OM, but more painful

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15
Q

What is seen on otoscopy of Bullous Myringitis

A

Large Reddish vessicles on TUm

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16
Q

TX of Bullous Myringitis

A

Oral Macrolides (Mycoplasma pneumo)

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17
Q

Mastoiditis Presentation

DX

A

Sx’s days to weeks after acute OM
Erythema, edema, tender behind ear
External ear displaced
DX: CT scan of mastoid process

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18
Q

TX of external OM

A

Topical Abx

Oral cephalosporins if Pseudomonas

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19
Q

Acute Labyrinthitis Presentation

A

Acute onset of vertigo
Hearing loss
Preceded by URI

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20
Q

Acute Labyrinthitis TX

A

TX: Corticosteroids

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21
Q

Meniere’s

A

Chronic dz with acute vertigo lasting hours
Vertigo, tinnitus
Low frequency hearing loss
N/V, depression, suicide

22
Q

TX for Meniere’s

A

Anticholinergics
Antiemetics
Salt restriction
Thiazides

23
Q

Conductive hearing loss MCC

A

Otosclerosis

Fixed sclerotic otic bones sclerosis and don’t function

24
Q

Rinne test in Otosclerosis

A

Negative

Also in wax accumulation

25
Sensorineural hearing loss
Path in neural pathways from ear to brain | Positive Rinne
26
Cholesteoma
Grayish white pearly lesion behind TM | Ass'd with OM Infxn
27
TX of Cholesteoma
Surgical removal
28
MCC of Sensorineural hearing loss
Presbycusis
29
TX for familial hypercholesterolemia if lifestyle modifications and meds do not improve
Plasmapharesis or LDL apheresis
30
Drug interaction w Statins and what HAART agent
PI's: Ritonavir Myalgias, rhabdomyolysis, RF Next step - stop statin, change PI to NNRTI (efavirenz) If viral load persistently high -> Change to 2 new NRTIs and Efavirenz
31
Vaccinations given to Alcoholic patients?
Influenza Pneumococcal Hep A Hep B
32
TX of choice Alcohol abuse
Group counseling = Alcoholic Anonymous
33
TX of Alcohol abuse
``` AA Benzos - Chlordiazepoxide Disulfram Topiramate Naltrexone Acamprosate ```
34
Toxicity that causes pupillary dilation
Amphetamines Cocaine Hallucinogens - LSD
35
TX of amphetamine abuse induced HTN
Benzos Phentolamine alpha blocker
36
TX for cocaine, PCP, amphetamine or LSD OD for seizures, agitation and psychosis
Benzos | Haloperidol
37
Refeeding syndrome Pathophys Presentation
``` Sudden shift from fat to carb metabolism Hypophosphatemia, Hypokalemia, Hypomagnesemia Cardiovascular collapse Rhabdomyolysis Confusions Seizures ```
38
What is pain disorder
Specific pain complaint cannot be explained Analgesic pain does not relieve TX: psychotherapy
39
Difference bt Factitious and Malingering
Facticious - intentional induction of dz w/out a clear gain Malingering - intentional induction of dz WITH a clear gain
40
Presentation of binge eating disorder
Pt binges, but does not purge Weight gain Deep psychological problem - use as coping mechanism
41
Presentation of eating disorder | Etiology
Binge eating = obsessed w food Addiction NOT coping mechanism
42
MCC Delirium
UTIs Meds Benzos, Anticholinergics (TCAs)
43
Sundowning in delirium or dementia or both?
Dementia
44
Drugs that are CI in Agitation in delirium and dementia pts
Benzos Anti-cholinergics Worsen sx's
45
TX for Agitation in delirium and dementia pts
Low dose AP | Haloperidol
46
Comorbidities with ADHD
``` Oppositional Defiant disorder Conduct disorder Learning disabilities Depression Bipolar disease Anxiety ```
47
Difference bt conduct disorder and oppositional defiant disorder
Both exhibit aggressive behavior ODD does not have illegal and destructive activity TX ODD = strict, clear cut rules Conduct = psychotherapy
48
AEs of Atomoxetine
Increased risk of suicidality | Liver injury
49
TX of Tourette's
``` Psychotherapy Low dose AP's - Risperidone - Fluphenazine - Pimozide - Tetrabenazine = no tardive dyskinesia ``` SSRIs if comorbidities
50
Presentation of childhood disintegrative disorder
Regression of development after 2 yrs of normal development
51
Presentation of Rett Disorder
Females ONLY Loss of previously acquired motor skills B/t 6-30 months Stereotype hand movements - midline hand wringing
52
What is pseudocyesis
False belief pt is pregnant

DIT (3 decks)

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