Adult - Neuro Flashcards
Which gender more typically develops migraine?
female
Which gender more typically develops cluster?
male
Headache described as “vise-like”
tension
Are focal neurological symptoms such as flashes of light or zig zags in the vision associated with tension headache? Migraine?
not with tension
yes with migraine
When is the typical age of onset of migraine?
adolescence or early adulthood
What foods contain nitrates?
pickles
bologna
Is migraine usually unilateral or bilateral?
unilateral
What are some drugs that can be used prophylactically for migraine?
amitriptyline (Elavil) - anti-depressant
propranalol (Inderal) - beta blocker
gabapentin (Neurontin) - analgesic, anti-seizure
topiramate (Topamax) - anti-seizure
In new onset migraine what are the four laboratory studies to consider?
ESR
BMP
CBC
VDLR
In new onset migraine what are the imaging studies to consider? why?
CT to r/o brain tumor
What is the patho of migraine?
dilation and pulsation of branches of external carotid artery
follows the trigeminal nerve pathway (CN V)
What is the standard management of acute migraine?
sumatriptan (Imatrex) - subcutaneously
What is the standard management of an ugly migraine?
JUST KIDDING!! :-)
Which is more likely to be associated with family history - migraine or cluster?
migraine
What is the pattern of cluster headache?
severe, unilateral, periorbital pain occuring daily for several weeks
For which two types of headache is sumatriptan (Imatrex) used?
migraine and cluster
Prior to a triptan, what is a therapy that may help relieve a cluster headache?
100% O2
Does TIA have any residual effects?
no
What is TIA indicative of?
in many cases, an impending stroke
What vision symptoms may be present with TIA?
IPSilateral monocular blindness = same side, one eye
What motor symptoms may be present with TIA?
CONTRAlateral paresthesia of arm, leg, or face = opposite side of the body
How are vertibrobasilar TIAs characterized?
more “neuro” presentation - vertigo, ataxia, dizziness
How are carotid TIAs characterized?
more traditional “stroke-like” - altered LOC, aphasia, dysarthria
What imaging test is best for distinguishing between infarct, tumor, or hemorrhage?
CT
What imaging test is best for detecting ischemic infarcts?
MRI
If a CT is negative but the patient can’t move part of the body, what is a likely cause?
ischemic infarct (not bleed)
What is the number one cause of heart failure?
hypertension
When is endarterectomy indicated?
in cases of > 70 - 80 % stenosis in symptomatic patients
What are pharm management options for TIA?
aspirin
clopidogrel (Plavix)
ticlopidine (Ticlid)
With what side effects is ticlopidine (Ticlid) associated?
agranulocytosis
thrombotic thrombocytopenia purpura
GI intolerance
** requires lab monitoring, not used as much as aspirin and plavix **
What is the most important diagnostic test for establishing the classification of a seizure disorder?
EEG
Why are imaging studies done following an initial seizure?
MRI or CT to r/o brain tumor
Which type of seizure does NOT involve loss of consciousness?
simple partial
What differentiates a complex partial seizure from a simple complex?
complex partial involves loss of consciousness
What neurotransmitter is lacking in Parkinson’s disease?
dopamine
What is the trio of symptoms in Parkinson’s disease?
rigidity
tremor
bradykinesia (slow movement)
What are the two categories of medication in Parkinson’s disease?
those which increase available dopamine
and
anticholinergics which alleviate tremor and rigitity
Parkinson’s complaint -
“my feet are sticking to the floor”
adjust which type of med?
dopamine
Parkinson’s complaint -
“I have to rock several times to get up”
adjust which type of med?
dopamine
Parkinson’s complaint -
“my tremor is much worse”
adjust which type of med?
anticholinergic
Parkinson’s complaint -
“I’m feeling very rigid”
adjust which type of med?
anticholinergic
What is the marker for Parkinson’s disease?
none known
Bell’s palsy -
able to move forehead?
NO
Stroke -
able to move forehead?
YES
Bell’s palsy -
theory on causation
reactivation of herpes virus
Bell’s palsy -
abrupt or insidious onset?
abrupt
Bell’s palsy -
which cranial nerve?
facial - CN VII
Bell’s palsy -
treatment?
prednisone taper
acylcovir
Bell’s palsy -
typical side of the face?
R
stabbing or electric shock type of pain on one side of the face
trigeminal neuralgia
Trigeminal neuralgia -
which cranial nerve?
trigeminal - CN V
Trigeminal neuralgia -
can be related to what other disorder?
MS
Trigeminal neuralgia -
management
anti-seizure drugs
muscle relaxants
tricyclic antidepressants
