Amer's notes Flashcards
Dementia + Abn gait + urinary incont, Dx?
Normal pressure hydrocephalus
Muscle rigidity + Dementia + old age + Behaviroal changes + hallucinations, Dx?
Lewy body dementia
Muscle rigiditiy + Tremor only
Parkinsons
Young male + Weakness in lower extremity + weakness in face + upper extremity nomral + Hx of diarrhea 1 wk ago, dx?
GBS “post upper RTI or Diarrhea”
Mx of GBS & Mysthenia in acute attack
IVIG or Plasmaphersis “ICU”
Fasiculations in the dominant hand + Sensory normal + Pulmonary failure
ALS
Weakness eye & diplopia after exercise + proximal muscle weakness in progressive manner + Repetition causes more weaknes Dx?
Myasthenia gravis
Patient w/small lung cancer + proximal muscle weakness + improves with repetition, dx?
Lambert syndrome
MS in acute attack (Gait impairement, blurry vision, fatigue) + MRI showed new leison
High dose Steroid
GBS pathophysiology
Demylinating disorder.
Inv in GBS VS Mysthenia
Both LP
- GBS: NCS “it’s peripheral nerve disease”
- Mysthenia: MRI + EMG
Mx of mysthenia gravis in chronic
pyridostigmine
Inv for MS:
MRI will show periventricular plaque
No 1, RF for stroke
HTN
No. RF for CKD
DM
No1. RF fpr acute coronary syndrome
dyslipidemia
60y + Hemiparesis + 10 days post stroke, nxt?
Asprin. too late to do any acute mx
80 yrs + DM + HTN + Vision loss for 20min in left eye + resolved before reaching ER, Dx
TIA
“Criteria: <1hr, normal CT”
40 year + Demential + personality changes + No tremor or rigidity, Dx
Frontrotemproal
Alzehimers dementia diagnosed 1yr, Best inv:
MRI
initial is the mini-mental
Chromosome in Alzehimer disease
Chromosome 21
“tau, B-amyloid”
Elderly + Dementia + Gait changed & slow for 2m. Dx?
Normal pressure hydrocephalus..
Urinary incont is only in 20-30% of patients
tx of parkinson tremor:
Carbidopa/levidopa “it cause reduction in BP so only give in severe”
85 + DM & HTN + tremor + Gait abn + Shuffling gat + Mask face
Parkinsons
Intention tremor VS Resting tremor
Intention is cerebllar
Resting is parkinsons
Parkinson + low BP, dx?
shydragr
28 yr + 2d fever & lethargy + developed Seizure, Mx
this is Complicated Meningitis
Vancomycin + Ceftriaxone + steroid “reduce the edema in meningitis”
old + change level of conciousness + Fever + LP gram +Ve Bacilli +ve catalyse test, Mx?
only give ampicillin because it’s confirmed to be listeria monocytogenis
“No need to give vancomycin & ceftriaxone”
59yr + LP lymphocyte 90% + No gram stain findings, tx
- If there’s Photophobia, neck rigidity
- If there’s Change in mental status
- this is meningitis, so viral meningitis => Supportive
- This is encephalitis, So viral encephalitiy ==> Acyclovir “HSV is MC”
Indian + chronic headache + LP showed lymohcytosis, dx?
TB meningitis
51 Yr, MC organism for bacterial meningitis
Strep pneumonia
30 Female + Fever + headache + Neck rigidity, what do you expect to see in CSF
“Bacterial is the MC”
SO: High protein, Low glucose, & PMN
Prevention measure in meningitis & when to stop isolation
Droplet
after 24 hrs
Prevention measure in Covid:
PPE
Prevention measure in TB & when to stop isolation
airboren
2wk or 72 hours
Came from alhaj + Rash + convulsion + fever, organism?
nisseria meningitidis
Contact prophylaxis in meningitis with gram -ve dipplococci:
Ciproflaxocin
Pt after neurological intervention+ Fever + LP showed MRSA, Tx?
Vancomycin only.
we have the organism no need to add the other agents
Generlized seizure + 20mg diazipam (full dose) + still seizing, nxt?
- IV phenytoin
Repeat diazipam if he didn’t take the full dose. “which he took already”
prophylactic for cluster & migraine headache
- Verapmil “CCB –> Cluster –> Chronic”
- Betablocker “BB –> Bigraine” واحد بزكب
headache + Nasuea + Can’t tolerat noises + Normal vrain, tx?
triptan
Headache + red eye + unilateral tearing
O2
bilateral band headache - crushing - behind the eye, dx
tension headache
man + 2hr stroke w/CT showing ischemia+ hx of ischemic stroke 2m ago, mx?
asprin
avoid thrombolytic because recent stroke <3m
TB meningitis CSF findings?
lymphocyte, high protein, low glucose
late complications of meningitis
deafness
pathophysiology of Mg
Ab against Ach receptors
30 Female + L eye pain + Decreased direct pupillary reflex + normal indirect pupillary reflex + Decreased sensation in the same side of face + bilateral LL spasticity + loss sensation + povisitve babinski, best test?
MS “bizzare sx”: Brain & spinal MRI
45male + unilateral facial nerve weakness 1hr + medically free, Mx?
this is facial palsy give
steroid
Clinical features with abducent nerve palsy
Dilopia
nystagmus
esotropia
headache
30 yr, throbbing headache + N&V, mx?
triptan
