Hon - Review And Bolded Words Flashcards
What characterizes FTD?
Emotional dullness, loss of moral judgement, progressive dementia
Common migraine location?
Gender ratio and age?
Description?
Unilateral
Female, 35-40 y/o
Throbbing, sharp, pressure
When is warfarin generally indicated for stroke patients?
AFib Prosthetic Valve MI Atrial septal defect Hypercoagulable state Large vessel disease Aortic arch disease
Aphasia, right sided sensory and motor symptoms, right visual field cut is associated with what kind of stroke?
Left hemisphere
What helps Essential tremor temporarily?
Long-term tx?
EtOH
Propanolol, primidone, benzodiazepine
What type of M.S. Has a slow downhill course?
Exacerbations and remissions?
Secondary progressive
Relapsing remitting
NIH stroke scale greater than 20 indicates what?
Less than 10?
17% risk of hemorrhage
2-3% risk of hemorrhage
ADEM occurs when?
Reoccurs when?
Following a viral infection or immunization
NEVER
What are the symptoms of CBD?
Cortical and BG dysfunction
Bradykinesia and rigidity
Sensory loss, apraxia, myoclonus, aphasia
Writhing, sinuous movements?
Athetosis
What is the triad of normal pressure hydrocephalus?
Dementia
Gait disturbance
Urinary incontinence
What is a defined by a post-ictal state?
Confused or disoriented
What is the most important information in the diagnosis of epilepsy?
The history of the event
Devic’s disease is aka what?
Testing for what in the blood and CSF makes this diagnosis?
Treat how?
Neuromyelitis Optica (NMO)
Aquaporin antibodies
Steroids followed by immunosuppresion
All stroke patients should have IV access but what should never be included in the IVF?
Glucose
Irregular, brief, dance like movements?
Chorea
When does Wilson’s disease present?
Clinical features?
Treatment?
Childhood or young adult
Bradykinetic AND hyperkinetic
De-Penicillamine (chelater)
LP for CSF reveals what in M.S. Patients?
Oligoclonal bands
Increased IgG
What medication is used to treat an acute exacerbation in M.S.?
High dose corticosteroids (solumedrol)
How long does a classic migraine last?
What’s special about it?
15-30 minutes
AURA
Sustained muscle contractions that produce twisting and repetitive movements and abnormal postures?
Dystonia
What is the treatment for AD?
Slow the progression of the disease
AChE inhibitors and NMDA receptor antagonist
Inheritance of Wilson’s disease?
Produces what dysfunction?
Due to what?
Autosomal recessive
Neurologic and hepatic
Decreased binding of copper to cerruloplasmin -> free copper
Cluster HA location?
Behavior?
Associated symptoms?
100% unilateral, orbitotemporal
Frenetic, pacing, rocking
Ipsilateral ptosis, Miosis, conjunctival injection, lacrimation, stuffed or runny nose
Hallmark of idiopathic torsion dystonia?
Dystonic movements and postures with NO other signs
What is the condition characterized by prolonged seizure (more than 10 min) or repeated seizures without recovery in between?
1st line treatment with what?
Status epilepticus
Benzodiazepine
Which type of M.S. Is the most common?
2nd most common?
Relapsing remitting (45-50%)
Secondary progressive (20-25%)
Essential tremor has what clinical presentation?
Postural or kinetic tremor of both hands, may involve head or neck
Movement induced tremor, OPPOSITE of PD
What is characteristic of a seizure?
Urinary/bowel incontinence
Tongue injury
Tonic/clonic movements
Post-ictal state
What defines dementia?
Decline in memory and at least 1 other cognitive function
Tension-type HA intensity?
Disability?
Location?
Prodrome/aura?
Mild to moderate
Does NOT prohibit daily activities
Bifrontal, bioccipital neck, shoulders
NONE
What is the tetrad of symptoms to Diffuse Lewy Body Disease?
Dementia
Bradykinesia/rigidity with NO tremor
Psychotic symptoms (visual hallucination)
Extreme sensitivity to antipsychotic agents
What can treat spasticity in M.S.?
Intention tremor?
Urinary urgency?
Urinary retention?
Baclofen, tizanadine, diazepam
Propranolol, primidone, clonazepam
Oxybutinin, Detrol LA
Bethanechol
Clinical course of Diffuse Lewy Body Disease?
Progresses more rapidly than AD
Periods of markedly increased confusion lasting days to weeks, mimics delirium
How is epilepsy defined?
2 or more unprovoked seizures
What is a temporary loss of consciousness caused by a fall in BP?
Syncope
Ipsilateral ataxia, vertigo, nystagmus is associated with stroke?
Cerebellar
What are the % findings on an EEG of petit mal with hyperventilation?
90%
Percentages of following stroke:
Hemorrhagic vs. ischemic
20% to 80%
Brief, rapid, repetitive, seemingly purposeless stereotyped action?
Tic
Cluster HA intensity?
Affects who?
Recent association with what?
Severe, excruciating
Males
obstructive sleep apnea
SUNCT syndrome is what?
Occurs in whom?
Tx?
Short lasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing
Men over 50
Lamotrigine
Large amplitude, flinging movement, usually from the proximal part of an extremity?
Hemiballism
What is mild cognitive impairment disease?
Memory complaint that is isolated
Tested abnormal memory for age, precursor to AD
How to diagnose Wilson’s?
Serum cerruloplasmin level
AND
24 hr. Copper excretion in urine
What are the symptoms of PSP?
Bradykinesia, rigidity
Loss of voluntary eye movements (vertical gaze)
What are the symptoms of MSA (Shy-Drager)?
Bradykinesia and rigidity
Pronounced autonomic dysfunction
Pronounce ORTHOSTASIS
Tourette’s more common in who?
Most cases are what?
Treatment?
Males
Sporadic
Clonidine, Haldol, Phenothiazine
What symptom of normal pressure hydrocephalus is more likely to be reversed with shunting?
Gait disturbance
The following is describing what?
disorder of the brain and spinal cord characterized by periods of increasing and decreasing symptoms and signs (exacerbation and remissions) due to loss of myelin
M.S.
What anti platelet agents are used to control stroke?
ASA
Aggrenox
Plavix
What will a MRI show in a patient with M.S.?
Ovoid lesions of high signal on T2W1 in the periventricular white matter and spinal cord, lesions may enhance
What is the treatment for Trigeminal neuralgia?
Carbamazepine
Oxcarbamazepine
What drugs are used for the maintenance of M.S.?
IFNs
Some others
What is the criteria for vascular dementia?
Focal signs on neurologic examination, normally to 1 side
What may be a form of arteritis and occurs in children and adolescents as a complication of a previous group A strep infection?
Characterized how?
Sydenham’s Chorea
Unilateral choreiform movements
CN findings with contralateral hemisensory or hemimotor symptoms, and vertigo indicate stroke where?
Brainstem
PD has Lewy bodies where?
Dementia occurs when?
Hallucinations when?
Midbrain
Occurs late
In response to antiparkinsonian drugs
What is an example of focal torsion dystonia?
Writer’s cramp
Dystonia confined to 1 focal area
What is a contraindication for Triptan use?
Raynaud’s syndrome
HTN
Ergotamines
MAOI
Paroxysmal Hemicrania is very similar to what?
Treated with what drug?
Cluster headache
Indomethacin
What are the common visual disturbances in diffuse Lewy body disease?
Response to Levodopa is what?
Animals and children
POOR
Benign M.S. Cases make up what %?
What makes up 15-20%?
10-15
Primary progressive
BOTOX is FDA approved preventative treatment for what?
Chronic migraine
What is characterized by a spontaneous attack of vertigo that does not involve hearing loss or tinnitus and resolves spontaneously?
What other Sx?
Vestibular neuronitis
Vertigo
Nausea
Vomiting
What is a theory for cause of Meniere’s Disease?
INC in endolymph volume -> endolymph hydrops
What antibiotics can cause equilibrium disorder?
Aminoglycoside
Tetracycline
Vancomycin
Repeated episodes of vertigo without other neurological symptoms should suggest what?
Non-neurological cause
What are the peripheral causes of vertigo?
BPPV
Vestibular neuronitis
Meniere’s
Drug induced ototoxicity
What is SCA1?
Olivopontocerebellar
What is SCA3?
Machado-Joseph
A port wine stain that extends to the upper eyelid indicates what?
Susceptible to what?
Ataxia-Telangiectasia
Recurrent sinopulmonary infections
What causes coma?
B/L hemisphere dysfunction
Or
Brainstem dysfunction
Consciousness depends on arousal from what brain structure?
Cerebral cortex by the ARAS
What is mental blunting, increased sleep, aroused to mild stimuli?
Obtundation
What is disorientation, stimuli misinterpreted, hallucinations?
Delirium
What is arouses only to noxious stimuli and not environmental, only rudimentary awareness?
Stupor
A musty smell on a pt indicates what?
Hepatic failure
What 3 things cause pinpoint pupils?
POP
Pilocarpine
Opiates
Pontine Lesion
Bobbing nystagmus means lesion where?
Ping pong?
Pons
Midbrain
Convergence and retractory nystagmus means lesion where?
Mesencephalon
Doll’s eye is testing where?
Caloric reflex?
mid pons
Low pons
What is Hyperpnia regulating alternating with apnea?
Lesion where?
Cheynes-Stokes breathing
Diencephalon
Apneustic breathing is where?
Lower pons
Pupillary reactions are usually preserved in what type of stupor/coma?
Diffuse or metabolic
