Internal Med Neurology Flashcards
s/s of bells palsy
unilateral weakness of facial muscles
diagnosis of bells palsy
clinical
treatment of bells palsy
- prednisone
- valacyclovir
s/s of cerebral aneurysm rupture
thunderclap HA
s/s of cluster HA
- ipsilateral autonomic sx (HA, sweating, skin flushing)
- grouped attacks over weeks to months
Treatment of cluster headaches
high flow oxygen with non-rebreather
etiology of complex regional pain syndrome
follows trauma
s/s of CRPS
- neuropathic pain
- swelling, erythema, edema
- joint fibrosis and stiffness
diagnosis of CRPS
- clinical
- increased uptake on bone scan
treatment of CRPS
- NSAIDS
- add neuropathic pain med
- Lidocaine
- Bisphosphonates if abnormal uptake on bone scan.
etiology of encephalitis
herpesviruses
s/s of encephalitis
- fever
- n/v
- HA
- altered mental status
- meningeal signs
diagnosis of encephalitis
CSF PCR amplification
treatment of encephalitis
- antivirals
- neuro checks
s/s of essential tremor
- bilateral
- goal directed movements
- resolves with rest and alcohol
- exacerbated by stress
diagnosis of essential tremor
clinical
treatment of essential tremor
- propranolol
- primidone
Etiology of giant cell arteritis
Autoimmune vasculitis
s/s of giant cell arteritis
- jaw claudication
- temporal HA
- scalp tenderness
- Vision loss/changes if severe
diagnosis of giant cell arteritis
temporal artery biopsy
treatment of giant cell arteritis
high dose steroids
etiology of GBS
Autoimmune process stimulated by viral or bacterial infection (campylobacter jejuni or CMV MC i think)
s/s of GBS
- paresthesias in feet and works proximally
- pain
- proximal muscle weakness
- paralysis
- diminished DTRs
diagnosis of GBS
LP with CSF analysis
treatment of GBS
- hospitalization
- plasmapheresis and IVIG
etiology of huntington’s disease
genetic mutation
s/s of huntingtons disease
- chorea
- progressive loss of voluntary motor control
- mental status changes
- hypotonia
diagnosis of huntington’s disease
genetic testing.
management of huntington’s disease
- dopamine inhibitor
- symptomatic
most common primary malignant brain tumor
glioma
most aggressive glioma
glioblastoma
MC malignant brain tumor in children
Medulloblastoma
astrocyte
Forms blood-brain barrier in CNS
oligodendrocyte
creates myelin
ependymal cell
create CSF
microglia
clear debris and dead neurons
management of glioma
- surgical resection
- if over 40 or unable to remove whole tumor: radiation followed by chemo
characteristics of medulloblastoma
originates in the cerebellum
meningioma
tumor that develops of the dura mater or arachnoid mater
etiology of meningitis
- hematogenous spread
- strep pneumo
s/s of meningitis
- HA
- fever
- meningeal signs
- rash with neisseria
diagnosis of meningitis
lumbar puncture
treatment of meningitis
- dexamethasone
- rocephin + vanc
- acyclovir
- infant: cefotaxime
- under 1mo and over 50y: ampicillin
- tick season: doxy
- anaerobic need: flagyl
s/s of migraines
- unilateral, throbbing, headaches
- n/v
- aura
- photophobia
- phonophobia
treatment of migraines
- naproxen
- triptans
- preventative meds
etiology of multiple sclerosis
autoimmune
s/s of multiple sclerosis
- paraesthesias
- hypesthesias
- unpleasant sensations
- pain
- optic neuritis
- weakness
- trigeminal neuralgia
diagnosis of multiple sclerosis
- 2 or more signs and 2 or more symptoms
- sx lasting over 24 hours and separated by at least a month
- MRI lesions
- oligoclonal bands on CSF
- elevated intrathecal IgG
treatment of multiple sclerosis
- steroids
- plasma exchange
- ocrevus
etiology of myasthenia gravis
- autoimmune
- anti-AchR
- anti-MuSK
s/s of myasthenia gravis
- progressive muscle weakness
- ptosis
diagnosis of myasthenia gravis
- ice pack test
- serology
- repetitive nerve stimulation
- single fiber electromyography
treatment of myasthenia gravis
- anticholinesterase inhibitors (pyridostigmine)
- Steroids
- IVIG (myasthenic crisis)
- thymectomy
s/s of parkinsons
- tremor
- bradykinesia
- intellectual decline
- rigidity
diagnosis of parkinsons
clinical
treatment of parkinsons
levo-dopa
etiology of carpal tunnel
compression of median nerve
s/s of carpal tunnel
- neuro sx to digits 1-3
- thenar trophy
- tinel and phalen
diagnosis of carpal tunnel
NCS/EMG
treatment of carpal tunnel
cock up wrist splint
etiology of tension HA
stress
treatment of tension HA
- NSAIDs and tylenol
- control stress and anxiety
