Management

Question 1

How do you determine if a likely stroke patient is within the tPA window?

Answer 1

If no evidence of hemorrhage on head CT then within 3-h time window

Question 2

What is shown to benefit the outcome of spinal cord injuries and within what time range must it be given?

Answer 2

high-dose IV methylprednisolone

given within 8 hours

Question 3

What is the best treatment for trigeminal neuralgia?

Answer 3

carbamazepine (Tegretol)

or phenytoin (Dilantin)
or gabapentin

Question 4

Name prophylactic treatments for migraines.

Answer 4

amitriptyline hydrochloride, propanolol, verapamil, valproate

Question 5

In what situation is prophylactic management of migraines indicated?

Answer 5

when HA occur at least 1 to 2 times per month

Question 6

What medications are used to treat an acute migraine attack?

Answer 6

metoclopramide hydrochloride, sumatriptan, ergotamine tartrate

Question 7

When is aspirin within 48 hours of acute ischemic stroke indicated?

Answer 7

when due to atherosclerotic thrombosis or embolism

Question 8

What is management of a patient with infective endocarditis?

Answer 8

IV antibiotics

no other antiplatelets or anticlotting

Question 9

Reversal of warfarin?

Answer 9

vitamin K - takes 12-24 hours

Prothrombin complex concentrate - rapid reversal (min-hours)

Question 10

Reversal of heparin?

Answer 10

Protamine sulfate

Question 11

Treatment for homocysteinuria?

Answer 11

B6, folate, B12

Question 12

What is riluzole used for and what is MOA?

Answer 12

ALS

MOA - glutamate inhibitor

Question 13

What drug class is ketorolac?

Answer 13

NSAID

Question 14

What is used for acute MS exacerbation to hasten neurologic recovery?

Answer 14

Glucocorticoids

Question 15

What medication can prevent vasospasm 3 days after SAH?

Answer 15

nimodipine

Question 16

What is the best management for Friedreich ataxia?

Answer 16

supportive, no disease-modifying therapies available

Question 17

What is first line therapy for restless leg?

Answer 17

dopamine agonists - pramipexole

Question 18

What birth defects are associated with phenytoin?

Answer 18

fetal hydantoin syndrome - orofacial clefts, microcephaly, nail/digit hypoplasia, cardiac defects, dysmorphic facial features

Question 19

What is first-line treatment for IIH?

Answer 19

acetazolamide

+ furosimide if continued sx

Question 20

What is the mechanism of acetazolamide?

Answer 20

inhibits choroid plexus carbonic anhydrase to decrease CSF production

Question 21

Treatment for lithium toxicity

Answer 21

hydrate if >4

then hemodialysis

Question 22

Treatment for acute dystonic reaction from antipsychotic.

Answer 22

benztropine - anticholinergic

Question 23

Patients with a-fib should be treated with long-term…

Answer 23

anticoagulation

warfarin

Question 24

Treatment for ALS?

Answer 24

Riluzole - glutamate inhibitor