Master the Boards Flashcards
Which stroke artery presents with weakness/sensory loss on one side, homonymous hemianopsia, and aphasia?
MCA
Which stroke artery presents with personality/cognitive defects, urinary incontinence, and leg>arm weakness?
ACA
Which stroke artery presents with sensory loss of half of face, 9th and 10th CN involvement, and sensory loss and ataxia of the limbs?
PCA
If the patient is already on aspirin at the time of the stroke, what should you do (2 options)?
- Add dipyridamole
or - Switch to clopidogrel
Below or equal to what age do you fix a PFO in context of a stroke?
60
What commonly used meds can increase the metabolism of lamotrigine to ineffective levels?
Estrogens/OCPs
What medication should you give for subarachnoid hemorrhage to prevent stroke?
Nimodipine
What dx presents with loss of all function except for position and vibratory sense, paralysis an dloss of DTRs at the level of infarction?
ASA infarction
What dx presents with loss of position and vibratory sensation?
B12 deficiency or neurosyphilis
What dx presents with contralateral/ipsilateral?
Brown-Sequard
What dx presents with loss of pain and temperature across upper back and both arms (cape-like distribution)?
Syringomyelia
T/F: antiparkinson drugs can cause psychosis?
True
What do you add if a patient with Parkinson’s on tx becomes psychotic?
Add clozapine or an atypical antipsychotic
What’s the tx for restless leg syndrome?
Pramipexole (DA agonist)
Which trinucleotide repeat is present in Huntington’s?
CAG trinucleotide on chromosome 4
How is ALS diagnosed?
Electromyography
What does electromyography show in ALS?
Loss of neural innervation in multiple muscle groups
How are CK levels changed in ALS?
Elevated
What’s the most common cause of death in ALS?
Respiratory failure
What are 2 drugs that delay ALS progression?
- Edaravone
2. Riluzole
What is “pseudobulbar affect?”
Emotional lability in ALS, stroke, and MS
What’s the best treatment for pseudobulbar affect?
Dextromethorphan plus quinidine
What dx presents with distal weakness and sensory loss, wasting in the legs, tremor, and foot deformity with a high arch?
Charcot-Marie-Tooth
What’s the test for Charcot-Marie-Tooth?
Electromyography
Is there a treatment for Charcot-Marie-Tooth?
No
Which nerve palsy presents with wrist drop?
Radial
“Radial Rist”
What nerve is “Saturday night palsy?”
Radial
Which nerve palsy presents with pain/numbness on outer aspect of one thigh, often from obesity, pregnancy, or sitting with crossed legs?
Lateral cutaneous nerve of thigh
Which nerve palsy presents with pain/numbness in the ankle and sole of foot?
Tarsal tunnel
Which nerve is involved in tarsal tunnel?
Tibial
What’s the tx for Bell’s palsy?
Prednisone
Why does corneal ulceration occur with 7th CN palsy?
Because of difficulty closing the eye at night
What’s the direction of paralysis in Guillain-Barre?
Ascending from the legs
What’s the tx for Guillain-Barre?
IVIg or plasmapharesis (not combined)
What’s a variant of Guillain-Barre syndrome that involves the oculomotor nerve?
Miller-Fisher Syndrome
Which antibody tests Lambert-Eaton Myasthenic Syndrome?
Anti-P/Q-type voltage-gated calcium channel antibody
Lambert-Eaton vs MG pathophysiology?
Ab’s against presynaptic Ca channels vs. post-synaptic ACh channels
What’s the best tx for MG?
Pyridostigmine or neostigmine
What’s the first line treatment for AD?
Donepazil, rivastigmine, galantamine
Do you treat Lewy Body Dementia with Carbidopa/Levodopa?
Yes
Which dementia is rapidly progressive and involves myoclonic jerks?
Creutzfeldt-Jakob
