MKSAP Neuro Flashcards
Tx of menstrual migraine
mefenamic acid
migraine w/ aura is CI for what medication
OCPs
sxs more associated with hemorrhagic, not ischemic stroke
HA
vomiting
HTN
impaired LOC
sxs of Lambert Eaton
proximal UE and LE weakness
autonomic sxs (dry eyes, ED)
no DTRs
proximal limb weakness
autonomic sxs (dry eyes, ED)
no DTRs
Lambert Eaton
inclusion body myositis usually affects what muscles
quadriceps
deep finger flexors
tx of myasthenia crisis (extreme m weakness that might need intubation)
plasma exchange
med CI in myasthenia gravis
fluoroquinolones aminoglycosides mcrolides lithium Mg
dx of guillain barre
EMG
CSF results of guillain barre
albuminocytologic dissociation (spinal fluid cell count normal but spinal fluid protein level elevated)
severe, acute onset headache is called
thunderclap headache
causes of thunderclap headaches
subarachnoid hemorrhage
carotid or vertebral a dissection
venous sinus thrombosis
reversible cerebral vasoconstriction
INR level for rtPA
1.7 or less
BP must be below ___ for rtPA
185/110
preferred meds to lower BP in stroke
IV labetalol or nicardipine
anti nausea med that can cause EPS
prochlorperazine
metoclopramide
acute unilateral headache with Horner syndrome
acute carotid dissection
things to do if suspect SAH
CT
if neg, LP
tx for MS related fatigue
amantadine (DA rec agonist)
tx for primary progressive MS
symptomatic tx
big diff among SUNCT, paroxysmal hemicrania and cluster HA
SUNCT lasts 30-120 seconds
paroxysmal hemicrania lasts 15 min
cluster lasts an hour
tx of SUNCT, paroxysmal hemicrania, and cluster HA
SUNCT: lamotrigine
paroxysmal hemicrania: indomethacin
cluster: O2, verapamil
meds to tx essential tremor
propranolol (#1)
primidone
gabapentin
topiramate
drugs of choice for epilepsy in pts with liver dz
levetiracetam
gabapentin
pregabalin
(all renally excreted)
anti epileptic that’s highly protein bound
phenytoin
myeloneuropathy and anemia in a patient with gastric bypass, check for
copper deficiency
too much zinc (which can decrease copper levels)
B12 deficiency
neuromyelitis optica has predilection for
optic nerves
spinal cord
defn of medication overuse HA
HA more than 15 times a month
med use of more than 10 days a month
reasons not to do CEA in large stenosis (and do carotid angioplasty and stenting instead)
stenosis above C2
medical conditions that are risky for surgery
radiation induced stenosis
restenosis after CEA
2 things to order with new onset seizure
EEG
MRI
symmetric spasticity especially of lower limbs
muscle weakness
primary lateral sclerosis
weakness
sensory loss
decr DTRs
chronic inflammatory demyelinating polyradiculoneuropathy
children and adolescents with seizures in sleep
rolandic epilepsy
child with myoclonic and generalized tonic clonic seizures when waking up
juvenile myoclonic epilepsy
med if SAH
nimodipine (prevent vasospasm)
tx of status epilepticus
IV lorazepam or diazepam
solitary mass in deep white matter, and next step
primary CNS lymphoma (do stereotactic brain biopsy, then tx with MTX then whole brain radiation)
ADR of DA agonists (ropinirole, pramiprexole, bromocriptine)
incr compulsive bx
sleep attacks
orthostatic HoTN
when can you withdraw seizure meds
what seizure free for 2 years (and doesn’t have exception of lifelong seizure d/o)
BP goal if use tPA
less than 180/105 for 24 hours after giving tPA
migraine with aura, don’t use what med
OCPs!
migraine tx in breastfeeding mother
sumatriptan
frovatriptan
