MKSAP Neuro VI Flashcards
Treatment of choice for prevention of chronic tension-type headache
amitriptyline
New headache after age 50 years, use of an anticoagulant, and progressive headache pattern are all red flags indicating a ____. Other red flags for secondary headache include first or worst headache, abrupt-onset or thunderclap attack, episode associated with neurologic symptoms lasting more than 1 hour, alterations in consciousness, abnormal physical examination findings, and onset after exertion, sex, or Valsalva maneuvers.
Secondary head ache.
Brain MRI is study of choice
In patients with multiple sclerosis who take fingolimod as a disease-modifying therapy, monitoring with ______ are necessary because of the increased risk of ___.
regular ophthalmic examinations; macular edema
Fingolimod also requires first-dose monitoring because of ___.
The first-dose bradycardia that occurs in most patients and should not be used in patients with heart block.
_____ is a language-predominant neurodegenerative dementia in which language is often the only cognitive domain affected for years before the development of additional cognitive deterioration; structural brain imaging often shows asymmetric involvement of the _____.
Primary progressive aphasia; left temporal lobe
How does metaclopramide work?
Dopamine-blocking agent (so it can cause similar SFX to antipsychotics like tardive dyskinesia)
What is akathisia?
movement disorder characterized by a feeling of restlessness and an overwhelming need to be in motion manifested as pacing, rocking from foot to foot, lifting the feet as if marching in place, and crossing and uncrossing the legs;
What is acute dystonic reaction?
sustained, frequently painful muscle contractions that can cause abnormal twisting postures, repetitive movements, and difficulty speaking.
After the initial hospitalization, however, the risk of recurrent ischemic and hemorrhagic stroke remains increased if the blood pressure is higher than ______.
130/80 mm Hg (you should start antihypertensives if BP is higher than that on follow-up)
Oral prednisone administered within _____ of symptom onset expedites the speed and rate of full recovery in patients with Bell palsy.
72 hours
How does transverse myelitis look like on MRI
T2-weighted MRI with hyperintense lesion with peripheral contrast enhancement in the spinal cord
If transverse myelitis is refractory after high dose dex, what do you do?
Plasma exchange therapy
What is Glatiramer acetate
copolymer of four amino acids that, among other mechanisms of action, may bind major histocompatibility complex molecules and induce a shift in the immune response away from autoimmunity
What is PML (progressive multifocal leukoencephalopathy) caused by?
Reactivation of JC virus
In a patient with mild cognitive impairment, _____ and _____ have a greater than 80% sensitivity and specificity in identifying Alzheimer disease as the cause.
decreased Aβ42 peptide and increased tau protein and p-tau levels in the cerebrospinal spinal fluid
