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PNLE > MS Neuro > Flashcards

MS Neuro Flashcards

1
Q

What Cranial Nerve is affected in Trigeminal Neuralgia?

A

CN V

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2
Q

DOC for Trigeminal Neuralgia

A

Carbamazepine (Tegretol)

An anticonvulsant drug; used for analgesic effect for neuropathic pain by calming down the nerves

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3
Q

TSL of Carbamazepine (Tegretol)

A

5-12 mcg/mL

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4
Q

_________ pain indicates nerve damage

A

Neuropathic

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5
Q

Adverse Effect of Carbamazepine (Tegretol)

A

Agranulocytosis

WOF: Infection
Monitor: CBC

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6
Q

Surgery for Trigeminal Neuralgia

A

Retrogasserian Rhizotomy
- killing nerve fibers responsible for pain signals

2nd Option: Microvascular Decompression
- relocation of cerebral artery that compresses trigeminal nerve

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7
Q

Alternative Medications for Trigeminal Neuralgia

A

⭐ Baclofen (Lioresal)

Others: Gabapentin (anticonvulsant), Duloxetine (SNRI = antidepressant and for neuropathic pain), Lamotrigine

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8
Q

Alternative medication for Trigeminal Neuralgia which hits two birds in one stone (an antidepressant and for neuropathic pain)

A

Duloxetine (SNRI)

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9
Q

⭐ Temporary unilateral facial paralysis ⭐ affecting CNS ___ exhibited by exacerbations and remissions

A

Bell’s Palsy; VII

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10
Q

Gradual improvement in Bell’s Palsy occurs in how many weeks?

A

3-5 weeks

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11
Q

Full recovery usually takes up to in Bell’s Palsy?

A

3-6 months

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12
Q

Treatment in Bell’s Palsy should be initiated ____ hours of symptom onset

A

72 hours

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13
Q

⭐ In Bell’s Palsy, viral infection confuses immune system, thus triggering autoimmune. Give the 4 causative factors:

A
  • Herpes Simplex (STD)
  • Herpes Zoster (Shingles)
  • Epstein-Barr Virus (Mononucleosis; Kissing Virus)
  • Cytomegalovirus
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14
Q

⭐ It is characterized by a facial droop / sag / wrinkling / flaccid

A

Bell’s Palsy

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15
Q

Steroids for Bell’s Palsy

A

Prednisone (Strongest)

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16
Q

⭐ Vitamin B complex (B1, B6, B12) is a management for Bell’s Palsy. Enumerate all B complex

A
  • B1 (Thiamine)
  • B2 (Riboflavin)
  • B3 (Niacin)
  • B5 (Panthothenic Acid)
  • B6 (Pyridoxine)
  • B7 (Biotin)
  • B9 (Folic Acid)
  • B12 (Cyanocobalamin)

TIP: Ta Ra Na Pa Py BFC

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17
Q

In Bell’s Palsy, when should you wear eye patch and protective glasses (sunglasses, goggles)

A

AM - Protective Glasses
PM - Eye Patch

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18
Q

What kind of stimulation is done in Bell’s Palsy?

A

Electrical Stimulation; this wakes up the sleeping or paralyzed muscles which speeds up recovery

Other: Moist Heat & Gentle Massage

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19
Q

⭐ Earliest Sign of Myasthenia Gravis

A

Ptosis
- Descending manifestations

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20
Q

A neuromuscular condition affecting myoneural junction leading to generalized muscle weakness or voluntary muscle problem

A

Myasthenia Gravis

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21
Q

⭐ Primary cause of Myasthenia Gravis

A

Autoimmune

d/t damaged acetylcholine receptor sites

22
Q

⭐ Diagnostic Test for Myasthenia Gravis

A

Tensilon Test

23
Q

This is given for myasthenic crisis for stablization or to rule out cholinergic crisis

A

IV Edrophonium

24
Q

What does a relief of symptoms within 5-10 minutes after administration of Edrophonium mean?

A

(+) Myasthenia Gravis

25
Q

Ice Test is a localized test for muscles in myasthenia gravis. Cold temperature is placed on an affected area for how many seconds or minutes?

A

60 seconds / 1 minute

26
Q

Immunosuppressants for Myasthenia Gravis

A

Methotrexate & Azathioprine

27
Q

Anticholinesterase or Long-Acting Cholinergic Drug (Maintenance Use) for Myasthenia Gravis

A

Pyridostigmine & Neostigmine

Tip: -stigmine

EXCEPT EDROPHONIUM because it is SHORT-ACTING

28
Q

Best Time to Administer Anticholinesterase

A

AM, Before Meals (ADLs and prevention of dysphagia)

29
Q

Initial sign that the drug is effective in Myasthenia Gravis

A

Increased strength in chewing and swallowing

30
Q

Type of Crisis in Myasthenia Gravis caused by undermedication

A

Myasthenic Crisis

31
Q

Type of Crisis in Myasthenia Gravis caused by overmedication

A

Cholinergic Crisis

32
Q

Drug used for Myasthenic Crisis

A

Tensilon

33
Q

Drug used for Cholinergic Crisis

A

Atropine (Fast-Acting Anticholinergic)

34
Q

⭐ Always prepare this at the bedside of those with Myasthenia Gravis

A

Tracheostomy Set, Bag-Valve Mask, Endotracheal Tube

35
Q

Dialysis of plasma wherein the antibodies are targeted

A

Plasmapheresis

36
Q

⭐ Surgery for Myasthenia Gravis

A

Thymectomy (responsible for production of WBC)

37
Q

Other Term for Gullain-Barre Syndrome

A

Acute Idiopathic Polyneuritis

38
Q

⭐ A condition characterized by a temporary shutdown of motor and sensory nerves causing a temporary body paralysis

A

Gullain-Barre Syndrome

39
Q

⭐ A person has ascending paralysis. What is the supporting history for diagnosis of GBS?

A

Recent history of viral or GI infection

40
Q

⭐ The only bacteria causing GBS which causes gastroenteritis, an inflammation of stomach and intestines causing upper and lower GI symptoms

A

Campylobacter jejuni

41
Q

⭐ This is characterized by paresthesia (pins & needles)

A

Gullain-Barre Syndrome

42
Q

A permanent, irreversible condition exhibited by exacerbations and remissions characterized by a progressive, demyelination of CNS leading to infalmmation of myelin sheath

A

Multiple Sclerosis

43
Q

Triad that confirms multiple sclerosis

A

Charcot’s Triad
- Stacatto
- Intentional Tremors
- Nystagmus

44
Q

Electrical shock sensation along the spine and the arms upon neck flexion in people affected by Multiple Sclerosis

A

Lhermitte’s Sign (Barber Shock Phenomenon)

45
Q

Worsening s/sx of MS when the person is exposed to hot temperatures

A

Uhthoff’s Phenomenon

46
Q

⭐ Diagnostic Test for Multiple Sclerosis

A

Electroencephalogram (EEG)

Electrodes are attached in the head to assess brain waves or activity

47
Q

Lumbar puncture shows ______ gamma globulin levels and a ______ serum globulin

Choices: Decreased, Normal, Increased

A

increased, decreased

Rationale: Inflammation is in the brain, not in the blood

48
Q

⭐ DOC for Multiple Sclerosis

A

Interferons

TIP: INTERFERes progression of MS

49
Q

Interferons for Multiple Sclerosis

A
  • Avonex
  • Betaseron
  • Copaxone ⭐
50
Q

Interferons for Multiple Sclerosis are best taken on?

A

Morning to perform ADLs

51
Q

When administering interferons for multiple sclerosis, what should you watch out for?

A

Flu-Like Symptoms

PNLE (15 decks)

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