N3 Flashcards
Clinical findings of Alzheimer’s disease?
Early
Late
Early?
Anterograde amnesia(immediate recall affected, distant memories preserved) Visuospatial deficit (lost in neighbor) language difficulty(difficulty finding word) Cognitive impairment with progressive decline
Late?
Neuropsychiatric(hallucination and wandering)
Dyspraxia(difficulty in performing learned motor skill)
Lack of insight regarding deficit
Noncognitive neurologic deficit(pyramidal and extrapyramidal motor, myoclonus, and seizure)
urinary incontinence
Cause and symptom of cochlear hair damage?
Metabolic load
Loud voice(High-frequency voice loss and base of cochlear hair cell damage)
a patient will have Sensorineural hearing loss
using earplug is preventive
cerebra hemorrhage fetcher?
2nd common site for IPH
Occipital headache radiate to the neck and shoulder
Nech stiffness(extension to 4th ventricle)
Nystagmus
Ipsilateral Hemi-ataxia(Corticopontocerebral fibers decussate twice)–vermis injury
ipsilateral Extremity ataxia–hemisphere injury
If expand–cranial palsy or stupor and comma
Decompress if size > 3cm
Hemineglect syndrome?
Damage of the non-dominant(usually left)hemisphere
Perform commands on the ipsilateral side
Not see contralateral space(detect by asking to write clock)
Agnosia(not know their defect)
Clinical presentation of Mystenia gravis?
Fluctuating and fatigable proximal muscle weakness
Occular(diplopia and ptosis)
Bulbar(dysphagia and dysarteria)
Respiratory(in crisis)
Cause of exacerbation?
medication(aminoglycoside,flouroquinolol)
NM blocking agent
Beta-blocker
MgSo4
Penicillamine
Physiologic stress(Inf.,Surgery,Px,childbirth)
Diagnosis?
Ice pack test(bedside)
Ach-R binding Ab(specific, diagnostic)
Chest CT(for all patient)
Managment?
ACE inhibitor(physostigmine)
Immunosuppressant for acute exacerbation
Tymectomy(Good clinical progresion enen patient w/o mass)
Corticosteroid indication in multiple sclerosis?
Acute exacerbation
disabling symptoms
plasmapheresis in refractory case
Meralgia paresthetica?
Pain, paraesthesia, and numbness in LFCN distribusion
Compression of LFCN by inguinal ligament
Due to tight belt, clothing and surgery
Obesity,surgery(arthroplasty),lumbar lordosis(Px) and DM increase the risk
Wt loss,behavior change and anticonvulsant(gabapentin in sever case)
Internuclear ophthalmoplegia?
affected side fails to adduct but contralateral eye abducts with horizontal nistagmus
Due to the heavy myelinated medial longitudinal fiber( paired neural tract that communicates CN III with Vl)injury
Cause?
Unilateral–Lacunar stroke with pontine artery
Bilateral–Multiple sclerosis
Treatment of Parkinson’s disease?
Anticholinergic (Triphenixidil)-especially for tremor Levodopa MAO inhibitor(selegiline) can be used for mild symptoms
What is pronator drift(involentary hand pronation on patient supinate on closed eye) indicates?
Upper motor lesion/pyramidal tract b/c affect more supinator muscle
Ischemic stroke present within 3-4.5 Hr?
Alteplase
IS without previous antiplatelet treatment?
Asprin
Start within 24 hours of symptoms
IS occur on a patient with Asprin?
Asprine +Clopidogril/dipyridamol
Stroke with evidence of atrial fibrillation?
Prolonged anticoagulant therapy
Stroke with large anterior circulation artery occlusion with presentation 24 hr of symptoms?
Mechanical thrombectomy(whether alteplase used or not) then Asprin
Patient with intracranial large artery atherosclerosis?
Asprin with clopidogril for 90 days then Asprin.
Unfractionated heparin/LMWH and acute stroke?
Not should be used increase the risk of bleeding
cause of subdural hematoma?
Rapture of bringing vien