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Clin Med > Neuro > Flashcards

Neuro Flashcards

1
Q

What are the signs/symptoms of a tension headache?

A

Non-pulsating, band-like pain
Tends to worsen over the course of the day

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2
Q

What is the treatment for a tension headache?

A

NSAIDs
Lifestyle changes
Triptans for refractory/severe symptoms

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3
Q

What are the signs/symptoms of a migraine?

A

Gradual onset
Periodic, throbbing/pulsatile pain (mod-severe) (typically lateralized)
N/V
Photo/phonophobia
Fatigue
Irritability

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4
Q

What is the treatment for a migraine?

A

If new, full workup of new acute HA
NSAIDs
Sleep
Vasoconstrictors
Triptans
Avoid triggers

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5
Q

When/how would you give prophylaxis for migraines?

A

More than 4 HA/month (beta blockers, SSRIs, gabapentin)

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6
Q

Which type of HA is more common in men than women?

A

Cluster HA

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7
Q

What are the signs/symptoms of a cluster HA?

A

Sudden, unilateral, transient, very severe/incapacitating pain
Non-throbbing
Not worse w/activity
Pt appears restless
Ipsilateral nasal congestion
Lacrimation/tearing

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8
Q

What is the treatment for a cluster HA?

A

100% O2
Triptans
Ca+ channel blocker (verapamil)
Prophylaxis (if meets criteria)

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9
Q

What is your suspected diagnosis if a pt presents with complaints of a unilateral HA w/tenderness to palpating temporal artery, and their labs reveal an elevated ESR/CRP?

A

Temporal arteritis

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10
Q

What is the treatment for temporal arteritis?

A

Temporal artery biopsy
High dose oral prednisone
Monitor ESR/CRP

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11
Q

What is your suspected diagnosis if a pt presents with pain and paresthesias in thumb, index, middle, and ring finger that gets worse as night and also describes feeling as if their extremity is “weak”?

A

Carpal tunnel syndrome

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12
Q

What is a test that can be ordered to confirm suspected carpal tunnel syndrome?

A

Nerve conduction test

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13
Q

What are the treatment options for carpal tunnel syndrome?

A

Splint
Injections
Surgery

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14
Q

What are the signs/symptoms of diabetic peripheral neuropathy?

A

Stocking glove distributed numbness
Mild (progressive) weakness of lower legs
Decreased DTRs
Gait abnormalities
Distal hair loss
Muscle wasting

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15
Q

What is the definition of syncope?

A

Abrupt onset LOC lasting a few seconds to a few mins. w/a full recovery
May be mildly disoriented (no post-ictal state)

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16
Q

What is ataxia?

A

Loss of muscle control in the arms and legs
May lead to a lack of balance, coordination, and trouble walking
May affect the fingers, hands, arms, legs, body, speech, and even eye movements

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17
Q

What are the signs/symptoms of MS?

A

Sensory disturbances: weakness, visual disturbances, balance issues, tightness in trunk & chest, diplopia
Relapse Presentation: new or worsening symptoms that develop acutely and last 24 hours w/o fever or infection, visual changes (optic neuritis), unilateral numbness, Lhermitte’s Sign (electrical sensation)

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18
Q

What is the treatment for MS?

A

Refer to neuro
Manage symptoms
Prevent relapse & disability
Exercise
Injections (copaxone - can use in pregnant pts)
Oral meds for mild cases
Infusions (Ocrevus)
Steroids for relapse IV or PO (IV Solumedrol PO Prednisone)
Plasma exchange if refractory

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19
Q

What is your suspected diagnosis if a pt presents with sudden unilateral paralysis of their face and dryness in the ipsilateral eye?

A

Bell’s Palsy

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20
Q

What is the treatment for Bell’s Palsy?

A

Corticosteroids (Prednisone)
Lubricating eye drops
Neuro consult

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21
Q

What are the signs/symptoms of Guillain-Barre Syndrome?

A

Dysesthesias
Paresthesias of feet and hands that spreads by the hour
Acute symmetric ascending weakness of limbs
Areflexia
Back & leg pain
Cardiac arrhythmias
Respiratory muscle paralysis can cause death

22
Q

Guillain-Barre Syndrome is commonly preceded by what?

A

URI (campylobacter Jejuni)

23
Q

What is the treatment for Guillain-Barre?

A

Admit to hospital
Pain mgmt
DVT prophylaxis
Plasma exchange
IVIG

24
Q

What are the signs/symptoms of Myasthenia Gravis?

A

Insidious onset
May be preceded by infection/illness
Ptosis
Diplopia
Swallowing difficulties
Respiratory difficulties
Limb weakness
Symptoms fluctuate
Increased weakness at the end of the day

25
Q

What is a diagnostic test specific to Myasthenia Gravis work up?

A

Tensilon challenge

26
Q

What is the treatment for Myasthenia Gravis?

A

Anticholinesterase (pyridostigmine)
Thymectomy
Immunosuppressants
IVIG
Pt education
Refer to neuro

27
Q

What are signs/symptoms of ALS?

A

Focal wasting of muscle groups
Limb weakness w/varying symmetry & distribution
Gait disturbance
Dysphagia
Dysphonia
Fasciculations
Cognition typically intact

28
Q

Is there a treatment for ALS, if so what is?

A

No curative treatment
Outpatient supportive care
Refer to neuro

29
Q

What are similar symptoms seen in bacterial and viral meningitis?

A

HA
Fever
Stiff neck

30
Q

What are symptoms specific to bacterial and viral meningitis?

A

Bacterial: N/V, malaise, rash, AMS
Viral: may have viral prodrome, less ill than bacteria

31
Q

What is the treatment for bacterial meningitis?

A

Abx (cephalosporin & vanc)
Corticosteroids

32
Q

What is your suspected diagnosis if a pt presents with facial droop, drowsiness, confusion, focal neurological deficits, and upper extremity weakness?

A

Ischemic stroke

33
Q

What is the treatment for an ischemic stroke?

A

tPA if < 3 hours since onset of symptoms
Allow for higher BP
PT/OT

34
Q

What are the signs/symptoms of hemorrhagic stroke?

A

Lacunar infarcts
HA
N/V
LOC
Seizures
Increased ICP

35
Q

What commonly presents with pts stating they are experiencing “the worst headache of their life”, or describe it as a thunderclap headache?

A

Subarachnoid hemorrhage

36
Q

What is the treatment for subarachnoid hemorrhage?

A

Moderate control of BP
Surgical clipping or endovascular coil of aneurysms
Ca+ channel blocker
More aggressive treatment of HTN at discharge

37
Q

What is the most common and most aggressive of the primary brain tumors?

A

Glioblastoma Multiforme

38
Q

What is the prognosis/treatment options for Glioblastoma Multiforme?

A

Poor prognosis and rapidly progressing
Radiation and chemo may prolong life
Full surgical resection unlikely

39
Q

What is the presentation of a seizure?

A

Usually begin w/arrest of motion & blank stare
May have convulsions
May lose control of bowel/bladder
May have a prodrome
Post-ictal state following event

40
Q

What are common meds used to treat seizures?

A

Keppra
Ethosuximid for absence

41
Q

What are the different types of seizures?

A

Partial (localized) or generalized (global)
Simple partial: no impairment of consciousness, motor signs
Complex partial: consciousness impaired
Generalized: non focal origin;
Absence seizures (typical - staring/lack of attention or atypical - associated w/movement)
Myoclonic seizures (tonic, clonic, or tonic-clonic)
Atonic seizures

42
Q

What is status epilepticus?

A

Active seizure lasting 5 mins or longer, a 2nd seizure w/o recovering from 1st, or repeated seizures for 30 mins or longer

43
Q

What is the treatment for status epilepticus?

A

O2
Ativan (IV or rectum)
Anticonvulsants

44
Q

What are the signs/symptoms of Parkinson’s?

A

Tremor (pill-rolling that stops w/ purposeful use of hand)
Bradykinesia
Rigidity (cogwheel)
Postural instability
Flat affect
Cognitive dysfunction/maybe psychosis or depression
Seborrheic dermatitis
Fatigue

45
Q

What is the treatment for Parkinson’s?

A

Carbidopa/Levodopa
MAO-B inhibitors
Amantadine
Botox
DBS
PT/OT

46
Q

How do patients get Huntington’s disease?

A

It is inherited

47
Q

What are the signs/symptoms of Huntington’s?

A

Dysarthria
Dysphagia
Apraxia
Involuntary movements
Cognitive decline
Impulsivity, irritability, depression

48
Q

What diagnosis has been called “mad cow disease”?

A

Creutzfeld-Jacob Disease (CJD)

49
Q

What are the signs/symptoms of Creutzfeld-Jacob Disease (CJD)?

A

Personality changes
Anxiety/depression
Impaired motor coordination
Insomnia
Blurred vision
Speech difficulties

50
Q

What is your suspected diagnosis if a pt presents with complaints of loud snoring w/gaps in breathing, waking up tired, and daytime sleepiness?

A

Obstructive sleep apnea

51
Q

What is the treatment for obstructive sleep apnea?

A

CPAP
BiPAP
Surgical removal of uvula
Dental device
Weight loss
Tracheotomy (gold standard)

Clin Med (15 decks)

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