Neuro 2 Flashcards
huntingtons chorea inheritance
autosomal dominant
there is genetic anticipation- trinucleotide repeats increase every generation meaning onset is quicker and severity higher
what medication may be used in huntingtons for chorea symptoms
tetrabenzine
what tumor is myasthenia gravis associated with
thymoma
antibodies associated with myasthenia gravis
anti Ach receptor antibodies
MuSK antibodies
LRP4 antibodies
what muscles are most affected in myasthenia gravis
proximal muscles of the limbs
small muscles of the head and neck
mx of myasthenia gravis
pyridostigmine- cholinesterase inhibitor
immunosupression eg prenisolone or azothioprine
rituximab
how is a myasthenic crisis managed
non invasive or mechanical ventilation
IV immunoglobulins or plasmapheresis
lambert eaton myasthenic syndrome has autoantibodies against
voltage gated calcium channels on presynaptic membranes
features of autonomic distrubance
dry mouth
impotence
blurred vision
dizziness
urinary retention
ileus
heart arrythmia
how to differentiate myasthenia gravis from LEMs
LEMs muscle strength improves with use
myasthenia gravis muscle strength is worse with use
LEMs is associated with
small cell lung cancer
what is charcot marie tooth disease
an inhertied disorder causing peripheral neuropathy
drugs causing peripheral neuropathy
isoniazid
amiodarone
leflunomide
cisplatin
features of charcot marie tooth disease
peripheral neuropathy
high foot arches- pes cavus
distal muscle wasting
hyporeflexia
hypotonia
infections associated with GBS
campylobacter jejuni
cytomegalovirus
EBV
GBS pathophysiology
antibodies synthesised by B cells against the offending pathogen also fit antigens on the myelin sheath or nerve axons
ix for GBS
nerve conduction studies
CSF analysis
what does lumbar puncture show in GBS
raised protein with normal cell counts and glucose
time frame of GBS
usually sx peak 2-4 weeks after initial infection
recovery can take months to years
NF1 inheritance
autosomal dominant
how many neurofibromas are considered significant
2
sx NF1
neurofibromas
glioma of optic nerve
bony dysplasia- bowing
iris harmatomas
axillary freckling
bilateral acoustic neuromas
NF2
features of tuberous sclerosis
ash leaf spots
shagreen patch
angiofibromas (small pigmented papules across face and cheeks)
cafe au lait spots
isolated patch of white hair on head
neurological:
epilepsy
learning disability
brain tumors
first line for chronic or frequent tension headaches
amitriptyline
sinusitis mx over 10 days
steroid nasal spray
abx- phenoxymethylpenicillin
what is a silent migraine
aura but no headache
when are triptans used in migraine mx
acutely
triptan dosing for migraines
take one dose as soon as sx start
if it doesnt work do not take another dose during the same attack
triptan moa
5 HT receptor agonists (stimulate serotonin receptors)
migraine prophylaxis meds
propanolol
topiramate
amitriptyline
topiramate caution
very teratogenic- take effective contraception
medical word for constricted pupil
miosis
medial word for dilated pupil
mydriasis
cluster headaches acute treatment
triptan
high flow oxygen
propylaxis for cluster headache
verapamil
