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DIT Step 2 > Neuro 2. P 9 Degen Disorders and more > Flashcards

Neuro 2. P 9 Degen Disorders and more Flashcards

1
Q

Progressive muscle weakness with viral meningitis is what?

A

THINK POLIO

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2
Q

Lewi bodies?

A

In parkinsons, halo around eosinophilic inlcusion

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3
Q

Parkinson pathogen

A

Substantia nigra: loss of dopamine producing cells. dopa needed for melanin so that is why negra.

Relative increase in ACh (WHY YOU USE BENZTROPIN, it is anticholinergic)

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4
Q

MPTP is what?

A

A meth ingredient that puts you at risk for parkinsons

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5
Q

Mask like facies is b/c of what

A

Hypokinesia of face, so expressionless

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6
Q

Carbidopa does what?

A

Less break down in outer body

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7
Q

What is selegiline?

A

MAO b inhibiro in brain to prevent breakdown of dopamine

Neuroprotective!!!

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8
Q

Ends in tropine? what mechanism is it?

A

anticholinergic, like atropine!

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9
Q

*** Amantadine increases dopamine release

A

So can be used short term in parkinsons

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10
Q

C’s of huntingotns?

A

CAG disorder on chromosone Cuatro

Caudate atrophy on MRI
aCetylcholine and gaba decreased
Cognitive decline
Chroeiform
Cuarenta age of onset
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11
Q

Tx for huntington?

A

Tetrabenazine (thing tetra for 4 or cuatro for C’s of hungtingtongs!)

also atypical antipsychotics

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12
Q

ALS is 4 star topic

What are presenting symptoms?

A

Assymetric weakness

Dysarthria (motor speech) or Dysphagia (bulbar dysfunction)

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13
Q

UMN lesions in ALS?

LMN?

A

Slow stiff movements. Incoordination. SPASTIC HYPERREFLEXICE

LMN is anterior horn. FLACCID AND MUSCLE ATROPHY AND FASCICULATION

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14
Q

ALS dx?

A

EMG to show denervation widespread

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15
Q

Drug for ALS? mnemonic

A

RILUZOLE by reducing glutamate cytotoxicity

riLUzole for LU Gehrig disease

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16
Q

Presentation of MS?

A

Woman 20-40 years old with multiple defects that are intermittent: vision, paresthesia, sensory, weakness

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17
Q

Eye finding with MS? NEED TO KNOW

A

Unilateral optic neuritis
Inflammation of optic nerve. Eye pain with movement. ACUTE. Central vision loss

Internuclear ophthalmoplegia. Damage to medial longitudinal fasciculus. MLF. Helps eyes to track together. Ipsilateral eye can’t adduct on lateral gaze. MEDIAL RECTUS!

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18
Q

Eye pain worse with movement with central vision loss?

A

optic neuritis. IT IS MS

Will have afferent pupillary defect. Marcus Gun pupil

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19
Q

*** Internuclear ophthalmoplegia

A

M’s in MLF

MLF blocked so no Medial rectus in MS

So affected eye cannot look toward nose

Contralateral nystagmus

Normal conversion

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20
Q

MS labs. IMPORTANT LAST THING!

A

CSF: more protein. Mildly up WBC

Oligoclonal bands!!!!

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21
Q

MS is clinical diagnosis but MRI helps

A

oh

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22
Q

NMO is neuromyelitis optica, similar to MS on presentation. How do you tell them a part?

A

NMO is bilateral optic neuritis
NMO spares brain on MRI
NMO IgG is present if on test

MS is unilateral
MS has white lesions on MRI

23
Q

Tx of MS that is acute?

A

Corticosteroids! High dose!

24
Q

Tx of MS maintenance?

A

Interferon beta (THAT IS THE MAIN THING), avoid stress

Natalizumab

25
Q

What if syringomyelia is big? What is affected?

A

LMN in anterior horn, so weakness and flaccid paralysis!

26
Q

Tx of syringomyelia?

A

Decompression. or shunting if recurrent

27
Q

Workup for dementia? What are big things to consider!

A

CMP, CBC, UA, TSH, RPR, B12!!!,
HIV, MRI or CT

HIV is biggie! syphillis too, don’t forget it for the tests!

28
Q

Amyloid plaques, neurofibrillary tangles and neuronal atrophy is in what?

A

Alzheimer A for amyloid plaques!

29
Q

What genetic disease is risk for alzheimer?

A

Trisomy 21 b/c APP gene is on chromosome 21

30
Q

Alzheimer dx?

A

Dx of exclusion! Do the workup and rule out other causes with H and P and stuff.

Cortical atrophy is on MRI but not diagnositc

31
Q

Alzheimer tx? mnemonic for it?

A

Anticholinesterase!!! Slows progression

Donepezile Galantamine Rivastigmine

DONE FORGETTING Guzman and Rivas! Mymen! (memantine)

Memantine helps too

32
Q

Dementia with visual hallucinations think what?

A

Lewy body dementia. YOU SAW THIS!

also have syncope

Also have parkinsoninism

33
Q

What do you see with frontotemporal dementia?

A

AKA Picks on you! they make sense

Inappropriate social behavior (they Pick on you!) (frontal lobe is inhibition)

Progressive aphasia

34
Q

Tx of wet, wobbly and wacky?

4 STAR

A

dementia, gait disturbance/hard to lift up. Incontinence

Dilation of ventricles. Need shunt it

35
Q

Big clue dementia vs delerium?

A

Delerium is acute. Think meds like benzos or anticholinergic!

Steroids can cause it too.

UTI

Hypoxia!!!!

36
Q

Delerium workup?

A 
Electrolytes
UA
Pulse Ox
Meds
CT of brain (at the end)
37
Q

*** Delerium tx?

A

Reorient. Lights, Blinds, interact with patient.

Avoid restraints make it worse

Haloperidol can reduce agitation or if danger to themselves

38
Q

Myasthenia gravis associations?

History?

A

Thymoma. Thymus neoplasm. Thyrotoxicosis! So CT!

Weakness worsening to the day, Ptosis and diplopia

39
Q

Unexpected Tx of myasthenia gravis?

A

Thymectomy! Plasmapheresis

And of course neostigmine and pyridostigmine

Prednisone and azathioprine

40
Q

Refractory myastenia gravis tx?

A

IvIg

41
Q

Lambert Eaton syndrome?

What is affected?

Who has it?

A

Resembles myasthenia.

Presynaptic volted gated Ca++

It is a paraneoplastic syndrome so small cell cancer (so smokers)

42
Q

Myasthenia graves vs lambert eaton?

A

Weakness worth with use in MG and LE is better with use!

43
Q

Facial paralysis, think about what 2 things?

A

Guillain barre and lyme disease!

44
Q

Guillain barre has what affect on sensation?

A

None

Thank campylobacter jejune, HIV, EBV or immuniation!!

45
Q

Dx of guillain barre?

A

Clinical presentation or CSF analysis.

Albuminocytologic dissociation. High proteins and normal WBCs

EMG is demyelination

46
Q

Tx guillain barre?

What do you need to know for sure?

A

May need ventilation, watch for ileum.

Telemetry

IV IG OR PLASMAPHERESIS IS BIGGIE

47
Q

What autoimmune neuro syndrome do steroids not help in?

A

GUILLAIN BARRE. Instead do IVIG or plasmapheresis

48
Q

Dx of bell palsy?

A

Clinical. Entire face b/c lower motor nerve problem. Bells palsy looks worse than stroke on the face!

Cortical stroke is only bottom half of face

49
Q

What do you need to rule out with lyme disease in bell palsy?

A

History!

FAKE key lyme

Facial Arthritis, kardiac block, Erythema migrants

50
Q

Bell palsy tx?

A

Eye car. So artificial tears and patch overnight

Glucocorticoids

Valacyclovir may or may not help!

51
Q

DONT STUDY COMPLEX REGIONAL PAIN SYNDROME

A

SU 191

52
Q

Tx of hemiballismus? What causes it?

A

Subthal nucleus stroke

Haloperidol is tx

53
Q

*** Tics tx?

A

Tourrette, OCD, ADHD

Fluphenazine, Pimozide, Tetrabenazine

Think anti dopamine, So tetrabenazine just like huntinton, pimozide and fluphenazine just like high potency neuroleptics

DIT Step 2 (77 decks)

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