Neuro 3 neoplasm and more Flashcards
Mets to brain mnemonic
Lots of Bad Stuff Kills Glia
Lung, Breast, Skin, Kidney GI (colon)
NEurofibromatosis Type 2 associated with what?
Bilateral acoustic schwanoma
Mnemonic for adult brain tumors
What is terrible prognosis?
MGM Studios
Metastasis (50%)
Glioblastoma 6 month (KJP)
Meningioma
Schwanoma
Mnemonic for peds brain tumors?
Animal Kingdom, Magic Kingdom, Epcot
Astrocytoma
Medulloblastoma
Epindymoma
Tx for brain tumor? Unexpected one?
Resection, Radiation, Chemo
CORTICOSTEROIDS to decrease inflammation and antiseizures
Metastatic tumors of brain tx?
Full body imaging, surgical resection, palliative radiation
Cafe au lait spots?
Brown pigmentation in NF1!
Also get neurofibromas which are benign
Type 1 is chromasome 17 (17 letters in von recklinghausen)
Also get brown deposits in eyes (hamartoma)
Neurofibromatosis?
Chromasome 22 with bilateral schwanoma
Benzo sleep affect?
Increase N2 and decrease N3
REDUCE NIGHT TERROR and nocturnal neurosis
Night terrors are during N3 (slow wave) and appear awake but are still asleep
Nightmares are REM
Narcolepsy dx?
Cataplexy (sudden loss of muscle tone basically diagnostic)
Other causes excessive sleepiness are ruled out like OSA
Tx for narcolepsy. What about cataplexy aspect?
Naps!
Modafinil (stimulant)]
SSRI help with cataplexy
Melatonin side effect?
Vivid dreams
Doxepin is what?
A TCA
Zolpidem and Zaleplon mechanism?
Unfortunate afect?
Benzo gaba receptor. Short term only
Causes rebound insomnia
Ramelteon works how? When can’t it be used?
Works on melatonin so NON addictive. BUT CANT USE IF BAD LIVER
Restless leg syndrome is what? Tx how?
Legs feel parasthesia or spiders or ants crawling on them.
Treat with pramipexole or ropinirole or other dopamine agonists or clonazepam
First step after brain tumor dx?
full body CT scan for primary tumors
Waves of sleep?
BetaAlphaThetaSleep spindles Drink (low frequency high amplitude) Blood
Syncope with head turning or shaving or tight collar?
Carotid sinus hypersensitivity
syncope has brief limb jerking and incontienence
So not easy
Remember situational syncope with cough or pissing or what pooping
Patient with family history of sudden death and they have syncope, you should give halter monitor
they may have hypertrophic cardiomyopath
SU page 194 is a 4 star topic!!
workup for coma
Coma eval 4 major parts
History
Pupils
Ocular motility
Motor function
Large nonreactive pupil is from what?
uncal herniation, damage below idling and CN III involvement
Conjugation toward ice water
nystagmus away
No eye deviation
INTACT brain stem (B/C YOUR BRAIN IS LIKE WHAT THE HELL!)
Normal response
CN III or VI involvement
Doll’s eyes mean what?
Intact brainstem
Decorticate is flexed/extended
Decerebrate is elbows extended
Cortical or thalamic
Midbrain
Empiric therapy for LOC?
Glucose check!
Thiamine before giving glucose to stop wrench
Naloxone
why thiamine before glucose in alcoholic with hypoglycemia?
can worsen maxillary body and wernicke encephalopathy. Thiamine is B1
*** Syncope with prolonged standing?
vasovagal
Syncope with gi stimulation?
Situational
orthostatic measurements?
HR of 20 or more or systolic down 20 or diastolic loss of 10