Neuro 3 neoplasm and more

Question 1

Mets to brain mnemonic

Answer 1

Lots of Bad Stuff Kills Glia

Lung, Breast, Skin, Kidney GI (colon)

Question 2

NEurofibromatosis Type 2 associated with what?

Answer 2

Bilateral acoustic schwanoma

Question 3

Mnemonic for adult brain tumors

What is terrible prognosis?

Answer 3

MGM Studios

Metastasis (50%)
Glioblastoma 6 month (KJP)
Meningioma
Schwanoma

Question 4

Mnemonic for peds brain tumors?

Answer 4

Animal Kingdom, Magic Kingdom, Epcot

Astrocytoma
Medulloblastoma
Epindymoma

Question 5

Tx for brain tumor? Unexpected one?

Answer 5

Resection, Radiation, Chemo

CORTICOSTEROIDS to decrease inflammation and antiseizures

Question 6

Metastatic tumors of brain tx?

Answer 6

Full body imaging, surgical resection, palliative radiation

Question 7

Cafe au lait spots?

Answer 7

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)

Question 8

Neurofibromatosis?

Answer 8

Chromasome 22 with bilateral schwanoma

Question 9

Benzo sleep affect?

Answer 9

Increase N2 and decrease N3

REDUCE NIGHT TERROR and nocturnal neurosis

Question 10

Night terrors are during N3 (slow wave) and appear awake but are still asleep

Answer 10

Nightmares are REM

Question 11

Narcolepsy dx?

Answer 11

Cataplexy (sudden loss of muscle tone basically diagnostic)

Other causes excessive sleepiness are ruled out like OSA

Question 12

Tx for narcolepsy. What about cataplexy aspect?

Answer 12

Naps!
Modafinil (stimulant)]

SSRI help with cataplexy

Question 13

Melatonin side effect?

Answer 13

Vivid dreams

Question 14

Doxepin is what?

Answer 14

A TCA

Question 15

Zolpidem and Zaleplon mechanism?

Unfortunate afect?

Answer 15

Benzo gaba receptor. Short term only

Causes rebound insomnia

Question 16

Ramelteon works how? When can’t it be used?

Answer 16

Works on melatonin so NON addictive. BUT CANT USE IF BAD LIVER

Question 17

Restless leg syndrome is what? Tx how?

Answer 17

Legs feel parasthesia or spiders or ants crawling on them.

Treat with pramipexole or ropinirole or other dopamine agonists or clonazepam

Question 18

First step after brain tumor dx?

Answer 18

full body CT scan for primary tumors

Question 19

Waves of sleep?

Answer 19

BetaAlphaThetaSleep spindles Drink (low frequency high amplitude) Blood

Question 20

Syncope with head turning or shaving or tight collar?

Answer 20

Carotid sinus hypersensitivity

Question 21

syncope has brief limb jerking and incontienence

Answer 21

So not easy

Remember situational syncope with cough or pissing or what pooping

Question 22

Patient with family history of sudden death and they have syncope, you should give halter monitor

Answer 22

they may have hypertrophic cardiomyopath

Question 23

SU page 194 is a 4 star topic!!

Answer 23

workup for coma

Question 24

Coma eval 4 major parts

Answer 24

History
Pupils
Ocular motility
Motor function

Question 25

Large nonreactive pupil is from what?

Answer 25

uncal herniation, damage below idling and CN III involvement

Question 26

Conjugation toward ice water

nystagmus away

No eye deviation

Answer 26

INTACT brain stem (B/C YOUR BRAIN IS LIKE WHAT THE HELL!)

Normal response

CN III or VI involvement

Question 27

Doll’s eyes mean what?

Answer 27

Intact brainstem

Question 28

Decorticate is flexed/extended

Decerebrate is elbows extended

Answer 28

Cortical or thalamic

Midbrain

Question 29

Empiric therapy for LOC?

Answer 29

Glucose check!
Thiamine before giving glucose to stop wrench
Naloxone

Question 30

why thiamine before glucose in alcoholic with hypoglycemia?

Answer 30

can worsen maxillary body and wernicke encephalopathy. Thiamine is B1

Question 31

*** Syncope with prolonged standing?

Answer 31

vasovagal

Question 32

Syncope with gi stimulation?

Answer 32

Situational

Question 33

orthostatic measurements?

Answer 33

HR of 20 or more or systolic down 20 or diastolic loss of 10