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PANRE > Neuro > Flashcards

Neuro Flashcards

1
Q

Most significant and treatable risk factor for stroke?

A

HTN

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2
Q

Strokes involving anterior circulation are likely to produce what signs and symptoms?

A

Hemispheric: aphasia, apraxia, hemiparesis, hemi-sensory loss and / or visual field defects

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3
Q

Strokes involving posterior circulation are likely to produce what signs and symptoms?

A

Brainstem: coma, drop attacks, vertigo, nausea, vomiting and / or ataxia

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4
Q

Best imaging to differentiate ischemic from hemorrhagic stroke - recommended during acute phase?

A

Noncontrast CT

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5
Q

Thrombolytic therapy is most effective if given within how long of symptom onset?

A

3 hours

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6
Q

What is the indication for carotid endarterectomy?

A

> 70% stenosis of the common or internal carotid artery

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7
Q

What two diseases are associated with cerebral aneurysms?

A

polycystic kidney disease

coarctation of the aorta

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8
Q

A patient presents to the ER with a generalized sudden onset headache, “the worst headache in my life.” What must you suspect / rule out?

A

subarachnoid hemorrhage

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9
Q

Treatment for status epilepticus?

A

IV diazepam or lorazepam until seizure stops, with a loading dose of phenytoin or fosphenytoin

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10
Q

What is pathogenesis of multiple sclerosis?

A

inflammation associated with multiple foci of demyelination in CNS white matter

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11
Q

True / False: age of onset for MS is 18-45 years, and is more common in women than men.

A

True

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12
Q

Two most common presenting symptoms of MS?

A

sensory complaints in the limbs and vision loss (high correlation with optic neuritis)

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13
Q

What diagnostic test allows for visualization of white matter lesions in CNS?

A

MRI with gadolinium

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14
Q

What is commonly found in CSF of patients with MS?

A

oligoclonal bands

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15
Q

What two meds have been shown to improve spasticity commonly seen with MS?

A

Baclofen and diazepam

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16
Q

Most common form of dementia?

A

Alzheimer’s

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17
Q

What class of medication may be used to delay progression of Alzheimer disease and improve memory function?

A

acetylcholinesterase inhibitors

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18
Q

What med has been used in treatment of moderate to severe Alzheimer disease?

A

memantine (Namenda)

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19
Q

What is a potential cause of fronto-temporal dementia, and what disease is this associated with?

A

Pick disease, associated with ALS

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20
Q

Common frontal lobe symptoms associated with frontotemporal dementia?

A

behavior symptoms: (euphoria, apathy, disinhibition) and compulsive disorders

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21
Q

Most common type of headache?

A

tension headache

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22
Q

Treatment of choice for cluster headaches?

A

oxygen and / or SC sumatriptan

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23
Q

Preferred therapy for prophylaxis of cluster headaches?

A

verapamil

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24
Q

What med is used to help control benign essential tremors?

A

propranolol

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25
Q

Essential clinical features that establish a diagnosis of Parkinson disease?

A

Resting tremor
bradykinesia
rigidity
postural instability

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26
Q

When considering bradykinesia in patients with Parkinson disease, what are common facial features?

A

infrequent blinking

mask-like facies

27
Q

When testing passive ROM in a suspect Parkinson patient, what would you expect to find?

A

cogwheel rigidity

28
Q

One which chromosome is the gene responsible for Huntington disease found?

A

chromosome 4

29
Q

Characteristic features of Huntington’s?

A

progressive chorea

dementia

30
Q

Most common initial manifestation seen with Tourette syndrome?

A

Phonic tics: grunts, barks, hisses, coughing or verbal utterances

31
Q

What disease process is characterized by chronic impairment of muscle tone, strength, coordination or movements?

A

Cerebral Palsy

32
Q

When do symptoms of restless leg syndrome most commonly occur?

A

during periods of prolonged inactivity or rest

33
Q

In addition to prescription drugs, a trial of what else is recommended in all restless leg syndrome patients?

A

Iron (except in patients with iron overload)

34
Q

On which side of the face is Bells Palsy most common?

A

Right: 60% of cases

35
Q

In what two patient populations is Bells Palsy more prominent?

A

pregnant women

diabetics

36
Q

What cranial nerve supplies the muscles affected in Bells palsy?

A

CN VII

37
Q

When does the facial weakness of Bells palsy peak?

A

about 21 days or less

38
Q

What other disease processes lead to facial palsy that should be ruled out prior to a diagnosis of Bells palsy?

A 
Stroke
Tumors
Lyme
AIDS
Sarcoidosis
39
Q

Most common neuropathy in western hemisphere?

A

diabetic neuropathy

40
Q

What med has recently been approved for treatment of diabetic neuropathy?

A

Duloxetine (Cymbalta): SNRI

41
Q

Most common precipitant of Guillain-Barre syndrome (acute idiopathic polyneuropathy)?

A

Campylobacter jejuni

42
Q

Pattern of weakness with Guillain-Barre syndrome?

A

symmetrical extremity weakness, beginning distally and ascending.

43
Q

In what percentage of patients with Guillain-Barre syndrome are cranial nerves affected?

A

45-75%

44
Q

What treatment has been shown to reduce the recovery time and may reduce likelihood of residual deficits in Guillain-Barre syndrome?

A

plasmapheresis

45
Q

What form of treatment of Guillain-Barre syndrome is preferred over plasmapheresis in children, and adults with cardiovascular instability?

A

IV immunoglobulin (IVIG)

46
Q

Characteristics of myasthenia gravis?

A

muscle weakness and fatigability, which improves with rest

47
Q

What is the mainstay of treatment for myasthenia gravis?

A

cholinesterase inhibitors, such as pyridostigmine

48
Q

Three primary causes of bacterial meningitis?

A

Strep pneumo
Group B strep
Neisseria meningiditis

49
Q

Most common bacterial cause of meningitis in neonates <1m old?

A

group B strep

50
Q

Clinical feature of neisseria meningiditis?

A

petechial rash

51
Q

Prompt lumbar puncture (LP) and CSF analysis are essential in making the diagnosis of bacterial meningitis. Prior to LP, what diagnostic test needs to be performed, and why?

A

Head CT to rule out space-occupying lesion

52
Q

Neonates with bacterial meningitis are commonly treated with what antibiotic?

A

ampicillin and cefotaxime

53
Q

Treatment of choice for bacterial meningitis in immunocompetent children >3m old, and adults <55yrs old?

A

Cefotaxime or Ceftriaxone PLUS vancomycin

54
Q

What two potential med combos are used for bacterial meningitis in patients >55yrs old, or with Hx of alcoholism / debilitating illness (regardless of age)?

A

ampicillin + cefotaxime OR

ceftriaxone + vancomycin

55
Q

What med is recommended in adults with meningitis secondary to strep pneumo, and in children >1m old with meningitis secondary to H. flu type B (HIB)?

A

dexamethasone

56
Q

Treatment for suspect herpes viral meningitis?

A

acyclovir

57
Q

Presenting symptoms in patient with brain abscess?

A

vomiting, fever, altered mental status, focal neurologic signs

58
Q

Lumbar puncture is contraindicated in patients with what type of presenting symptoms / signs?

A

focal neurological symptoms or signs - brain stem herniation may occur

59
Q

In head trauma patients, loss of consciousness greater than what duration implies a worse prognosis?

A

2 minutes

60
Q

What would you expect to find on exam in a patient with central cord syndrome?

A

Lower motor neuron deficit, loss of pain / temperature with sparing of posterior column functions

61
Q

Most common primary intracranial neoplasms?

A

gliomas

62
Q

Most common sources of intracranial metastasis?

A

Lung, breast, kidney and GI cancers

63
Q

6 major hormones produced by anterior pituitary?

A 
ACTH
TSH
LH
FSH
GH
prolactin
64
Q

Two hormones stored in posterior pituitary?

A

ADH (vasopressin)

oxytocin

PANRE (18 decks)

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