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Medicine Boards - Erica > Neuro > Flashcards

Neuro Flashcards

1
Q

ABCD2 score

A

to predict risk of recurrent stroke
age>=60
BP >=140/90
unilateral weakness (2 points) or isolated speech disturbance (1 point)
TIA Sx duration >=60min (2 points) or 10-59min (1 point)
DM
admit for score of 3+ or shady follow up

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2
Q

Meningioma features

A

Lightbulb sign = intense homogenous contrast enhancement

Dural tail

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3
Q

Mild cognitive impairment

A

MMSE less than 26/30

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4
Q

When to offer daily migraine prophy

A

HA frequency or use of acute meds>2d/wk or >8d/mo

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5
Q

Temporal lobe seizure features

A

Rising (“roller coaster”) sensation in epigastrium

Anxiety w or w out autonomic signs

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6
Q

Myotonic dystrophy

A

weakness, fatigue, and a myopathic waddling gait who also have muscle stiffness and delayed grip relaxation.
myotonia—an impairment of muscle relaxation secondary to increased cellular membrane hyperexcitability

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7
Q

AED in setting of OCP requirement

A

Keppra

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8
Q

oxcarbazepine AE

A

hyponatremia

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9
Q

topiramate contraindications

A

nephrolithiasis

gluacoma

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10
Q

AEDs for elderly pts

A

lamotrigine
levetiracetam
gabapentin

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11
Q

multiple system atrophy

A

parkinsonism, cerebellar ataxia, and early postural instability and falls

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12
Q

when to perform decompression surgery for carpal tunnel

A

active denervation on nerve conduction studies, weakness, and atrophy on exam
or if Sx uncontrolled with more conservative measures

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13
Q

chronic inflammatory demyelinating polyradiculopathy

A 
progressive weakness
areflexia
sensorimotor neuropathy
progression lasting beyond 8 weeks
(similar to Guillan Barre but more slowly progressing)
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14
Q

idiopathic intracranial hypertension

A

elevated CSF opening pressure (normal is 60-250mm H20) in the absence of space occupying lesion

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15
Q

Crutzfeld Jakob

A

Rapidly progressive dementia
Myoclonus
Bland CSF
Non diagnostic imaging vs hyperintensities on diffusion-weighted imaging (DWI): basal ganglia, cortex, thalamus

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16
Q

initial treatment mild Parkinsonism

A

MAO inhibitor
selegiline
rasagiline
*can also worsen dyskinesia

17
Q

initial treatment for moderate severity PD based on age

A

> 70yrs: levodopa

18
Q

meds for prolonging levodopa effect

A

catechol-O-methyltransferase inhibitors:
entacapone
tolcapone
*can cause dyskinesia

19
Q

refractory epilepsy

A

disabling seizures for longer than 1 year despite treatment with adequate doses of two or more AEDs

20
Q

treatment of Parkinsons hyperpyrexia syndrome

A

resume Parkinson’s meds

21
Q

status migranosis

A

migraine >72hrs
initial Tx: IVF, anti-emetics
then try IV dihydroergotamine if inpt or oral steroids if outpt

22
Q

best MS med to use in pregnancy

A 
glatiramer (class B)
but also reasonable to trial off meds in pregnancy given protective MS effect
23
Q

treatment of aneurysmal sub arachnoid hemorrhage

A

nimodipine

24
Q

migraine definition

A 
headache lasting 4-72hrs 
PLUS 2 of the following 4:
unilateral location
throbbing quality
moderate to severe intensity
worsening with physical activity
25
Q

treatment of ALS

A

riluzole (inhibitor of glutamate release, exact mechanism of action unknown)

26
Q

diagnosis of Parkinson’s disease

A

bradykinesia (=generalized slowing of movement) plus one of:

1) resting tremor
2) rigidity
3) postural instability

27
Q

when to think of cerebral artery vasospasm after SAH

A

decline in neuro function

5-10d post bleed

28
Q

AEDs to use in the setting of chemo

A

valproic acid
lacosamide
lamotrigine
levetiracetam

29
Q

chronic migraine Dx and Tx

A

HA 15 or more days per month for more than 3 months
often increasingly frequent attacks of migraine that are eventually accompanied by an interval milder headache - on at least 8 days of the month, the headache of chronic migraine must be severe, possess migraine features, or respond to migraine-specific therapy
need to check MRI
Tx: topiramate and onabotulinumtoxinA

30
Q

Tx MS related fatigue

A

modafinil
armodafinil
amantadine

31
Q

less likely to cause statin myopathy

A

hydrophilic statins (vs lipophilic statins)
rosuvastatin
pravastatin
fluvastatin

32
Q

stroke BP goals

A

for hemorrhagic stroke SBP

33
Q

anti epileptics for chemo pts

A

valproic acid, lacosamide, lamotrigine, and levetiracetam

Medicine Boards - Erica (11 decks)

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