Neuro

Question 1

Contraindications to TPA (SAMPLESTAGES)`

Answer 1

Stroke in 3 mo
Anti-coag (INR >1.7, >PTT)
MI in 3 months
Prior Intracrainal bleed ever
LOW PLT 400
Seizure w/ stroke

Question 2

Single greatest stroke risk factor?

Answer 2

HTN

Question 3

Blockage indications for CEA?

Answer 3

60% + symptoms
OR
>70%

NO TX if 100%!!

Question 4

When vasospasm after SAH?

When rebleed?

Answer 4

4-10 days

24 hrs

Question 5

Cavernous sinous thrombosis tx?

Answer 5

Broad ABX, Cef + zosyn +/- Vanco

Surg if no response in 24 hrs

Question 6

CLuster headache acute and ppx tx?

Answer 6

Acute: high O2
Ppx: Verapamil

Question 7

First line anti-convulsant in kids?

Answer 7

Phenobarbital

Question 8

Absence seizure 1st line?

2nd line?

Answer 8

Ethosuxamide

Valproic acid

Question 9

MG treatment?

Answer 9

Pyridostigimine (Anti-cholinesterase)

Question 10

What meds can’t you give MG patients?

Answer 10

Aminoglycosides
Fluoroqinolones
B blockers

Question 11

Anti-emetic that can cause NMS/dystonia?

Answer 11

Metoclopramide (DA antagonist)

Question 12

Prothrombin Complex Concentrate contains what? is used when?

Answer 12

Clotting factors

Rapid reversal of elevated INR (hemorrhagic stroke with elevated INR)

Question 13

INTERMITTENT “Curtain” vision loss?

Work up?

Answer 13

Amarosis Fugax

Carotid US (usually from transient occlusions)

Question 14

Class of meds that can cause increased prolactin? Mechanism?

Answer 14

Anti-psychotics (DA anatagonist)

Inihibition of Prolactin inhibitory factor

Question 15

Trigeminal neuralgia tx?

Answer 15

Oxcarbazepine

Carbamazepine

Question 16

Status epilepticus tx 1st, 2nd, 3rd line?

Answer 16

1st: Benzo
2nd: Phosphenytoin
3rd: Phenobarbital

Question 17

Who gets anti-convulsants after 1st seizure (3)?

Answer 17

EEG changes
Family history
Present status epilepticus

Question 18

Adenoma sebaceum
Shagreen patches
Ash leaf patches

w/u?

Answer 18

Tuberous sclerosis
(AD)
—- MRI to look for subependymal astrocytoma —-
—- ECHO to look for cardiac rhabdosarcoma —-
—- Abdo MRI to look for renal lesions —-
—- EEG —-

Question 19

Soft, felsh colored lesions
Lisch nodules
Cafe au lait
Meningiomas, gliomas

Answer 19

NF1

Question 20

Port-wine stain
Seizures
Skull XRay w/ calcifications of angioms

Answer 20

Sturge-Weber

Question 21

Benzotropine and trihexyphenidyl MOA and s/e?

Answer 21

Anti-cholinergics

• Dry mouth
• Urine retention

Question 22

Carvidopa/Levidopa s/e?

Answer 22

EARLY: Hallucinations

LATE: dyskinesia

Question 23

Ropinerole, Pramipexole, Bromocriptine MOA and s/e?

Answer 23

DA agonists

Low BP, Confusion, hallucination, compulsive gambling

Question 24

Only parkinson treatment shown to slow progression?

Answer 24

MOAIs (Selegiline, rasagiline)

Question 25

Treatment for Parkinson patient with hallucination/confusion?

Answer 25

START anti-psychotic

Dont stop DA agonists

Question 26

Tx for RLS?

Answer 26

DA agonists (Pramopexole)

Question 27

Tx for Huntington dyskinesa?

Answer 27

Tetrabenzine

Question 28

Tx for tourettes?

Answer 28

Anti-psychotics

Question 29

MAB for MS and s/e?

Answer 29

Natalizumab

Can develop PML (worsening neuro deficits)

Question 30

Guillane Barre tx?

Answer 30

IVIG
OR
Plasmaphoresis (not both)

Question 31

COMT MOA, when given?

Answer 31

Decrease metabolism of Carvi/levidopa

Given only in combo with carvi/levi

Question 32

Bilateral CN8 schwannomas?

Answer 32

NF2

Question 33

Primadone (MOA, used for, S/e?)

Answer 33

Converts to Phenobarbital

Essential Tremor

Acute porphyria (colicky abdo pain, neuro and psych complaints) elevated urine porphyrobiligen

Question 34

Chlordiazepoxide MOA?

Answer 34

GABA (benzo)

Question 35

Bilateral trigeminal neuralgia = ?

Answer 35

MS

Question 36

What stroke DONT you give Aspirin?

Answer 36

Bacterial endocardial emboli

Question 37

CRVO vs. amarosis fugax?

Answer 37

CRVO = Cotton wool, hemorrhages, blood and thunder

CRAO/amarosis = cherry red spot