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MS3 > Neuro 7 > Flashcards

Neuro 7 Flashcards

1
Q

What is an “aura” when it comes to seizures

A

Aura = simple partial seizure that precedes progression to bigger seizure

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2
Q

What is Lennox-Gastaut syndrome

A

Pediatric seizure syndrome associated with intellectual disability

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3
Q

Major trigger for seizures in Juvenile myoclonic epilepsy (JME)

A

Sleep deprivation

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4
Q

During a seizure, do eyes usually turn toward towards or away from the affected side?

A

Away (“wrong way eyes”)

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5
Q

What is Todds paralysis and what is it often confused with

A

Postictal partial or complete hemiplegia

Can mimic stroke

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6
Q

Where in the brain is seizure: “deja-vu” sx, epigastric rising, nausea, vertigo, lip smacking

A

Temporal lobe

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7
Q

Where in the brain is seizure: neglect, aphasia

A

Parietal lobe

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8
Q

Where in the brain is seizure: nocturnal (looks like patient wakes up and acts weird), often without postictal state, fencing posture

A

Frontal lobe

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9
Q

Describe presentation of progressive supranuclear palsy

A

♣ Supranuclear ophthalmoplegia, with limitation of vertical more than horizontal gaze
♣ Axial rigidity and neck extension
♣ Early falls as a consequence of impaired postural reflexes, neck extension, and inability to look down

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10
Q

What are peripheral side effects of Levodopa

A

Nausea and vomiting, cardiac arrhythmias, orthostatic hypotension

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11
Q

What are the central side effects of Levodopa

A

Neuropsychiatric sx (anxiety, agitation, hallucinations, confusion)

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12
Q

MOA of Carbidopa

A

DOPA decarboxylase inhibitor (prevents peripheral conversion of L-Dopa to Dopamine)

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13
Q

Drug category and MOA of Entacapone

A

COMT inhibitor

Prevents conversion of L-Dopa to inactive metabolite in the periphery

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14
Q

MOA of Tolcapone

A

COMT inhibitor both peripherally and centrally

Prevents conversion of L-Dopa to inactive metabolite

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15
Q

MOA of Selegiline as Parkinson tx

A

Monoamine oxidase inhibitor (MAO-B), preventing metabolism of DA

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16
Q

MOA of Ropinirole

A

D2 receptor agonist

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17
Q

MOA of Pramipexole

A

D3 receptor agonist

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18
Q

MOA of Amantadine

A

NMDA antagonist - enhances effects of endogenous DA

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19
Q

What antimucarinics are used in the tx of Parkinsons

A

Benztropine

Trihexyphenidyl

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20
Q

What type of tremor is present in Essential tremor

A

Postural tremor (emerges during sustained maintenance of a posture)

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21
Q

What limbs are preferentially effected in Essential tremor

A

hands > arms > head&raquo_space; legs

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22
Q

What can decrease sx of Essential tremor

A

Alcohol

23
Q

Tx of essential tremor

A

Beta-blockers (Propranolol)

Primidone (barbiturate)

24
Q

Action tremor is caused by dysfunction of what?

A

Cerebellum and cerebellar outflow tract

25
Q

What is chorea and what is the signature associated disease

A

Chorea = involuntary, abrupt, and irregular movements that flow randomly from one body part to another

Huntingtions

26
Q

What causes hemiballismus

A

Usually from contralateral lesion in the subthalamic nucleus, caudate, or putamen

27
Q

What is dystonia

A

Sustained muscle contraction leading to repetitive twisting movements or abnormal postures

28
Q

Example of and treatment of dystonia

A

Ex = torticollis

Tx = Botox

29
Q

Hiccup is what type of movement

A

Myoclonus

30
Q

Tx of myoclonus

A

Clonazepam

31
Q

Tx of tics

A

Dopamine antagonists (Haloperidol or SGA)

32
Q

Presentation of Wilson disease

A

Liver dysfunction and neuropsychiatric sx

Kayser-Fleishcer rings, renal disease

33
Q

Describe possible neuro sx seen in Wilson disease

A

Tremor, ataxia, dysarthria, dyskinesia, parkinsonism, cognitive dysfunction, disturbances of mood and personality

34
Q

Lab values seen in Wilson disease

A
  • Increased serum copper
  • Decreased serum ceruloplasmin
  • Increased urine copper excretion
35
Q

Tx of Wilson disease

A

Copper chelation with D-penicillamine

36
Q

4 components of presentation is Sturge-Weber syndrome

A
  1. Seizures
  2. Port-wine stain of CN V1/V2 distribution
  3. Intellectual disability
  4. Glaucoma

Think: guy has seizure and spills wine on face. Wine gets in eye (glaucoma) and he goes whoops

37
Q

Triad of sx in Tuberous sclerosis

A
  1. Intellectual disability
  2. Seizure
  3. Angiofibroma
38
Q

Can hyperventilation precipitate focal seizures

A

No

Only absence seizures, which are generalized seizures

39
Q

Describe pathophys of Guillain-Barre syndrome

A

o Demyelinating polyradiculoneuropathy (of peripheral nerves)

40
Q

Describe presentation of Guillain Barre

A

o Ascending symmetrical paralysis over days to weeks

o Autonomic dysfuction (e..g tachycardia, urinary retention, and arrhythmias) occur in 70% of patients

41
Q

CSF findings of Guillain Barre

A

o CSF is usually abnormal and may show high protein with few cells

42
Q

Tx of Guillain Barre

A

o Treatrement = IV immunoglobulin or plasmapheresis

43
Q

Sx present in Meniere disease - other than vertigo, what are the ear sx?

A

Due to increased pressure and volume of endolymph

  • Episodic vertigo with nausea and vomiting
  • Ear fullness/pain
  • Unilateral sensorineural hearing loss
  • Tinnitus
44
Q

Describe post-concussion syndrome

A

HA, dizziness, sleep disturbance, cognitive impairment, behavioral abnormalities (e.g. irritability)

45
Q

What is the value of normal ICP

A

<15

46
Q

What percentage of severe post-head trauma patients experience seizure

A

25%

47
Q

Presentation and tx of neurosarcoidosis

A

♣ Presentation
• Cranial neuropathy due to basal meningitis
• Facial and optic nerves most frequently affected
♣ Treatment:
• Steroids

48
Q

Cause of Wernicke encephalopathy

A

Thiamine (B1) deficiency

49
Q

Triad of Wernicke’s

A

Ophthalmoplegia, (truncal) ataxia, confusion

50
Q

Tx of Wernicke’s

A

Administer thiamine BEFORE glucose

51
Q

What is Korsakoff syndrome

A

Isolated memory disturbance and confabulation, personality change

52
Q

Will Methylmalonic acid be increased or decreased in B12 deficiency

A

Increased

B12 is needed to convert MMA to Succinyl CoA

53
Q

Presentation of B12 deficiency

A

Damage to posterior and lateral columns of the spinal cord

Paresthesias, weakness, gait problems

MS3 (88 decks)

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