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HK Last - Cardio > Neuro > Flashcards

Neuro Flashcards

1
Q

symmetrical descending paralysis

A

botulism

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2
Q

workup for guillan barre

A

High protein in CSF (normal glucose and WBC)

Electromyography and nerve conduction studies

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3
Q

workup shingles

A

Tzank smear

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4
Q

workup meningitis

A

viral: increased CSF protein, leukocytes, normal glucose
bacterial: increased CSF protein, leukocytes, decreased glucose

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5
Q

tx peripheral neuropathy

A

anitseizure meds: gabapentin, carbamezapein, phenytoin

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6
Q

workup rabies

A

if animal persent, brain biopsy for negri bodies

if encephalitis and presumed rabies, skin biopsy pt at nape of neck and viral cultures and PCR

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7
Q

rabies tx

A

rabies vaccines (passive and active)

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8
Q

tx for tetanus

A

tetanus immunoglobulin (TIG) to bind exotoxin
Metronidazole
benzos for spasms

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9
Q 
acute onset of worst HA
facial pain 
altered consciousness
seizures
blurred vision
A

possible cerbral aneurism

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10
Q

workup for aneurism

A

CT angiogram
MRI
Angiogram

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11
Q

what do you need to diagnose AVM

A

MRI! CT can only identify large AVM

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12
Q

when to send a HA pt to ER

A 
worst
thuderclap
LOC
fever
Babinski positve
neuro issues (gait, etc)
papilledema
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13
Q

LMN palsy causing unilateral facial paralysis
ipsilateral lower face involvement
drooping of corner of mouth
difficulty speaking

A

Bell’s Palsy

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14
Q

workup Bell’s palsy

A

CT
nerve conduction testing
MRI

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15
Q

first line therapy trigeminal neuralgia

A

carbamezapine

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16
Q

workup seizures

A

complete neuro
CBC, elctrolites
CT
EEG, MRI

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17
Q

treatment seizures

A

IV lactated ringer or normal saline

lorazepam and diazepam IV

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18
Q

head trauma
seizure without LOC
one side of body effected
staring spells

A

complex partial seizure

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19
Q

what is elevated in hours after Grand Mal seizure

A

CK

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20
Q

UMN signs: spasticity, Babinski, hyperreflexia
LMN signs: muscle weakness, atrophy
no sensory changes or bowel/bladder involvement
progressive degenerative MN dz

A

ALS

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21
Q

workup ALS

A

EMG
muscle biopsy
CT or MRI

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22
Q

tx ALS

A

Riluzole (glutamate antagonist)

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23
Q

autosomal dominant dz

slow onset chorea, irritability, cognitive decline

A

Huntington

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24
Q

workup Huntingtons

A

Genetic testing
CT
MRI atrophy of caudate nuclei and cerebral cortex

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25
Q

tx Huntingtons

A

Tetrabenazine for chorea
benzo
antipsychotics - risperidone for movements

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26
Q 
immune mediated inflammatory disease of myelin
sensory dysfunction
UMN dysfunction
bladder dysf
sexual dysf
optic neuritis
intention tremor
UTI and constipation
A

MS

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27
Q

tx MS

A

interferon-beta to decrease inflammation
Methotrexate
benzos for spasticity

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28
Q

workup MS

A

MRI shows demyelinating plaques

CSF increased protien, leukocytes, and IgG

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29
Q

inflammation of spinal cord grey matter leading to muscle weakness and flaccid paralysis
fever, neck stiffness
asymmetrical muscle wekaness

A

poliomyelitis

30
Q 
CNS neoplasm
worsening headache
n/v
atered mental status
visual and motor disturbance
A

astrocytoma

31
Q

double vision, weakness, gait issues, dificulty swallowing

A

glioma

32
Q

unilateral hearing loss, tinnitus, disequilibrium

A

schwannoma/acoustic neuroma

33
Q

what is correlated with acoustic neuroma

A

Neurofibromatosis Type II leads to multiple tumors

34
Q

next step for sensorineuro hearing loss

A

audiometry

35
Q

tx for Huntingtons

A

Terbenazine

36
Q

best test to confirm Cerbrovascular accident

A

CT

37
Q

supplements for stroke pt

A

ALA

38
Q

serologic marker for Alzeimers and chronic traumatic encephalopathy

A

APOe E4

39
Q

what supplement should be avoided while taking Levodopa

A

pyridoxine because it increases dopamine breakdown

40
Q

what drug is a dopamine receptor agonist: Levodopa, carbidopa, pramiprexole

A

pramiprexole

other too decrease peripheral breakdown of dopamine

41
Q

CNS image of choise

A

MRI

42
Q

increased and decreased serotonin

A

increased: anxiety
decreased: depression, aggressin

43
Q

increased and decreased GABA

A

increased: lethargy
decreased: anxiety

44
Q

increased and decreased acetylcholine

A

increased: memory, delirium, delusions
decreased: aggression, depression

45
Q

side effect of dopamine blocking with neuroleptic drugs

A

increased prolactin

46
Q

increased vs decreased dopamine

A

increased: psychosis, anxiety, confusionm aggression
decreased: dementia, movement disorders, depression

47
Q

catecholamines and precursors

A

dopamine and norEPI

phenylalanine is precursor to tyrosine

48
Q

precursor to serotonin

A

tryptophan

49
Q

what will enhance effects of serotonin

A

B6, tryptophan, 5-HTP

50
Q

tricyclic antidepressants

A

amitryptiline

nortryptyline

51
Q

SSRI

A

citalopramCelexa

escitalopram: Lexapro

52
Q

pain management strategy

A

increase Serotonin, DOPA, and NE

53
Q

H1 blockers non-sedating vs sedating)

A

Non-sedating: loratadine (claritin)
Cetirizine (zyrtec)
Gexofenadine (allegra)

Sedating:
diphenhydramine
promethazine
cyproheptadine

54
Q

glycine
caution with what
helpful with waht

A

helps: anxiety, wound healing, muscle spasm

extreme caution in bipolar pt

55
Q

anti convulsant/seizure

A

anti-seizure: phenytoin and carbamazepine
Gaba: Gabapentin, neurontin, pregabalin, lyrica
clonazepam
benzo: alprazolam and diazepam
other: valproate, topiramate, lamotrigene, lamictal

56
Q

seizure that spreads to different parts of body, sensory sx, flushing, epigastric

A

jacksonian seizure

57
Q

seizures at menstruation due to hormone fuctuations

A

catemenial

58
Q

bipolar meds

A 
lithium
atypical antipsychotics: risperidone, quetiapine, ariprazole
carbamezepine, phenytoin
lamotrigine
valproate
59
Q

what is good to supplement with lithium

A

folate

60
Q

what mineral should combined with methylphenidate for ADHD

A

zinc

61
Q

methergine

A

Ergot for migraines

62
Q

HA with tearing, red eye, 15-180min, one sided, can be triggered, rapid onset, no N/V

A

cluster ha

63
Q

dull diffuse ha on waking

A

carbon monoxide poisoning

64
Q

DEA drug class schedules

A 
c-1 heroin, lsd, marijuana
c-2 oxycodone, percocet, codeie and hydrocodone alone
c-3 codeine and hydrocodone with ...
C-4 diazepam
C-5 buprenophine
65
Q

DEA class for tramadol

A

none

66
Q

muscle relaxants

A

methocarbamol
carisoprodol
cyclobenzaprine

67
Q

peripheral pain control

A

NSAIDs: aspirin, ibuprofin, rofecoxib, celocoxib, indomethecin, naproxen, toradol (not used a lot)
Steroids:
Gout meds - colchicine, allopurinol

68
Q

cox2 inhibitors

A

rofecoxib

celocoxib

69
Q

what do you want to be careful with when giving SAMe

A

serotonin, NE, dopamine

70
Q

what is CI with dopamine agonist

A

tyrosine and phenylalanine

71
Q

what does zinc deplete

A

copper

give in 20:1 (zinc to copper)

72
Q

toxic dose of tyelenol

A

7-10mg

2-4/day ok

HK Last - Cardio (16 decks)

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