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LMCC > Neuro > Flashcards

Neuro Flashcards

1
Q

Normal pressure hydrocephalus

A

Wacky, wet and wobbly
Mental impairment
Urinary incontinence
Gait disturbance
Caused by abnormal accumulation of CSF In ventricular system
ICP always normal, absence of papilledema on ophthalmoscopy
Dx: CSF removal with documentation of gait before and after procedure

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2
Q

Tx for essential tremor

A

Primidone (first choice in older pts) and propranolol (first choice in younger pts)

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3
Q

Major neuropathologic findings in Parkinson dz

A

Lewy bodies

Loss of dopaminergic neurons in substantia nigra

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4
Q

Symptoms of Parkinson dz

A 
TRAP
Tremor 
Rigidity 
Akinesia 
Postural instability
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5
Q

Best diagnostic test for Parkinson

A

Positron emission tomography (PET) and single photon emission CT (SPECT)
Uses dye to measure dopamine neurons in substantia nigra

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6
Q

Distinguishing feature between encephalitis and meningitis

A

Cerebral function is altered in encephalitis

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7
Q

MS treatment

A

Immunomodulatory therapy
IV steroids for symptom mgmt
Others: IV immunoglobulins, emergent plasmapheresis

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8
Q

Myasthenia gravis

A

Most common presenting symptom is ptosis
Caused by antibodies binding to ACh receptors and blocking NMJ
Often a/w thymus hyperplasia

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9
Q

First line tx for acute cluster headaches

A

100% O2 6-12L per minute for 15min via face mask

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10
Q

Progressive multifocal leukoencephalopathy

A

Rare fatal brain infection caused by JC virus
A/w natalizumab (monoclonal antibody used for treating MS, CD)
Dx: Brain biopsy is gold standard, MRI, JC virus detection in CSF PCR

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11
Q

MS diagnosis

A

CSF for elevated IgG, oligoclonal bands

MRI for “Dawson’s fingers” and enhancing plauqes

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12
Q

Tx for absence seizures

A

Ethosuximide

AKA Valproic acid

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13
Q

Most common cause of chronic cerebellar ataxia

A

Alcoholism

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14
Q

GBS CSF exam

A

Albuminocytologic dissociation

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15
Q

Guillain Barre Syndrome most commonly caused by

A 
Cytomegalovirus 
HSV 
EBV 
Viral hepatitis 
Campylobacter jejuni --> severe GBS
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16
Q

Parkinson’s risk factors

A 
\+ve fam hx 
Head injury
Male
Rural living 
Exposure to pesticides
Drinking well water
17
Q

Parkinson’s protective factors

A

Coffee
Smoking
NSAID use
E replacement in postmenopausal women

18
Q

Surgical options of parkinson’s treatment

A

Deep brain stimulation of globus pallidus

Thalamotomy

19
Q

Parkinson’s pharmaco treatment

A

Levodopa-carbidopa (Converts to DA) preferred for pt > 65
MAO-B inhibitiors (selegiline, rasagiline) - mild
Amantadine - mild
Dopamine agonist usually preferred for pt =65 (pramipexole)
Anticholinergics usually only used if pt =65 with tremor but no significant bradycardia or gait disturbance (benztropine)

20
Q

Symptomatic carotid artery stenosis tx

A

Urgent endarterectomy

21
Q

Med regimen post-TIA

A

DAPT (ASA + Clopidogrel)
Statin
Treat HTN,DM

22
Q

Time limit for tPA for stroke tx

A

4.5h after onset

23
Q

Time limit for thrombectomy

A

6h after onset

24
Q

Epilepsy syndromes that often start with febrile sz

A 
Dravet syndrome (severe myoclonic epilepsy)
Febrile sz tend to be more severe, frequent and come in clusters
25
Q

Status epilepticus

A

Prolonged repetitive seizure activity that lasts >5-10min without spontaneous cessation or recurrent sz without full return to consciousness between seizures

26
Q

Anti-epileptic most dangerous in pregnancy

A

Valproic acid

27
Q

Folic acid dose for epilepsy pts in pregnancy

A

At least 1mg (possibly up to 4mg)

28
Q

Anti-epileptic drug monitoring during pregnancy

A

At start of pregnancy
q4wks
6wk post partum
Immediately if pt reports or presents with sz or medication toxicity

29
Q

GBS treatment

A

IVIG or plasmapheresis +/- pain mgmt

30
Q

Myasthenia gravis treatment

A

Acetylcholinesterase inhibitors (ie. pyridostigmine)
If no response, steroids
Immunosuppression can be used as steroid-sparing therapy

LMCC (22 decks)

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