Neuro Flashcards
1
Q
TIA management
A
statin, aspirin, decrease bp
2
Q
Rapid deceleration/direction change/pivot
A
ACL
3
Q
Popping sound
A
tear
4
Q
RICE
A
rest, ice, compression, elevation
5
Q
ACL vs. meniscal tear
A
A is much more acute . Meniscal more chronic and locking/clicking sound or catching, and twisting force problem
6
Q
femoral neck/intertrochanteric fracture
A
Most common hip fracture where get shortening and external rotation
7
Q
phantom limb pain vs. neuroma
A
phantom limb is right away vs. neuroma weeks after amputation
8
Q
functional weakness sign
A
give way weakness
9
Q
genu varum normal until
A
age 2
10
Q
iron studies for HHH
A
high everything: iron, transferrin or ferritin
11
Q
slit lamp test for what diagnosis
A
wilsons disease
12
Q
erythema marginatum
A
acute rheumatic fever
13
Q
Beta lactam and sulfa drug reaction
A
BS=serum sickness and get fever, polyalthralgias and urticaria
14
Q
back pain first line
A
exercise
15
Q
glucorticoids and back pain. When helpful?
A
only if radicular
16
Q
in children: back pain particularly with lumbar extension
A
spondelolesthesis
17
Q
SI tenderness and limited lumbar flexion
A
AS
18
Q
back pain and fever
A
epidural abcess
19
Q
pain worse with flexion or extension? (lumbar disc herniation)
A
worse with flexion
20
Q
pain related to strain
A
non-specific
21
Q
pain with flexion vs. extension
A
flexion worse with herniated disc. extension worse with spondelolesthesis
22
Q
DIP, morning stiffness, deformity, dactylitis =sausage digits, also h/o rash, also can have nail hyperkeratosis
A
psoriatic arthritis
23
Q
pagets disease risk factor
A
due to disorganized bone remodeling, osteosarcoma
24
Q
splenomegaly, RA, and neutropenia
A
Felty syndrome
25
lacunar vs. ACA vs. intracerebral hemorrhage
If the patient has severe HTN and diabetes if legs are affected say more than arms then we say that is an ACA stroke rather than lacunar where everything affected equally
lacunar is more focal
vs. hypertensive intracerebral hemorrhage in basal ganglia thalmaus pons and cerebellum. In IC hemorrhage, First focal deficits that than become more global.
26
greater than 20 drop in systolic blood pressure when standing
autonomic insufficiency
27
respiratory problems with polymyositis?
No
28
triggers of MG crisis
infection, surgery, childbirth
29
complex grief
marked by deep yearning for lost loved one
30
TRAUMA
traumatic event, avoidance, unable to function, 1 month, arousal
31
Autism components
anti-social and repetitive/rigid behavior
32
hip fracture
First step is surgical correction so need cardiac tests etc. and xray...
33
Todds paralysis
hemiplegia after secondary generalized seizure often lasting up to 36 hours
34
NF1 vs NF2
1. cafe au lait spots, ax freckling, lish nodules, neurofibromas
vs.
2. acoustic neuroma, vestibular schwanomas are b/l. no cafe au lait spots or freckling
35
PCP signature feature and tx
nystagmus tx give benzos
36
MG vs. polymositis
MG is same everywhere whereas poly more proximal weakness
37
Acute stress disorder
>3 days and <1 month
38
WWARTS
wound up, worn out, absent minded, restless touchy sleepless
39
Hyponatremia when risking cerebral edema tx
3% hypertonic saline
40
neurocycsticercosis tx
albendazole
41
JAI how many joints?
5. dont forget can also get a rash
42
tx JAI
Naproxen
43
when refer for endarterectomy
70 if symptomatic and 80 if asx
44
cyclothymia
>2 years but less severe form
45
nightmare disorder vs. non-REM sleep disorder
nightmare disorder-REM but then wake up and recall vs.
| non-REM arousal
46
depression, myalgia, yawning, abdominal cramping
opioid withdrawal
47
BITE (osteogenesis imperfecta)
Bone fractures, I (eyes-blue sclera), Teeth, Ears (hearing loss)
48
After first seizure what imaging do you get
non-contrast CT to rule out bleed
49
tx CN poisoning
amilynitrate induces the meth and then thiosulfate binds the cyanide also vb12 derivative can gie
50
FEV to FVC ratio in sarcoid
high
51
Alcohol withdrawal syndrome (4)
```
Mild (6-24 h)
Seizures (12-48)
Alcohol hallucinosis (12-48)
DT (48-96)
Confusion, agitation, fever
```
52
seretonin syndrome mneumonic
```
Hyperthermia
Anticog
Reflexes (hyper)
Myoclonus
Fast heart rate
Unconscious
Loss of GI
```
**not rigidity
53
NMS
AMS rigidity due to anti-dopamine
54
myotonic dystrophy genetics
CTG trinucleotiderepeat
55
Benztropine SE
tx either acute dystonia (torticollis) or parkinsons problems
56
if one psych drug is leading to TD, what do you do?
give another like clozapine
57
Avascular necrosis
sickle cell, steroids, RA
58
neurogenic arthropathy
charcot joint
59
pituitary apoplexy
is hemorrhage leading to decreased hormone
60
REM in depression
decreased REM latency (get to REM quicker) and decreased slow wave sleep
61
shift work disorder vs. delayed sleep wake
delayed sleep wake-on different schedule but given chance to sleep will sleep. night owls but they can sleep through the night vs. shift work has trouble sleeping
62
Body dysmorphic disorder tx
tx with CBT and SSRI
63
most common cause of pediatric stroke
sickle cell disease
64
brain abcess vs. cavernous sinus thrombosis
fever, herniation vs. III, IV, V, VI palsies
65
short vs. upslanting palpebral fissures
Alcohol vs. Downs
66
tx Mg crisis
fluids and plasmapheresis. Don't give pyridostigmine because if intubated can increase secretions
67
GB motor, sensory or both?
BOTH
68
adult form of rickets
osteomalacia
69
amytriptiline SE
orthostatic hypotension
70
vetebral dissection strokes
Wallenberg is:
- Ipsalateral loss of pain and temperature (spinal trigeminal tract)
- Contralateral trunk and limbs (spinothalamic)
- Ataxia (inferior cerebellar penducal)
- Nysagmus, dysphagia
- Ipsalateral horners
71
Adjustment disorder
within 3 months of disorder and not lasting more than 6 months
72
severe ear pain, ipsalateral paralysis and vesicular rash
ramsay hunt (herpes)
73
first line therapy for ALS patients with decreased respiratory drive
PEEP which opens up airways
74
Patellofemoral pain syndrome moves that exacerbate
pain with squatting or lunging
75
Sodium nitroprusside RF
cyanide tox because has lots of Cyanide leading to metabolic acidosis
76
improved hearing in background noise
Conductive hearing loss due to boney overgrowth especially if fhx
77
organophosphate poisoning vs. opioids
both poinpoint pupils but organophosphate has hypersalivation (think water when working in garden outside). give atropine or pralidoxime vs. naloxone
78
Bulemia first line/binge eating
fluoxetine
79
cyproheptadine give for
serotonin syndrome
80
phyostigmine
antichoinergic tox
81
succinylcoline
muscle relaxant
82
2 years 2 sx
dysthymic disorder
83
cyclothymic
hypomania and depression 2 years but dont meet criteria for either
84
mechanical humming
think tinnitis
85
imiprimine
TCA
86
what does sodium bicarb do
sodium decreases the depressant action of myocardial sodium channels
87
PML
caused by JC virus <200, non-enhancing brain lesions
88
SCFE and where
insidious onset and posterior displacement
89
legg calves perthes
avascular osteonecrosis of the femoral head in boys 3-12 insidious onset
90
how much should do check in if prescribe opioids?
q 3 months
91
injury to ulnar at wrist vs. elbow
latter also has decreased grip strength
92
spina cord injury first line
foley catheter
93
aortic dissection can cause what kind of murmur
regurg
94
complication of osteoarthritis
effusion or popliteal cyst
95
brain solitary mass vs. metasteses tx
surgical resection vs. radiation
96
kid with jaundice and vomiting and hepatosplenomegaly...
galactosemia where can't metabolize galactose--> glucose
97
if hearing problems, face sensation and paralysis dx
vestibular neuritis
98
PTSD signs and symptoms
CBT and SSRI
99
lead poisoning firstline
First check if falsely elevated, dimacarpol and if really bad >70 then do dimercaprol +EDTA
100
SSRI management
continue at dose of 4-6 weeks before upping it
101
ADD components
inattention and hyperactivity (blurts out) before 12
102
med for ADD
amphetamine or atomoxetine for people with substance disorder or don't want amphetamines
103
spinal cord injury
autonomic dysreflexia
104
Clasp knife where in brain?
corticospinal/pyramidal tracts
105
Isoniazid SE
peripheral neuropathy
106
conduct disorder vs. anti-social
<18 vs. >18
107
propranolol
good for performance-only social anxiety disorder. If social anxiety give an SSRi
108
can aortic dissection lead to horners?
YES
109
perioribital echymosis and opsoclonus myoclonus
neuroblastoma
110
ophthalmologic problems and graves what tx
give steroids, propranolol, and methiamozole
111
gastric surgery deficiency
copper leading to hematologic deficiencies
112
what does hyperventilation do intracranial pressures
lowers it via vasoconstriction
113
most common cause of hemorrhage in young adults
AV malformation
114
bilateral carpal tunnel
hypothyroidism due to mucin filling
115
small fiber involvement
pain, paresthesia
116
large fibers
loss of proprioception
117
postpartum psychosis
within 2 weeks of pregnancy
118
TCA tox, what do you give?
Sodium bicarb
119
When can you stop antidepressants
one time MDD then just 6 months and if chronic then 1-3 years if equal or greater than 3 times then indefinitely
120
if c-spine injury what do you do?
image the rest of the spine
121
polymyositis: weakness or pain vs. polymalga rhematica
More weakness (get muscle bx) vs. pain (ESR, CRP)
122
aminoglycasides side effect
ototoxic and vestibular dysfunction
123
sciatica first line
trial of NSAIDs
124
cervical spondylosis
spinal canal narrowing leading to lower motor neuro signs in upper extremities and upper motor neuron in the lower extremities
125
unresponsiveness, reduced respirations, shallow breathing and decreased bowel signs
opioid intoxication
126
concussion management
rest for 24 hours before gradually increase q 24 hours that symptomatic
127
status epilepticus
seizure lasting equal or greater than 5 minutes or 2 seizure events where no regaining of consciousness
128
tx status epilepticus
benzos and then some nonbenzo like fosphenytoin, phenytoin, anval, levitracetam
129
CMV and hearing
hearing loss
130
postdural puncture headaches
better with lying down
131
knee dislocation first line
check for arterial brachial index
132
phyostigmine give for
anticholinergic tox
133
cryptoccal symptoms
increased intracranial pressure and so get nausea and vomiting in immunocompromised person
134
ICP what CN affected
often 6 nerve palsy and get diplopia
135
claw toe deformity
diabetes
136
whiplash
usually just affects upper extremity
137
ambylopia
one eye so the other eye works harder which is why correct good eye
138
cryptococcal meningitis what CD4 and what do you give
HIV <100
| ampho B + flucytosine and then later fluconasole
139
post herpetic neuraliga tx
gapapentin
140
lateral epicondylitis
pain with passive flexion and active extension
141
MFS
GB, immune mediated polyneuropathies
opthalmoplegia, ataxia and areflexia
associated with anti-GQ1b antibodies
142
purpuric rash with meningial signs
n. meningitidis
143
panic disorder what give? tx
SSRI
144
acetometaphine tox
get levels and administer charcoal
145
ottawa ankle rules for ankle
1. Pain at the malleolar zone
2. Pain at medial malleolus or lateral malleolus
3. Unable to bear 4 steps (2 on each side)
146
Ottawa rules for foot
Pain at the midfoot, tender at navicular or
tender at base of 5th metatarsal
or unable to bear weight 4 steps (2 on each side)
147
central retinal artery vs. vein occlusion
artery get paleness vs. hemorrhage and tortuous veins
148
alcoholic cerebellar degeneration vs. wernicke
you get purkinje cell and cerebellar vermis degeneration, wide based gait, good finger to nose but impaired heel to shin because more of a truncal issue vs. nystagmus, ataxia and encephalitis
149
common cause of hemothorax
rib fracture with intercostal vessel injury
150
ever contract for safety?
No
151
acute dystonia vs. tardive dyskenesia
acute dystonia earlier whereas TD later
Anticholinergics don't work with TD. Have to stop the meds.
However, anticholinergics (benzotripine) does work for AD
152
AMD
progressive bilateral loss of central vision so impaired due to cataracts
153
open angle glaucoma vs. acute macular degeneration
open vs. closed
GOOD central vision bad peripheral vision
vs. good peripheral vision and bad central
open is insidious onset of peripheral vision.
vs. eye pain and poorly reactive mid dilated pupil and red which is contrasted to GCS that is not fixed and dilated
154
anticholinergic on EKG
long qrs
155
hemorrhage what do u do
decompression
156
pelvic fractures first line
pelvic binder
157
8th cervical and first thoracic nerve
klumpke palsy, which nerve?
158
first line greenstick fracture first line
immobilization
159
first step in assessing someone who is anxious
thyroid
160
optic glioma what disease is it associated w
NF1
161
what drug do you have to be careful about in older adults
benzos
162
shortened and internally rotated hip
posterior fracture often from MVA
163
can get bulbar symptoms with polymyositis?
yes
164
brief psychotic disorder vs. bipolar
In bipolar mood predominates
165
cervical radiculopathy better when
hand placed on head
166
cervical myelopathy is
upper motor neurons below the lesion
167
gower sign first step
get CPK
168
MDD with psychotic features tx
ETC
169
vasopasm after SAH
3-10 days after and give nipodipine
170
DMD complications
Heart problems so need an echo
171
buprenorphine vs. nalaxone
opioid withdrawal vs. intoxication
172
acamprosate and naltraxone first line for what
alcohol disorder where worry about relapse
| acamprosate (glutamate modulator) naltraxone (mu antag) give for alcohol withdrawal
173
fomepizole
ethylene glycol poisoning
174
chlordiazepoxide, what type of drug is it ?
benzo
175
how to treat catatonia?
benzos
176
difference between pituitary adenomas and cranyopharyngioma
latter calcifies
177
simple febrile seizure
6 mo-5 years .
generalized, last <15 minutes
does not recur within 24 hours
178
sensorineural hearing loss vs. conductive
sensorineural lateralizes to unaffected ear whereas conductive lateralizes to the affected ear
AC>BC in sensorineural hearing loss
BC>AC in conductive
179
how to distinguish between polymyositis and hypothyroid myopathy
hypothyroid myopathy delayed reflexes and more myalgias
| Poly ESR and CK elevated in half
180
vertical diplopia, cant upward eye movements due to
entrapment of inferior rectus muscle
181
CN IV vs. inferior rectus
vertical diplopia on downward gaze (because can't look down) vs. vertical diplopia on upward gaze (because can't look up)
182
pheo is constant or paroxysmal
paroxysmal
183
panic disorder vs. social anxiety
panic-unexpected trigger vs. social anxiety-social situations
184
nightmares vs. sleep terror
wake up and in REM not wake up and not REM
185
rotator cuff tear vs. adhesive capsulitis
just active movement problems vs. active/passive
186
depression, what hormone is elevated?
increased cortisol
187
HIV memory problems
Dementia if < 200
188
Parkinsons can get what kind of psychiatric symptoms
hallucinations
189
1 RR means
that equal chance in both groups
190
when dont have to do CT before LP
<5 years
191
preventative measures during preg for migraines
beta blockers like propranolol
192
helpful therapy for schiz
family therapy
193
acute angle closure glaucoma sx vs. temp arteritis
pain and dilated pupil vs. no dilation
| tx first with pilo or acetazolamide
194
cocaine what do u do
myocardial toxicity treat with benzos but also calcium channel blockers
195
back pain dont forget could be ___cancer
pancreatic cancer
196
valproate
liver function tests abnormal and can get tremor
197
carpal tunnel syndrome manifestation of
RA
198
ankylosing spondylitis hand problems
enthestisis
199
HIV rash vs. niseria meningitis
maculopapular vs. petichiael
200
Mag tox what causes it
renal insufficiency
201
>0.8 cm lung nodule
must be excised
202
guillan berre WBCs and RBCs
nml
203
reactive attachment disorder
dont like to be comforted. often kids who are orphans
204
patellofemoral syndrome pain reproducable when
push patella around groove
205
patellofemoral tx
do quad exercises
206
ischemic stroke high risk for
hemorrhagic transformation (48 hours after), and do repeated CT
207
HIDA used when
u/s is equivocal for cholecystitis
208
Neuroleptic malignant syndrome vs. malignant hyperthermia
from dopamine antagonists vs. anesthetics
fever, tachycardia, tachypnea, and muscle rigidity
209
retinitis pigmentosa
night blindness, loss of peripheral vision and deposition
210
migraines in pregnancy tx
tyelnol
211
methanol SE
vision loss and coma
212
giving O2 can case neuro problems
CO2 retention
213
Huntington Disease degen of
GABA
214
Dont give any anti-depressant if have
bipolar disorder. THAT INCLUDES buproprion
215
strabismus what do u do
dilate to see if red reflex which would be malignant
216
what shows up on the urine drug screen?
only natural, non-synthetic opioids like heroin and codeine
217
trauma after ear infection
reassurance and follow up
218
zinc deficiency
alopecia, dermatitis, scaly skin, abnormal taste, impaired wound healing
219
cataracts what does pt see
halos and blurring with glare
220
diabetic retinopathy what does pt see
floaters
221
MMSE >26
normal aging
222
compression of median nerve dx
NCS
223
causes of ICH
vitamin A tox
224
what do you give for malignant hyperthermia
dantrolene
225
akathesia more often w first or second generation anti-psychotics
first
226
carbon monoxide brain injury
hypoxic brain injury
227
polymyalgia rheumatic tx w
steroids
228
HSV encephalitis
lymphocytes, WBCs, RBCs, and give acyclovir
229
anterior shoulder dislocation leads to
innervates the teres minor and deltoid so weakened shoulder abduction and decreased sensation over the lateral shoulder
230
imaginary friends normal from age
3-6
231
tick born paralysis
ascending paralysis, no motor, no fevers, normal CSF
232
enlargement of ventricles in
schizophrenia
233
positive sharp waves
ALS
234
metaphyseal corner fractures
signs of child abuse
235
essential tremor tx
propranolol and primadone
236
sudden focal neuro def with tradual worsening is
intraparanchymal hemorrhage
237
osteomalacia is decreased min of bone so Ca and P and PTH
low low beccause not absorbed and high PTH
238
agitation in young vs old
benzos vs. haloperidol
239
pes anseurinis
pain over medial tibial condyle often associated with overuse. do quad strengthening and NSAIDs
240
bilateral schwanommas associated with which condition
NF2
241
case control vs. cohort
case control ivestigators split by disease status whereas cohort split by exposure status so thats why latter tests incidence of disease
242
vertigo with valsalva
perilymphatic fistula
243
tx tourettes
tetrabenazine (dopamine depletion)
antipsychotics
alpha 2 andrenergic receptor
244
spinal cord compression first line
glucorticoids
245
oxytocin similar to what hormone
ADH
246
progesterone in preg leads
respiratory alkalosis
247
internal capsule vs. cortical stroke
full side vs. just upper or just lower (if both would be a very large stroke)
248
effaviranez
have weird neuropsych symptoms like vivid dreams
249
cataracts can lead to
loss of red reflex
250
carpal tunnel syndrome
if wrist splint fails, corticosteroid injection
251
heat exacerbates
MS
252
ethylene gycol is
anti-freeze
253
temporal lobe encephalitis
herpes
254
pain worse with downhill compared to up
think neuro cause (worse with spine extension/better with flexion)
=lumbar spine stenosis
255
temporal lobe epilepsy
automatisms
256
most common viral meningits in kids
coxsackie B
257
rhabdo causes
seizures, drugs,
258
refeeding syndrome phosphate
becomes low
259
kleptomania vs. theft
small, insignificant vs. more costly items
260
what is most subject to change (mean, median, mode)
mean
261
fentanyl what kind of opioid is it
long acting opiod
262
charcot marie tooth disease
slow hereditary polyneuropathy-->foot drop, muscle weakness, and leg atrophy
263
SAH if CTN negative
LP
264
MD with psychotic features
give SSRI+antipsychotic
265
lithium
hypercalcemia, neph DI, CKD, thyroid function
266
second gen antipsychotics SE
HLD, DM
267
Harmful mnemonic for serotonin syndrome
```
Hyperthermia
Acog
Reflexes
Myoclonus
Fast HR
Uconscious
Loss of GI
```
vs. neuroleptic=fever, rhabdo, CK, leukocytosis
268
MSA
parkinsons, autonomic dysfunction and widespread neuro stuff like corticospinal problmes
269
neuroleptic malignant syndrome
stiffness without problem with reflexes
270
arsenic vs. lead poisoning
arsenic has more skin findings like hypo or hyperpigmented, hyperkeratosis, pancytopenia vs. lead poisoning has GI poisoning and no skin changes
BOTH skin findings
271
when giving a long acting injectable
when already know can tolerate the oral formula
272
cathinones
bath salts
273
osteomalacia
high PTH, decrease Ca, P
274
bipolar mania vs. schiz
remember schiz has the negative symptoms as well
275
shin splints vs. stress fracture
shin splints causes anterior leg pain that is like stress fracture but people who do casual running. diffuse tenderness. more overweight individual vs. underweight
276
plantar fascitis progression
better as day goes on
277
calcaneal apophysitis
kids who play sports and heel pain
278
suprascapular nerve entrapment
supplies for supraspinatus (abduction) and infraspinatus
| external rotation
279
glucocorticoid myopathy
looks like polymyalgia rheumatica
280
steroids can lead to (in eyes)
increased pressure
281
patella riding high vs. low
patella rupture vs. quadricips rupture
282
beta blocker overdose
glucagon
283
prolactin vs. risperidone
prolactinoma will only decrease TSH
284
TEF
vetebral, anal, cardiac, TE fistula, renal, limb abnormalities
285
MG risk
preg
