Neuro and gen med Flashcards
What is the most common presentation of neurosarcoid?
cranial neuropathy due to chronic basal meningitis
A patient presents with a rash on the umbilicus around to the back. Weeks later, pain persists and she is unable to touch the area. This is..
post herpetic pain
Is the peripheral neuropathy of diabetes reversible?
No
Besides peripheral neuropathy, what are common neuropathies associated with diabetes?
Cranial neuropathy (III, IV, VI), focal compression neuropathy, radiculopathy
What EEG pattern correlates with metabolic disease?
triphasic waves
How do you monitor AED levels in renal failure?
need to follow free levels
What old disease used to afflict patients on dialysis and looked a lot like CJD (dysarthria, aphasia, ataxia, dementia)?
dialysis dementia from aluminum
A dialysis patient receives a renal transplant and is on tacrolimus. On post op day #3, he is mildly confused and becomes rapidly agitated. What is this? How do you treat?
Posterior Reversible Encephalopathy Syndrome - treat with IV lorazepam, phenytoin
What are the causes of PRES?
eclampsia, hypertensive encephalopathy, uremic encephalopathy, endothelial dysfunction due to drugs
A patient on long term dialysis presents with thickened dura, headache, papilledema, and lymphocytic CSF. What is this?
nephrogenic systemic fibrosis
A patient takes isoniazid and starts experiencing what neurological symptoms? What is lacking?
polyneuropathy - lacking pyridoxine
What patients are at risk for Wernicke’s ?
bariatric patients, cancer patients, alcoholics
What patients used to experience copper deficiencies?
older patients that had dentures - Zn used to bind Cu
A young patient trying to get rid of her acne presents with pseudotumor cerebri. What is this, probably?
vitamin A overdose
A patient who hangs out indoors all the time has osteomalacia. What neurologic symptoms may be present?
proximal myopathy
A patient presents with hydrocephalus and is found on imaging to have subependymal nodules. You should suspect.. (and how do you treat?)
tuberous sclerosis - treat with rapamycin
A patient presents with cafe au lait marks, freckling under the armpits, and soft bumps under the skin. This is..
NF1
A patient presents with bilateral hearing difficulties, ringing in the ears. He was adopted but told that his birth parents had some disease. Think..
NF2
A young mother who just delivered comes in with a headache and right focal seizure as well as right hemiparesis. This is most likely…
venous sinus thrombosis
What are the other mechanisms of stroke during pregnancy?
PFO embolic, hypercoagulable, antiphospholipid antibody, aneurysm, pre-eclampsia
What are the peripheral neuropathies that occur during pregnancy?
facial palsy, carpal tunnel, meralgia paresthetica (lateral femoral cutaneous nerve), obturator nerve, femoral neuropathy, GBS
How big are the risks of epilepsy during pregnancy?
25% increased seizures at second trimester - due to lack of compliance, increased metabolism, hormone changes, etc. ; 2 fold increased risk of fetal malformation, but not nearly as great a risk as falling
What AED should you try to avoid during pregnacy?
valproic acid, carbamazepine
What is the most common manifestation of lupus peripherally? Centrally?
peripheral - distal symmetric polyneuropathy
central - stroke due to hypercoagulable state
