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Board Prep > NEURO CRAP > Flashcards

NEURO CRAP Flashcards

1
Q

Autonomic hyperreflexia: injury above ___

A

usually T6 or above

always T10 or above

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2
Q

Autonomic hyperreflexia: triggered by ___

A

stimulation of hollow organs below injury
childbirth
bowel movement
cutaneous stimulation

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3
Q

Autonomic hyperreflexia: hemodynamics

A 
constrict below
bradycardia, HTN
dilate above (but can't communicate with area below)
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4
Q

Autonomic hyperreflexia: s/s

A 
HTN
Brady
nasal stuffiness
blurred vision
headache
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5
Q

ALS: begins where?

A

hands

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6
Q

ALS: patho

A

degeneration of motor neurons

does NOT affect occulor muscles

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7
Q

ALS: most common cause death

A

respiratory failure

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8
Q

ALS: succs/nondepolarizers

A

because of up regulation, DO NOT use succs (hyperkalemia)

extra sensitive to nondepolarizers (they are weak to begin with hello)

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9
Q

MG: patho

A

autoimmune
IgG blocks post junctional Ach nicotinic receptors, so same amount of Ach but not enough working receptors
skeletal muscle weakness late in day

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10
Q

MG: what surgery/body part affected?

A

thymus

thymomectomy

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11
Q

MG and preggo:

A

worse in pregnancy

IgG crosses placenta, neonate can be weak after delivery

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12
Q

MG treatment:

A 
anti cholinesterase (pyridostigmine)
overdose can cause cholinergic crisis
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13
Q

Eaton Lambert Syndrome: patho

A

IgG destroy PRE synaptic calcium channel (so less Ach release)
often seen side by side with MG

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14
Q

Eaton Lambert Syndrome: musculature

A

affects proximal muscles first

weakness worse in morning

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15
Q

Eaton Lambert Syndrome: succs/NDMR

A

increased sensitivity to succinylcholine

increased sensitivity to NDMR

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16
Q

Eaton Lambert Syndrome: body part associated/comorbidity seen?

A

small cell carcinoma of lung

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17
Q

MG: succs/NMDR

A

because less post junctional receptors, less NDMR needed
so MORE sensitive to roc/NMDR

prolonged duration of succinylcholine, because pyridostigmine impairs pseudocholinesterase
resistant to succinylcholine

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18
Q

GBS other name:

A

acute idiopathic polyneuritis

19
Q

GBS patho

A

myelin in peripheral nerves destroyed
paralysis follows flu-like illness
paralysis moves distal to proximal
lasts 2-4 weeks

20
Q

GBS most common culprits

A

EBV, CMV, campylobacter

21
Q

GBS treatment

A

plasmapheresis, IV IgG

22
Q

GBS succs/NDMR

A 
succs no (upregulation)
increased sensitivity to NDMR (already weak hello)

also increased response to ephedrine

23
Q

Familial Periodic Paralysis treatment

A

could be hypo or hyperkalemic

treatment is acetazolamide for both

24
Q

Familial Period Paralysis succs/NDMR:

A

hypokalemic: NDMR ok but short acting (roc) better, succs questionable
hyperkalemic: NDMR ok, no succs

25
Q

Muscular dystrophy patho

A

no dystrophin
x-linked recessive
predisposed hyperkalemia

26
Q

muscular dystrophy MH

A

NOT linked
increased risk MH like syndrome that’s hyperkalemia and rhabdo
triggered by succs

27
Q

seen with muscular dystrophy

A 
kyphoscoliosis
resp muscle weakness
deep Q waves
increased aspiration risk
degeneration cardiac muscle
unstable sarcolemma, leaky muscle cell membrane
28
Q

scoliosis surgery needed when:

A

Cobb angle greater than 40-50

29
Q

myotonic dystrophy management (3)

A

avoid succs
avoid hypothermia
avoid anticholinesterase

30
Q

MS patho

A

demyelination CNS

31
Q

MS anesthesia/succs:

A

avoid hyperthermia
avoid spinals**
NO SUCCS

** spinal could exacerbate symptoms: need to know per apex even though clinically not significant

32
Q

Scleroderma patho/SE:

A 
fibrosis
HTN
pulmonary HTN
limited mouth opening
CREST syndrome, raynauds
33
Q

there is NO increased risk MH in what 4 muscular disorders?

A

Becker muscular dystrophy
neuroleptic malignant syndrome
myotonia congenita
myotonic dystrophy

34
Q

MH is definitively linked to:

A

King-Deborough syndrome
Central core disease
Multiminicore disease

35
Q

things that exacerbate SLE

A 
PISSED CHIMP
Preggo
Infection
Surgery
Stress
Enalapril
D-penicillamine
Captopril
Hydralazine
Isoniazid
Methyldopa
Procainamide
36
Q

RA three airway issues:

A

TMJ- decreased mouth opening
Cricoarytenoid: decreased diameter glottic opening
C-spine: AO sublaxation, limited extension

37
Q

most common airway problem in RA:

A 
AO sublaxation
(AO sublaxation is when distance between interior arch of atlas and the odontoid process is greater than 3mm)
38
Q

RA complications:

A 
aortic regurgitation
anemia
pleural effusion
restrictive ventilatory defect
morning stiffness
because NSAIDs first line, may bleed
39
Q

Alzheimers key points/treatment:

A

beta amyloid plaque, dysfunctional synapse (not as much Ach)
apoptosis (programmed cell death)
treatment to restore Ach - give cholinesterase inhibitors

40
Q

Alzheimers and succs:

A

succs prolonged, increased duration of action

41
Q

Parkinsons patho

A

chronic neurodegenerative disorder of the basal ganglia
destruction of dopaminergic neurons
relative increase in Ach
increased GABA activity in thalamus

42
Q

parkinsons diagnosis:

A

pill rolling tremor
skeletal muscle rigidity
postural instability
bradykinesia

43
Q

parkinsons treatment

A

levodopa and carbidopa (need to give together –> potentiation)
anticholinergics

44
Q

Parkinson’s anesthesia key points

A

antidopaminergic drugs bad
risk for autonomic instability, orthostatic hypotension, arrhythmia, aspiration
anticholinergics can be used for exacerbation (Benadryl has these properties)
succs and NDMR fine

ketamine controversial

Board Prep (16 decks)

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