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Clin Med I > Neuro Guests: Dizzy, HA, Seizures, Peri Neuropathy > Flashcards

Neuro Guests: Dizzy, HA, Seizures, Peri Neuropathy Flashcards

1
Q

____ vertigo is not triggered by movement and is associated with vertical nystagmus.

A

Central Vertigo

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2
Q

Pt presents with horizontal nystagmus and vertigo that is triggered by movement.

… Dx?

A

Peripheral Vertigo

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3
Q

What is the gold standard test for posterior canal BPPV?

A

Dix-Hallpike Maneuver

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4
Q

True or False: 63 y/o patient with new onset dizziness is typically benign and non-concerning.

A

False

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5
Q

What test assesses for posterior fossa lesion and looks for misalignment of eye when covering/uncovering the eye?

A

Skew Test

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6
Q

A negative HINTS exam can rule out ____ better than MRI in the first 24-48 hours.

A

stroke

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7
Q

A positive HINTS exam is 100% sensitive and 96% specific for presence of _____

A

central lesion

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8
Q

Dix-Hallpike maneuver would be considered positive if:

  1. ___
  2. ___
A
  • symptoms are reproduced

- nystagmus is present

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9
Q

What are some central causes of vertigo

A
  • Strokes
  • CNS tumors
  • Acoustic neuroma
  • Trauma
  • Drug intoxication
  • Multiple sclerosis
  • AV malformations
  • vertebrobasilar migraine

etc

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10
Q

Calcitonin is a neuropeptide that signals ___ in the ___ nerve.

A
  • pain

- trigeminal

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11
Q

when can a patient be prescribed CGRP antagonists

A
  • if migraine occurs 15x/month (chronic migraines)

- has tried and failed 3 other types of meds

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12
Q

What are the 4 common rescue medications

A
  • OTC ibuprofen/APAP
  • Sumatriptan
  • Ergotamines
  • Fioricet
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13
Q

Triptans are vasoconstrictors and should not be given to patients with hx of ___ and ____.
An alternative would be ____

A
  • MI and stroke

- Fioricet

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14
Q

what is typically in a migraine cocktail (ER)

A
  • Toradol
  • Benadryl
  • Compazine

(NSAID, antihistamine, antiemetic)

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15
Q

What are the downsides to Toradol

A

hard on the kidneys and stomach

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16
Q

what would you Tx a pt with a migraine who prefers natural supplements

A
  • Magnesium
  • CoQ10 (esp for statin-induced HA)
  • VitB2
  • Vit D
17
Q

Caucasian male presents with excruciatingly severe, unilateral HA esp around the left eye with lacrimation. No N/V. He appears restless.

… Dx?
… Tx?

A
  • Cluster HA
  • injectable/nasal triptans
  • 100% O2 6L (hard to cover with insurance)
  • Verapamil (Ca CH blocker)
18
Q

Pt, who is obese, presents with pulsatile tinnitus, headaches, blurry vision. LP has an opening pressure >250 mm/H2O.

… Dx?
… Tx?

A
  • idiopathic intracranial hypertension
  • drain fluid via LP until pressure normalizes
  • diet changes, Diamox
19
Q

_____ are inflamed neck nerves that can be due to bad posture, whiplash, s/p neck surgeries

A

Occipital neuralgia

20
Q

When can botox be used as migraine therapy?

A
  • if migraine is chronic (15x/month)

- failed 3 medications

21
Q

what is the most common cause of syncope

A

vasovagal (brain overreacts to a trigger and “shuts down” your heart)

22
Q

____ is when there is a drop in systolic BP by 20 or a drop in diastolic by 10 after standing for 3 minutes

A

Postural hypotension

23
Q

Degree of rotation for Dix-Hallpike

A

45 degrees

24
Q

Elderly pt presents with syncope after suddenly turning their head.
What is this and why does this happen?

A
  • carotid sinus syndrome
  • pressure to sensitive baroreceptors at the carotid body > slows heart rate > drop in BP > poor brain perfusion > syncope
25
Q

what are some causes of seizures

A
  • excessive alcohol
  • low glucose, mg, and ca
  • insomnia
  • Meds: tramadol, wellbutrin, Abx
26
Q

what med is good for seizures and trigeminal neuralgia

A

Carbamazepine (Tegretol)

27
Q

what med is good for headaches and seizures, but can make you forget words

A

Topiramate (topamax)

28
Q

what med is good for seizures and is fast acting, but makes you cranky and depressed

A

Keppra

29
Q

what med is good for mood and IQ, but can cause a rash and is slow acting

A

Lamotrigine

30
Q

what med is good for seizures in pregnant women

A
  • Lamictal (lamotrigine)

- Keppra (levetiracetam)

31
Q

what med is good for seizures, but can cause weight gain and is bad for pregnant women

A

depakote

32
Q

what are seizure medications that are not typically strong enough for seizures and can cause LE edema?
… which is cheaper?
… which has fewer S/E?

A
  • Gabapentin (cheaper)

- Lyrica (fewer S/E)

33
Q

what med is used for status epillepticus and is also a fast acting, but temporary (band-aid effect)

A

Benzodiazepines

Ativan or valium

Clin Med I (21 decks)

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