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Internal Med Rotation > Neuro Problems > Flashcards

Neuro Problems Flashcards

1
Q

2 main elements needed for MS diagnosis

A

dissemintaiton of CNS lesions in both space and time

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2
Q

what happens with MS?

A

demyelinating event in teh DNS

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3
Q

what lesions are present w/ MS and how are they seen?

A

Cerebral of spinal plaque with adiscrete region of demyelination w/ relative presevation of axons . Seen w/ MRI

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4
Q

what is found in the CSF of people w/ MS?

A

oligoclonal bands

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5
Q

clinical presentation of MS

A

parethesiasis in upper and lower extremities
monocular vision loss (due to optic neuritis)
Diploplia (internuclear opthalmoplegia0
ataxia, intention tremor (cerebellar involvement)
urinary difficulties
memory loss, personality changes

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6
Q

type of MS w/ attacks followed by complete remission

A

relapsing-remitting

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7
Q

Type of MS where the dz is gradually worsening

A

secondary progressive

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8
Q

type of MS that presents later in life and has a steadily progressive course

A

primary progressive

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9
Q

MS type where patients have laregely progressive dz exacerbated by acute attacks and little remission

A

relapsing progressive

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10
Q

first line therapy for acute attack of MS

A

high does parenteral corticosteroids

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11
Q

does pregnant women w/ MS experience more or fewer symptoms

A

fewer, they are usually symptom free during pregnancy

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12
Q

presents with flat, uniformly hyperpigmented macules that ppear during the first year and after birth, suggested by the presence of 6 or more. Can also have optic pathway glioma (by age 3 usually)

A

Neurofibromatosis type 1

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13
Q

raised, often pigmented hamartomas of the iris that are a specific finding for neurofibromatosis type 1. They don’t affect vision

A

LIsch nodules

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14
Q

what causes myasthenia gravis?

A

antibody-mediated, T-cell dependent immunologic attack directed at proteins in the postsynaptic membrane of the neuromuscular junction

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15
Q

most common presenting symptom of myathenis gravis

A

ptosis and/or diplopsia

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16
Q

other symptoms of myasthenia gravis

A

dysarthria
dysphagia
fatigable chewing

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17
Q

first line therapy for myasthenia gravis

A

AchE inhibitiors (pyridostigmine)

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18
Q

what surgery can help patients w/ myasthenia gravis

A

thymectomy (if they don’t have mUSK antibody- associated MG w/o thyoma)

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19
Q

3 main symptoms of Parkinson’s

A

tremor, bradykinesia, rigidity

20
Q

what type tremor is seen w/ parkinson’s

A

pill-rolling, rest tremor, most noticeable when body isn’t engaed in purposeful activities

21
Q

when do you see a tremor w/ essential tremor?

A

when the affected limb is being used

22
Q

Partial seizure with preserved consciousness

A

Simple

23
Q

Simple partial seizure resulting in rhythmic motor activity

A

Jacksonian

24
Q

Characterized by repetitive automatisms and impaired consciousness.

A

Complex partial

25
Q

2 types of generalized seizure

A

Tonic-clonic

Absence

26
Q

What type seizure is an aura associated with

A

Simple partial seizure

27
Q

what does a diagnosis of dementia require?

A

memory loss and at least oen other cognitive dysfunction (aphasia, apraxia, agnosia, disturbances of executive function)

28
Q

Dementia results from ischemic injury

A

vascular dementia

29
Q

dementia due to intraneuronal inclusions w/ aggregations of synaptic protein (alpha-synuclein)

A

Lewy Body Dementia

30
Q

presents w/ gait abnormality, incontinence and dementia

A

normal pressure hydrocephalus

31
Q

dementia characterized by fluctuation of cognitiion (drowsiness, staring into space, diorganized speech) visual hallucinations, parkinsonism

A

Lewy body dementia

32
Q

confirmatory score of dementia on MMSE

A

24 out of 30 (or less)

33
Q

Tx of normopressure hyrdocephalus

A

placement of a ventriculoperitoneal shunt

34
Q

mainstay of medical treatment for AD

A

cholinesterase inhibitors

35
Q

NMDA receptor blocker used for dementia

A

memantine

36
Q

what drug may frontal temporal dementia respond to

A

trazodone

37
Q

druation of a migraine

A

4-72 hours

38
Q

HA with unilateral, retroorbital sharp or knife-like pain. often occur w/ lacrimation and nasal congestion

A

cluster HA

39
Q

thunderclap HA, worst HA of my life

A

SAH

40
Q

acute tx for migraine HA

A

triptans

41
Q

prevention tx for migraines

A

propranolol, amitriptyline

42
Q

acute tx for tesnsion HA

A

APAP, apsiring

43
Q

prevention tx for tension HA

A

amitriptyline

44
Q

acute tx for cluster HA

A

oxygen, triptan

45
Q

Prevention tx for cluster HA

A

verapamil

46
Q

what color with CSF be with a SAH

A

yellow discoloration- indicative of hemorrhage or there will be RBCs

Internal Med Rotation (13 decks)

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