Neuro/psych Flashcards
PTSD tx
SSRI, SNRI first line
If sleep disturbance, augment with prazosin (other alpha blockers do not have evidence) and consider eval for OSA
Most effective drug for motion sickness
Scopalomine. Patches > oral.
Contraindications to donepazil
Bradycardia/Syncope – can cause bradycardia (cholinesterase inhibitor)
pathologic tinnitus
unilateral
pulsatile
associated with asymmetric hearing loss
1st line tx conversion do/somatic sx disorder
SSRI
T/f: can use maxalt and sumitriptan w/in same 24 hours
FALSE
in office option for refractory migraine
IM antiemetic like promethazine, prochlorperazine
IV reglan is best
1st line tx PTSD
SSRI or venlafaxine + therapy
‘gv when do try Z drug
after CBT, doxepin, extended release melatonin
cluster headache dx/tx
unilateral, orbital pain, vasomotor phenomenon (block nasal passage, rhinorrhea conjunctival injection)
Tx: 100% O2, verapamil, indomethacin
most common causes of peripheral neuropathy
DM
hypothyroidism
nutrition
liver disease
renal
meds: amioo, dig, macrobid, statins
MGUS
anti-psychotic use in behavioral disturbance in dementia
off label. Abilify is the only one that has shown small reductions
first line depression in adolescents AFTER psychotherapy
prozac
than sertraline, citalopram
Frequency of stroke subtypes
ITE HIS
Ischemic: thrombotic > embolic
Hemmorhagic: intercerebral > subarach
CHA2DVASC
CHF, HTN, Age >75, DM, Vasc, Age 65-74, Stroke hx
2+= DOAC, warf
1+ = ASA or DOAC
0= ASA
indications for TPA
Neg CT, no hx ICH, no seizure, BP <185/110
Age > 80 = <3 hrs, no AC
Age <80 = 4.5hr, INR < 1.7
When to decrease BP in acute ischemic stroke
> 220/120
Labetolol (10mg) or Nicardipine (5mg/hr) –> goal dec by 15%
BP control for hemorraghic or subarach?
hemmoragic CVA <140
SAH < 160
diff between TIA and stroke
Neurologic dysfunction/impairment w/:
+MRI= stroke
-MRI= TIA
Secondary management after stroke/TIA
DAPT foor 21 days
max MME for opiods, and threshold for prescribing naloxone
Max= 90
Naloxone= 50
Contraindications to triptans
CAD
hx of stroke
PVD
chronically uncontrolled HTN
meds that slow progression of parkinsons?
None.
Carbidopa/levadopa is 1st line for motor symptoms
1st ddx in acute AMS of eldrely without undrlying explanationo
delerium if ACUTE. Aka do not just diagnose dementia
Vascular dementia usually happens after……
CVA. Also will have “uncontrolled” HTN
New concussion management
- 24-48hr rest > return to learning > step wise return to sports once base to academic baseline
central vision loss with peripheral sparing
macular degeneration
halos and decreased night visin
cataracts
patchy peripheral vision loss
glaucoma
sudden scattered floaters
retinal detachment
