Neurology Flashcards
Droxidopa MOA/use
droxidopa: for neurogenic orthostatic hypotension in parkinsons
Apomorphine MOA/use
apomorphine: can be used for patients that have rapid/sudden wearing off of PD meds
Difference between dementia and mild cognitive impairment
-dementia: impairment in 2 out of 5 major domain functions and affects daily function!
-functional domains:
Memory
Executive: paying bills, planning
Perception: visuospatial, dressing, appearance
Language
behavior
-mild cognitive impairment: only 1 of the domains is affected and does not significantly impact daily functioning
Diagnostic difference between dementia with lewy bodies and parkinson disease dementia
Dementia with lewy bodies: onset of cognitive impairment within 1 year of motor dysfunction
Cognitive impairment after 1 year of motor dysfunction: parkinson disease dementia
What is the clinical presentation of Charot-Marie-Tooth disease?
numbness, distal extremity weakness, unsteady gait, areflexia, high arches, hammer toes, and atrophy of distal extremity muscles and foreleg muscles (“stork leg” deformity)
What paraneoplastic syndrome is associated with ovarian teratoma?
Anti-NMDA-R encephalitis
Treatment includes removal of the teratoma to eradicate the immune stimulus and immunosuppression with glucocorticoids or intravenous immune globulin.
What is uhthoff phenomenon?
Multiple Sclerosis: a transient worsening of baseline neurologic symptoms in the setting of hot weather, physical exertion, or fever. Any patient with a suspected relapse should be screened for causes of Uhthoff phenomenon masquerading as a relapse (or “pseudorelapse”) to avoid unnecessary treatment.
What is Lhermitte sign?
Shock-like sensation radiating down the spine or limbs with flexion of the neck.
Can happen with MS or with other causes of upper cervical cord lesions
What is Mitoxantrone?
Mitoxantrone: Only FDA approved tx for secondary progressive MS; Don’t use anymore due to cardiac toxicity and leukemia!
What is Ocrelizumab?
Ocrelizumab: only FDA tx for primary progressive MS
*Other MS medications are NOT helpful in progressive forms of MS
What is Dalfampridine? SE/adverse effects?
Improves walking speed, gait in patients with MS
Should not be used in patients with seizure disorder or kidney dysfunction!
What is Pimavanserin?
Pimavanserin is the only FDA med for Parkinson psychosis (BUT only start this once you have tried to stop dopamine receptor agonists like pramipexole, while maintaining patient on levodopa)
What should you monitor for when using carbamazepine?
hyponatremia and agranulocytosis
What are the contraindications to using Donepezil?
Relative contraindications for the use of cholinesterase inhibitors in the treatment of dementia include sick sinus syndrome, left bundle branch block, uncontrolled asthma, angle-closure glaucoma, and ulcer disease.
What is tetrabenazine used for?
Tetrabenazine: can be used for chorea in Huntingtons
