Neurology Flashcards
What is a tool to risk stratify people who present with syncope that they will have a serious outcome in the next 30 days. Serious event would be death, pulmonary embolism, G.I. hemorrhage, ventricular arrhythmia
The Canadian syncope risk score from -2–6 points. The higher the points the higher the risk. Those in the very low and low risk categories had a less than 1% chance of a serious event in the next 30 days.
Three subtypes of PD
The major subtypes are as follows:
●Tremor-dominant
●Akinetic-rigid
●Postural instability and gait difficulty
What is hypomimia
Hypomimia (masked facial expression)
Difference between Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB)
Clinically, patients are diagnosed with PDD if their illness begins with PD and they develop dementia at least a year after the onset of parkinsonian motor symptoms.
When dementia begins before or concurrently with parkinsonian motor symptoms, DLB is the more likely diagnosis.
Treatment for intermittent RLS, <2 per wk
avoid caffeine and alcohol, regular exercise, half-whole tab of Sinemet daily, low-dose benzo, low-dose codeine or tramadol, iron therapy, only use Sinemet in intermittent RLS because of augmentation concerns
what is augmentation in RLS mean
symptoms worsening because of medications, up to 70% of patients taking levodopa daily especially in doses 200 mg or more
best way to take iron therapy, recommended iron level for RLS
evening time with 100-200 mg vitamin C on an empty stomach, between 100-300 mcg per L
first-line therapy for chronic persistent RLS–
alpha 2 delta calcium channel ligands ( gabapentin, Lyrica, horizont) dopamin agonists are second line (Mirapex and Requip and rotigotine patch),, take meds 1-2 hrs before usual onset of sxs
max doses of mirapex, requip
0.5 mg, 4 mg
two potential complications from dopamine agonists for RLS
risk of RLS augmentation, impulse control problems
Type of tremor in Parkinson’s?
New onset, unilateral, resting
Test that can differentiate between essential and Parkinson tremor
DaTscan: A test to help in the diagnosis of Parkinson’s
Major difference between Bealls palsy, and other concerning causes of paralysis
Bell’s palsy always involves the forehead, and cannot completely shut the eye. Think of a big bell sitting on someone’s forehead.
Major difference between Bealls palsy, and other concerning causes of paralysis
Bell’s palsy always involves the forehead, and cannot completely shut the eye. Think of a big bell sitting on someone’s forehead.
Treatment options for Bell’s palsy
Prednisone 50–60 mg daily times five days then taper over five days. Valacyclovir 1 g TID×5 days. Never use antivirals alone. The combination reduces the risk of dyskinesis significantly, which is unwanted facial movements. 
Define chronic insomnia
3 days per week for 3 months
Two types of proteins related to AD
Beta Amyloid and Tau
What are the different types of medication for AD?
-Acetylcholine eaterase inhibitors
-Memantine NMDA receptor antagonist works on the glutamate system 
- aducanamab
Mechanism of action of Actylcholinesterase inhibitors
Mechanism of action of aducanumab?
Difference between MCI from dementia?
-MCI doesn’t interfere with the patients everyday activities
-1/3 Of MCI pts due to AD will develop AD in five years
-MCI doesn’t always lead to dementia
Other causes of cognitive changes
Urinary track infection, mental health, concerns, untreated, sleep apnea, medication, alcohol, B12 deficiency, thyroid problems, history of TBI and concussion 
Things that patients can do to help reduce development of vascular dementia and other general forms of dementia
Control, blood pressure, control, diabetes, control, cholesterol, lose weight and stop smoking
Stay active mentally and physically
