Neurology Flashcards
Progressive supranuclear palsy
Hallmark findings:
- impairment of vertical eye movements
- square wave jerks (couplets of inappropriate horizontal saccades)
- a supranuclear gaze paresis
- facial dystonia
- axial rigidity (typically falls backward)
Treatment of MS-related fatigue
Amantadine or modafinil
Treatment of MS-related spasticity
Baclofen, tizanidine, cyclobenzaprine
Goal BP in ischemic stroke (not eligible for tPA)
<220/120
Goal BP in ischemic stroke (eligible for tPA)
<185/110
Presentation within 3 hours of stroke onset
Treatment of Guillain-Barre syndrome
Plasma exchange + IVIg
Anti-epileptic(s) safe in pregnancy
- Carbamazepine
Options to reduce BP in ischemic stroke (including post-tPA)
- Nicardipine
- Labetalol
Only FDA-approved drug for ALS
Riluzole
Subacute inflammatory demyelinating disorder in children and young adults characterized by simultaneous demyelination in multiple regions of the central nervous system.
Acute disseminated encephalomyelitis (ADEM)
Mild parkinsonism + Visual hallucinations
Lewy body dementia
Apathy, perseveration, hoarding, disinhibition, and other personality changes
Frontotemporal dementia
Antibody against muscle-specific tyrosine kinase (MuSK)
Myasthenia gravis
Antibody against post-synaptic acetylcholine receptor
Myasthenia gravis
First-line therapy for myasthenia gravis
Pyridostigmine
Anti-NMDA receptor encephalitis
Ovarian teratomas
Anti-Hu receptor antibodies
Paraneoplastic syndrome associated with small cell lung cancer
Gait impairment, urinary incontinence, and cognitive change
Normal Pressure Hydrocephalus
Dx: Brain MRI
First-line drug for treating partial and generalized epilepsy that is well tolerated, has the highest rate of retention, and has the best efficacy among older patients (>60 y/o)
Lamotrigine
Most common neurologic presentation of Wilson disease
Parkinsonism
Cut-off to start statin on a stroke patient
LDL>100
Multiple sclerosis medication associated with progressive multifocal leukoencephalopathy
Natalizumab
Punding
Excessive, compulsive, repetitive complex activity that serves no essential purpose; associated with dopamine agonist medication
ABCD2 score
Score >3 needs hospital admission for TIA
- Age>60
- BP>140/90
- Clinical symptoms (e.g. hemiparesis) - 2pts
- Diabetes
- Duration >60min
Feature that is most pathognomonic for Parkinson’s disease
Resting tremor
Other features: Rigidity, bradykinesia, loss of postural reflexes, gait freezing
Absolute exclusion criteria for IV tPA
1) Recent major surgery
2) Arterial puncture at noncompressible site
3) Recent systemic hemorrhag
4) Prior h/o hemorrhagic stroke
5) Coagulopathy
Relative exclusion criteria
1) Rapidly improving
2) Minor symptoms
3) Seizure at onset
4) Hyper/Hypoglycemia
5) Age
