Neurology Flashcards
What type of headache? Unilateral, pulsatile, lasting 4-72 hrs, recurrent, +/- nausea/vomiting, photo-sensitivity
migraine headache
ESR level in temporal arteritis?
> 50
Tx of Temporal Arteritis
Prednisone 40-60 mg daily for 1-2 months with slow taper + ASA to reduce the risk of stroke and vision loss
Treatment for Pseudotumor cerebri
start acetazolamide +/- diuretic, stop offending rx, weight loss for obese patients, may need repeat LP or shunt for refractory cases
HTN cut off in ischemic stroke
do not treat unless >220 SBP or DBP >110; if TPA >185/110
Absolute C/I for TPA
active bleeding, current use of anticoagulant, hx of IC hemorrhage, stroke in previous 3 months, platelets <100,000
When do you start ASA/Plavix for stroke?
if not TPA start immediatly; if TPA given then start 24hr before starting
Time window for TPA
3-4.5 hr
**aafp uses 3hr cut off
BP range for hemorrhagic stroke
gradually lower BP & keep between 130-120
Broca vs Wernicke aphasia
Broca: speech is nonfluent, effortful, monotone with impaired naming, repetition & writing. Comprehension preserved
Wernicke: Fluent, possibly excessive speech with frequent paraphasias(substituting words). Comprehension impaired with impaired reading, writing, naming and repetition.
Triad for wernicke encephalopathy
encephalopathy, oculomotor dysfunction, gait ataxia
*in reality confusion is the MC symptom - will also develop korsakoff syndrome over time
Korsakoff syndrome
permanent and significant impairment of short term memory with inability to form new memories and impaired remote memory. apathy & lack of insight to the disorder but alert and responsive.
Meniere’s disease vs labyrinthitis vs vestibular neuritits
Meniere’s Disease: episodic vertigo w/tinnitus/hearing loss during episodes
Labyrinthitis: inflammation of the labyrinith w/persistent vertigo, usually follows URI and has hearing loss/tinnitus
Vestibular neuritis: inflammation of the vestibular nerve resulting in persistent vertigo w/o hearing loss, usually follows URI
Inheritance pattern and symptoms of Friedreich Ataxia
AR mutation w/expanded GAA repeat on chrom 9.
*ataxia, kyphoscoliosis, restrictive lung dz, cardiomyopathy
Inheritance and mutation in huntington disease
AD, CAG repeats
When do you need dual antiplatelet therapy for a TIA?
Dual antiplatelet therapy with aspirin and Plavix are recommended for the first 21 days in patients with a high-risk TIA. After that continue with aspirin alone
What is DRESS syndrome?
Drug reaction with eosinophilia and systemic symptoms
Best rx to prevent cluster headache?
Verapamil
Best rx for chronic tension headache
(More than 15 headaches a month) topamax or valproate
Best prevention rx for migraines associated with menses?
Frovatriptan
