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ABR > Neurology > Flashcards

Neurology Flashcards

1
Q

Contraindications to triptans (I.e. sumatriptan)

A

CAD
Vasculitis
Pregnancy

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2
Q

Management for refractory migraines (lasting > 72 hours)

A

IV prochlorperazine or metoclopramide + IV diphenhydramine

OR

IV Dihydroergotamine

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3
Q

Prophylaxis for migraines < 15x per month

A

Beta blockers
Topiramate
Valproate
Amitryptyline

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4
Q

Prophylaxis for migraines > 15x per month

A

1) Topiramate

2) Botox

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5
Q

Recurrent unilateral/retro-orbital headaches > 6-10x per day lasting 15-20 min.

Management

A

Dx: Chronic paroxysmal headaches

Tx: Indomethacin

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6
Q

Headache with obesity and vision problems and/or blurring of optic disc margins (papilledema).

A

Idiopathic intracranial hypertension

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7
Q

Management for trigeminal neuralgia

A

MRI Brain

Carbamazepine

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8
Q

Ptosis, miosis, anhydrosis

A

Compression if sympathetic chain (I.e. pancoast tumor - CXR; or carotid artery dissection - CTA neck)

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9
Q

Ptosis + mydriasis

A

Berry aneurysm compression of CN III

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10
Q

Optic nerve lesion

A

Ipsilateral complete blindness

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11
Q

Optic chiasm lesion

A

Bitemporal hemianopia

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12
Q

Optic tract lesion

A

Contralateral dense homonymous hemianopia

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13
Q

Optic radiation lesion

A

Contralateral homonymous quadrantanopia / dense hemianopia / macular sparing

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14
Q

Carotid artery syndrome

A

Ipsilateral visual loss

Contralateral motor or sensory changes

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15
Q

Vertebrobasilar syndrome

A

Dizziness
Diplopia
Dysarthria

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16
Q

Most important risk factor for stroke

A

Hypertension

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17
Q

Symptomatic with > 70% carotid artery stenosis

A

Carotid endarterectomy + ASA

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18
Q

Symptomatic with > 70% carotid artery stenosis and NOT surgical candidate

A

Transcarotid stent + ASA

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19
Q

Symptomatic with < 50% carotid artery stenosis

A

ASA

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20
Q

Asymptomatic with > 80% carotid artery stenosis

A

Carotid endarterectomy + ASA

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21
Q

Asymptomatic + total carotid artery occlusion

A

Medical management (collaterals present)

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22
Q

HTN, visual disturbances with hemianopsia/auras/cortical blindness. MRI brain with white matter edema in parietal-occipital region

A

Posterior reversible encephalopathy syndrome

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23
Q

Ipsilateral loss of pain/temp in face

Contralateral loss of pain/temp in body

A

Lateral medullary syndrome

Wallenberg syndrome - posterior inferior cerebella artery

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24
Q

Hemiparesis with involuntary shaking movements
Quadriplegia
Locked-in syndrome

A

Basilar artery stroke

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25
Q

Hyperdense lesion in parietal area suggestive of subarachnoid hematoma

A

Amyloid angiopathy

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26
Q

Management for subarachnoid hemorrhage

A

angiogram and endovascular clip

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27
Q

Management for Vasospasm In subarachnoid hemorrhage

A

Nimodipine

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28
Q

ONLY horizontal nystagmus

A

Peripheral vertigo

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29
Q

Peripheral vertigo + hearing loss

A

Labyrinthitis

Meniere’s disease

30
Q

Veritgo, tinnitus +

1) fluctuating hearing loss
2) progressive hearing loss

A

1) Ménière’s disease

2) acoustic neuroma

31
Q 
Brain atrophy (enlarged sulci) on CT/MRI with dilated ventricles. 
Increased Beta amyloid. Telomere short lengthened.
A

Alzheimer’s disease (most common cause of dementia)

32
Q

Management for Alzheimer’s

A

Mild (MMSE 21-25): anticholinesterase (donepezil, galantamine, rivastigmine)

Mod (MMSE 11-20): anticholinesterase + memantine (NMDA antagonist)

Severe (MMSE < 10): palliative

33
Q

Adverse effects of cholinesterase inhibitors

A

Syncope
Bradycardia with increased PPM placement
Hip fracture

34
Q

60 y/o. Cognitive impairment. Poor short-term memory. Can’t recall names. Paranoid delusions.

A

Alzheimer’s disease

35
Q

Dementia with Visual hallucinations.

Cytoplasmic inclusion bodies and alpha-synuclein protein

A

Dementia with Lewis Bodies

36
Q

Dementia
Hereditary
Choreiform movement

A

Huntington disease

37
Q

Loss of interest. Disinhibition. Urinates on neighbors lawn. Hypersexual.

A

Frontotemporal dementia

38
Q

Dementia.
Urinary incontinence.
Wide-based gait.
Enlarged ventricles. Not enlarged sulci

A

Normal pressure hydrocephalus

39
Q

Internuclear ophthalmoplegia

Inability to addiction ipsilateral eye. Nystagmus of Contralateral abducting eye

A

Medial longitudinal fasciculus

40
Q

Paresthesias
Vibration/position sense loss
Weakness, spasticity, hyperreflexia
Optic neuritis

A

Multiple sclerosis

demyelination of white matter

41
Q

Management for acute relapse of Multiple sclerosis (INO, optic neuritis, functional impairment)

A

IV methylprednisolone 1g OD x 3-5 days

42
Q

Check for JC antibodies prior to starting this.

A

Natalizumab

43
Q

Resting pronation/supination tremor
Cog wheel rigidity
Retarded movement
Loss of reflex (frequent falls)

A

Parkinson’s disease

Decreased dopamine in substantia nigra

44
Q

Adverse effects of levodopa

A

Involuntary movements
Psychiatric symptoms
On-off phenomenon (alternating hyper/hypokinesia

45
Q

Management for on-off phenomenon with levodopa

A

Take with low protein meal
Increase dose/dosing frequency
consider adding selegiline/rasagiline

46
Q

Antero-posterior flapping tremor
Exacerbates with anxiety
Alleviates with alcohol

Management

A

Dx: Essential tremor

Tx: propranolol. Then primidone

47
Q

Progressive weakness throughout the day. Diplopia/ptosis. DTRs normal.

A

Myasthenia Gravis

48
Q

Work-up for myasthenia gravis

A

1) Ach receptor Abs (post-synaptic)
2) nerve stimulation studies
3) CT chest (r/o thymoma)

49
Q

Management for myasthenia crisis

A

1) PLEX
2) immunoglobulins
3) steroids

50
Q

Weakness gets better with activity
Hyporeflexi
+ptosis
No diplopia

A

Lambert-Eaton syndrome

51
Q

Only motor deficits
UMN and LMN lesions
Sensation intact

Management

A

Dx: ALS

Tx: Riluzole

52
Q

LMN (UL weakness, starts in hands and moves proximal) and sensory (pain/temp sensation loss) changes

A

Syrinogomyelia

Cavitation of central spinal cord

53
Q

Foot drop
Cannot invert foot
Cannot evert foot

A

L5 radiculopathy

Lumbar vertebral foramina

54
Q

Foot drop
Can Invert foot
Cannot evert foot

A

Peroneal n. Injury

Fibular head

55
Q

Management for foot drop with high steppage gait

A

Foot ankle orthosis

56
Q

Etiology and management of spinal stenosis

A

Etiology: hypertrophy of ligamentum flavum

Tx: PT. Not surgery

57
Q

CSF value in Guillain-Barré syndrome

A

Increased protein

Normal WBCs

58
Q

Descending paralysis
Blurred vision, diplopia, dysarthria, dysphagia, diarrhea
Dilated pupils

A

Botulism toxicity

59
Q

Extreme focal tenderness with light touch

Bluish discoloration

A

Complex regional pain syndrome

Reflex sympathetic dystrophy

60
Q

Antiepileptic that causes kidney stones

A

Topiramate

61
Q

Best AED with depression

A

Lamotrigine

62
Q

AED that causes hyperammonemia

A

Valproate

63
Q

Seizure with epigastric rising sensation, psychic sensation, deja vu

A

Focal unaltered awareness seizure (temporal lobe)

64
Q

Seizure that spreads from UE to ipsilateral LE followed by weakness

A

Jacksonian seizure (frontal lobe)

65
Q

Enhancing lesion

T cells < 50

A

Lymphoma

66
Q

Ring enhancing lesion

Gray-white matter junction

A

Brain abscess

67
Q

Multiple ring enhancing lesions

T cells < 100

A

Toxoplasmosis

68
Q

Multiple non-enhancing lesions

T cells < 200

A

Progressive multifocal leukoencephalopathy

69
Q

White matter plaques, enhance with activity

A

Multiple sclerosis

70
Q

High frequency hearing loss

A

Presbycusis

71
Q

Brachial plexopathy (lower) + Horners Syndrome

A

Cancer invasion

72
Q

Brachial plexopathy (upper) + Paresthesias, fasciculations

A

Radiation injury

ABR (12 decks)

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