Neurology Flashcards
types of lesions involved in alzheimers
-amyloid plaques
-neurofibrillary tangles
s/s of alzheimers
-difficulty learning and recalling information
-visuospatial problems
-language impairment
-behavior changes
diagnosis of alzheimers
clinical
-cerebral atrophy on imaging
treatment of alzheimers disease
donepezil
rivastigmine
memantine
s/s of bells palsy
acute onset facial weakness
loss of taste
hyperacusis
bells palsy vs stroke
bells palsy: forehead does NOT wrinkle with raising eyebrows
stroke: forehead DOES wrinkle with raising eyebrows
diagnosis of bells palsy
clinical
treatment of bells palsy
-prednisone
-valacyclovir
types of stroke
-ischemic: thrombotic or embolic (MC d/t afib)
-hemorrhagic: intracerebral or subarachnoid
etiology of intracerebral hemorrhage
prolonged uncontrolled hypertension
s/sx of stroke
-facial drooping
-hemiparesis
-vision loss
-aphasia
-ataxia
-HA
-LOC
most important piece of info for stroke
last known normal
stroke workup
CT w/o contrast
treatment of ischemic stroke
-determine tpa eligibility
-bp less than 185/110 before tpa can be administered
-if not eligible for tpa, cant treat until bp is 220/120
IV nicardipine, IV clevidipine, IV labetalol
DO NOT LOWER MORE THAN 15% in 24HRS
treatment for intracerebral hemorrhage
SBP 150-220: reduce SBP to 130-140
If >220, not enough evidence to provide specific recommendations
Elkins slides
treatment of subarachnoid hemorrhage
reduce bp to 160
labetalol, nicardipine, or enalapril
Prevent vasospams w/ Nimodipine PO or NG for 3 weeks
TIA
stroke like symptoms that resolve in 1-2 hours
workup and treatment of TIA
same as stroke
s/s of vascular dementia
white matter lesions on MRI
management of vascular dementia
same as alzheimers
s/s of dementia with lewey bodies
-fluctuating cognitive impairment
-tremors
-bradykinesia
-gait changes
-visual hallucinations
diagnosis of dementia with lewy bodies
autopsy
treatment of dementia with lewy bodies
same as alzheimers
s/s of delirium
-acute onset
-attention deficits
-cognitive impairment
usually only lasts hours to weeks
treatment of delirium
treat underlying cause
s/s of essential tremor
-bilateral
-both postural and kinetic
-resolves with rest
-exacerbated by stress
-improves with alcohol
management of essential tremor
propranolol and primidone
s/s of migraine
-prodrome: euphoria, hunger, yawning
-aura: scotoma, flashing lights, sounds
-unilateral throbbing HA
-photophobia and phonophobia
treatment of migraine
-triptan
-preventative therapy (topamax or BB or antidepressant)
s/s of tension headache
-band like, non-pulsating, bandlike pain across forehead
-tenderness to back of neck musculature
-usually caused by stress
MC type of HA
treatment of tension HA
NSAIDs or tylenol
s/s of cluster HA
-Sudden onset, brief, unilateral repetitive headaches localized behind one eye
-ipsilateral conjunctival injection, lacrimation, rhinnorhea (autonomic symptoms)
treatment of cluster HA
-100% O2 with a nonrebreather
-sumatriptan
s/s of parkinsons
caused by dopamine depletion in basal ganglia
-resting pill rolling tremor
-rigidity
-bradykinesia
-shuffle gait
-cogwheeling of extremeties
treatment of parkinsons
carbidopa/levadopa
focal seizure with retained awareness
no LOC or memory loss
focal seizure with impaired awareness
altered consciousness
which type of generalized seizure is not associated with LOC
myoclonic
absence seizure
-spacing out
myoclonic seizure
sudden, irregular jerks or twitches
atonic seizures
drop attacks
tonic seizures
-muscles tighten and stiffen
clonic seizures
-rhythmic jerking
tonic clonic seizures
-both tonic and clonic
-bowel or bladder incontinence
diagnosis of seizures
EEG
treatment of seizures
focal:
generalized:
generalized pregnant:
absense:
-absense: ethosuximide
-focal: lamictal
-generalized: depakote (valproate)
-generalized pregnant: keppra
status epilepticus
seizure lasting more than 5-10 minutes or several seizures occurring in a 30 minute timeframe
treatment of status epilepticus
IV lorazepam
etiology of BPPV
-calcium deposit in semicircular canal
s/s of BPPV
-recurrent brief episodes of vertigo
-occurs after change in head position
diagnosis of bppv
Dix-Hallpike maneuver
treatment of BPPV
-reposition otolith with epley maneuver
