Neurology Flashcards
Which anti-hypertensive agents may be used for migraine prophylaxis?
Beta blockers (usually Propranolol or Timolol)
Which vitamin may be used for migraine prophylaxis?
Vitamin B2 (a.k.a. Riboflavin)
Which 2 anticonvulsants are typically used for prophylaxis against migraines?
Valproic acid and Topiramate
What are some of the main side effects of carbamazepine use?
- Dizziness
- GI upset
- Hypocalcemia
- Hyponatremia
For what type of seizures is ethosuximide prescribed?
Absence (petit-mal) seizures
Which anti-epileptic medication is most notorious for causing neural tube defects in the children of pregnant women using the medication?
Valproic acid
What is the best imaging study to diagnose Multiple Sclerosis?
MRI of the brain
What is the characteristic cerebral imaging finding in Multiple Sclerosis?
Increased T2 signal and decreased T1 signal.
What is the diagnosis in a patient lacking ipsilateral adduction to a contralateral gaze?
Internuclear ophthalmoplegia
Meniere’s disease features which type of vertigo: Central or Peripheral?
Peripheral.
What is cataplexy?
Weakness or flaccid muscles upon excitement.
What type of visual loss results from right optic tract lesion?
Left-sided homonymous hemianopia.
What type of vision loss results from left optic nerve lesion
Left monocular blindness.
What type of vision loss results from right optic radiation lesion?
Left quadrantanopia (anopia affecting a quarter of the vision field).
Which vessel is typically involved in Epidural hematomas?
Middle Meningeal artery
Which involves venous bleeding: Subdural or Epidural hematoma?
Subdural hematoma
Which are more rapidly evolving: Subdural or Epidural hematomas?
Epidural hematoma
The upper face is usually spared in supranuclear or infranuclear palsy?
Supranuclear palsy
What is the characteristic rash of Lyme disease?
Erythema chronicum migrans
What toxicity is associated with mitoxantrone use?
Cardiotoxicity
What medication should be avoided in patients with the JC virus as it can lead to progressive multifocal leukoencephalopathy (PML)?
Natalizumab
What are the 4 types of Multiple Sclerosis (MS)?
- Primary-progressive MS (PPMS)
- Relapsing-remitting MS (RRMS)
- Secondary-progressive MS (SPMS)
- Progressive-relapsing MS (PRMS)
What form of Multiple Sclerosis is described here? “The most common form, relapses occur and are followed by
remission.”
Relapsing-remitting MS (RRMS)
What type of Multiple Sclerosis is described here? “Slowly progressing MS with no periods of remission.”
Primary-progressive MS (PPMS)
What type of Multiple Sclerosis is described here? “Develops in people having a relapse of MS. Partial recoveries do occur but the disease gets progressively worse with each cycle.”
Secondary-progressive MS (SPMS)
What are 2 main causes that need to be ruled out before proceeding with the treatment of a patient with psychosis?
Electrolyte abnormalities and infection
Which commonly prescribed antipsychotic can exacerbate Parkinsonian symptoms?
Haloperidol.
What dopamine receptor antagonist medication is used to help with diabetic gastroparesis?
Metoclopramide
What are the four cardinal features of Parkinson’s disease?
- Resting tremors
- Bradykinesia
- Rigidity
- Postural instability
What is the preferred treatment for middle-aged patients with Parkinson’s disease?
Pramipexole
What medication can be given in conjunction with levodopa for Parkinson’s disease?
Carbidopa (which prevents peripheral conversion of levodopa to dopamine).
What is the likely diagnosis in a patient with chronic lower back pain that improves with leaning forward or walking uphill?
Spinal stenosis
What is the most likely diagnosis in a patient with malignancy, new lower back pain, leg weakness, paresthesias, and loss of bowel or bladder control?
Cord compression.
What is the likely diagnosis in an obese individual with chronic lower back pain lacking inflammatory features?
Degenerative disc disease (or osteoarthritis).
What type of cancer is associated with Eaton-Lambert syndrome?
Small cell (or Oat cell) lung cancer.
What reflexes are characteristically seen in Eaton-Lambert syndrome?
Decreased reflexes (hyporeflexia).
In myasthenia gravis, antibodies are directed against which receptors?
Post-synaptic acetylcholine receptors.
What reflexes are characteristically seen in patients with hypothyroidism?
Delayed reflexes.
What reflexes are characteristically seen in patients with West Nile virus?
Decreased reflexes (hyporeflexia).
What reflexes are characteristically seen in subacute combined degeneration?
Increased reflexes (hyperreflexia).
What is the most important goal within the first 24 hours after t-PA administration?
- Blood pressure control:
In the first 24 hours after t-PA administration, what
medications/interventions should be avoided?
Aspirin, Heparin, Coumadin, or any sort of Feeding.
What can uncontrolled hypertension cause in a patient with ischemic stroke given tissue plasminogen activator (t-PA)?
Transformation into hemorrhagic stroke.
What are the clinical features typically seen in Creutzfeldt-Jakob disease?
Progressive dementia and quick jerky movements (myoclonus jerks) that are exacerbated by loud noises.
What are three major sources of Creutzfeldt-Jakob disease?
Contaminated Corneal transplants, Growth hormone or Surgical instruments.
What EEG findings are expected in Creutzfeldt-Jakob disease?
Slow background with intermittent sharp waves present.
Of the major forms of cancer, which is least likely to lead to brain metastasis?
Prostate cancer.
In women, what is the most likely cancer to spread to the brain parenchyma?
Breast cancer.
What area of the brain has a lesion in locked-in syndrome?
Lower brainstem, namely the pons area.
What type of EEG results are expected in a patient with locked-in syndrome?
Normal EEG.
