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0. pdf review ? > Neurology > Flashcards

Neurology Flashcards

1
Q

How long does a migraine usually last?

A

4-72 hours

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2
Q

What is the treatment of choice for cluster headache

A

100% oxygen or triptan therapy. Oxygen is unique to cluster headaches.

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3
Q

What is the most common etiology in encephalitis?

A

Herpes Simplex

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4
Q

What are the four main organisms responsible for meningitis?

A
  1. Streptococcus

  2. Neisseria Meningitidis
 3. HIB

  3. Listeria
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5
Q

30 year old patient is admitted due to fever and headache. On physical exam you notice the patient is alert and oriented x2. The patient has a positive Kernig and Brudzinski sign. The neurological exam is normal. What is the next best step?

A

This patient has meningitis. The fact that he has an altered level of consciousness requires that a CT be ordered as the first step. Other indications for CT as the first step include: immunosuppression, focal neurological deficit, and papilledema.

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6
Q

What is the treatment of choice for essential tremor?

A

Propranolol is first line.

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7
Q

How does chorea present when seen in Huntingtons Disease?

A

Chorea is a rapid arrhythmic involuntary movement disorder that makes the patient appear as if they are dancing or restless.

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8
Q

What is the pathophysiology in parkinsons disease?

A

There is a decrease in dopamine in the substantia nigra. Also, lewy bodies will be present in the nuclei of neurons.

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9
Q

A 70 year old patient is brought in by his daughter due to progressive cognitive decline. The daughter also states that he has had a couple instances of hallucination. On physical exam you notice tremor at rest, rigidity of the upper extremities on passive flexion, and a shuffling gait. What is the most likely diagnosis?

A

This patient is presenting with signs and symptoms consistent with lewy body dementia.
Lewy body dementia: Parkinsons + Hallucinations + Dementia

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10
Q

Where do most subarachnoid hemorrhages arise from?

A

Most are from ruptured berry aneurisms from the anterior circle of willis

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11
Q

If subarachnoid hemorrhage is suspected, what is the next best test? When is LP done in the workup for subarachnoid hemorrhage?

A

The first test that should be ordered is a non contrast CT. If the CT is negative, but the suspicion remains, an LP should be ordered. A negative LP and a negative CT is enough to reliably exclude the diagnosis.

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12
Q

How can you differentiate a traumatic tap from what is seen in subarachnoid hemorrhage?

A

A traumatic tap will have have less RBCs with each tube collected. Subarachnoid hemorrhage will have the same amount of RBCs in each tube.

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13
Q

What are the three arteries involved in ischemic stroke?

A
  1. Middle cerebral artery
 2. Anterior cerebral artery


3. Posterior cerebral artery

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14
Q

What is the first diagnostic test ordered in the workup of a stroke?

A

Everyone should have a non contrast CT of the head to rule out hemorrhage.

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15
Q

How long do you have to give TPA?

A

You have 4.5 hours from the time symptoms began. If that time frame has passed, give aspirin.

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16
Q

What are first line medications for the management of hypertension during a stroke?

A
  1. Labetolol


2. Nicardepine

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17
Q

Why is an EKG done as part of the workup for stroke?

A

An ekg is done to rule out arrythmias such as AFIB.

18
Q

When is endarterectomy indicated?

A

This is indicated when carotid artery duplex demonstrates >70% stenosis.

19
Q

A patient is diagnosed with TIA. He has an aspirin allergy. What medication is an acceptable substitute for stroke prophylaxis?

A

Clopidogrel is given to those patients with aspirin allergy.

20
Q

If a patient is on aspirin and suffers a TIA, what is the next step in treatment?

A

The next step is to either:


1. Switch to clopidogrel
 2. Add dipyridamole

21
Q

What are the three indications for hospitalization after suffering a concussion?

A
  1. GCS
22
Q

What is the most common precipitating infection for GBS?

A

Campylobacter infection. Infection usually precedes GBS symptoms by two weeks.

23
Q

What three diagnostic tests that should be ordered in anyone suspected of having GBS?

A
  1. Nerve conduction studies

  2. Electromyography

  3. LP
24
Q

What is the most dangerous complication of GBS?

A

Paralysis of the respiratory muscles. About 1/3 of patients will require ventilatory assistance.

25
Q

What is the most common form of dementia?

A

Alzheimer’s is by far the most common type of dementia.

26
Q

What is the difference between dementia and delerium?

A

Dementia is gradual in onset and permanent. Delerium is rapid in onset and usually has a reversible cause. Delerium will also present with fluctuations in consciousness.

27
Q

What two labs should be ordered in the workup for dementia?

A

The two tests which should always be ordered include:

  1. B12 level

  2. TSH
28
Q

What are two most common presentations in multiple sclerosis?

A
  1. Sensory symptoms


2. Optic neuritis

29
Q

Describe Lhermitte sign.

A

Electric shocks that run down the spine and limbs with flexion of the neck. Seen in multiple sclerosis.

30
Q

What will lumbar demonstrate in multiple sclerosis?

A

Look for oligoclonal bands.

31
Q

How are acute exacerbations in multiple sclerosis treated?

A

Acute exacerbations are treated with glucocorticoids. If the patient is unresponsive, give plasma exchange.

32
Q

What is the most serious complication of myasthenia gravis?

A

Weakness of the respiratory muscles. This can progress to respiratory failure: myasthenia crisis.

33
Q

What will EMG show in myasthenia gravis?

A

Progressive weakness is seen with repetitive stimulation.

34
Q

Thymectomy is contraindicated if what antibodies are present?

A

Do not perform thymectomy if MuSK antibodies are present.

35
Q

What type of seizure classification does absence seizure fall into?

A

This is considered to be a generalized seizure.

36
Q

Describe Todds paralysis?

A

Paresis that occurs following a seizure.

37
Q

What physical exam findings can help differentiate a seizure from syncope?

A

Patients who have had a seizure will present with postictal confusion. Those with seizures will also have tongue biting, foaming of the mouth, and/or urination.

38
Q

What is the definition for status epilepticus?

A

This is defined as a seizure that lasts >5 minutes.

39
Q

What is the first line treatment in the management of status epilepticus?

A

First line treatment includes benzodiazepines.

40
Q

What is the treatment of choice for absense seizures?

A

Ethosuximide

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