Neurology Flashcards
What type of dementia is this- frontal and temporal lobe atrophy with speech abn, decr executive function, mood change, hyper-ORAL movement
Pick’s disease - can also find on biopsy- gliosis, neuronal loss, neuronal swelling, silver containing cytoplasmic inclusions
What type of dementia is this- visual hallucinations, parkinsons like motor probs (rigid, intention tremor)?
Lewy body dementia- also see cytoplasmic inclusions
Statis epilepticus tx and management (labs)
Ie if still see twitching
Cbc, bmp, glc, utox
Need to tx bc stress and neuronal damage assoc w m&m
Tx w benzo ggt
Give thiamine in wernickes to prevent
Korsakoff psychosis - injury in mammillary bodies
Carbamezepine side effect
Neutropenia (bone marrow suppression)
And siadh hyponatremia
Which nerve is affected?
Loss sensation anterior and medial thigh, shin, and foot arch. Cant extend knee.
Femoral nerve
Which nerve is affected? Foot drop and loss sensation dorsum of foot?
Common peroneal nerve
If incr carbidopa impr parkinson symptoms but worsens psychosis what do u do next?
Add seroquel
Cutting down on dopa would make pt rigid again
Acute onset double vision, ptosis, muscle weakness, sluggish and dilated pupils, dysarthria in a 33 yo woman.
Botulism
Esp if just had CANNED food
Presynaptic NMJ disorder. Botulism toxin inhi release of ach into synaptic cleft.
Confirm with serum botulinum toxin
Vs MG is a POSTsynaptic NMJ disorder causes by ab to ach-r
What do you get with following lesions
- nondom parietal lobe
- dom parietal love
- nondom temporal lobe
- dom temporal
- nondom parietal lobe difficulty copying drawing and wearing clothes
- dom parietal lobe cant do math, cant name fingers, cant write. Confused w left and right
- nondom temporal lobe homonymous quadrantopia
- dom temporal lobe - homonomous quandrantopia and wernikes aphasia (wordy and doesnt make sense)
Elderly lady w ams, normal ct, cxr, lp, cbc, bmp, ua. Next test?
Tsh!!! Esp in elderly
Not abg bc bmp normal
Shoulder pain in smoker, horners syndrome, hand muscle atrophy with weakness is what? What finding needs urgent intervention?
Asymmetric DTRs in setting of BACK pain suspicious for spinal cord compression
Large prolactinoma tumor impinging on optic chiasm
Is dopaminergic agonist which will shrink tumor in days. Rarely do surgery anymore. Surgery is for nonfunctioning pituitary adenoma
20s yo f with gait prob, weakness, 2 days ago w eyevision loss w eye pain. A yr ago w numbness and unsteady that resolved. What does pt have?
Tx in acute flare?
Tx to prevent relapses?
MS- relapsing remitting- lesions disseminated in time and space.
50% get optic neuritis
If have optic neuritis- IV steroids then oral steroids
Prevent relapse w disease modifying agents like b interferon and glatiramer acetate. Dont want long time steroids.
Tx if spasticity in MS with
Baclofen or tizanidine
Headache with occasional vision change and hearing rhymic pulsations when bending down. Ophthalmic exam w venous engorement, hard exudate, and peripapillary flame hemorrhage
Pseudotumor cerebri which is idiopathic intracranial htn causing papilledema and may lead to optic atrophy and blindness
some meds like isotretinoin cause
After stroke, and giving tpa, what is goal bp?
What is dont give tpa, what is goal bo
185/105 or less
If no tpa goal is
Pt found to have pituitary tumor w mildly high prolactin level, high alpha subunit should get what tx?
Transphenoidal resection for nonfunctioning tumor (high alpha cells)
Note that mild elevation of prolactin dhe to increase in pituitary stalk. Vs prolactinoma would have levels like 200/
Tx for teen w few months of arm jerks and now w generalized tonic clonic seizure, eeg showing bl polyspike and slow discharge
Has juvenile myoclonic epilepsy
Tx is valproic acid
Wouldnt be meningitis this chronic onset
What is tx for cluster ha proph?
Verapamil!!
Could even use sumatriptan for acute episode but 100% o2 via mask is best
Pt w stroke 7 hrs ago. Next step in tx is
Next next step?
Do a s&s study to assess if pt can take meds or eat!!
Hepsq for dvt ppx!! Most frequent cause death in stroke pt is PE!!!
Vertigo, dizziness, and neuro signs like diplopia, dysarthria, numbness due to
Vertebrobasilar insuff
Vs labyrinthitis- get vertigo, tinnitus, n, loss of balance but in setting if recent viral illness
If facial weakness and cant even raise eyebrow on that side, suspicious for… What additional workup?
If facial weakness and can raise eyebrow
If entire one side of face w weakness it is due to peripheral n palsy like bells palsy - neuropathy of cn7.
Forehead sparing suggests intracranial lesions
Even if bells palsy dont need lyme serology unless travel edemic area
Tx is bells is eye drops and steroid
What improves survivial in metastatic brain?
Whole brain radiation by 3-6 months
Sudden severe headache w high bp and vomiting should get what first
Cth to ro sah! If that is neg and high suspicion then do lp!!!
60 yo woman w headache and now diplopia, ptosis, mild anoscoria of eye due to
Subarach hemm of PCA aneurysm posterior communicating artery
