Neurology Flashcards
First step if concerned about wernicke’s encephalopathy?
give IV thiamine, before glucose
definitive tx of SAH?
surgical clipping, embolization of vessel
tx of myasthenia graqvis?
cholinesterase inhibitors - pyridostigmine
plasmapheresis, IVIG
immunosuppression
brain tumor: rare, slow growing, often found in frontal lobe
oligodendroglioma
brain tumor: benign, most common childhood supratentorial tumor
craniopharyngioma
brain tumor: most common malignant primary brain tumor in adults, rapidly progressive
gliobastoma
brain tumor: most commonly secretes prolactin, may cause bitemporal hemianopia
pituitary adenoma
brain tumor:highly malignant cerebellar tumor in children
medulloblastoma
brain tumor: common primary brain tumor, typically benign
meningioma
tx of absence seizure?
ethosuximide
leg pain when walking, worsening, pain when walking downhill, equal pulses, DTR absent in ankles and knees, normal motor and sensory. Negative SLR. Dx?
lumbar spinal stenosis
tx of multiple sclerosis?
steroids
tx of parkinsons dx?
levodopa/carbidopa
weakness and numbness in right hand as though asleep. Cannot extend right wrist or fingers after falling asleep on chair with arm hanging over. Dx? tx?
radial nerve palsy
usually no tx
tx of restless leg syndrome, intermittent? persistent?
intermittent - levodopa, benzos
persistent - pramipexole, ropinirole, gaba, pregabalin
dx of cryptococcus meningitis?
india ink stain or cryptococcal antigen of CSF
tx of cryptococcus meningitis?
ampho + flucytosine x 2 weeks
oral azole x 6 weeks
patient has loss of sensation and motor paralysis of both lower extremities. PEx reveals loss of pain and temperature senstion and motor function at level of T10 and below. Vibration sense and proprioception are intact in the feet. Dx? why are vibration sense and proprioception preserved?
anterior spinal artery syndrome
dorsal columns spared
tx of NPH?
ventricular shunting
15 year old with tingling and weakness in legs for a week. Decreased coordination and difficulty with jogging. Admitted for gastroenteritis 2 weeks ago. Absent bilateral patellar and achilles reflexes. Motor strength is 3/5 in lower extremities. Sensation intact. Dx? analysis of CSF? tx?
Guillain=barre syndrome
increased protein, normal cell count
albuminocytologic dissociation
ICU monitoring, plasmapheresis and IVIG
Cause of acute self limited vertigo with hearing loss and tinnitus?
acute labyrinthitis
Vertigo is independent of head movement, no hearing loss or tinnitus, may result from viral infection?
vestibular neuritis
Vertigo + ataxia, hearing loss, and tinnitus, MRI shows tumjor near internal auditory canal
acoustic neuroma
Vertigo with change of head position, no hearing loss, tinnitus or ataxia. Positive Dix-Hallpike maneuver
BPPV
Chronic vertigo and hearing loss and tinnitus, treat with salt restriciton and diuretics
meniere’s disease
58 yera old woman with 2 week history of lower back pain, urinary incontinence and fficulty walking. Diagnosed with lung cancer. Bilateral weakness in lower extremities, decreased sensation in dermatomes L2 and lower, and 1+ deep tendon reflexes in lower extremities. No XR findings. Dx? tx?
spinal cord compression
steroids
47 year old with muscle weakness in hands and progressively worsened over past two months, weakness in legs, worsening of balance, slurred speech. Muscle atrophy and fasciculations in hands and calves. Handgrip strength is 1/5. Motor strength is 2/5 in other major muscle groups of upper and lower extremities. Sensory exam is normalo. Biceps, patellar and achilles are all 3_. Babinski positive bilaterally. Dx? tx?
amyotrophic lateral sclerosis
riluzole
Loss of sensation of pain and temp in cape-like distribution over the neck, shoulders, and down both arms. MRI shows dilated cavitation in cervical spinal cord. Dx? Tx?
syringomyelia
surgical shunt
