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Internal Medicine Mnemonics > Neurology > Flashcards

Neurology Flashcards

1
Q

Generalized Tonic-Clonic Seizures

A

Drugs: Valporic Acid, Phenytoin, Carbamazepine

Alt. drugs: Phenobarbital, Lamotrigine, Topiramate

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2
Q

Partial Seizures

A

Drugs: Carbamazepine, Lamotrigine, Phenytoin

Alt. drugs: Felbamate, Phenobarbital, Topiramate, Valporic Acid

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3
Q

Absence Seizures

A

Drugs: Ethosuximide, Valporic Acid

Alt Drugs: Lamotrigine, Levetiracetam, Zonisamide, Clonazepam

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4
Q

Myoclonic and Atypical Absence Syndromes

A

Drugs: Valporic Acid

Alt Drugs: Clonazepam, Levetiracetam, Topiramate, Zonisamide, Felbamate

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5
Q

Status Epilepticus

A

Lorazepam, Diazepam, Phenytoin, Phenobarbital

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6
Q

Ethanol

A

Most frequently abused drug, causes Wernicke-Korsakoff syndrome in overdose and delirium tremens in withdrawal

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7
Q

Thiamine

A

Used for prevention of Wernicke-Korsakoff syndrome

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8
Q

Diazepam

A

Used for treatment of alcohol withdrawal

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9
Q

Methanol

A

Wood alcohol, causes visual dysfunction due to formaldehyde accumulation

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10
Q

Ethylene glycol

A

Found in antifreeze, causes nephrotoxicity due to oxalic acid accumulation

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11
Q

Formepizole

A

Alcohol dehydrogenase inhibitor

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12
Q

Disulfiram

A

Alcohol dehydrogenase inhibitor

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13
Q

Midazolam

A

Used in acute anxiety attacks, anesthesia induction, preoperative sedation

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14
Q

Diazepam

A

Used in seizure disorders (status epilepticus), alcohol withdrawal, tranquilizer

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15
Q

Flunitrazepam

A

Date-rape drug

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16
Q

Flumazenil

A

Antidote to benzodiazepine overdose

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17
Q

Thiopental

A

Used in anesthesia induction, Lethal injection, Truth serum

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18
Q

Phenobarbital

A

Used in seizure disorders in children, can precipitate porphyria, potent inducer of CYP450

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19
Q

Parkinson’s Disease (PD)

A

Most common form of Parkinsonism

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20
Q

Mutations of the LKKR2 gene

A

Most common cause of Familial PD

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21
Q

Dopamine blocking agents

A

Most common cause of secondary Parkinsonism

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22
Q

Protein misfolding & accumulation and mitochondrial dysfunction

A

Most significant pathogenic mechanism in Parkinsonism

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23
Q

Levodopa-carbidopa

A

Mainstay therapy for PD

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24
Q

Tremors

A

Major clinical effect of central-acting anticholinergic drugs

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25
Q

Amantadine

A

Most widely used antidyskinesia agent in patients with advanced PD and the only oral agent that has been demonstrated in controlled studies to reduce dyskinesia

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26
Q

Dementia

A

Most common cause of nursing home placement in PD patients

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27
Q

Essential tremor

A

Most common movement disorder

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28
Q

Dystonic tremor of PD

A

Major differentials for tremors

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29
Q

B-blockers or primidone

A

Standard drug therapies for essential tremors

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30
Q

Focal dystonias

A

Most common form of dystonia

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31
Q

Drug-induced dystonia

A

Most commonly seen with neuroleptic drugs or after chronic levodopa treatment in PD patients

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32
Q

SLE

A

Most common systemic disorder that causes chorea

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33
Q

Dystonia

A

Most common acute hyperkinetic drug reaction

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34
Q

Akathisia

A

Most common subacute drug reaction

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35
Q

Liver Biopsy

A

Gold standard for diagnosis of Wilson’s disease

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36
Q

Tremor affecting the upper limbs

A

Most common psychogenic movement disorder

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37
Q

Diabetes mellitus

A

Most common cause of peripheral neuropathy in developed countries

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38
Q

Median neuropathy at the wrist and ulnar neuropathy at the elbow

A

Most common diabetic mononeuropathies

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39
Q

Seventh nerve palsy, followed by third nerve, sixth nerve, and, less frequently, fourth nerve palsies

A

Most common cranial mononeuropathies in DM

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40
Q

Trigeminal nerve

A

Most common mononeuropathies in scleroderma

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41
Q

Seventh nerve

A

Most common cranial nerve involved in sarcoidosis

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42
Q

Carpal tunnel syndrome

A

Most common mononeuropathies in uremia

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43
Q

Distal symmetric polyneuropathy

A

Most common form of peripheral neuropathy associated with HIV infection & usually seen in patients with AIDS

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44
Q

Lung cancer

A

Most common associated malignancy with neuropathies

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45
Q

GBS and myasthenia gravis

A

Most common causes of acute generalized weakness leading to admission in ICU

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46
Q

Guillain Barre Syndrome (GBS)

A

Manifests as rapidly evolving areflexic motor paralysis with or without sensory disturbance, associated with Campylobacter jejuni found in undercooked chicken

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47
Q

Myasthenia Gravis (MG)

A

Neuromuscular disorder characterized by weakness and fatigability of skeletal muscles, caused by a decrease in the number of available acetylcholine receptors (AChRs) at neuromuscular junctions due to an antibody-mediated autoimmune attack, associated with diplopia

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48
Q

Trainsient Ischemic Response (TIA)

A

Requires that all neurologic signs and symptoms resolve within 24 hrs (most last <1hr) regardless of whether there is an imaging evidence of new permanent brain injury

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49
Q

Stroke

A

Occurred in the neurologic signs last for more than 24 hours

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50
Q

Ischemic Penumbra

A

Tissue surrounding the core region of infarction is ischemic but reversibly dysfuncitonal

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51
Q

Lacunar Infarction

A

Refers to infarction following atherothrombotic of lipohyalinotic occlusion of a small artery (30-300 um)

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52
Q

4-10 minutes

A

Decrease in cerebral blood flow to zero causes death of brain tissue within

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53
Q

Nonrheumatic atrial fibrilation

A

Most common cause of cerebral embolism overall

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54
Q

Carotid bifurcation atherosclerosis

A

Most common source of artery to artery embolism

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55
Q

Common carotid bifurcation and proximal internal carotid artery

A

Atherosclerosis within the carotid artery occurs most frequently in

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56
Q

Transient symptoms (small vessel TIA)

A

Herald a small-vessel infarct

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57
Q

Hypertension

A

Most significant risk factor of stroke and TIA

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58
Q

Aspirin

A

Only antiplatelet agent that has proven effective for the acute treatment of ischemic stroke

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59
Q

Headache

A

Principal side effect of dipyridamole

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60
Q

Within 2 weeks of symptom onset (benefit is more pronounced in men>75 y.o.)

A

Endarterectomy for carotid atherosclerosis is most beneficial when performed

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61
Q

Hallmark of top of the basilar artery occlusion

A

Sudden onset of bilateral signs, including ptosis, papillary asymmetry or lack of reaction to light and somnolence

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62
Q

Plain cranial CT

A

Imaging modality of choice in patients with acute stroke to rule out bleed

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63
Q

Conventional x-ray cerebral angiography

A

Gold standard for identifying and quantifying atherosclerotic stenoses of arteries

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64
Q

Trauma

A

Bleeding into subdural and epidural spaces is principally produced by

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65
Q

Basal ganglia (especially putamen), thalamus, cerebellum, pons

A

Most common sites of hypertensive intraparenchymal hemorrhage

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66
Q

Putamen (Sentinel) sign: contralateral hemiparesis

A

Most common site of hypertensive hemorrhage

67
Q

Cerebral amyloid angiopathy

A

Most common cause of lobar hemorrhage in the elderly

68
Q

Choriocarcinoma Malignant melanoma Renal cell carcinoma Bronchogenic carcinoma

A

Most common metastatic tumors associated with intracerebral hemorrhage

69
Q

> 3cm in diameter

A

Most cerebellar hematomas of this diameter will require surgical evacuation

70
Q

Seizure

A

Paroxysomal event due to abnormal excessive or synchronous neuronal activity in the brain

71
Q

Epilepsy

A

Condition where a person has recurrent seizures due to underlying causes not associated with structural brain damage

72
Q

Triad of Lennox-Gastaus Syndrome

A
  1. Multiple seizure typers (usually generalized tonig-clonic, atonig, and atypical absence seizures)
73
Q

Early childhood and late adulthood

A

Highest incident of seizures

74
Q

Daydreamind and a decline in school performance recognized by the teacher

A

First clue of typical absence seizures

75
Q

Electrophysiologic hallmark of typical absence seizures

A

Generalized, symmetric, 3-Hz spike-and-wave discharge that begins and ends abruptly, superimposed on a normal EEG background

76
Q

Generalize tonic-clonic seizures

A

Main seizure type in 10% of all persons with epilepsy

77
Q

Generalize tonic-clonic seizures

A

Most common seizure type resulting from metabolic derangements

78
Q

Metabolic disorders

A

Degenerative CNS diseases

79
Q

Anoxic brain injury

A

Pathologic myoclonus is the most commonly seen in association with

80
Q

Mesial Temporal Lobe Epilepsy Syndrome

A

Most common syndrome associated with focal seizures with dyscognitive features

81
Q

Febrile seizures

A

Most common seizures arising in late infancy and early childhood

82
Q

First goal in the approach to seizure

A

Determine if event was truly a seizure

83
Q

Valporic acid Lamotrigine

A

Best initial choice for the treatment of primary generalized tonig-clonic seizures

84
Q

Valpotic acid

A

Drug choice in patients with generalized epilepsy syndromes having mixed seizure types

85
Q

Key determinants in initiation and the monitoring of therapy

A

Clinical measures of seizure frequency and presence of side effects, not the laboratory values

86
Q

First 3 months after discontinuing therapy

A

Most recurrences of seizure occur in the

87
Q

Most common surgical procedure for patients with temporal lobe epilepsy

A

Resection of the anteromedial temporam lobe (temporal lobectomy) or a more limited removal of the underlying hippocampus and amygdala (amygdalohippocampectomy)

88
Q

First task in the approach to CNS infection

A

Identify whether an infection predominantly involves the subarachnoid space (meningitis) or whether there is evidence of either generalized or focal involvement of brain tissue in the cerebral hemispheres, cerebellum, or brainstem

89
Q

Bain tissue is directly injured by a viral infection

A

Encephalitis

90
Q

Fever, headache, and nuchal rigidity

A

Classical clinical triad of meningitis

91
Q

Headache, fever, focal neurologic deficit (present in <50%)

A

Classic clinical triad of brain abscess

92
Q

Cerebritis

A

Non-encapsulated brain abscess

93
Q

Nuchal rigidity (“stiff neck”)

A

Pathognomonic sign of meningeal irritation and is present when neck resists passive flexion

94
Q

Bacterial meningitis

A

Most common form of suppurative CNS infection

95
Q

S. pneumoniae

A

Most common cause of meningitis in adults>20 years

96
Q

Petechial or purpuric skin lesions

A

Important clue to diagnosis of meningococcal infection

97
Q

Cerebral herniation

A

Most disastrous complication of increased ICP

98
Q

S. pneumoniae and N. meningitides

A

Most common etiologic organisms of community-acquired bacterial meningitis

99
Q

Enteroviruses, HSV type 2, HIV, Arboviruses

A

Most important agents in acute viral meningitis

100
Q

Headache

A

Most common symptom of brain abscess

101
Q

Combination of high dose parenteral antibiotics and neurosurgical drainage

A

Optimal therapy for brain abscess

102
Q

Cranial MRI

A

Preferred diagnostic test for any patient suspected of having a brain tumor, and should be performed with gadolinium contrast administration

103
Q

Neuroimaging

A

The only test necessary to diagnose a brain tumor

104
Q

Dexamethasone

A

Glucocorticoid of choice for brain tumors because of its relatively low mineralocorticaoid activity

105
Q

The only established risk factors for primary brain tumors

A

Exposure to ionizing radiation: meningiomas, gliomas, schwannomas Immunosuppression: primary CNS lymphoma

106
Q

Most common primary brain tumor of childhood

A

Grade I astocytomas: pilocytic astrocytomas (WHO grade I)

107
Q

Meningiomas

A

Most common primary brain tumor overall

108
Q

Epstein-Barr Virus (EBV)

A

Frequently plays an important role in the pathogenesis of HIV-related primary CNS lymphoma

109
Q

Medulloblastomas

A

Most common malignant brain tumor of chilhood

110
Q

Grade IV astrocytoma (Glioblastoma)

A

Most common malignant brain tumor overall

111
Q

Cerebral convexities

A

Where meningiomas are most commonly located

112
Q

Dural metastasis

A

Main differential diagnosis for meningioma

113
Q

Most common schwannomas

A

Vestibular schwannomas or acoustic neurons

114
Q

Gray matter-white matter junction

A

Most common site of brain metastases

115
Q

Supratentorial

A

85% of all brain metastases are

116
Q

Lung and breast cancer

A

Most common sources of brain metastases

117
Q

Melanoma

A

Malignancy with greatest propensity for brain metastasis, found in 80% of patients at autopsy

118
Q

Prostate and breast cancer

A

Malignancies with propensity to metastasize to the dura and can mimic meningioma

119
Q

MRI

A

Brain metastases are best visualized on ___ where they appear as well-circumscribed lesions

120
Q

Melanoma, thyroid, kidney cancer

A

Cancers with greatest propensity to bleed

121
Q

Lung cancer

A

Most common cause of hemorrhagic metastasis

122
Q

Acute leukemia

A

Most common among hematologic malignancies to matastasize to the subarachnoid space

123
Q

Breast and lung carcinomas and melanoma

A

Solid tumors that most frequently cause leptomeningeal metastases

124
Q

Demonstration of tumor cells in CSF

A

Definitive method and often considered the gold standard to diagnose leptomeningeal metastases

125
Q

Hematologic malignancies

A

CSF cytologic examination is most useful in

126
Q

Thoracic spine, followed by the lumbar and then cervical spine

A

Part of the spine affected most commonly in epidural metastasis

127
Q

Back pain

A

Presenting symptom of epidural metastasis in virtually all patients

128
Q

MRI of the complete spine

A

Best test for epidural metastasis

129
Q

Complete removal of the mass, typically anterior to the spinal canal

A

Surgical procedure of choice for epidural metastasis

130
Q

Whole-Brain Radiotherapy (WBRT)

A

Standard treatment for beain metastases

131
Q

Late delayed toxicity

A

Most serious toxicity from radiotherapy as they are often irreversible

132
Q

Leukoencephalopathy

A

Complication seen most commonly after WBRT

133
Q

Neurotoxicity

A

Second only to myelosupression as dose-limiting toxicity of chemotherapeutic agents

134
Q

Vomiting that precedes headaches

A

Highly characteristic of posterior fossa brain tumors

135
Q

Headache

A

Dominant symptom in temporal (giant cell) arteritis

136
Q

Migraine, tension-type headache, and cluter headache

A

Most common primary headache syndromes

137
Q

Trigeminovascular input from the meningeal vessels

A

Key pathway for pain in migraine

138
Q

Migraine

A

Most disabling headache

139
Q

Judicious use of one or more drugs that are effective in migraine

A

Mainstays of pharmacologic therapy in migraine

140
Q

Severity of the attack

A

Most important factor in selection of the optimal regimen for a migraine patient

141
Q

Most effective drug classes in the treatment of migraine

A

Anti-inflammatory agents, 5-HT, 1B/1D receptor agonists (triptans), and dopamine receptor antagonists

142
Q

Most efficacious of the triptans

A

Rizatriptan and eletriptan

143
Q

Periodicity

A

Core feature of cluster headache

144
Q

Most satisfactory treatment in cluster headache

A

Administration of drugs to prevent cluster attacks until the bout is over

145
Q

Subarachnoid hemorrhage

A

Most serious cause of secondary headache

146
Q

Most evident in the morning and improves during the day

A

Classic headache associated with a brain tumor

147
Q

Sympathetic Effects

A

Myrdiasis, sweating, increased heart rate, bronchodilation, GU and GI contraction, uterine relaxation and contraction, vasodilation of the skeletal muscles, vasoconstriction of the skin and GI tract, ejaculation

148
Q

Adrenergic receptors

A

Alpha-1 (for smooth muscle contraction in sphincters, radial muscle of the iris, vasoconstriction)

149
Q

CN III (Oculomotor nerve)

A

Cranial nerve for opening of eyelids, contraction of most EOMs, accommodation and pupillary constriction

150
Q

CN VII (Facial nerve)

A

Cranial nerve for specail sensation (taste) of the anterior 2/3 of the tongue

151
Q

CN V (Trigeminal nerve)

A

Cranial nerve for general sensation (e.g. pain) of the anterior 2/3 of tongue

152
Q

CN VII (Facial nerve)

A

Cranial nerve for facial muscles

153
Q

CN V (Trigeminal nerve)

A

Cranial nerve for facial sensation and muscles of mastication

154
Q

Acetylcholine (Ach)

A

Found in various sites (e.g. ANS and NMJ), decreased in HUntington’s dementia and Alzheimer’s dementia

155
Q

Norephinephrine (NE)

A

Found in the locus ceruleus of the pons, for arousal/wakefulness

156
Q

Dopamine

A

Found in the substantia nigra, decreased in Parkinson’s disease, increased in schizophrenia, for fine-tuning of movements

157
Q

Serotonin

A

Found in the median raphe of the brainstem, derived from tryptophan, converted to melatonin, involved in mood and sleep

158
Q

Glycine

A

Found in spiral interneurons, main inhibitory neurotransmitter

159
Q

GABA

A

Found in the brain, main inhibitory neurotransmitter, from glutamate

160
Q

Glutamate

A

Excitatory neurotransmitter in the CNS

161
Q

Hippocampus

A

Output pathway from reward and punishment centers, lesions here will produce anterograde amnesia

162
Q

Thalamus

A

Helps seach memory storehouses, lesions here will produce retrograde amnesia

163
Q

Beta waves, Alpha waves, Delta waves

A

Waves in the EEG of alert, sleeping, and relaxed individuals, respectively

Internal Medicine Mnemonics (8 decks)

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