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ABEM > Neurology > Flashcards

Neurology Flashcards

1
Q

Contraindications to tap

A 
age<18
bp 185/110
inr 1.7
prior ICH
within 3 month brain surgery
seizure symptoms
3-4.5
age>80
AC and any INR
NIh>25
stroke/diabetes
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2
Q

dose of TPA

A

0.9 mg/kg with 10% as boils and then over 1 hr

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3
Q

Horner Syndrome…think

A

Stroke!!

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4
Q 
seizure pearls
hiv-focal
elevated glucose
brown machines or subcu modules
being treated for Tb
mexico trip
A 
toxoplasmosis
HHN-hyoerosmolar
can tumor-von recklinghausen
pyridozine (b6)-inh overdose
cyatercercosis
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5
Q

treatment for west nile encephalitis

A

supportive

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6
Q

toxoplasmosis tx

A

pyrimethamine, sulfadiazine

spiramycin if pregnant

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7
Q

hiv neurocystercercosis

A

anti-helminthic. seizure often presenting sign

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8
Q

cmv treatment in hiv

A

hart and gangiclovir and foscarnet

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9
Q

cryptococcus treatment hiv

A

amphotericin b, fluconazole

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10
Q

side effects of any meds

rifampin
INH
Pyrazinamide
Ethambutol
Streptomycin(cns)
A

orange fluids
neuropathy (b6)
rash-uric acid
can’t see red-green colors

ONUC

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11
Q

AMS Evaluation

DONT

AEIOU-TIPs

A

Dextrose
Oxygen
Narcan
Thiamine

Acidosis
Endocrine/Electrolytes
Infection
Oxygen/Opioids
Uremia

Trauma, Temperature
Insulin
Porphyria
Stroke

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12
Q

GCS

A

EVM
Eyes
Verbal
Motor

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13
Q

most common location for bone mets

A

thoracic spine

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14
Q

suspect cord compression/epidural abscess but can’t get MRI

A

give steroids first (16mg decadron)

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15
Q

meningitis most common and drugs

A

0-4 weeks -ecoli, gbs (Amp/Gent)
4 w-3m - neonatal plus strep (cef/amp/vanc)

all others it’s strep and cef and vanc until 50 yrs and then add amp again

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16
Q

N. Meningitis close contacts. what abx

A

ridampin 1 month or cipro

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17
Q

neuronitis vs labrynthitis
manieres triad
perilymph fistula

A

neuritis-NO loss
triad - tinnitus, vertigo, hearing loss
hearing worse with pneumatic otoscopy

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18
Q 
myasthenia gravis
cause
features
definitive test
treatment
A 
igg auto abs against ach nicotinic receptors
small muscles of face, proximal>distal
tensilon test (edrophonium)-inhibits achesterase...more ach available at the synapse
treat with pytidostigmine, but if you give too much you will have cholinergic crisis (sludge) - give atropine
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19
Q

GBS

A

ascending paralysis.eapecially after viral or campylobacter diarrhea

IVIG and plasma exchange

monitor FEV1<15…intubate

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20
Q

Tick paralysis

A

ascending paralysis like gbs. remove the god damn tick

21
Q

Optic Neuritis classic eye finding

A

afferent pupillary defect (it dilates when light is shown in eye)

22
Q

GBS

A

progressive bilateral lower extremity ascending in nature
usually proceeding a infection (think campylobacter)
FIV<15 equals intubate
IVIG and plasma exchange
MRI - selective anterior cord enhancement likely

23
Q

idiopathic intracranial hypertension

A

young, obese women
look for vitamin A toxicity, OCP, steroids, tetracyclines
diplopia with lateral gaze (CN VI)
only abnormality is increased opening pressure

24
Q

most common cause of stroke in children

A

sickle cell

25
Q

What is factove V leiden

A

most common cuase of inherited hypercoagulable disorder, mostly europeans

26
Q

intracranial hemorrhage EKG findings

A

Cerebral T Waves - Deep, inverted T waves, prolonged QT

27
Q

Ascending paralysis

A

Tick paralysis, GBS

28
Q

descending paralysis

A

MG, botulism, miller-fischer GBS

29
Q

most common primary brain tumor

A

meningioma

30
Q

most common malignant brain tumor

A

glioma

31
Q

most common source of brain mets

A

lung cancer

32
Q

headaches from tumors are worse at what time of day

A

morning…lying flat all night

33
Q

association with temporal cell (giant) arteritis

A

polymyalgia rheumatica

34
Q

carotid artery dissection, whats it look like?

A

partial horners syndrome, ptosis, miosis, no anhidrosis

look for patient with recent neck manipulation

35
Q

symptoms of ACA stroke

A

weakness of leg and sensation loss, ataxia

36
Q

MCA stroke symptoms

A

contralateral lower face weakness, hemiplegia, ataxia, speech impairments

37
Q

brainstem stroke sx

A

double vision, taste, hearing face weakness, swallowing issues, bp/respiration dysfunction

38
Q

stroke vessel for homonymous hemianopsia

A

posterior cerebral artery

39
Q

Parkinsons Disease

A

Lewy bodies, dopaminergic neuron loss in substantia nigra
tx with carbidopa
most common cause of death is respiratory failure

40
Q

demyelination syndromes

A

multiple sclerosis and GBS

41
Q

loss of anterior horn cells

A

ALS, progressive degernerative disease

42
Q

neurofibrillary tangles

A

alzheimers

43
Q

Syringomyelia

A

cyst in spinal cord, Cape like distribution of loss of PAIN AND TEMPERATURE….preservation of light touch and proprioception

44
Q

anterior cord syndrome

A

loss of MOTOR FUNCTION/pinprick/temp
preservation of position/vibration (wiggle big toe)…grandma doesn’t know why you are moving her lil’ piggies
FORCED FLEXION INJURY

45
Q

Central cord syndrome

A

HYPEREXTENSION INJURY
upper extremity»lower extremity

grandma hits airbag (hyperextension) - no arm movement, but can move legs!!!

46
Q

medulloblastoma

A

most common malignant brain tumor in children
morning headaches, posterior fossa (cerebellum)

ataxia, “setting-sun” sign of eyes,

47
Q

Direct Factor Xa inhibitors vs

direct thrombin inhibitor

A

rivaroxaban, apixaban (Xa), dabigatran (thrombin)

Dabigatran has reversal agent (Idacrucizumab 2.5 grams 15 min apart Praxbind) - takes 2.5 hours to work.

48
Q

INR of FFP

A

1.6

ABEM (6 decks)

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