Neurology Flashcards by Nick Garrett

Contraindications to tap

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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dose of TPA

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

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Horner Syndrome…think

Stroke!!

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seizure pearls
hiv-focal
elevated glucose
brown machines or subcu modules
being treated for Tb
mexico trip

toxoplasmosis
HHN-hyoerosmolar
can tumor-von recklinghausen
pyridozine (b6)-inh overdose
cyatercercosis

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treatment for west nile encephalitis

supportive

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toxoplasmosis tx

pyrimethamine, sulfadiazine

spiramycin if pregnant

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hiv neurocystercercosis

anti-helminthic. seizure often presenting sign

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cmv treatment in hiv

hart and gangiclovir and foscarnet

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cryptococcus treatment hiv

amphotericin b, fluconazole

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side effects of any meds

rifampin
INH
Pyrazinamide
Ethambutol
Streptomycin(cns)

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

ONUC

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AMS Evaluation

DONT

AEIOU-TIPs

Dextrose
Oxygen
Narcan
Thiamine

Acidosis
Endocrine/Electrolytes
Infection
Oxygen/Opioids
Uremia

Trauma, Temperature
Insulin
Porphyria
Stroke

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GCS

EVM
Eyes
Verbal
Motor

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most common location for bone mets

thoracic spine

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

give steroids first (16mg decadron)

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meningitis most common and drugs

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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N. Meningitis close contacts. what abx

ridampin 1 month or cipro

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neuronitis vs labrynthitis
manieres triad
perilymph fistula

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

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myasthenia gravis
cause
features
definitive test
treatment

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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GBS

ascending paralysis.eapecially after viral or campylobacter diarrhea

IVIG and plasma exchange

monitor FEV1<15…intubate

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Tick paralysis

ascending paralysis like gbs. remove the god damn tick

Optic Neuritis classic eye finding

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

GBS

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

idiopathic intracranial hypertension

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

most common cause of stroke in children

sickle cell

What is factove V leiden

most common cuase of inherited hypercoagulable disorder, mostly europeans

intracranial hemorrhage EKG findings

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

Ascending paralysis

Tick paralysis, GBS

descending paralysis

MG, botulism, miller-fischer GBS

most common primary brain tumor

meningioma

most common malignant brain tumor

glioma

most common source of brain mets

lung cancer

headaches from tumors are worse at what time of day

morning...lying flat all night

association with temporal cell (giant) arteritis

polymyalgia rheumatica

carotid artery dissection, whats it look like?

partial horners syndrome, ptosis, miosis, no anhidrosis | look for patient with recent neck manipulation

symptoms of ACA stroke

weakness of leg and sensation loss, ataxia

MCA stroke symptoms

contralateral lower face weakness, hemiplegia, ataxia, speech impairments

brainstem stroke sx

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

stroke vessel for homonymous hemianopsia

posterior cerebral artery

Parkinsons Disease

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

demyelination syndromes

multiple sclerosis and GBS

loss of anterior horn cells

ALS, progressive degernerative disease

neurofibrillary tangles

alzheimers

Syringomyelia

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

anterior cord syndrome

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

Central cord syndrome

HYPEREXTENSION INJURY upper extremity>>lower extremity grandma hits airbag (hyperextension) - no arm movement, but can move legs!!!

medulloblastoma

most common malignant brain tumor in children morning headaches, posterior fossa (cerebellum) ataxia, "setting-sun" sign of eyes,

Direct Factor Xa inhibitors vs | direct thrombin inhibitor

rivaroxaban, apixaban (Xa), dabigatran (thrombin) | Dabigatran has reversal agent (Idacrucizumab 2.5 grams 15 min apart Praxbind) - takes 2.5 hours to work.

INR of FFP

1.6