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PANCE > Neurology (7%) > Flashcards

Neurology (7%) Flashcards

1
Q

Positive Tinel sign and Positive Phalen sign would indicate what condition

A

Carpal Tunnel Syndrome

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2
Q

What is a positive Phalen sign

A

flexing the wrist to 90 degrees for 1 minute elicits symptoms in the median nerve distribution

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3
Q

What is the distribution of the median nerve

A

1st-3rd digits and half of the 4th

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4
Q

first line treatment of carpal tunnel syndrome

A

NSAIDs and Volar wrist splint at night

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5
Q

what is the most common cause (organism) of Guillain-Barré syndrome

A

Campylobacter jejuni

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6
Q

pathophysiology of Guillain-Barré syndrome

A

Destruction of the myelin in Schwann cells following respiratory or GI illness (acute immune mediated polyneuropathy)

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7
Q

what dx study is used to dx Guillain-Barré syndrome

A

Lumbar puncture: elevated CSF protein

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8
Q

Treatment of Guillain-Barré syndrome

A

Hospitalization +
Plasmapheresis or IVIG

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9
Q

Abortive treatment for cluster headaches

A

High flow 100% Oxygen
(and sub q sumatriptan)

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10
Q

Prophylaxis for cluster headaches

A

Non-dihydropyridine CCB such as verapamil

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11
Q

Abortive treatment for Migraine headaches

A

NSAIDs or acetaminophen
or Triptans (ergotamines)

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12
Q

Preventative treatment for Migraine headaches

A

BBs: propranolol
TCAs: amitriptyline

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13
Q

Most common cause (organism) of Encephalitits

A

HSV type 1

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14
Q

What two PE findings would make you think encephalitis over meningitits?

A

Altered mental status
And focal neurological deficits (hemiparesis / hyperreflexia)

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15
Q

Initial step in the diagnosis of encephalitis

A

Head CT to r/o lesion or stroke

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16
Q

An MRI with temporal lobe edema is suggestive of

A

encephalitis

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17
Q

Lumbar puncture findings suggestive of encephalitis

A

Normal glucose,
Elevated protein,
Elevated lymphocytes

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18
Q

Tx of encephalitis

A

IV acyclovir

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19
Q

Neisseria meningitidis can present with what skin finding?

A

Petechiae or ecchymotic rash

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20
Q

What is a positive kernig sign

A

elicitation of pain or resistance with passive extension of the patient’s knees past 135 degrees

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21
Q

What is a positive brudzinski sign

A

when neck flexion causes the individual to flex their hips and knees automatically

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22
Q

Lumbar puncture findings suggestive of bacterial meningitis

A

Elevated opening pressure,
Leukocytosis,
Low glucose,
Elevated Protein count

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23
Q

Treatment of bacterial meningitis in Neonates

A

Cefotaxime or Ceftriaxone PLUS Ampicillin

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24
Q

Treatment of bacterial meningitis in children and older adults

A

Cefotaxime or Ceftriaxone PLUS
Vancomycin

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25
Q

Treatment to add for bacterial meningitis for listeria coverage

A

Ampicillin

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26
Q

degeneration of neurons in the substantial nigra and depletion of dopamine is what neurological condition

A

Parkinson’s disease

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27
Q

What are the four cardinal symptoms of Parkinson’s disease

A
  1. Resting “pill-rolling” tremor
  2. Bradykinesia (shuffling gait, masked facies)
  3. Muscular rigidity (cogwheel rigidity)
  4. Postural instability
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28
Q

what is the post mortem pathology indicative of Parkinson’s disease

A

Lewy bodies (eosinophilic intracellular inclusions)

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29
Q

Pharmacologic treatment of Parkinson’s disease in older pts or more severe cases

A

Carbidopa-Levodopa
(does wear off with prolonged use)

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30
Q

Pharmacologic treatment of Parkinson’s disease in younger pts or less severe cases

A

Dopamine agonists (pramipexole, ropinirole)

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31
Q

Most common primary malignant brain tumor in adults

A

Glioblastoma

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32
Q

postmortem definitive diagnosis of Alzheimer disease

A

Neurofibrillary tangles and amyloid plaques

33
Q

postmortem definitive diagnosis of frontotemporal dementia

A

round, silver staining inclusions (Pick bodies)

34
Q

What is the most common immune mediated inflammatory demyelinating disease of the CNS

A

Multiple sclerosis

35
Q

The most common type of multiple sclerosis is

A

Relapsing remitting

36
Q

Optic neuritis and internuclear ophthalmoplegia are symptoms of what neurological condition?

A

Multiple sclerosis

37
Q

Explain Marcus Gunn pupil or relative afferent pupillary defect that can be a PE finding of MS

A

when a light is shined into the affected eye it will not constrict (as it should)

38
Q

Gold standard diagnostic test of MS

A

MRI with gadolinium: hyperintense T2 plaque (periventricular) and Dawson’s fingers

39
Q

Treatment of acute exacerbations of MS

A

IV high dose corticosteroids

40
Q

Long term pharmacological therapy of MS

A

IV monoclonal antibodies: -“mab”

41
Q

Fatigable muscle weakness that worsens with use and improves with rest is

A

Myasthenia gravis

42
Q

Pathophysiology of

A

IgG antibodies against the acetylcholine receptors at the postsynaptic membrane

43
Q

Bulbar symptoms (difficulty chewing/swallowing) and ocular (ptosis/diplopia) that worsens throughout the day and improves with rest is likely

A

Myasthenia gravis

44
Q

A positive ice pack test (ptosis improves) is indicative of

A

Myasthenia gravis

45
Q

General treatment of Myasthenia gravis

A

AChE inhibitors - Pyridostigmine

46
Q

Treatment of acute exacerbations of Myasthenia gravis

A

plasmapheresis and IVIG

47
Q

Amaurosis fugax is

A

temporary vision loss

48
Q

In order to be a TIA, symptoms must resolve within (how long?)

49
Q

Imaging studies for suspected TIA

A

initial - Head CT
Best - Head/neck CTA/MRA

50
Q

Pharmacology general treatment of TIA

A

High intensity statin + dual antiplatelet therapy (ASA+clopidogrel)

51
Q

Carotid TIA treatment

A

Carotid endarterectomy

52
Q

MC cause of ischemic stroke

A

Thrombosis

53
Q

MC artery impacted with Ischemic stroke

A

Middle cerebral artery

54
Q

Initial imaging with ischemic stroke

A

Non-contrast CT

55
Q

Best imagining with ischemic stroke

A

CT angiography

56
Q

Pharmacologic therapy for ischemic stroke

A

Thrombolytic therapy (alteplase or TPA) IF presenting within 4.5 hrs and no contraindications

57
Q

Pharmacologic secondary stroke prevention

A

High intensity statin + dual antiplatelet therapy (ASA+clopidogrel)

58
Q

MC cause of hemorrhagic stroke

59
Q

Acute management of hemorrhagic stroke

A

1) lower BP as quickly as possible (IV labetolol)
2) Elevate HOB to 30 degrees
3) reversal of anticoagulation therapy or coagulopathy

60
Q

Etiology of Subarachnoid hemorrhage

A

saccular aneurysm of circle of willis rupture

61
Q

Sudden onset of thunderclap headache “worst headache of my life” is suggestive of

A

Subarachnoid hemorrhage

62
Q

CSF analysis showing xanthochromia (hemoglobin degradation products) is suggestive of

A

Subarachnoid hemorrhage

63
Q

Gold standard test for Subarachnoid hemorrhage

A

Cerebral angiography (CTA)

64
Q

what two populations are at risk for subdural hematoma

A

Alcohol use disorder
Older population

65
Q

Describe subdural hematoma

A

Pt fell and hit their head. Was fine but now is declining

66
Q

Describe CT finding of subdural hematoma

A

Crescent shaped hematoma that does cross suture lines.

67
Q

Tx of subdural hematoma

A

Neurosurgical emergency

68
Q

Epidural hematoma is more common in

A

Men > women
Older // younger adults

69
Q

Postauricular ecchymosis (Battle sign) and Raccoon eyes are indicative of

A

Basilar skull fracture

70
Q

Describe CT finding of epidural hematoma

A

Biconvex/lens shaped and does not cross suture lines

71
Q

Tx of epidural hematoma

A

Neurosurgical emergency

72
Q

Seizure that involves both hemispheres of the brain

A

Generalized (different types tonic-clonic, absence, atonic, ect)

73
Q

Seizure that does NOT involve both hemispheres of the brain

A

Focal (impaired awareness or retained awareness)

74
Q

Tx of active seizure

A

1st line: Benzodiazepines

75
Q

Prophylactic treatment of seizures

A

Anticonvulsants (valproic acid, carbamazepine)

76
Q

Tx of absence seizures

A

Ethosuximide

77
Q

what shoulder dislocation is MC from seizures

A

Posterior shoulder dislocations

78
Q

what is status epilepticus

A

single seizure lasting >5 mins OR repeated seizures without return to consciousness

79
Q

First line treatment for status epilepticus

A

First line: Benzodiazepines (IV lorazepam, IM midazolam, or rectal diazepam)

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