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MKSAP > neurology > Flashcards

neurology Flashcards

1
Q

In MS, ensure Vitamin D supplementation.

A

linked to higher disease activity and more relapses

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2
Q

mild cognitive impairment

A

score lower than 26/30 without significant functional decline
can get brain CT/MRI to rule out structural cause

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3
Q

TIA eval

A

ABCD^2 score, =>3: admit

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4
Q

incidental meningioma

A

lightbulb sign, calcification, dural tail
benign, repeat MRI 3-6 months after initial discovery
if growing/symptomatic->surgery->radiation

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5
Q

first seizure eval

A

auras: deja vu (simple partial seizure)
changes in awareness, periods of inattention
any aura before seizure=focal

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6
Q

migraine MRI

Migraine frequency/ use of acute medications> 2 days/wk

A

white matter signal abnormalities
if NSAIDs dont cut it->oral triptan ->subq triptan

timolol for ppx, topimarate also for ppx

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7
Q

Temporal lobe epilepsy

frontal lobe seizures

A

rising epigastric sensation, fear and anxiety, fidgety
normal EEG and MRI
if refractory to 2 AEDs->surgery (lobectomy)

motor symptoms that awaken from sleep

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8
Q

Myotonic dystrophy

diagnosis

A

weakness+ fatigue+ waddling gait+ muscle stiffness+ delayed grip relaxation

EMG

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9
Q

Primary progressive aphasia

treatment

A

progressive loss of language function with other cognitive functioning intact

speech and language therapy

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10
Q

tardive dyskinesia

caused by

A

chorea and dystonia

dopamine antagonists such as metoclopramide, risperidone

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11
Q

Interferon beta side effects

natalizumab
fingolimod
teriflunomide

A

LFTs q3-6 months (autoimmune hepatitis)
screen for JC virus (PML)
eye exams
amylase and lipase (pancreatitis)

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12
Q

secondary stroke prevention

A

aspirin+ dipyridamole

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13
Q

Antiepileptic in woman taking OCPs/preggo

A

keppra

failure of OCPs otherwise

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14
Q

newly diagnosed stroke admit to

A

stroke unit, reduces mortality

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15
Q

unknown epilepsy syndrome (gen vs focal) treatment

A

broad spectrum AED such as topiramate, lamotrigine, keppra, valproic acid, zonisamide

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16
Q

NPH treatment

A

lumbar puncture to assess response before VP shunt

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17
Q

acute headache+ neck pain+ transient vision loss+ miosis+ ptosis+ anhidrosis

diagnosis
treatment

A

carotid artery dissection

MRI of soft tissue of neck
aspirin

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18
Q

essential tremor treatment

A

propranolol->primidone->topiramate (not of kidney stones/glaucoma)->deep brain stim

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19
Q

spinal cord compression 2/2 plasmacytoma/ myeloma

A

steroids, radiation (if stable spine and minimal neuro deficits)
surgical decompression if unstable/severe neuro deficits

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20
Q

spinal cord compression 2/2 plasmacytoma/ myeloma

A

steroids, radiation (if stable spine and minimal neuro deficits)
surgical decompression if unstable/severe neuro deficits

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21
Q

GI effects on cholinesterase inhibitor (donepezil, rivastigmine)

A

stop

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22
Q

small fiber neuropathy

diagnosis

A

pain and paresthesia with no neuro deficits

glucose tolerance test

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23
Q

psychogenic nonepileptic seizures

diagnosis

A

long, closed eyes, can be incontinent, >2 AEDs,PTSD (no Keppra)
video EEG monitoring

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24
Q

MS urge incontinence 2/2

treatment

A

spasms

oxybutynin

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25
Q

seizures in oldies

A

lamotrigine, Keppra, gabapentin

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26
Q

asymptomatic carotid artery stenosis

A

statin, no CEA

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27
Q

cerebral vasoconstriction syndrome

treatment

A

recurring thunderclap headaches, stroke on imaging

normalize BP

28
Q

CNS lymphoma diagnosis

treatment

A

surgical biopsy without resection

methotrexate and radiation

29
Q

Afib in setting of stroke anticoag

A

wait for 2 weeks

30
Q

solitary metastatic brain tumor treatment

A

resection followed by radiation

31
Q

myasthenic crisis

relapse without crisis

A

plasmapheresis or IVIG

high dose steroid

32
Q

Cluster headache treatment

ppx

A

oxygen, subq sumatriptan

verapamil (can cause heart block, monitor ECG)

33
Q

cognitive dysfunction in multiple sclerosis

A

counseling and therapy

34
Q

med overuse headache

A

> 10 days/month

35
Q

persistent facial nerve palsy after 3 months

A

MRI of brain

36
Q

first seizure in setting of risk factors (previous head injury, focal brain lesion, postictal Todd’s paralysis

A

AED

37
Q

MS diagnosis
MS preventive care
associated with trigeminal neuralgia

A

MRI of brain

routine vaccinations

38
Q

Patient with resolving headache a week after trauma

A

no imaging, restrict contact sports

39
Q

parkinsonism+ cerebellar ataxia+ early postural instability+ falls

+impairment in vertical eye movements
Parkinson diagnosis

A

multiple system atrophy

progressive supranuclear palsy
bradykinesia (slowing with repetitive movements)+rigidity/resting tremor/postural instability

40
Q

active denervation+ muscle weakness and atrophy in carpal tunnel syndrome

A

decompression surgery

41
Q

intracranial hemorrhage + SBP >180

A

lower to 160 with IV labetalol

42
Q

progressive weakness+ areflexia+ sensorimotor neuropathy for more than 8 weeks
treatment

A

chronic inflammatory demyelinating polyradiculopathy

steroids

43
Q

idiopathic intracranial hypotension

treatment

A

elevated opening pressure with no CNS lesion (headache, papilledema, visual symptoms)
acetazolamide->optic nerve fenestration

44
Q

cryptogenic stroke with PFO

A

prolonged cardiac monitoring to detect a fib

45
Q

meds wearing off in Parkinson’s

A

increase carbidopa-levo or add entacapone

if can’t be tolerated (dyskinesia, visual hallucinations)->DBS

46
Q

restless legs syndrome vs spasticity

A

discomfort, urge to move, periodic limb movements while sleeping vs tonic leg spasms and cramps

47
Q

parkinsonian-hyperpyrexia syndrome

A

AMS, hyperthermia, rhabdo, rigidity, dystonia

medication withdrawal, restart levodopa

48
Q

Refractory migraine (>72 hours)

A

dihydroergotamine+ prochlorperazine/metoclopramide

49
Q

MS preggo

A

no fingolimod, mitoxantrone, teriflunomide

50
Q

aneurysmal subarachnoid hemorrhage complication
prevent with
treat with
diagnose with

A

vasospasm (also rebleeding, hydrocephalus)
oral nimodipine (21 days)
IV dopamine
CTA Brain

51
Q

UMN+ LMN symptoms

treatment

A

ALS

riluzole

52
Q

UMN+ LMN symptoms

treatment

A

ALS

riluzole

53
Q

Secondary headache

management

A

Escalation in frequency and intensity, neuro symptoms> 1 hr med overuse headache is milder, no new neuro sx

brain MRI

54
Q

unruptured intracranial aneurysms

coiling when

A

smoking cessation, BP control
>12 mm
nimodipine only when there’s hemorrhage

55
Q

hyperdensity on CT

post TPA neuro changes

A

infarct

CT without contrast

56
Q

Tics

A

suppressible

57
Q

Seizure treatment in patient with brain tumor

A

AED that is not cleared by liver (chemo drugs)

valproic acid, lacosamide, lamotrigine, keppra

58
Q

persistent myopathy on steroids

A

taper steroid to distinguish between steroid induced myopathy (stable CK) and inflammatory myopathy (elevated CK)

59
Q

Chronic migraine

treatment

A

headache >15 days/month for >3 months

topiramate/ onabotilumtoxin A

60
Q

paraneoplastic limbic encephalitis

diagnosis
treatment

A

inflammation of emotional and memory structures, subacute, personality change,psychosis, seizures, cancer related
serum/CSF paraneoplastic antibodies
immunotherapy

61
Q

treatment of fatigue in MS

A

modafinil->meth

62
Q

statin related myopathy, which statin to give

A

hydrophilic: rosuvastatin, pravastatin, fluvastatin

63
Q

Creutzfeldt-Jakob MRI

A

hyperintensities in cortex/thalamus/ganglia

subacute, rapidly progressive

64
Q

persistent AMS after convulsive status epilepticus

A

continuous EEG monitoring

65
Q

dalfampridine contraindication

A

for MS, any kidney disease

MKSAP (6 decks)

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