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IM > neurology > Flashcards

neurology Flashcards

1
Q

treatment of trigeminal neuralgia

A

carbamazepine

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2
Q

resting tremor, cogwheel rigidity, bradykinesia, postural instability

A

PD

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3
Q

loss of dopamine in the substantia nigra

A

PD

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4
Q

tremor with movement, hx in family, propranolol

A

essential tremor

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5
Q

is there a tx for intention tremor?

A

NO, based in cerebellum

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6
Q

AD, anticipation, chorea, trinucleotide repeat

A

HD

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7
Q

first line tx for cluster HA

A

OXYGEN!

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8
Q

verapamil as ppx for _____ HA

A

cluster HA

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9
Q

*** 3 ppx meds for migraine HA

A

propranolol, topiramate, valproic acid

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10
Q

young woman on OCP with HA, papilledma, and LP with opening pressure > 25

A

pseudo tumor cerebri

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11
Q

*** tx of pseudo tumor cerebri

A

Acetolamide
Serial LPs
VP shunt

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12
Q

*** suspect cord compression, what rx to give?

A

steroids

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13
Q

plaques and tangles, chromosome 21, diffuse cortical atrophy

A

alzheimers

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14
Q

frontotemporal degeneration, personality changes

A

Pick’s disease

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15
Q

undercooked meat, myoclonus, dementia in young person

A

CJD

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16
Q

wet, wobbly, weird

A

normal pressure hydrocephalus - increased ICP, sx relieved with LP

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17
Q

how to differentiate labrynthitis from vestibular neuritis

A

labrynthitis = hearing loss

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18
Q

hearing loss, tinnitus, vertigo

A

meniere’s disease

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19
Q

meniere’s tx

A

salt restrict, thiazides, meclizine for anti-vertigo

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20
Q

corneal copper accumulation on slit lamp + dysarthria, dystonia, depression

A

Wilson’s disease, copper accumulation in brain and liver

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21
Q

*** pill-rolling tremor, fluctuating cognition and visual hallucinations, dementia BEFORE PD symptoms

A

Dementia with Lewy Bodies

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22
Q

ataxia, urinary incontinence, dilated ventricals on brain imaging

A

normal-pressure hydrocephalus

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23
Q

*** microatheroma, lipohyalinosis, internal capsule of brain, pure motor hemiparesis

A

lacunar infarct

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24
Q

risk factors for lacunar infarct

A

HTN, hyperlipidemia, DM, smoking

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25
Q

*** bridging veins + concave hemorrhage that crosses suture lines

A

subdural hematoma

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26
Q

head/neck pain + ipsilateral ptosis, miosis, anhidrosis

A

carotid artery dissection

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27
Q

profound neurological deficits - hemi sensory and vision loss

A

carotid artery thrombosis with infraction to cerebral hemisphere

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28
Q

pt on OCP or with malignancy + new HA, AMS, seizures, focal neuro deficits

A

cerebral sinus thrombosis

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29
Q

thunderclap HA + ruptured saccular aneurysm

A

subarachnoid hemorrhage

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30
Q

*** oligoclonal IgG bands on CSF

A

MS

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31
Q

albuminocytologic dissociation

A

Guillan Barre

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32
Q

CSF with neutrophillic pleocytosis

A

bacterial CNS infection, meningitis

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33
Q

HIV with AMS, EBV DNA in CSF, solitary ring-enhancing lesions

A

primary CNS lymphoma

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34
Q

tremor of both hands with ACTION, relieved by alcohol, tx with propranolol

A

essential tremor

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35
Q

tremor at REST that decreases with voluntary movement

A

PD

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36
Q

tremor WORSE as hand reaches target + ataxia, dysmetria, gait disorder

A

cerebellar dysfunction

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37
Q

encephalopathy, ocular dysfunction, gait ataxia

A

wernicke encephalopathy due to THIAMINE deficiency

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38
Q

what are TWO important things to rule out in FIRST time seizure

A

metabolic causes (electrolytes, blood glucose) and toxic causes (urine drug screen)

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39
Q

if urine tox screen and metabolic labs are BOTH NORMAL, what next in first seizure workup?

A

imaging to rule out structural cause + EEG

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40
Q

lacunar infarct/posterior limb of internal capsule

A

unilateral motor impairment - NO sensory or visual deficits

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41
Q

MCA occlusion

A

CONTRALATERAL somatosensory + motor deficit
Aphasia
Hemineglect
Homonymous hemianopia
Conjugate eye deviation toward side of infarct

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42
Q

ACA occlusion

A

CONTRALATERAL somatosensory + motor deficit
Lack of will/initiative
Dyspraxia, emotional disturbance, urinary incontinence

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43
Q

occlusion of this artery can result in urinary incontinence

44
Q

occlusion of these TWO arteries can result in contralateral somatosensory and motor deficits

A

MCA and ACA

45
Q

occlusion of this artery results in aphasia

46
Q

*** If a person is right handed and has an occlusion of the Left MCA, what unique symptom may they develop?

47
Q

Occlusion of the MCA of the dominant lobe can lead to ____

48
Q

Occlusion of the MCA of the NON-dominant lobe can lead to _____

A

hemineglect or anosognosia (lack of awareness regarding one’s illness)

49
Q

antibodies against ACh receptors of the motor end plate

A

myasthenia gravis

50
Q

eyes, neck and upper extremity fluctuating weakness

A

myasthenia gravis

51
Q

inflammatory demyelination and ascending paralysis

52
Q

autoimmune demyelination of white matter tracts in CNS

53
Q

inability to raise the eyebrow, close the eye, drooping of mouth corner, disappearance of nasolabial fold

A

Bell’s palsy - peripheral neuropathy of 7th cranial nerve `

54
Q

4 migraine preventative meds

A

topiramate, divalproex sodium, TCA, beta blockers

55
Q

“washed-out” color vision in young woman + afferent pupillary defect on exam

A

MS with optic neuritis

56
Q

*** acute painless vision loss + exam with retinal whitening and cherry red spot

A

central retinal artery occlusion

57
Q

*** drusen yellow deposits

A

macular degeneration, central vision leoss

58
Q

*** gradual painless peripheral vision loss + exam with increased cup:disc ratio

A

open-angle glaucoma

59
Q

*** floaters, flashes of light + peripheral vision loss

A

retinal detahcment

60
Q

*** rapid severe eye pain, halos around lights, pupil dilated and minimally responsive to light, tearing, HA, N/V

A

acute angle glaucoma

61
Q

anorexic/alcoholic with confusion, horizontal nystagmus and wide-based gait

A

Wernicke encephalopathy - give thiamine then glucose

62
Q

large ischemic strokes and those treated with thrombolytics are at risk of ____

A

hemorrhagic transformation - if suspect, get an emergent noncontrast CT, surgical decompression needed

63
Q

imaging to rule out brain bleed

A

CT WITHOUT contrast

64
Q

visual defects, HA, sx of hormonal deficiencies

A

think SELLAR mass - pituitary adenoma, craniopharyngioma, meningioma

65
Q

arises from Rathke’s pouch, compresses optic chiasm, bitemporal blindness

A

craniopharyngioma

66
Q

*** tumor that causes HA, hearing loss, vertigo, tinnitus, balance problems

A

cerebellopontine angle tumors

67
Q

*** bridging veins, crescent-shaped hypodensity that crosses the suture lines

A

subdural hematoma

68
Q

early personality changes, compulsive behaviors, executive dysfunction

A

fronto-temporal dementia

69
Q

loss of GABA, caudate nucleus and putamen atrophy, CAG trinucleotide, AD with anticipation

A

Huntington disease

70
Q

*** loss of ACh producing neurons in nucleus basalis of Meynert

A

Alzheimers

71
Q

loss of dopamine-producing neurons

72
Q

brain abscess bugs

A

strep viridans and staph aureus

73
Q

*** this toxin BLOCKS the release of inhibitory neurotransmitters glycine and GABA

74
Q

*** flaccid paralysis, impariment of presynaptic ACh release

75
Q

this physical exam finding is sensitive and specific for upper motor neuron OR pyramidal/corticospinal tract disease

A

pronator drift

76
Q

ataxia, intention tremor, imparied rapid alternating movements

A

cerebellar dysfunction

77
Q

*** movement of distal phalange with patients eyes closed and Romberg test *stand with eyes closed

A

tests for proprioception

78
Q

CSF with normal glucose and lymph predominance

A

viral meningitis

79
Q

CSF with low glucose < 40 and high WBC

A

bacterial meningitis

80
Q

this nerve is injured with anterior hip dislocation or pelvic surgery

A

obturator nerve - weakness with adduction

81
Q

*** Two most common cancer metastases to brain

A

lung and breast

82
Q

*** Patient is found to have multiple brain metastases, what cancers are likely?

A

lung and malignant melanoma

83
Q

CD4 < 100, fever, HA, AMS, seizures, multiple ring-enhancing lesions

A

toxoplasmosis

84
Q

*** brain cysts at various stages of developement

A

neurocysticercosis - pork tapeworm

85
Q

degenerative disease with parkinsonism, autonomic dysfunction, widespread neurological signs

A

multiple system atrophy (Shy-Drager syndrome)

86
Q

anhydrosis, miosis, ptosis

A

Horner syndrome

87
Q

*** chemo rx that can cause peripheral neuropathy

A

vincristine, paclitaxel and cisplatin

88
Q

ascending paralysis preceded by URI or diarrheal illness

89
Q

CSF with high protein and normal WBC and glucose

90
Q

*** GBS tx

A

IVIG and plasmapharesis

91
Q

cerebellar hemorrhage sx

A

occipital HA, neck stiffness, N/V, nystagmus, ipsilateral hemiataxia

92
Q

*** How often do nerve deficits related to MS generally hang around? vs TIA?

A

MS = days to weeks, TIA = seconds to minutes

93
Q

*** 3 things to treat acute MS exacerbation

A

glucocorticoids, immunoglobulins, plasma exchange therapy

94
Q

acute confusion, extreme hyperthermia, tachycardia, coagulopathic bleeding after prolonged exposure to high temp

A

exertional heat stroke

95
Q

*** unilateral foot drop, impaired ankle dorsiflexion, preserved plantar flexion, sensory changes over dorsal foot and lateral shin

A

common fibular neuropathy due to compressive injury

96
Q

subcortical white matter demyelination

97
Q

MOA and application of pyridostigmine

A

acetylcholinesterase inhibitor, myasthenia gravis tx

98
Q

patient with ptosis found to have thymoma on chest CT

A

myasthenia gravis

99
Q

myasthenia crisis tx

A

plasmapharesis and immunoglobulin

100
Q

*** ____ is the only antiplatelet agent that is effective in reducing the risk of early recurrence of ischemic stroke

A

aspirin; given to all patients with 24 hrs of presentation for stroke

101
Q

*** What to do for patients > 70% stenosis or carotid AND symptomatic?

A

endarectomy

102
Q

*** early side effects of carbidopa-levidopa

A

hallucinations, confusion, agitation, dizziness, somnolence, nausea

103
Q

painless flashes, floaters and curtain across visual field

A

retinal detachment

104
Q

autoantibodies against nicotinic acetylcholine receptors at the NMJ

105
Q

pt with fever, AMS, focal neuro deficits, seizures and CSF with normal glucose, elevated WBC with lymphocytes, tx with acyclovir

A

herpes encephalitis

106
Q

another word for vasovagal syncope

A

neurocardiogenic

IM (17 decks)

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