Neurology Flashcards
Which is the more common etiology of stroke?
Thromboembolic
What is the time window for TPA in an embolic stroke?
Ideally within 3 hours but demonstrates effectiveness up to 4.5 hours fro onset of symtoms
What is the threshold for carotid endarterectomy?
> 70% occlusion of the carotid
If a patient has a TIA, what are his/her risk of CVA?
33% in 5 years
How long must a seizure persist to be diagnosed as having status epilepticus?
5 minutes
What is the treatment for MS?
Acute: high dose IV steroids -> plasma exchange if that doesn’t work. Chronic - interferon beta decreases the frequency of acute events especially in more severe cases. Glatiramer acetate is used in more mild cases.
What is the risk of alzheimer’s disease by age 85?
30-50%
What is the standard treatment of alzheimer’s disease?
Acetylcholinesterase inhibitor (tacrine, donepezil, galantamine or rivastigmine) + Memantine
A patient with a chronic evolution of apathy and ALS receives a PET scan which shows frontal hypometabolism. What is the diagnosis?
frontotemporal dementia
What are the treatments/preventions of headache?
Triptans, botox for severe intractable headache
What is the prophylactic medication of choice for cluster headaches?
Verapamil
What are the 4 main clinical diagnostic criteria for Parkinson’s disease?
Resting tremor, bradykinesia, rigidity, postural instability
What is the next medication step for a Parkinson’s patient who fails levadopa/carbidopa therapy?
bromocriptine
What is the chromosomal location of the Huntington’s gene?
short arm of chromosome 4
What is an important supplement to ropinerole in restless leg syndrome?
Iron
What is the timeline of bell’s palsy paralysis?
peak weakness at 21 days, full recovery by 6 months
Patient with recent GI illness p/w new motor deficits in b/l lower extremities. Diagnosis? Treatment?
Guillan- Barre - admission and plasmapharesis or IVIG in the unstable/pediatric patients as well as supportive care
Patient with ptosis and easy fatiguability that waxes and wanes throughout the day. Diagnosis? confirmatory test?
Myesthenia gravis confirmed with edrophonium test
What is the mainstay of myesthenia gravis treatment?
pyridostigmine (cholinesterase inhibitor)
What is the typical starting therapy for bacterial mengitis?
a pcn + 2/3rd gen cef +/- vanc depending on MRSA risk
What is the treatment for viral (aseptic) meningitis?
only acyclovir if confirmed HSV induced, otherwise supportive
what is the treatment of spinal cord injury that has been shown to improve neurologic recovery? timeline?
steroids within 8 hours of the injury
