NEUROLOGY AND PSYCHIATRY Flashcards
What is the most common cause of syncope?
Neurally mediated (vasovagal)
Orthostatic hypotension definition
(reduction in SBP of at least 20 mmHg or DBP of at least 10 mmHg within 3 min of standing or head-up tilt on a tilt table.
What is the most important step in the management of syncope?
Rule out life threatening conditions.
hallmarks of a generalized seizures
Tonic-clonic movements
What is the most common type of seizure?
Generalized tonic-clinic
What is the most important diagnostic step in seizures?
EEG
presents exactly as stroke but symptoms last <24 hours and resolve completely.
Transient ischemic attack (TIA)
standard imaging modality to detect the presence or absence of intracranial hemorrhage
Computed tomography (CT) imaging of the brain
most common location site of hypertensive bleed.
Basic ganglia (putamen, internal capsule)
tearing of superior cerebral veins = gradual mental status change = crescent shaped
Subdural hemorrhage
anterior div of middle MA = lucid interval = Biconcave disk- shaped
Epidural hemorrhage
Profound weakness lower extremity > upper extremity
Anterior cerebral artery
- Profound upper extremity weakness
- Aphasia
Middle cerebral artery
- Vertigo, nausea and vomiting
- Dysarthria, ataxia
- Gait imbalance
Vertebrobasilar artery
Amaurosis fugax
Ophthalmic artery
- Ipsilateral face, contralateral body
- Vertigo, Horner’s syndrome
Posterior cerebellar
the most commonly affected artery in hemorrhagic stroke
MCA
Thrombolytics should be administered within ___ hours of the onset of symptoms.
3
What is the definitive test to detect site of bleeding in hemorrhagic stroke?
Cerebral angiogram
What is the most common non-traumatic cause of SAH?
Ruptured aneurysm
What is the gold standard for diagnosis of SAH?
Lumbar puncture
hallmark of aneurysmal rupture is blood in the CSF.
Xanthochromia is the gold standard for diagnosis of SAH
What is the most common form of suppurative CNS infection?
Bacterial meningitis
What is the best initial test for meningitis?
CT scan of the head then CSF analysis
What is the most accurate test?
CSF culture
What is the best initial therapy for meningococcal Meningitis?
Amphotericin B and 5flucytosine
The single strongest risk factor for dementia
increasing age.
most effective medication for parkinson
Levodopa/carbidopa
extend the duration of levodopa/carbidopa by blocking metabolism of dopamine. Used in those treated with levodopa/carbidopa
COMT inhibitor (tolcapone, entacapone)
Commonly associated infections of GBS
Campylobacter jejuni and Herpesvirus
ascending paresthesia, cranial nerve deficit (dysphagia, dysarthria, facial weakness, papilledema), autonomic dysfunction and respiratory muscle paralysis (extreme cases)
GBS
What is the most specific diagnostic test for GBS?
Nerve conduction study / electromyography
antibodies against acetylcholine receptors
MYASTHENIA GRAVIS (MG)
Presents with diplopia, drooping of eye lids, weakness of the muscles of mastication and dysarthria. Associated with thymomas
MYASTHENIA GRAVIS (MG)
What is the best initial test for GBS?
Anti-acetylcholine receptor antibodies (ACHR) immunoassay
Bipolar I vs II
Characterized as, for the same 2 weeks, the person experiences 5 or more of the following symptoms, with at least 1 of the symptoms being either a depressed mood or characterized by a loss of pleasure or interest:
- Depressed mood
- Markedly diminished pleasure or interest in nearly all activities
- Significant weight loss or gain or significant loss or increase in appetite
- Hypersomnia or insomnia
- Psychomotor retardation or agitation
- Loss of energy or fatigue
- Feelings of worthlessness or excessive guilt
- Decreased concentration ability or marked indecisiveness
- Preoccupation with death or suicide; patient has a plan or has attempted suicide
MAJOR DEPRESSIVE EPISODES
