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PNCE > Neurology JB > Flashcards

Neurology JB Flashcards

1
Q

Acute delirium tx

A

antipsychotic meds (risperidone, olanzapine, quetiapine)
benzo for alcohol and Benz withdrawal states (lorazepam) + thiamine and B12

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2
Q

akathisia tx

A

antihistamine
maybe BB

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3
Q

alzheimer dx

A

dx of exclusion
r/o other causes
cognitive testing

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4
Q

Amyotrophic lateral sclerosis (ALS) sx

A

instability, upper extremity weakness
sensation, urinary sphincter, and voluntary eye movements spared
cannot control motor movements
mixed upper and lower motor neuron signs

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5
Q

Bells palsy tx

A

prednisone- start 72h of sx onset
artificial tears
acyclovir- severe cases

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6
Q

C5 nerve root function

A

deltoids and biceps
dermatome: outer part of upper arm down to elbow

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7
Q

CN3 disorder

A

oculomotor nerve
inferior rectus, ciliary body
dilated pupil

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8
Q

complex regional pain syndrome sx

A

pain out of proportion to exam w/ skin changes (raynauds)
psychologic hx

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9
Q

complex regional pain syndrome tx

A

early mobilization after injury, NSAID, PT/OT
Pain: amitriptyline, gabapentin, calcitonin adjunct
tx failure: bisphosphonates, IVIG, nerve block
VitC prophylaxis after fx may decrease incidence

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10
Q

drugs to avoid when having dementia

A

avoid anticholinergic, opiates and benzos

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11
Q

what is Bovine spongiform encephalopathy

A

mad cow disease- from eating infected cattle meat
rapid mental deterioration within few months –> coma

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12
Q

epidural hematoma CT

A

convex (lens shaped) bleed
doesn’t cross suture line

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13
Q

gonococcal meningitis maintenance

A

vacine >55yo and high risk
tx close contacts w/ ciprofloxacin or rifampin

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14
Q

Guillain barre syndrome sx

A

ground to brain syndrome
preceding respiratory or GI infx
decreased DTR (LMN lesion), breathing difficulty

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15
Q

Guillain barre syndrome caused by

A

campylobacter jejuni

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16
Q

Guillain barre syndrome tx

A

plasmapheresis
IVIG
mechanical ventilation if respiratory failure
prednisone CI

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17
Q

huntington dz dx

A

CT scan: cerebral and caudate nucleus atrophy
genetic testing
PET scan: decrease glucose metabolism in caudate nucleus and putamen

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18
Q

huntington dz tx

A

no cure
chorea: antidopaminergics
antipsychotics, tetrabenazine
sleep and chorea: benzo

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19
Q

Lateral medullary (Wallenberg) syndrome sx/dx

A

head impulsive, nystagmus, test of skew exam
CT/MRI

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20
Q

basal ganglion lesion sx

A

problems w/ speech, movement, and posture
“parkinsonianism”

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21
Q

cerebellum lesion sx

A

dyssynergia, dysmetria, dysarthria, ataxia
ipsilateral

22
Q

cerebral meningioma dx

A

CT/MRI: intensely enhancing well defined lesion attached to dura
brain bx guided by imaging studies

23
Q

meningococcal meningitis sx

A

positive kernig
positive brudzinski

24
Q

Multiple sclerosis sx

A

uhthoffs phenomenon
Lhermittes sign
optic neuritis, vision loss
Marcus gunn pupil
UMN= spasticity, + upward babinski

25
Q

multiple sclerosis dx

A

clinical dx - at least 2 discrete episodes
MRI w/ gadolinium TOC= white matter plaques, hyper densities (hallmark)
LP: increased IgG in CSF

26
Q

multiple sclerosis tx

A

acute exacerbation: IV high dose CS 1st line. plasmapheresis if refractory
relapsing-remitting/progressive: beta interferon or glatiramer acetate
fatigue: amantidine
spasticity: baclofen and diazepam

27
Q

Myesthinia gravis sx

A

strongest in morning, weakest in evening

28
Q

Myesthinia gravis labs

A

AChr-ab
MuSK ab assays
edrophonium (tensilon) test
ice pack test

29
Q

Myesthinia gravis tx

A

pyridostigmine/neostigmine 1st line
plasmaphoresis/IVIG
thymectomy if thyoma
avoid FQ or aminoglycosides

30
Q

MC brain neoplasm

A

glioblastoma- most aggressive and MC

31
Q

neoplasm in frontal lobe sx

A

dementia, personality changes, gait, expressive aphasia, seizures

32
Q

neoplasm in temporal lobe sx

A

partial complex and generalized seizures

33
Q

neoplasm in parietal lobe sx

A

receptive aphasia
contralateral sensory loss
hemianopsia
spacial disorientation

34
Q

neoplasm in occipital lobe sx

A

contralateral homonymous hemianopsia

35
Q

neoplasm in thalamus sx

A

contralateral sensory loss

36
Q

neoplasm in brainstem sx

A

papillary changes
nystagmus
hemiparesis

37
Q

peroneal nerve injury sx

A

provides sensation to lateral leg
innervates peroneous longus, peroneus brevis, and short head of biceps
injuries can lead to foot drop

38
Q

neurogenic shock sx

A

decreased CO, warm dry skin, normal/decreased HR, wide pulse pressure
decreased SVR, bradycardia
decreased PCWP
due to acute spinal cord injury or regional anesthesia

39
Q

ulnar nerve neuropathy sx

A

+ tinels sign
+ froments sign

40
Q

vagus nerve normal fx

A

CN 10
motor: voice, soft palate, gag reflex
sensory: information about organs

41
Q

parkinsons dz tx

A

levodopa/carbidopa most effective
DA agonist: bromocriptine, pramipexole, ropinirole (to delay use of levodopa)
Ach: benztropine (<70yo w/ tremor predominance)

42
Q

restless leg syndrome tx

A

DA agonist TOC (pramipexole, ropinirole
gabapentin, pregabalin
benzo adjunct (clonazepam)
opioids in disease resistant cases
iron supplement w/ ferritin <75

43
Q

can’t give to patients with seizure disorder

A

Cant drive for 2 yrs, need to balance meds
buproprion lowers seizure threshold
Tdap cannot give

44
Q

subarachnoid hemorrhage (SAH) sx

A

sudden onset HA
thunderclap
worse HA of my life

45
Q

subarachnoid hemorrhage dx

A

CT first line –> LP (looking for blood or xanthochromia) –>
4 vessel angiography after confirm SAH

46
Q

subarachnoid hemorrhage tx

A

refer to interventional radiology for surgery
nimodipine, nicardipine, labetalol to lower BP
supportive tx
decrease ICP: mannitol, hyperventilation, head elevation

47
Q

subdural hematoma CT

A

concave (crescent shaped) bleed
can cross suture line

48
Q

tardive dyskinesia tx

A

clonazepam, valbenazine, deutetrabenazine
clozapine good if pt needs antipsychotic tx

49
Q

TIA dx

A

CT head BIT
carotid doppler, CTA, MRA
ABCD2 score to assess CVA risk

50
Q

trigeminal neuralgia (tic douloureux) tx

A

carbamazepine 1st line
oxcarbazepine
gabapentin, baclofen

51
Q

trigeminal neuralgia CN

A

CN5

52
Q

tumor lysis syndrome labs

A

hyperuricemia
hypocalcemia
kyperkalemia
hyperphosphatemia
acute renal failure

PNCE (33 decks)

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