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1 Internal Medicine > Neurology & Psychiatry > Flashcards

Neurology & Psychiatry Flashcards

Dementia, Depression, Altered Mental Status, Syncope, SUD

1
Q

What is the mnemonic for syncope causes?

A

HEAD: Hypoxia, Epilepsy, Anxiety, Dysautonomia

HEART: Heart disease, Embolism, Aortic stenosis, Rhythm abnormality, Tachycardia/bradycardia.

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2
Q

How is syncope evaluated (4)?

A
  1. Orthostatics
  2. ECG
  3. Holter monitor
  4. echo (if structural heart disease suspected)
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3
Q

What is the treatment for vasovagal syncope (3)?

A
  1. Reassurance
  2. hydration
  3. beta-blockers (if recurrent)
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4
Q
  • If they ask for the most ACCURATE test for Alzheimer →
  • Test for clinical diagnosis →
A
  • Brain biopsy
  • MRI
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5
Q

Dementia tx

A
  • Mild-to-Moderate Dementia → Acetylcholinesterase inhibitors (Donepezil, Rivastigmine, Galantamine)
  • Moderate-to-Severe Dementia → NMDA receptor antagonist (Memantine)
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6
Q

Workup for dementia (5)

A
  1. MMSE (Mini-Mental Status Exam) → Quick screening
  2. MoCA (Montreal Cognitive Assessment) → More sensitive for early dementia
  3. Neuroimaging (CT/MRI) → Rule out reversible causes (normal pressure hydrocephalus, tumors, strokes)
  4. B12 & TSH → Rule out metabolic causes
  5. RPR → Rule out neurosyphilis
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7
Q

What are the items on the SAD PERSONS suicide risk factors?

A
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8
Q

When would you treat a patient indefinitely for major depression?

A

If patient had ≥3 major depressive episodes

(first episode = tx for 6 months)

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9
Q

first line depression tx

A
  1. fluoxetine
  2. sertraline
  3. venlafaxine
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10
Q

SUD evaluation

A
  1. CAGE questions
  2. UA tox screen
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11
Q

tx for opioid use disorder
tx for alcohol use disorder

A
  • Opioid Use Disorder → Methadone or Buprenorphine/Naloxone (Suboxone)
  • Alcohol Use Disorder → Naltrexone (first-line), Disulfiram (second-line, for abstinent patients)
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12
Q

Prognosis: SUD

A

Relapse is common → Best outcomes with long-term therapy (MAT, therapy, social support)

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13
Q

timeline of alcohol w/d

A
  • 6-12 hours: tremor, HA, anxiety
  • 12-48 hours: seizure
  • 48-96 hours: DTs (hallucination, fever, autonomic instability)
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14
Q

delirium tremens tx

A

IV benzos

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15
Q

Ddx for altered mental status (AMS)

A

AEIOU TIPS mnemonic
Alcohol
Electrolytes
Infection
Overdose
Uremia
Trauma
Insulin
Poisoning
Stroke

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16
Q

If a comatose patient is found down, give …

A

“Coma Cocktail” = Dextrose (Glucose), Thiamine, Naloxone!

1 Internal Medicine (9 decks)

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