neurology UWorld Flashcards by danial A

acute severe periorbital pain with ipsilateral mitosis, lacrimation lasts 90 min
dx
tx

cluster headache
100% oygen
subcutaneous sumatriptan
ppx: verapamil, lithium

How well did you know this?

Not at all

Perfectly

headache, eye pain, nausea, decreased visual acuity, seeing halos, fixed mid-dilated pupil conjuctival redness

angle closure glaucoma

How well did you know this?

Not at all

Perfectly

obese patient on OCP;s, headache n/v papilledema**

idiopathic intracranial hypertension
can cause blindness
do a lumbar puncture or imaging to rule things out

How well did you know this?

Not at all

Perfectly

young obese female pt with transient episodes of blindness and pulsatile headaches, b/l papilledema
tx

intracranial htn
weight loss and acetazolamide

How well did you know this?

Not at all

Perfectly

migraine ppx

topiramate

OCP’s are contraindicated: increased estrogen increases risk of thromboembolism

How well did you know this?

Not at all

Perfectly

intraparenchymal hemorrhage likely d/t htn
what symptoms?

ipsilateral hemiataxia

How well did you know this?

Not at all

Perfectly

management of carotid atherosclerotic disease

How well did you know this?

Not at all

Perfectly

non pupil sparring CN III palsy vs pupil sparring management

ct- angiography

How well did you know this?

Not at all

Perfectly

old lady with headache, visual disturbance, and elevated ESR

giant cell arteritis
start prednisone and then obtain artery biopsy

How well did you know this?

Not at all

Perfectly

lobar intracranial hemorrhage

d/t amyloid

How well did you know this?

Not at all

Perfectly

pt usually takes warfarin, gets a cold, takes OTC and then gets brain bleed
next step

prothrombin complex concentrate (vitamin K + factor 2, 7, 9, 10)

How well did you know this?

Not at all

Perfectly

contralateral hemiparesis and hemianesthesia and conjugate gaze deviation toward the side of the lesion

putaminal hemorrhage
– always involve the adjacent internal capsule
hemiparesis + hemianesthesia d/t posterior limb corticospinal and somatosensory fibers
gaze deviation d/t anterior limb

How well did you know this?

Not at all

Perfectly

conjugate eye

How well did you know this?

Not at all

Perfectly

management of ischemic stroke

more than 4.5hrs –> anti platelet agents

How well did you know this?

Not at all

Perfectly

severe paroxysmal burning pain over affected areas, exacerbated by light touch. after a stroke neuropathic pain

allodynia – thalamic pain syndrome – after a stroke neuropathic pain

How well did you know this?

Not at all

Perfectly

right hemiparesis stroke

How well did you know this?

Not at all

Perfectly

pure motor stroke

How well did you know this?

Not at all

Perfectly

vertigo + nausea + nystagmus + sensation defects of the left side of the face and right extremities

dissection of left vertebral artery

left medulla

Alzheimer disease what will see on mri

Temporal Lobe Atrophy (prominent in the hippocampi and medial temporal lobes)

initial workup for suscepted cognitive impairment

B12

old lady with cognitive decline and then behavioral changes
tx

Alzheimers disease
mild to moderate : rivastigmine, donepezil, galantamine
mod to severe: Memantine an NMDA receptor antagonist

als

upper and lower motor neuron
corticospinal tract degeneration
anterior horn cell

ALS
tx

Riluzole
NIPPV

will also see postural tremor

gait abnormalities, cognitive impairments (executive function, memory deficits), urinary incontinence (urgency)

Normal pressure hydrocephalus **decreased CSF ABSORPTION by the arachnoid granulations **large ventricles with normal sulci on CT scan **next step: get an MRI brain

behavioral changes, (irritability, social inappropriateness, rudeness) + cognitive impairments (math errors, Montreal cognitive assessment) + Neuro signs ( chorea involuntary movements, hyperreflexia**)

huntingtons disease caudate nucleus atrophy

ptosis, fluctuating and fatiguable proximal muscle weakness ice pack test positive

myasthenia graves tx: pyridostigmine

progressive muscle weakness affecting proximal (standing up) and distal (buttoning shirt) muscles, with LMN hyporeflexia and muscle atrophy and sensation deficits

chronic inflammatory demyelinating polyneuropathy decreased peripheral nerve. conduction velocity

GBS ascending polyradiculoneuropathy csf: protein: WBC: RBC: GLUCOSE:

protein: HIGH WBC: normal RBC: normal GLUCOSE: normal tx: IVig or plasmapheresis

metformin after 5 years, develops sensory ataxia (gait unsteady, positive Romberg), lateral corticospinal tracts (babinksi), myelinated peripheral nerves -- parasthesisia extremities, neuropsychiatric manifestations

vitamin b12 deficiency

sudden symptoms of upper and lower facial drooping, disappearance of nasolabial fold, prodrome of ear pain

bells palsy no additional tests needed tx: high dose glucocorticoids

old guy who takes pyridostigmine outpatient, suddenly gets respiratory failure and is intubated what next ?

dx: myasthenia crisis give plasmapheresis or IVIG

excessive hip and knee flexion while walking, slapping down the foot, frequent falls dx d/t

motor neuropathy steppage -- common perineal neuropathy usually due to L5 radiculopathy (back pain radiating to foot, weakness foot eversion and dorsiflexion) or Common Peroneal nerve neuropathy: d/t compression of nerve at lateral aspect of fibula (crossing legs for long time( paresthesias and sensory loss over dorm of foot

hand weakness, stiffness,, atrophy, with flat affect and ptosis (male or female)

myotonic dystrophy CTG trinucleotide repeat DMPK gene

ALS diagnosis:

EMG

diffuse abdominal pain, peripheral neuropathy (upper extremity weakness, areflexia) and positive urobilinogen

AIP

unpleasant sensation of crawling in the legs, relieved temporarily with walking dx tx moa

restless legg syndrome gabapentin: alpha 2 delta calcium channel ligand

malignancy small cell lung cancer, proximal limb muscle weakness (combing hair, standing), deep tendon reflexes are absent, autonomic dysfunction (dry mouth, ED)

Lambert eaton autoantibodies on presynaptic voltage-gated calcium channels