Neuromedicine

Question 1

Alzheimer Rx

Answer 1

Symptomatic :
Anticholinesterase (Donepezil , rivastigmine , galantamine).

N-methyl D-aspartate receptor antagonist (memantine).
.
Ginkgo biloba ==> increase blood flow.

Piracetam.

Anti-psychotic ( haloperidol , Resperidone)
Anti-dep. (citalopram) & anxiolytic

Question 2

Lewy body disease Rx

Answer 2

No specific treatment.
Memantine
Anticholinesterase (rivastigmine)

Question 3

Primary progressive MS

Answer 3

ocriluzumab || alemtuzumab

Question 4

secondary progressive

Answer 4

Mitoxantrone || Cyclophosphamide
methotrexate || Pulse methylprednisolone (1G/month)

Question 5

Symptomatic treatment for MS

Answer 5

Vit.D
Omega 3
Spasticity : diazepam || baclofen
Detrusor hyperreflexia : propantheline
Detrusor dyssynergia : Phenoxybenzamine || Terazosin
Rx for UTI
Fatigue : Amantadine || Modafinil

Question 6

Devic disease

Answer 6

Iv infusion methyl pridnisolone 500- 1000 mg per day for 3-5 days Plasma exchange 20 cc/kg per session for 5 sessions on each other day iv immunoglobuline 400mg/kg per day for 5daysIf pt. not responding to steroid we can use PE immediately (PE rescue) after treat the acute attack by above treatment ,we prevent therelaps by Rituximub (anti CD20) physiotherapy and symptomatic treatment

Question 7

Essential tremor

Answer 7

Propranolol 20-80 mg daily
.
Primidon (1st gen barbiturate) started at small dose 12.5 mg then gradually
increase the dose to (125 -250) 3 times daily , side effect of this drug is .sedation and vomiting
.
Other treatment topiramate ,gabapentin ,and botulinum toxin

Question 8

Absence seizure Rx

Answer 8

Ethosuximide guided by EEG

Question 9

Generalized epilepsy with absence &&&& myoclonic

Answer 9

Valproate / lamotrigine

Question 10

Infantile spasm (seizure)

Answer 10

ACTH to supress CRH (proconvulsant neuropeptide)
&&&
Vigabatrin

Question 11

Epilepsy + migraine

Answer 11

Valproate or topiramate

Question 12

Hypoglycemic seizure

Answer 12

Glucose 10% 5ml/Kg For hypoglycemia