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neuroUworld2 Flashcards

1
Q

what condition is seen in up to half of patients with temporal arteritis

A

polymyalgia rheumatica- present with pain and achiness in the morning; ESR is elevated and sx improve with steroids

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2
Q

migraine prophylaxis

A

amytriptaline

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3
Q

migraine treatment

A

prochlorperazine (IV antiemetic); can be used as monotherapy or in combo with tryptans or NSAIDs

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4
Q

IV antiemetics that can be used for migrains

A

chlorpromazine, prochlorperazine, metoclopramide

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5
Q

definition of heat stroke

A

AMS and temp over 40 degrees C

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6
Q

malignant hyperthermia

A

affects genetically susceptible individuals during anesthesia with halothane and succinylcholine

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7
Q

INO

A

defect in the MLF in the dorsal pontine tegument

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8
Q

destruction of the frontal lobe causes what kind of deviation of the eye

A

ipsilateral

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9
Q

best treatment for schizophrenia

A

clozapine; used for those who have failed other treatments

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10
Q

mood stabilizers for bipolar disorder

A

lamotrigine and lithium

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11
Q

infarcts in mutliple different vascular territories

A

think embolic, though can be thrombotic in like the internal carotid

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12
Q

symptoms in embolic disease

A

abrupt and usually maximal at onset; think of it as the clot gets pushed somewhere and stops there and then gets pushed out of the way somewhat

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13
Q

where are frontal eye lobes?

A

right above brocas, on the lateral side of the frontal lobe; supplied by MCA

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14
Q

right frontal eye field

A

allows you to do conjugate gaze to the left

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15
Q

hyperglycemic nonketotic state

A

happens in diabtetics with glucose over 600; causes AMS and focal neuro deficits

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16
Q

PCKD is assoc with what

A

increased risk of berry aneurysms that can rupture and cause a SAH

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17
Q

typical locations for the plaques in MS

A

periventricular, deep white matter, basal gang, corpus callosum

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18
Q

what does CSF show in MS?

A

so this is counterintuitive bc it is a demyelinating disease like GB, but in MS, the CSF is normal protein and WBCs; you do see elevated IgG and oligoclonal bands

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19
Q

where in the circle of willis are aneurysms most likely to rupture

A

anterior circ

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20
Q

amyloid angiopaty

A

second most common cause of intracerebral hemorrhage; abnormal amyloid deposition in the blood vessels that makes them fragile; typically lobar location

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21
Q

AVM can cause what kind of brain bleed

A

intracerebral or subarachnoid depending on the location

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22
Q

venous sinus thrombosis

A

progressively worsening headache over several days

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23
Q

symptoms of opiate intox

A

parasymp is activated; pinpoint pupils, respiratory depression

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24
Q

naloxone

A

opiate antag used to treat opiate overdose

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25
Q

flumazenil

A

antidote for benzo overdose; antagonist of the GABA receptor

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26
Q

clonidine

A

anti-hypertensive drug that acts on alpha receptors

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27
Q

Meniere’s disease

A

vertigo, tinnitus, ear pain unilateral

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28
Q

BPPV

A

dix hallpike maneuver causes nystagmus

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29
Q

vestibular neuritis

A

severe vertigo but no hearing loss

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30
Q

how to releive sx of BPPV

A

Epley maneuver

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31
Q

increased CSF erythrocytes in HSV encephalitis

A

that’s right

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32
Q

herpes encephalitis

A

can have focal neuro findigns, and will affect the CSF content

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33
Q

pinpoint reactive pupils

A

hemorrhage in the pons

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34
Q

where do hypertensive bleeds usually occur

A

basal gang (putamen); the cerebellum, thalamus, and pons are also common locations

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35
Q

unlike FEF lesions, pontine and thalamic lesions cause eye deviation where

A

away from the lesion

36
Q

anisocoria

A

can be due to uncal herniation; from mass effect on the left compressing the lef CN3 parasymp fibers

37
Q

acute exacerbations of MS are treated with what?

A

IV steroids

38
Q

long term therapy for MS

A

beta interferons or glatirimir acetate

39
Q

arreflexic weakness in the upper extremities and loss of pain and temp with preserved dorsal columns in a cape distrib

A

syringomyelia (cord cavitation)

40
Q

syringobulbia

A

when syringomyelia starts in the C-region of the cord and extends proximally to involve the medulla

41
Q

causes of syringomyelia

A

trauma, inflamm spinal cord disorders, or SC tumors

42
Q

caudal displacement of the cerebellar tonsils through the foramen magnum

A

arnold-chiari malformaiton; neuroimaging may show caudal displacement of the fourth ventricle; often assoc with syringomyelia

43
Q

what CN palsy is sometimes seen in pseudotumor cerebri

A

sixth nerve palsy

44
Q

what can make pseudotumor cerebri worse?

A

vit A or glucocorticoid

45
Q

in what direction does GBS move

A

ascending weakness

46
Q

reflexes and sensory in GBS

A

sensory affected but not as much as motor; reflexes are lost (unlike in MG)

47
Q

absent rectal tone, urinary incontinence, motor and sens loss in the lower extremities

A

cauda equina syndrome

48
Q

MMSE score less than what means ementia

A

24 out of 30

49
Q

CT scans in Alzheimers

A

normal initially, but then some atrophy in the temporal and parietal lobes and hippocampus

50
Q

difference between FTD and alzheimers

A

FTD has onset earlier (40-60yo); FTD initially presents with more personality/social disinhib stuff and AD presents first with more memory stuff

51
Q

treatment for trigeminal neuralgia

A

carbamazepine

52
Q

SE of prolonged carbamazepine

A

aplastic anemia

53
Q

what to do when carbamazepine fails to control trigeminal neuralgia

A

surgical options

54
Q

treatment of herpetic neuralgia

A

acyclovir

55
Q

diabetic neuropathy

A

sensation goes first, and motor is a late finding

56
Q

difference bt conus medullaris and cauda equina

A

conus is the end of the cord and cauda equina is the roots that are hanging down

57
Q

causes of cauda equina syndrome

A

compression of spinal nerve roots from metastatic prostate cancer; disc herniation, spinal stenosis, tumors, infxn, hemorrhage, or injury

58
Q

cauda equina

A

sensory to the saddle region, motor to anal and urethral sphincters, parasymp innerv to the bladder and lower bowel

59
Q

main diff between CE and conus

A

CE is only LMN, whereas conus is both UMN and LMN

60
Q

sensory differences in CE vs conus

A

CE has saddle and conus has perianal

61
Q

motor weakness in CE vs conus

A

CE is assym whereas conus is symm

62
Q

reflexia in conus vs CE

A

conus has hyperreflexia and CE is hypo

63
Q

radiating pain

A

more likely nerve root

64
Q

management of CE and conus

A

steroids and surgery

65
Q

causes of IIH

A

growth hormones, tetracyclines, and excessive vit A

66
Q

homonymous hemianopia- what major vessel is involved

A

MCA or PCA

67
Q

MCA occlusion of non-dominant lobe

A

contralat neglect

68
Q

alexia without agraphia

A

localizes to posterior brain on the dominant side

69
Q

visual hallucinations localize where?

A

calcarine cortex

70
Q

sumatriptan

A

seratonin agonist used for migraines

71
Q

tremors increase at the end of goal directed activities

A

essential tremor

72
Q

treatment for huntington’s chorea

A

haloperidol

73
Q

first step in treatment for pseudotumor cerebri

A

acetazolamide

74
Q

tx of patients in myasthenic crisis

A

endotrach intubation and withdrawal of acetylcholesterase inhib for several days; then ivig and plasmapheresis

75
Q

most common early side effects of levadopa/carbidopa

A

hallucintions, confusion, agitation; the dyskinesias don’t happen until about 5-10 years of treatment

76
Q

side effects of anti-cholinergics

A

urinary retention

77
Q

which gender is more likely to get alzheimers

A

female

78
Q

pick’s disease

A

aka FTD

79
Q

visual spatial defects in Alzheimers versus FTD

A

alzheimers impaired, FTD intact

80
Q

drugs in dementia with lewy bodies

A

worsening with neuroleptic drugs; poor response to dopamine agonists

81
Q

bilaeral trigeminal neuralgia can be seen in what

A

multiple sclerosis

82
Q

prolonged seizures is bad why?

A

can lead to cortical necrosis

83
Q

cerebellar atrophy

A

can be caused by longterm use of antiepileptic drugs or alcohol

84
Q

where do toxo brain lesions typically occur?

A

basal gang and the gray white matter junction junction at the cortex

85
Q

most common cause of brain abscesses in immunocompetent hosts

A

strep and bacteroides (anaerobes)

86
Q

IV drug users endocarditis on what side

A

right must be IV drug user; left can happen to anyone

Neuro (43 decks)

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