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Internal Med > OME - Neuro > Flashcards

OME - Neuro Flashcards

1
Q

Carbidopa MOA?

A

Prevents conversion of L-dopa —> Dopamine

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3
Q

What makes up fiorcet?

A

BAC
Butalbital
Acetaminophen
caffeine

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4
Q

Pt w/Alzheimer’s disease what goes 1st? Then what?

Treat how?

Die when?

A

Memory, then dementia

AChE-I’s: tacrine or donepezil

5-10 years, bc of PNA

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5
Q

Myoclonic seizure treated with what?

Pt presents how?

A

Valproate

Jerkey muscle

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6
Q

Pt that has vertigo, N/V, hearing sx 4 weeks post URI has what?

Treat how?

A

Labyrinthitis/vestibular neuritis

Steroids

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9
Q

What meds are used to treat young, functional people with Parkinson’s disease?

Names?

A

Dopamine agonists

Ropinirole, Pramipexole

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10
Q

What is the primary sx of MS?

If suspected get what?
See what?

A

Blurry vision/Diplopia from optic neuritis

MRI
Periventricular plaques, multiple lesions, lesions on corpus callous

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12
Q

How to treat M.G. If it is compromising life?

Refractory disease treated how?

A

IVIG or plasmapheresis

Prednisone, azathioprine

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14
Q

What signs indicate death?

A

Rigor Mortis

Lividity (dark blue pooling of venous blood)

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15
Q

What is the confirmatory test for Guillain-Barre?

What etiology>

A

EMG or NCV

Diarrhea illness or flu vaccine

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17
Q

Atonic seizure treated with what?

Pt is like what?

A

Valproate

Floppy head, wears helmet bc they fall over

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18
Q

NPH presents how?

What sx 1st?

Dx how?

Treat how?

A

Wet, wobbly, wacky

Motor

CT or MRI

VP shunt or serial LPs

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20
Q

What are examples of Thrombotic stroke?

A

CAD/PVD
Atherosclerosis
HTN

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21
Q

Pt that has Persistent Vegetative State has what signs?

A

Flat EEG but opens eyes

+ Caloric test

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22
Q

What drugs used for chronic management of MS?

A

IFN
Fingolimod
Glatiramer

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23
Q

What are the 4 classic pts at risk for stroke?

A

All have FND

1) HTN, DM, smoker, Old
2) AFib, valve
3) young women w/neck pain
4) thunderclap HA

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24
Q

Central causes of dizziness include what?

A 
CVA
Post fossa tumor
MS
Meds
Abscess
Migraines
Seizures
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25
Q

Pt that has brain death has what sx?

A

Absent EEG

Absent brain stem reflexes —> No COWS or corneal reflex

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26
Q

What is always preserved in normal aging?

What indicates dementia?

A

Language comprehension and vocab

MMSE score < 22

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27
Q

What does the CSF show in guillon Barre show?

What is contraindicated?

A

Inc Protein, VERY FEW cells

Steroids

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28
Q

What does the EMG of lambert-Eaton look like?

MG?

A

Weak then gets stronger

Reversed

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33
Q

Old pt w/back pain that has point tenderness and vertebral stepoff has what?

A

Compression fracture

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34
Q

Pt has no cerebrum, what does the COWS test show?

A

Eyes move to cold water but NO nystagmus

35
Q

Lambert-Eaton has what?

MOA?

What sx?

A

Abs against Pre-synaptic Ca channels

Inhibits release of ACh-vesicles

Prox muscle weakness that improves with use

36
Q

Pt w/M.G. Has what physical symptoms?

A

Difficulty swallowing, chewing, fatigibility over the course of the day that is relieved by rest

40
Q

Pt in coma, what is the work up?

What is in the coma cocktail?

A

CMP, CT, LP, EEG

B1, D50, O2, Naloxone

41
Q

When can you give tPA?

A

Present w/in 4.5 hours of symptom onset

43
Q

Pt that has pain in back that is symmetric, belt-like and achey, what origin?

Treatment?

If it doesn’t work do what next?

A

MSK pain

NSAID + exercise

XRay then MRI after 4-6 weeks of NSAID trial

45
Q

Spinal stenosis has what sx?

Gets better when?

A

Leg and butt pain

Flexion, exercise

46
Q

Elderly male w/shooting lightning back pain w/no inciting event has what?

Work up?

Tx?

A

Osteophyte

XRay then MRI

Surgery

47
Q

Pt that has vertigo, rotary nystagmus on head movement that is < 1 minute has what?

Caused by what?

A

BPPV

Otolith

50
Q

What is the 1 time that you do NOT need a heparin bridge when giving warfarin?

A

AFib

52
Q

Treatment for meneire’s?

A

Diuretics and low salt diet

57
Q

Treatment for M.G. Is what?

How to diagnose?

Confirm with what?

A

Pyridostigmine (AchE-I)

Serum ABs to ACh-receptor

EMG

58
Q

What sign indicates the brain cortex is dead?

A

Blurring of gray-white matter junction

59
Q

Pt w/lightning or shooting pain down leg that is worse w/hip flexion, movement, cough, or activity has what?

Tx?

A

Disc herniation

Neurosurgery > conservative at 6 months

62
Q

Mask like expressionless face think what?

What other sx?

A

Parkinson’s

TRAP
Tremor - pill rolling resting
Rigidity 
Akathesia 
Parkinson’s like gait
63
Q

Pt that has b/L, vice-like pain that radiates from the front to the back/neck has what?

Tx?

A

Tension HA

NSAID

65
Q

Parkinson’s pt with tremor only, treat how?

A

Benztropine (ACh-R antagonists)

69
Q

What meds to give Parkinson’s pt when levodopa/Carbidopa begins to fail?

A

COMT - Capones

MAOB - selegiline

70
Q

What is trigeminal autonomic cephalgia?

What sx?

Work up how?

Treat how?

Prophylax how?

A

Cluster HA

Rhinorrhea, lacrimation, conjunctival injection, Horner’s

MRI

Oxygen 1st, then sumatriptan

Verapamil

71
Q

How medically treat Migraines?

Prophylax with what?

A

Tristan or Ergot (careful in CAD)

Propranolol, verapamil/diltazem, or valproate/topiramate

72
Q

Pick’s disease presents how?

A

Personality goes 1st, hypersexual/aggressive

74
Q

Loss of pain/temp and motor fx that is B/L has what going on?

A

Ant. Spinal artery occlusion

75
Q

How does vascular dementia present?

Pt has what RFs?

Image with what?

A

Step-wise decline w/each stroke

HTN, DM, CVA

MRI

79
Q

Pt w/suspected cord compression what is 1st step?

Then what?

Then what?

A

Dexamethasone

Xray

MRI (if xray Neg)

81
Q

Pt complains of intermittent low back pressure relieved by farting or shitting has what?

A

Visceral organ pain

83
Q

What are the red flags in a HA pt?

A

New HA > 50
Sudden crescendo HA
Fever + HA
FND

85
Q

What is the mainstay of stroke tx?

If allergy use what?

If 2nd stroke use what?

A

ASA

Clopidogrel

ASA + Dipyridamole

86
Q

Fever + HA + FND = ??

Work up how?

Treat?

A

Abscess

CT

Drain, Abx

87
Q

IIH has what symptoms?

Pt is what?

Imaging looks like what?

Treat how?

A

Inc ICP, papilledema

Women, obese, on OCPs

negative CT, LP w/Inc pressure

Acetazolamide, VP shunt/LPs

88
Q

What are the 3 etiologies of stroke?

A

Ischemic - embolus
Ischemic - thrombosis (plaque rupture)
Hemorrhagic

90
Q

What is the treatment for old (>70) or non functioning pts with Parkinson’s?

Which crosses the BBB?

A

Levodopa-Carbidopa

Levodopa

93
Q

What is the algorithm of aborting a seizure?

A

IV Benzo (lorazepam/Diazepam)
Fosphenytoin
Intubate —> Midazolma and propofol
Phenobarbital

94
Q

Pt that is having a hemorrhagic stroke with high BP give what?

A

IV esmolol

95
Q

What are examples of an emboli stroke?

A

AFib
Carotid Stenosis
IE

97
Q

Describe an intention tremor

A

Absent at rest, gets WORSE the closer it gets to the target

Internal Med (7 decks)

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