Passmed Flashcards
What drug is used as migraine prophylaxis if a patient has asthma
Topiramate
What drugs can be used as migraine prophylaxis?
- Propranolol
- Topiramate
- Amitriptyline
What are the teratogenic effects of topiramate (CA inhibitor)
Cleft lip/palate
- Cartilage formation
What drugs are used to arrest a migraine?
Triptan (sumitriptan) + [NSAID or paracetmaol]
What is the treatment of acute cluster headache?
O2 + Sumitriptan
What drug is used for prophylaxis of cluster headaches?
Verapamil
What are the symptoms of a pontine hemorrhage?
- Reduced GCS
- Paralysis
- Bilateral pin point pupils
What is the acute emergency management of Myasthenia gravis?
Plasmapheresis + IV immunoglobulin
What nerve supplies the palmer aspect of the thumb and nail bed of the index finger?
Median nerve
What nerve supplies lateral dorsal aspect of the hand (base of the thumb)?
Radial nerve
What nerve supplies sensation to the dorsal and palmar aspect of the pinky?
Ulnar
What is Ramsey Hunt syndrome a complication of?
Shingles
What does Alzheimer’s mainly affect in the brain?
Cortex and hippocampus
What drugs are used to treat Lewy body dementia and Alzheimer’s?
- Acetylcholinesterase inhibitors - donepezil, galantamine and rivastigmine
- Memantine (NMDA / glutamate receptor antagonist)
What Alzheimer’s drug is contraindicated in patients with bradycardia (adverse effects include insomnia)?
Donepezil (acetylcholinesterase inhibitor)
Progressive supranuclear palsy has what symptoms to differentiate from Parkinson’s?
- Early falls
- Possib;y symmetric symtoms
- Possibly early dementia
- Does not have tremor
- Degeneration of frontal lobe
Multi-system atrophy has what additional symptoms which can differentiate it from Parkinson’s?
- Postural hypotension
- No tremor
- Atonic bladder, ED
What are the symptoms of degenerative cervical myelopathy?
- Pain in neck, upper or lower limbs
- Loss of motor function, especially digital dexterity, or impaired gait and imbalance
- Loss of sensory function (numbness)
- Loss of autonomic function (urinary/fecal incontinence, impotence)
- +ve Hoffman’s sign
What may degenerative cervical myelopathy caused by / what will be seen on MRI?
Disc degeneration and ligament hypertrophy, with accompanying cord signal change
What drugs are massively linked to intracranial hypertension?
Tetracyclines
What opioid may be used in neuropathic pain?
Tramadol
What Parkinson’s drug may cause cardiac fibrosis?
Bromocriptine (dopamine receptor agonist)
What may be a contraindication to triptans?
Cerebrovascular disease
Adverse effects of Carbamezipine?
- Diplopia
- Headache, drowziness, ataxia
- SJS
- SIADH, hyponatremia
- Leucopenia and agranulocytosis
- P450 enzyme inducer
What channels does carbamezipine bind to?
Na+ channels incr refractory period
What is the 1st line medication for partial seizures?
Carbamezipine (also used in trigeminal neuralgia and bipolar)