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USMLE Neurology > Passmed > Flashcards

Passmed Flashcards

1
Q

What drug is used as migraine prophylaxis if a patient has asthma

A

Topiramate

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2
Q

What drugs can be used as migraine prophylaxis?

A
  • Propranolol
  • Topiramate
  • Amitriptyline
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3
Q

What are the teratogenic effects of topiramate (CA inhibitor)

A

Cleft lip/palate
- Cartilage formation

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4
Q

What drugs are used to arrest a migraine?

A

Triptan (sumitriptan) + [NSAID or paracetmaol]

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5
Q

What is the treatment of acute cluster headache?

A

O2 + Sumitriptan

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6
Q

What drug is used for prophylaxis of cluster headaches?

A

Verapamil

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7
Q

What are the symptoms of a pontine hemorrhage?

A
  • Reduced GCS
  • Paralysis
  • Bilateral pin point pupils
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8
Q

What is the acute emergency management of Myasthenia gravis?

A

Plasmapheresis + IV immunoglobulin

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9
Q

What nerve supplies the palmer aspect of the thumb and nail bed of the index finger?

A

Median nerve

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10
Q

What nerve supplies lateral dorsal aspect of the hand (base of the thumb)?

A

Radial nerve

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11
Q

What nerve supplies sensation to the dorsal and palmar aspect of the pinky?

A

Ulnar

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12
Q

What is Ramsey Hunt syndrome a complication of?

A

Shingles

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13
Q

What does Alzheimer’s mainly affect in the brain?

A

Cortex and hippocampus

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14
Q

What drugs are used to treat Lewy body dementia and Alzheimer’s?

A
  • Acetylcholinesterase inhibitors - donepezil, galantamine and rivastigmine
  • Memantine (NMDA / glutamate receptor antagonist)
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15
Q

What Alzheimer’s drug is contraindicated in patients with bradycardia (adverse effects include insomnia)?

A

Donepezil (acetylcholinesterase inhibitor)

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16
Q

Progressive supranuclear palsy has what symptoms to differentiate from Parkinson’s?

A
  • Early falls
  • Possib;y symmetric symtoms
  • Possibly early dementia
  • Does not have tremor
  • Degeneration of frontal lobe
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17
Q

Multi-system atrophy has what additional symptoms which can differentiate it from Parkinson’s?

A
  • Postural hypotension
  • No tremor
  • Atonic bladder, ED
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18
Q

What are the symptoms of degenerative cervical myelopathy?

A
  • 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
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19
Q

What may degenerative cervical myelopathy caused by / what will be seen on MRI?

A

Disc degeneration and ligament hypertrophy, with accompanying cord signal change

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20
Q

What drugs are massively linked to intracranial hypertension?

A

Tetracyclines

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21
Q

What opioid may be used in neuropathic pain?

A

Tramadol

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22
Q

What Parkinson’s drug may cause cardiac fibrosis?

A

Bromocriptine (dopamine receptor agonist)

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23
Q

What may be a contraindication to triptans?

A

Cerebrovascular disease

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24
Q

Adverse effects of Carbamezipine?

A
  • Diplopia
  • Headache, drowziness, ataxia
  • SJS
  • SIADH, hyponatremia
  • Leucopenia and agranulocytosis
  • P450 enzyme inducer
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25
Q

What channels does carbamezipine bind to?

A

Na+ channels incr refractory period

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26
Q

What is the 1st line medication for partial seizures?

A

Carbamezipine (also used in trigeminal neuralgia and bipolar)

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27
Q

What is the 1st line medication for partial seizures?

A

Carbamazepine (also used in trigeminal neuralgia and bipolar)

28
Q

What drug can be used to treat idiopathic intracranial hypertension?

A

Acetazolamide

29
Q

What does a cerebellar vermis vs cerebellar hemisphere lesion affect?

A
  • Cerebellar vermis = gait ataxia
  • Cerebellar hemisphere = finger-nose ataxia
30
Q

A supracondylar fracture with a subsequent loss of pronation will be caused by damage to what nerve?

31
Q

After 2 doses of IV lorazepam what medication is given to arrest a seizure?

A

IV phenytoin

32
Q

How does exercise affect Lambert-Eaton syndrome vs MG?

A

Lambert Eaton improves after exercise unlike MG which worsens

33
Q

Colle’s fracture is an injury to what nerve?

34
Q

Patient is unable to abduct thumb what nerve is affected?

A

Median (thenar muscles)

35
Q

What are the 4 signs of Cushing’s reflex? (ICH)

A
  • Bradycardia
  • HTN
  • Wide pulse pressure
  • Respiratory depression
36
Q

Motor neuron disease is linked to what type of dementia?

A

Frontotemporal

37
Q

What are oligoclonal bands a sign of?

38
Q

Bilateral vestibular schwannomas are a sign of what syndrome?

39
Q

What drug is given for restless leg syndrome?

A

Ropinirole (dopamine agonist)

40
Q

What type of aneurysm may cause CNIII palsy?

A

PCA berry aneurysm

41
Q

What are the feautures of Neuroleptic malignant syndrome?

A
  • AKI (elevated CPK)
  • Altered mental status
  • Incr temp
  • Lead pipe rigidity
  • Autonomic instability
  • ## Tachycardia
42
Q

What are the causes of Neuroleptic malignant syndrome?

A
  • Dopamine receptor antagonists (antipsychotic)
  • Abrupt cessation of dopamine agonists
43
Q

What anti-epileptic can cause weight gain?

A

Sodium valproate

44
Q

What neurocutaneous syndrome has ash leaf spots and shagreen patches?

A

Tuberous sclerosis

45
Q

What are Jacksonian movements?

A

Clonic movements travelling proximally
- Feature of frontal lobe epilepsy

46
Q

What drugs should be avoided with MG?

A
  • Flouroquinolones (ciprofloxacin)
  • Beta blockers
  • CCBs
  • Botox
  • Muscle relaxants
  • Lithium
  • Magnesium
47
Q

Brain abcess is treated with what?

A

Ceftraixone and metronidazole

48
Q

When are triptans contraindicated?

A

Cardiovascular disease

49
Q

Injury to the surgical neck of the humerus affects what nerve?

A

Axillary nerve

50
Q

Hemangioblastomas are associated with what syndrome?

A

Von Hippel-Lindau

51
Q

Lambert-Eaton syndrome has antiBs against what?

A

Voltage gated calcium channels

52
Q

Ondanestron (anti-emetic in chemo) affects what receptor?

A

5HT-3-receptor antagonist

53
Q

A craniopharyngioma is derived from what tissue?

A

Embryonic pituitary tissue

54
Q

What is Lhermitte’s sign?

A

Flexion of the neck -> tingling of hands
- active inflammation or impingement on a disc, caused by many conditions (SCDC, MS, spondylosis)

55
Q

What is used to treat cerebral oedema in brain tumours?

A

Dexamethasone

56
Q

Phenytoin can cause what anemia?

A

Megaloblastic through altering folate metabolism

57
Q

What vasculitis is associated with polymyalgia rheumatica?

A

Temporal arteritis

58
Q

If the patient is moving around in pain due to a headache is it more likely a migraine or cluster headache?

59
Q

How is charcot-marie tooth disease inherited?

60
Q

What specifically will GBS show on lumbar puncture?

A

High protein

61
Q

Cervical spondylosis has what symptoms?

A
  • Degeneration of cervical spine
  • Neck pain
  • Shooting pains down arm
62
Q

What is the 1st line treatment of MG?

A

Pyridostigmine (blocks activity of acetylcholinesterase)

63
Q

What is the main symptom of open angle glaucoma?

A

Unilateral peripheral visual field loss

64
Q

How does CO2 affect cerebral blood flow?

A

Increased CO2 = increased cerebral blood flow
-> increased ICP

65
Q

How does hyperventilation affect cerebral blood flow and ICP?

A

Decreased CO2 therefore vasonstriction -> Less cerebral blood flow -> decreased ICP

66
Q

How does CO2 affect the blood vessels in the brain?

A

Increased PCO2 causes vasoconstriction

67
Q

Give examples of acetylcholinesterase inhibitors

A
  • Rivastigmine
  • Donepazil
  • Galantamine

USMLE Neurology (19 decks)

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