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MJ- F2 E4- Neuro > Popcorn- LL > Flashcards

Popcorn- LL Flashcards

1
Q

What is the most frequent HA?

A

Tension HA

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2
Q

What is the MC HA leading to a PCP visit?

A

Migraine

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3
Q

What are the 4 primary HA?

A

Migraine, Tension, Trigeminal (cluster), New Daily

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4
Q

Which headache’s ADE include Photophobia, Phonophobia, and Nausea?

A

Migraine (mc in Women)

- triggers = emotional stress, hormones

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5
Q

What HA is associated with trigeminal system dysfunction/ Pain

A

Migraines

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6
Q

whats more common, a migraine w or w/o aura?

A

W/o

Aura = feeling, sxs before a migraine

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7
Q

Are auras common in Menstrual migraines

A

No

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8
Q

What is abortive Tx for Migraines

A

NEAT- Ass
NSAID, Ergotamins, Acetaminophen, Tripans,
AntiemeticSS

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9
Q

Tx for mild -mod Migraines? NAA

A

1st line = NSAID
2nd line = Acetaminophen
3rd line = ASA/Caffiene

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10
Q

Tx for mod - severe Migraines? Try eating opioids -

A

1st line = Triptan
2nd line = ergots
3rd line = opioids

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11
Q

What does botulism block?

A

Substance P

“flip the b to a P”

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12
Q

What is associated with Tension HA?

A

Vice-grip, pericranial myofascial pain

“hands around the head” Bilateral,

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13
Q

Acute Tension HA treatment? NAA

A

1st line: NSAID, Acetaminophen, ASA

* No opioids, butalbital, muscle relaxant*

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14
Q

Chronic Tension HA treatment? T AD AC TLB
TCA (North America)
AD (Mexico Venezuela)
AC (Togo)

These countries all have tension!!

A

TCA (amitriptyline, Nortiptyline) Antidepressant (Mitra + Ven) Anticonvulsants (Topiramate, Gabapentin)
Tizanidine, Lidocane, Botulism

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15
Q

Cluster HA = Many times a day (8), mostly Episodic, Chronic.

What else is Popcorn to Cluster?

A

Cluster: conjuctival injection, lacrimation, Nasal conjection, Rhinorrhea (nose crap)

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16
Q

Cluster tx? “100% Sumatran Coffee,”

A

1st line = 100% O2, for 15 mins, Sumatripan, Corticosteroids.
Prophylatic = Verapamil

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17
Q

Popcorn New Daily headache?

A

1986, Self-limiting, bilateral, (like Migraine = Nausea, photophobia, phonophobia)

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18
Q

Red Flags Headache

A

New onset, (thunderclap = worst HA ever), Preg or post-partum severe HA, wakes patient from sleep, Weight loss, persistent morning headaches

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19
Q

Red Flags Headache

A

AMS, Confusion, Fever, Nuchal rigidity, Papilledema, Tender temporal artery, Severe HTN

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20
Q

Popcorn Pseudotumor Cerebri

A

Chronically ICP, Growth Hormones, Tetracyclines, Abducens palsu, Photopsia, backpain, retrobulbar pain

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21
Q

Pseudotumor Cerebri PE?

“ Obese patients vomit alot”

A

Obesity, Papilledema, Visual fields, Abducens palsy

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22
Q

Pseudotumor Cerebri TX?

“Fast weight loss, No salt or carbs

A

Furosimide, Weight lose, Stop Na, Carbonic anhydrase.

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23
Q

What are overused meds that lead to headache? “Buy others alcohol”

A

Butalbital, Opioids, ASA

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24
Q

SXS of med overdoes HA? “Megan Never Drinks Iced Amoretto”

A

Memory, Nausea, Diff conc., Irritable, Asthenia

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25
Q

Popcorn for Temporalis Arteritis. “Giant Elephants Crunches my Head”

A

Giant, High ESR (100), High dose Corticosterioids (only Tx) inflamed temporal arteries. Old men can’t wear hats

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26
Q

What is Tic Douloureux?

A

Compressed Trigeminal , any normal stim (shaving) causes pain. Sharp electrical pain

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27
Q

How do you dx and tx trigeminal neuraglia?

A

MRA (artery) and vascular decompression

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28
Q

Trigeminal neuraglia red flags? “2,3,4”

A

Bilateral, trigeminal sensory lose, under 40

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29
Q

Charcot - Marie - Tooth disease popcorn

“Country Music TV 1”

A

MC hereditary peripheral neuropathy. CMT1 = Dance (footdrop, pes cavus, hammer toe) No DTRs

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30
Q

Porphyria popcorn

“Aut dominates many harum, Sara, Angela, and Holly are very painful”

A

Autosomal Dom. Metabolic Heme dysorder, HAV porphoria, Sharp pain, agitation, hallucination, extreme pain

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31
Q

DM peripheral neuropathy popcorn.

A

Most common peripheral neuropathy in western world.

Distal, symmetry, neuro cachexia, Painless, Overactive sweat, Ataxia, bad gait, Syncope

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32
Q

DM peripheral Tx?

Dont overthink it

A

Glucose, Foot care, education

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33
Q

Hypothyroidism peripheral popcorn

A

Proximal myopathy = MC is Carpal tunnel

Tx = correct hypothyroidism

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34
Q

GI peripheral popcorn

A

No gluten, need more B12 and Vit E

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35
Q

infectious peripheral popcorn

A

Borrelia (lyme), Deer tick (ixodes dammini)

Facial neuropathy

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36
Q

Vit B12 (cobalamin) peripheral popcorn

A

Pernicious Anemia, Glossitis, absent achiles reflex.

Tx = Vit B12 supplement

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37
Q

Vit B1 (thiamine) peripheral popcorn

A

Beri beri disease
Chronic alcohol abuser, recurrent vomitter
Tx = parenteral thiamine replacement

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38
Q

Carpal Tunnel Synd popcorn

A

Compressed Medial nerve
Office worker, female, obesity, small space risk, Shake out & flick sign,
Thenar Atrophy
TX = NSAID, Surgery

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39
Q

(Ulnar neuropathy) Cubital Tunnel Synd popcorn

A

Pass btw the medial epicondyle and olecrenan. Tinel elbow sign. 5th and half of 4th finger sensory and motor.

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40
Q

(Ulnar neuropathy) Cubital Tunnel Synd Tx?

A

Use elbow pads

Surgical decompression

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41
Q

Radial neuropathy popcorn

A

Wrist drop, weak finger extension, Keep triceps reflex, heal spontaneously.
Tx: Cock-Up wrist or splint: No Surgery

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42
Q

Meralgia Paresthetica (lateral cutaneous femoralneuropathy) Popcorn

A

Numb lateral quad,

Tx: no tight belts, lose wt, NSAIDs

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43
Q

Peroneal neuropathy popcorn

A

Foot drop, L5 radiculopathy.

No leg crossing, heals spontaneously

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44
Q

Bells Palsy Popcorn

A

CN 7 & LMN, associated with HSV, DM, & 3rd trimester.
Unilateral face paralysis (Whole Face)
No corneal light reflex

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45
Q

Bells Palsy vs Stroke

A

“Stroke Spares” the forehead = wrinkles/ bilateral

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46
Q

How can you test for Bells Palsy?

” Garima & Megan love Chololate Blue Bell ice-cream”

A

Godalimuim MRI, Burreli, CT - Bells palsy

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47
Q

How can you tx Bells Palsy? “Eat Vanilla Pudding”

A

Eye protection, Valacyclovir, Prednisone

48
Q

CRPS popcorn

A

Triad: Burning, auto dysfunc, trophic changes = after surgery.
Trauma = trigger
Hot ashy hands

49
Q

CRPS diagnosis & Tx?

“Budapest Bones Need proper and neat sorting”

A

Budapest - clinical diag
Bone density scan
Tx: NSAID, Prednisone, Anticonvulsants, Nortriptylline, SNRIs

50
Q

Tourette’s popcorn

A

Men, ADHD, OCD, Motor and phonic tic,
Echopraxia (mimic), Copropraxia (dirty gesture)
Echolalia, Palilalia (repreat phrase faster and faster)

51
Q

How can you TX Tourette’s? “cartman cant genuinly treat Hankey (christmas poop) better”

A

1st Line = CIBT, Clonidine, Guanfacine.

Tetrabenazine, Haloperidol, Botulinum

52
Q

What time of sleep is regenerative?

A

N3

53
Q

Can you move when your dreaming? When are you dreaming

A

No way, Rem sleep

54
Q

What is the Mallampati scoring? “mallampati is a mouth full”

A

Measures airway . 1 = tonsils, uvula, ext are visable, 4 = only hard palate is visible

55
Q

In general what tests can diag sleep disorders? “Pa Students Hardly Ever”

A

Polysomnography, surface electromyogram, Home sleep test, Epworth Sleepiness scale.

56
Q

Who gets insomnia?

“WOULD” how do you diag?

A

Women, older, un-employeed, Low SES, divorced.

Diag with 3 sxs per week.

57
Q

Sleep tx? “Hey Bitch, Ambien and lunesta makes dolly sleepy!”

A

Hygiene, Benzo, Ambien and lunesta, Melatonin, Doxepin, Suvorexant

58
Q

OSA popcorn

A

Obese, Male, Old, High Mallampati score

59
Q

OSA Diag and Tx? “Polly wants a cracker”

A

Polysomnography

Weight loss, avoid alcohol, CPAP

60
Q

Narcolepsy popcorn

Narcos: killed Orexin, Emptied 15 clips, murdered 8 other

A

Narcos: killed Orexin, Epworth 15+ score, MSLT under 8 mins

61
Q

Tx Narcolepsy? “Pablo murdered many anxious cops fleeing the southern villa”

A

Provigil, modafinil, methyphenidates, amphetamines. Cataplexy = fluoxetine, tricyclics, Sodium oxybate, venlafaxine.

62
Q

Circadian = think shitty schedule

A

Shift workers, grave yard shift

63
Q

Parasomnia = N3

“paranatural phenom”

A

NREM = menses, sleep deprivation, emotional, Sleep terrors: tachy, sweaty, fear!

64
Q

what are the 3 patheways of CNS infection?

A

Blood, retrograde up a neuronal path, direct contiguous

65
Q

What does an LP measure? CC GG VP

A

Cell, Culture, glucose, gram, protein, viral

66
Q

When should you not do an LP?

A

Cushings triad (repsiratory depression, Brady, HTN)

Mass, skin infection, severe coag

67
Q

Is a little blood in vial 1 of 4 ok?

A

Yes, if theres blood in all 4 = subarachnoid hemorrhage, intracranial hemorrage, cerebral infacrt.

68
Q

Encephalopathy popcorn

A

VIRAL»Bacterial, Paraneoplastic.

No sign of meningial irritation (photophobia, nuchal rigidity)

69
Q

What can you see in a the PE for Encephalopathy?

A

Fundoscope: Papilledema, Retinitis

Skin = alot of shit

70
Q

How to diag Encephalopathy?

“Look sick? Cancel the STEPS

A

1st = MRI, then CT.

If patient looks sick, do a CT and Serum electrolytes, Thoat swab, sputum EEG, Peripheral smear, & Sputum culture.

71
Q

Encephalopathy hyponatremia is caused by

A

Ricketssia and SIADH

* on the test*

72
Q

How can you stablize an encephalitis patient? VENMO

A

Ventilate,
ET tube
n’
MOnitor electrolites

73
Q

Empiric Encephalopathy treatment?
* on the test*
A! Da Bitch Got Incarcerated:

A

Acyclovire 10 mg for 8 hours.

DVT, Bacterial, GI, Increased ICP

74
Q

Meningitis Popcorn.

“Fondling Noren produces nasty favors”

A

Fever, photophobia, HA/N/V, neck stiffness,

75
Q

Bacterial meningities POPCORN

A 
Adults = penetrating injury
Kids = brith canal/placenta
Rapid bact growth!!
Neonate = S. agalactiaa (lactating)
Babies = S. penumo
Teens = n. meningitides
Adults = s. penumo
76
Q

How can you diag Bact Meningities?

“Big ass lips can cause chaos”

A

Blood culture x2
Antibiotics
LP
CBC, CMP, COags

77
Q

Bacterial meningitis empiric tx?

“Another 50 Cent Victim”

A

Cetf/cefo + Vanco+ Amp (50)

+ acyclovir

78
Q 
Meningitis tx for
S. pneumo
N. meningitides
Listeria
H. Flu
A

S. pneumo - Vanco + Cephalo
N. meningitides - cephalo
Listeria - Amp/ Pen G
H. Flu - Cephalo

79
Q

Is Bact meningitis bad?

A

Emergency, untreated = 100% fatal

80
Q

Can you prevent Bact Meningitis?

* on the test*

A

Yes!
<1 month = Rif or Cirpo
>15 year = Ceftriaxone

Neonates (S. pneumo) = Quad meningitis A vax 
- Menactra (9months to 55yo)
- Menveo (2 months to 55Yo)
Meningitis B vas
- Trumenba
-Bexsero
81
Q

Whats Aseptic Meningtitis

TX (Install the NBA)

A

meningitis w/o infection - cancer, meds, SLE

-TX = Bactrim, NSAIDs, Chemo (Azathioprine, Infliximab

82
Q

What is drug resistant epilepsy?

A

seizure occur with 2 medications (15% of pts)

83
Q

How does epilepsy kill you?

A

SUDEP

sudden unexpected death in Epilepsy

84
Q

FOCAL siezures popcorn

A

Motor (shake), Aware, Hemisphere that spreads

85
Q

GENERAL siezures

A

From both sides of the brain

86
Q

Associations

Temporal lobe
Frontal lobe
Juvenial myoclonic
Lennox-Gastaut

A

Temporal lobe - MC, good outcome
Frontal lobe - less favorable
Juvenial myoclonic - lifelong, genetics
Lennox-Gastaut - drug resistant, behavioral decline

87
Q

MC causes of Epilepsy?

A

Structural (stroke, head trauma/tumor)

Infection - encephalitis

88
Q

When do you do an MRI

What about CTs

A

MRI = any new onset

CT = if MRI isn’t available

89
Q

What do you look for in an EEG?

A

Epileptiform btw seizures

90
Q

When do you treat Seizures?

“USE NOS”

A

Unprovoked seizures,
Sig brain abnormality,
Epileptiform on EEG

Nocturnal seizures
Old
Social factors (driving, work)

91
Q 
ADE of drugs
Wt gain
Wt lose
Kidney stones
Hyponatremia
Ostepenia
Cognition
Mood
A 
Wt gain - Valproate
Wt lose - topiramate, zonisamide
Kidney stones - topiramate, zonisamide
Hyponatremia - Carba, oxcarba, zonisamide
Ostepenia - Valproate
Cognition - All
Mood - All
92
Q

What drugs increase the risk of seizures in epileptic patients?
“Better make a clean dermal cut”

A

Buproprion, maprotile, ampxapine, clomipramine, demerol, cipro

93
Q

Seizures: enzyme inducers cause

A

Birth control to fail

valproate = never use in pregs

94
Q

When is surgery needed for epileptic pts?

A

Drug resistant, MC is a temporal lobe resection

95
Q

What are the three Epileptic diets? (LAKE)

A

Keto, low glycemic, Atkins

96
Q

What is status epilepticus

A

cont. seizure > 5 mins w/o return to baseline

97
Q

status epilepticus tx?

Ben loves valleries Pu, but denies rectal

A

Benzo, Levetiracetam, valproate, phenytoin, diacetam PR

98
Q

If a stroke occurs on the left side of the brain what side of the body is affected?

A

Right (cross over)

99
Q

CN 7 vs stroke on facial paralysis?

A

Stroke spares forehead,

CN 7 paralizes all (seven continents)

100
Q

85% of strokes are

A

Ischemic

101
Q

What does the Cincinnati Pre-hospital stroke scale measure?

A

Face droop
Arm drift
Slurred speech

102
Q

What can mimic a stroke

A

Hypoglycemia (<50)

103
Q

What is an ischemic stroke?

A

Blockage (Thrombotic = atherosclerosis - large vessels) (Embolic = Left side or Artery to Artery stroke - Lacunar = smaller vessels)

104
Q

AIS vs TIA

A

AIS
- sudden, stop blood perfusion, > 24 hrs, permanent damage

TIA (no acure infarct)
- Sudden, transient lack of blood, <24 hrs, < 1 hr, No permanent damage

105
Q

How can you risk stratify stroke risk

ABCD2 - 2 day risk

A

Age, BP >140/90, Clin sxs, Duration >60, DM

106
Q

What is the penumbra

A

zone of reversible tissue ischemia with a necrotic core

107
Q

Window to give tPA for stroke

A

3-4.5 hours

108
Q

FAST score for stroke

A

90% sensative if you all cincinnati shit

109
Q 
AIS ED stroke triage steps?
triage
Medical care
CT and labs
Tx
A

triage - tPA
Medical care - O2, BP, Wt, EKG CT
CT and labs- CT, ED
Tx - tPA, HTN, H/N/V

110
Q

What is MERCI

A

Cork-screw app that removes clots

111
Q

What is the main cause of Hemorrhagic Stroke

A

HTN&raquo_space; ICP, rupture blood vessel

112
Q

Arteriovenous malformations tx

A

Coil embolization, clip

113
Q

Glasgow coma scale

A 
3 = worst
15 = normal
114
Q

CNS herniation

  • subfalcine
  • Transtentorial
  • tonsillar
A
  • subfalcine - contra leg weakness
  • Transtentorial - CN III shit
  • tonsillar - obtundation
115
Q

Subarachnoid Hemorrhage Tx

A

Stool softener, cough suppressants

116
Q

Tx fore post stroke depression

A

SSRI

MJ- F2 E4- Neuro (19 decks)

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