Test 7 Reverse Flashcards
(162 cards)
1
Q
- FH2. Obesity3. Sleep apnea4. Head injury5. Femlae6. Analgesic overuse7. Caffiene
A
Risk factors Migraines
2
Q
- Pulsatile, throbbing2. Unilateral3. Last hours to days4. N&V5. Photo & phonophobia6. Cutaneous allodynia
A
Common migraine S/S
3
Q
10-30 min before HA1. Scintillating scotomas -peripheral flashing lights in periphery- pale blind spot that enlarges2. Fortification spectrum -zig zagging lines-teichopsia3. Prodrome of inc. excitability/irritability, fatigue, depression, appetite inc./cravings
A
Aura
4
Q
- Affects basilar artery2. HA3. Vertigo4. Slurred speech5. Impaired coordination 6. NO MOTOR defecits
A
Basilar migraine
5
Q
- Familial2. Paralysis on one side of body3. May persist for 24h w/o HA
A
Hemiplegic migraine
6
Q
- HA 2. Eye pain3. Vomiting4. Ptosis
A
Ophthalmoplegic migraine
7
Q
- Face, jaw & neck tenderness & swelling over carotid artery2. Older Pts3. Normal carotid on US
A
Mirgainous carotidynia
8
Q
- No HA2. Vomiting3. GI pain4. Younger Pts
A
Abdominal migraine
9
Q
- ONLY occur at menses
A
Catamenial migraine
10
Q
- 1st or worse migraine2. New >503. Thunderclap HA4. Abnormal neuro exam5. Rapid onset w/ strenuous activity 6. HA awakens from sleep7. Meningeal signs - vomiting, AMS, personality changes, stiff neck
A
When to get CT w/ migraines
11
Q
- Excedrin migraine & NSAIDS2. TriptansDihydroergotamine
A
Tx migraine
12
Q
- Reglan2. Compazine3. Atarax4. Phenergan
A
Antinausea for migraines
13
Q
Overuse of meds >10days/mo1. Acetaminophen2. Narcotics3. ASA4. NSAIDS5. Ergot alkaloids6. Triptans If overusing triptans, stop & use steroids
A
When do you get rebound HAs & what causes them?
14
Q
- > 2 HAs/wk2. Severe3. Duration >2 daysContinue for 2-3 mo then taper/DC1. Beta blockers2. Tricyclic antidepressants3. Anti-seizure meds (Depakote, Topamax)
A
When do you start prophylactic migraine meds & what do you give?
15
Q
- Men2. 20-40 yo3. FH 4. Tobacco5. Head injury6. Shift work
A
Risk factors Cluster HAs
16
Q
Excruciating, stabbing pain, unilateral, behind eye, jaw, teeth, 15min-3h Must have 1 of:1. Lacrimation2. Ipsilateral nasal discharge3. Ipsilateral flushing/sweating4. Conjunctival redness 5. Horner’s syndrome - ptosis, miosis
A
S/S cluster HA
17
Q
- Triptans2. OxygenProphylaxis:1. Verapamil2. Maybe steroids
A
Tx Cluster HAs
18
Q
Myofascial origin1. Vice-like, gripping band HA2. Forehead-occiput bilat3. Radiates to posterior neck & trapezius 4. Lasts 30mins-7days5. No N/V, photo/phonophobia, pulsatile, not worse w/ activity
A
S/S tension HAs
19
Q
- Stress/anxiety2. Depression3. Overwork4. Lack of sleep5. Posture6. Marital/family dysfunction7. Conversion 8. Malingering
A
Risk factors Tension HAs
20
Q
- Exercise2. Relaxation/Counseling/Yoga3. PT/acupuncture4. NSAIDS, tylenol5. Myofascial trigger point injections6. TCAs/SSRI
A
Tx Tension HAs
21
Q
aka idiopathic intracranial HTN1. Women 15-442. Obese women3. Accutane4. Tetracyclines5. OCs
A
Causes & Risk factors Pseudotumor cerebri
22
Q
- Retro-orbital pain2. Worse w/ eye mvmt3. Throbbing4. Worse in am5. N&V6. Monocular/binocular vision loss7. Pulsatile tinnitus8. Neck pain
A
S/S pseudotumor cerebri
23
Q
- Papilledema2. LP - high opening pressure
A
Dx pseudotumor cerebri
24
Q
- Wt loss2. Low Na diet3. Avoid sulfa meds4. Diuretics5. Steroids maybe6. NSAIDS/TCAs7. LP8. Surgery - optic nerve decompression, CSF shunt
A
Tx pseudotumor cerebri
25
1. Women >40 2. MS1. Washing face2. Brushing teeth3. Chewing4. Cold air
Risk factors & Triggers Trigeminal neuralgia
26
1. R side more common2. Stabbing/electric shock3. Assoc w/ facial spasm4. Attacks last <2 mins, dailry/monthly
S/S trigeminal neuralgia
27
1. Tegretol2. Maybe other anti-seizure meds3. Maybe baclofen, capsaicin, gamma knife, microvascular decompression
Tx trigeminal neuralgia
28
1. Disorientation2. Amnesia3. Confusion - vacant state, delayed answers to questions, poor concentration
S/S concussion
29
1. Ding - confusion, no LOC, sxs 15 min3. LOC
Grading concussions
30
1. Eye opening2. Motor response3. Verbal responseMinor: 13-15Moderate 9-12Severe <8
Glasgow coma scale
31
1. Mental status changes2. LOC >60s3. Pupillary asymmetry4. Vision changes5. Muscle/sensory deficits6. Cerebellar dysfunction - gait/ataxia, finger to nose testing
Red flags of concussion
32
Seizure, neuro deficit, anticoagulants1. Glasgow 60yo5. Basilar skull Fx6. Moderate pretrauma amnseia >15m7. Drug/alcohol intox8. High risk injury
When do you need a CT w/ concussion?
33
1. Battles sign - mastoid process, ecchymosis2. Raccoon eyes3. Hemotympanum4. CSF leakage via nose/ears
S/S basilar skull Fx
34
1. Asymptomatic & med free x24h2. Nonimpact aerobic exercise to inc. HR x24h3. Sport-specific light drills x24h4. Non-contact training drills x24h5. Full contact practice x24h6. Return to play
Steps to return to sports w/ concussions?
35
Bleeding btwn dura & arachnoidTearing of the Bridging veins*1. Confusion2. Slurred speech 3. HA4. Lethargy5. LOC6. N&V7. Weakness
S/S subdural hematoma
36
Small - burr holesLarge - craniotomy to evacuate clots
Tx subdural hematoma
37
Bleeding btwn dura mater & skullFrom trauma tearing of Middle meningeal artery*Biconcave lens on CT1. Initial LOC2. Then lucidTalk & die Tx - surgical evacuation, ligate bleed
S/S & Tx epidural hematoma
38
Bleeding into subarachnoid space - usually due to rupture of cerebral aneurysm 1. Thunderclap HA2. N&V3. Stiff neck4. Confusion5. Seizure6. Xanthochromia
S/S subarachnoid hemorrhage
39
Ischemic
What is the most common type of stroke?
40
Usually develop at branching points of arteries1. Old Black women2. HTN3. Straining4. Cocaine/amphetamines5. Blood thinners6. Alochol
Risk factors of aneurysm
41
Anterior communicating artery
What is the most common site of aneurysm?
42
1. Lower BP2. Monitor cardiac dysrhythmias 3. ICP monitoring4. Normothermia
Management goals of hemorrhagic stroke
43
1. HTN2. Aneurysm3. AV malformation
Causes of hemorrhagic stroke
44
1. Thrombotic - atherosclerosis2. Embolic - carotids & heart3. Lacular infarct
Causes of ischemic stroke
45
1. HTN2. Old Fat lazy blacks3. FH4. CAD5. Smoking6. Hypercholesterolemia/triglycerides7. Aortic arch plaque8. Migraine w/ aura in women >35 that smoke &/or use OCs
Risk factors of ischemic stroke
46
Sudden onset of neuro deficit1. Speech2. Monocular blindness3. Hemiparesis4. Amaurosis fugax Sx resolve w/in 24h
S/S TIA
47
50%Dx w/ ultrasoud or MRA Angiography Gold std but invasive
How much of the carotid is occluded if you can hear a bruit?
48
Occlusion commonly affecting caudate, thalamus & putamen
What are lacunar infarcts?
49
1. Confusion2. Amnesia3. Personality change4. Cognitive changes 5. Contralateral hemiparesis6. Contralateral sensory impairment7. If left = expressive aphasia8. Eyes deviate toward affected side
S/S Anterior cerebral artery occlusion
50
MC embolus1. Contralateral sensory/motor deficits2. Head & eyes deviate towards infarct3. Neglect to affected side4. Dysphagia5. Initially dec. muscle tone then spasticity develops6. Homonymous hemianopsia7. If L - global aphasia then Broca's aphasia
S/S Middle cerebral artery occlusion
51
1. Nystagmus2. Ataxia3. Vertigo 4. Dysphagia5. Dysarthria6. Sensory aphasia7. Alexia
S/S posterior circulation infarct
52
0: No stroke1-4: Minor stroke5-15: Moderate stroke16-20: Mod-severe stroke21-42: Severe stroke
NIH stroke scale
53
1. >182. NIH stroke scale 5 or + 3. <3h since onset of Sxs
When do you use TPA?
54
1. Control BP, glucose, fever2. Cerebal edema - mannitol, hyperventilationhigh risk of depression
Post CVA mgmt
55
Subarachnoid space
Where is the most common site for bacterial meningitis?
56
1. Otitis media2. Sinusitis3. PNA4. Immunocompromised
Where does bacterial meningitis usually come from?
57
Infants - Group B beta-hemolytic strep & enteric gram - bacilliKids - H. flu, N. meningitidis, S. PNAAdults1. Strep pneumo2. N. Meningitidis3. StaphOld people - S. pneumo, E. coli, Klebsiella, listeria
Organisms of bacterial meningitis
58
1. HA2. Stiff neck 3. Fever4. Photophobia 5. Kernig's sign6. Brudzinski's sign 7. Skin rash w/ N. meningococcal (petechial)
S/S Bacterial meningitis
59
1. Vanco + Ceftriaxone 2. Dexamethasone (steroid)If >50 Add ampicillin
Tx bacterial meningitis
60
1. Cerebral edema2. Vasculitis3. Inc. ICP4. Hydrocephalus5. Seizures6. DIC
Complications of bacterial menigitis
61
1. Rifampin2. Cipro3. Ceftriaxone
Post exposure prophylaxis of bacterial menigitis
62
Much more common but less deadly than bacterialKids - Enterovirus, arbovirus, HSV, borrelia burgdoferi, coxsackieAdults1. Enterovirus2. HSV3. Varicella-zoster
Causes of viral menigitis
63
1. Flu-like Sx2. HA3. Fever4. Malaise5. Photophobia6. Meningeal irritation
S/S viral meningitis
64
ImmunocompromisedSpreads from lungsTx1. INH2. Streptomycin3. Rifampin4. Pyrazinamide
Who gets TB meningitis & Tx?
65
Immunocompromised, DMCranial nerve palsiesLP - fungalTx1. Intrathecal amphotericin B
Who gets crytococcal meningitis & Tx?
66
Herpes simplex 1. HA2. Fever3. Mental status changes
What is the MCC of encephalitis?
67
LP - PCR GOLD StdMRI - diffuse edemaTx - acyclovir, steroids maybe High risk of neuro defecits1. Personality disorders/changes2. Dementia3. Aphasia4. Memory problems
Dx & Tx HSV encephalitis
68
Arbovirus Incubation - 2-18 days after mosquito bite, simmer-early autumnWest Nile - severe in elderly
What is the leading cause of epidemic encephalitis?
69
1. Fever2. Malaise3. Fatigue4. Weakness5. HA, eye pain, N&V6. Occipital LAN7. Maculopapular rash8. Conjunctivitis9. Flushing
S/S Arbovirus encephalitis
70
CBC - leukopeniaLP - lymphocytosis, IgM ELISA (+8-21 days after onset)Tx - supportive
Dx & Tx arbovirus encephalitis
71
RetinitisDx - LP - PCRImaging - ring enhancing lesionsTx - ganciclovir & foscarnet
CMV encephalitis in HIV Pts
72
1. Rabies2. Varicella zoster3. EBV4. Influenza5. Lyme6. Cat scratch disease7. Rocky mountain spotted fever
Other causes of encephatlitis
73
1. Chancre - 21-90 days2. Macular rash, 2-8wks3. 1-20 years, CV, neuro
S/S Stages of syphilis
74
Peripheral neuropathy from syphilis Inflammatory process involving dorsal root ganglionS/S1. Lightning pains in abdomen & legs2. Dec. proprioception3. Dec. vibratory sense4. Dec. DTRs5. Argyll-Robinson pupil (accomodate but don't react)
What is Tabes-dorsalis
75
Frontal lobe dementiaEmotional lability & memory issuesPsychosis
What is Syphilic paresis
76
LP - Fluorescent treponemal Ab test FTA-ABSTx - PCN
Dx & Tx syphilis
77
Cerebritis - abx/fungals2 - walled off/organized abscess that begins to expand - need surgery
Stages of brain abscesses
78
Cryptococcus, coccidioides, Histoplaslma, Aspergillosis All Amphotericin B
How to Tx fungal abscesses
79
Toxoplasmosis CT - ring enhancing lesionsDx - IgG & IgM Long term Tx
What is the MCC of cerebral mass lesions in HIV Pts?
80
Caused by JCV common in immunocompromised Demyelinating disorder Dx - LP PCRMRI - demyelinated white matterTx - dec. immunosuppression SIGNIFICANT neuro dysfunction
Progressive Multifocal leukencephalopathy
81
High dose ionizing radiation
What is the only proven cause of brain CA?
82
1. HA2. Seizures3. Cognitive/personality changes4. Focal weakness5. N&V6. Speech difficulty7. Visual changes 8. Papilledema9. CN6 palsy10. Gait disturbance
S/S Brain CA
83
1. Meningioma2. Pituitary adenoma3. Schwannoma4. Craniopharyngioma
Types of benign tumors
84
1. Gliomas2. Astrocytoma3. Glioblastoma4. Oligodendroglioma5. Pineal tumor6. Medulloblastoma
Types of malignant tumors
85
Medulloblastoma
What is the most common kid brain tumor?
86
Meningioma More common in women Arise from the meninges in the arachnoid space CT - dura tail & indentation of brain
What is the most common type of brain tumor?
87
I - BenignII - atypical, neither cancerous nor benign, grow faster & recurIII - anaplastic - malignant & invasive
Grading of meningioma
88
Watchful waitingCraniotomyRadiation - gamma knf=ife
Tx meningioma
89
MEN1 gene 1. Prolactinoma 2. Growth hormone3. ACTH4. Nonfunctioning (compress optic nerve)5. LS/FSH6. TSH
Pituitary adenoma
90
Pituitary tumor Compress optic nerveInc. ICP
Craniopharyngioma
91
C - arrise from cells in Rathke's ductP - arise from cells in anterior lobe
Craniopharyngioma vs. pituitary adenoma
92
Tumor CN VIII, from Schwann cellsBenign but can cause serious complicationsS/S usually unilateral1. Hearing loss2. Tinnitus3. VertigoDx - CTTx - Keyhole surgery
Acoustic neuroma & S/S
93
Astrocytoma I - Pilocytic - benignII - Low grade - benignIII - AnaplasticIV - Glioblastoma multiforme
What is the most common type of glioma & grading?
94
Block CSF flow - hydrocephalus More common in kids Cut it out, XRT
Ependymoma
95
Graded 2-3 Slower growing than astrocytoma Watchful waiting, surgery & CRT High rate of recurrence
Oligodendroglioma
96
NeurofibromatosisMay compress pituitary gland
What is optic nerve glioma assoc w/?
97
Production of melatoninHydrocephalus GradesPineocytoma - benignPeneoblastoma - malignant
Pineal tumor
98
Most common kids tumorFast growing, high gradeTx - surgery, XRT, chemo
Medulloblastoma
99
Lung & breast
What CA most commonly metastasize to the brain?
100
Type I - von Recklinghausen disease1. 6 or + light brown spots (cafe au lait)2. Freckles in unsual places (freckles & groin)3. Colored bumps on iris (Lisch nodules)4. Bony malformations5. Aneurysm, HTN6. Many develop gliomas Type II - usually don't have skin manifestations autosomal dominant
Neurofibromatosis
101
1. >60 2. Prior brain injury3. Insomnia, sleep deprivation4. Dec. visual/auditory function5. Hospitalization6. Polypharmacy7. Poor nutritional status8. Renal/hepatic failure9. Alcoholism10. Infection 11. Hypoxia, CHF, dehydration, MI12. Metabolic imbalances13. CVA, seizures
Risk factors for delirium
102
1. New info difficult to learn & retain2. Complex tasks hard to perform3. Unable to solve simple problems4. Get lost in familiar places5. Difficulty expressing oneself6. Irritable or aggressive behavior
Presentation of dementia
103
1. Cortical - alzheimers, metabolic2. Subcortical - vascular dementia3. Mixed - Parkinson's, Lewy body
Types of dementia
104
1. >652. Female3. FH4. Low edu level5. Head trauma6. Long standing HTN/MI7. ApoE
Risk factors of Alzheimers
105
1. Short term emory loss2. Aphasia3. Apraxia Dx of exclusion CT - cortical atrophy, volume loss medial temporal lobePET - hypometabolism
Dx Alzheimers
106
1. Cholinesterase inhibitors - Aricept, Exelon, Razadyne2. NMDA receptor antagonist - Namenda
Tx Alzheimers
107
1. DM2. CAD3. HTN4. CVA5. Smoking6. Men Alzheimer's meds not effective
Risk factors multi infarct dementia
108
1. Visual hallucinations - auditory, olfactory2. Fluctuations in alertness & attention3. Periods of staring into space4. Men 1. Alzheimers meds2. Parkinson meds3. Maybe anti-psychotics
S/S & Tx dementia w/ lewy bodies
109
Picks disease - 40-70 yo, FH1. Inappropriate behaviors & actions2. Dec. empathy3. Lack of judgement/inhibitions4. Apathy5. Repetitive compulsive behaviors 6. Lack of hygiene 7. Speech & language disorders8. Mvmt disorders9. Lack of awareness of behavioral changes
S/S Frontotemporal lobar degeneration
110
1. SSRIs2. Antipsychotics3. Alzheimers meds
Tx Frontotemporal lobar degeneration
111
Dec. CSF absorption due to scarring/fibrosis of arachnoid villusVentricles become distended & compress the periventricular tissues/vessels Causes - Idiopathic, head injury, SAH, meningitis
Normal pressure hydrocephalus
112
Can't think, can't walk, can't pee MRI - ventriculomegaly LP - Pressure at upper limits of normal Tx - shunt
S/S & Dx Normal Pressure Hydrocephalus
113
1. Weakness2. Sore tongue3. Easy bruising, bleeding gums4. Pallor5. Paresthesias6. Mood changes7. Dementia/memory loss
S/S Vitamin B12 deficiency
114
1. Ataxia2. Confusion3. Opthalmoplegia4. Vertical & horizontal nystagmus5. Short term memory loss6. ConfabulationTx - Thiamine
S/S & Tx Wernickes-Korsakoff's disease
115
Related to Parkinsons & FTLD1. Blurred vision2. Loss of balance3. Stiffness & bradykinesia4. Dysphagia5. Dysarthria6. Emotional labile7. Apathy/depressionParalysis of vertical gaze*** Startled appearance
S/S Progresive supranuclear palsy
116
1. Parkinson's meds for mvmt disorders2. SSRIs3. Alzheimers meds
Tx progressive supranuclear palsy
117
Don't know what caused it
What is a cryptogenic seizure?
118
1. Brain tumor, CVA, trauma2. Electrolyte abnormalities3. Medication overdoses4. Drug withdrawals5. Drugs 6. Infection/fever
Causes of seizures
119
1. Fever >382. Day care attendance3. Developmental delay4. Neonatal nursery >30days5. FH6. Viral infections 7. Vaccines 8. 6mo-5yrs
Risk factors for febrile seizure
120
1. Age <104F)4. 1st degree relative
Risk factors for recurrent febrile seizures
121
5-18 yrsNO aura 1. Vacant, dazed expression2. Pallor3. Last 10 sec max, several times/dayUsually stop by age 20 Tx - Zarontin, Depakote
Absence seizures
122
aka Grand Mal 1. Aura2. Tonic - muscular rigidity 3. Clonic - jerking4. Incontinence5. Tongue biting6. Sudden LOC Tx - Depakote, Dilantin, Tegretol
Generalized tonic clonic seizure S/S & Tx
123
AtonicLOC, head drops, loss of posture
What seizures have "drop attacks?"
124
1. Sensory weirdness2. GI Sxs, flushing3. Jerking limbs, paresthesias4. Hallucinations, deja vu, jamais vu
Simple partial seizures
125
Most common1. LOC2. Temporal lobe - may travel to frontal3. Aura - GI Sxs, sense of fear4. Stare, automatisms5. Lasts 30s-2 min6. May progress to generalized tonic-clonic Tx - Tegretol, DilantinTemporal lobe resection if no improvement w/ therapy
Complex partial seizures
126
Type of partial seizure that only occurs in kids S/S1. Face/cheek twitching2. Drooling3. Difficulty speaking 4. Centrotemporal spikes on EEG5. Often occur only during sleep
Rolandic epilsepy
127
kidsG - laughingD - crying
Gelastic/Dacrystic seizure
128
Life threatening!!Seizure that lasts >30min 2 or + seizures w/o recovery period Risk factors1. Medication2. Alcohol withdrawal3. Drug OD4. Intracranial infections5. Cancer
Status epilepticus
129
1. Lorazepam/diazepam 2. Check glucose
Tx status epilepticus
130
No mammary glands
Can you use valproate or carbamazepine in pregnant ladies?
131
aka psychogenic nonepileptic seizure Common in females, anxiety attacks, PTSD, conversion disorder1. Nonfocal - opposite arm/leg2. Pelvic thrusting3. Head turning side to side4. Eyes closed tight5. Tongue biting limiting top6. Postictal crying7. Memory of the event8. May be triggered by emotional/stressful situations
What are pseudoseizsures?
132
1. Seizure free for 2 years2. Normal EEGNo driving w/in 6 mo from last seizure
When do you stop/taper seizure meds?
133
1. Antipsychotics (Halidol)2. Metoclopramide
Drugs that can cause Parkinsonism
134
1. Rest tremor - Pill rolling 2. Rigidity - cogwheeling & lead pipe resistance 3. Bradykinesia - micrographia, slow, shuffling gait
S/S Parkinsons
135
1. Levodopa/carbidopaside effects - dyskinesias/choreiform mvmts
Tx Parkinsons
136
Onset 20-60 yoAutosomal dominant1. Action tremor - affects hands & head Exacerbated by stress/fatigue/stimulantsAlleviated by alcohol & rest
Benign essential tremor
137
1. Beta-blockers2. Anticonvulsant (Mysoline)
Tx Benign essential tremor
138
Mid-life onset, autosomal dominant1. Failing memory2. Restlessness3. Lack of initiative4. Choreiform mvmts5. Mental decline/dementiaNo Tx
Huntington's chorea
139
1. Women2. Idiopathic3. Iron deficiency anemia4. Pregnancy5. Hypothyroidism6. DM7. Meds - SSRIs8. Caffeine 9. Smoking
Restless legs causes
140
1. Dopamine agonistsMirapex, Requip
Tx Restless legs
141
1. MS2. CVA3. Traumatic brain injury4. Cerebral palsy5. ALS1. Muscle weakness2. Dec. motor control3. Spasticity4. Hyperreflexia5. Babinskis
Upper motor neuron diseases & S/S
142
1. Progressive bulbar palsy2. Bell's palsy3. ALS1. Paralysis2. Atrophy3. Fasciculations4. Loss of reflexes
Lower motor neuron diseases & S/S
143
1. Lower motor neurons, CN2. Progressive paralysis - V, VII, IX, X, XII3. Drooling, chewing, dysphagia, dysarthria4. Progresses to aspiration PNA 1-3yrs
Progressive bulbar palsy
144
Uncontrollable crying or laughing outbursts
Pseudobulbar palsy
145
aka Lou Gehrigs disease 30-60 yo1. Muscle aches/cramps2. Weakness, distal upper limbs & progresses inferiorly3. Dysarthria, dysphagia, spasticity, hyperreflexia4. Muscle fasciculations*
Amyotrophic lateral sclerosis
146
EMGRiluzole
Dx & Tx ALS
147
1. White females2. Richer people3. Northern latitude 4. 15-60yo
Risk factors Multiple sclerosis
148
1. Relapsing remitting2. Secondary progressive3. Primary progressive4. Progressive relapsing
Types of MS
149
Usually unilateralAcuity 20/100Onset hours to days1. Optic nerve pallor2. Pain w/ EOM Have 50% chance of developing MS w/in 5 years
Optic neuritis
150
1. Sensory loss2. Optic neuritis3. Weakness4. Paresthesias 5. Dysarthria6. Dec. pain, vibration & position sense7. Ataxia 8. Horizontal nystagmus9. Inc. DTRs, spasticity, Babinski, ankle clonus
S/S MS
151
1. MRI - spotty, irregular demyelination2. LP - Oligoclonal bands* 3. anti-MOG4. anti-MBP
Dx MS
152
1. Steroids2. Betaseron, Avonex, Rebif, Copaxone3. Symptomatic Tx
Tx MS
153
Progressive symmetrical weaknessUsually from antigen mimicryAcute inflammatory demyelinating polyradiculoneuropathy mostcommon 1. Proximal muscle weakness2. Legs then arms3. Myalgias - shoulder,back, thighs4. Paresthesias5. Dec. DTRs
Guillan Barre S/S
154
1. C. Jejuni2. EBV3. Mycoplasma4. H flu5. CMV6. VZVVaccinations - H1N1, tetanus, hepatitis
Common causes of Guillan Barre
155
LP - Inc. protein, EMGSupportive Tx
Dx & Tx Guillan Barre
156
Chronic form of Guillan Barre Symptoms >8wksDx - LP, EMG, nerve BxTx - steroids, IVIg
Chronic idiopathic demyelinating polyneuropathy
157
Neurmuscular autoimmune disease 1. Proximally asymmetric limb weakness2. CN weakness3. Lid lag, ptosis, diplopia4. Facial weakness, slurred speech5. Easy fatigueabilityOften get thymoma
Myasthenia gravis
158
1. ACh receptor Abs2. Anti-MuSK 3. EMG4. Tensilon blocks
Dx Myasthenia Gravis
159
1. Mestinon2. Immunosuppression3. IVIg4. Thymectomy
Myasthenia Gravis Tx
160
Myasthenia crisis1. Paralysis of respiratory muscles2. Aspiration
Complication of myasthenia gravis
161
Persistent pain in dermatomal distribution1. Age2. Female3. Severe rash, pain at outbreak4. Zoster ophthalmicusTx pain
Risk factors of postherpetic neuralgia
162
Relfex Sympathetic Dystrophy1. Skin color changes2. Temp3. Swelling4. Tremor/mvmt disorder5. Pain6. Changes in nail/hair growthTx - symptomatic & rehab
S/S RSD
