TTR

Question 1

Treatment for ET

Answer 1

Propanolol

DBS

Question 1

what dp you look for on imaging when doing a seizure workup?

between seizures what do you look for of EEG?

Answer 1

Medial Temporal Sclerosis or Cortical Dysplasia or tumor

Look for Inter-Ictal Spike –> spark for seizures

Question 2

considerations in treatment in kids w absent seizures

Answer 2

Cognitive side effects - Topiramate

Bheavioral - Phenobarb, Levetiracetam

weight loss in growing child - topiramate

Valproid acid - Girls in puberty !!!

Question 3

What are causes of worsening ischemic stroke?

Answer 3

Cytotoxic brain edema

Symptomatic Hemorrhagic Transformation

Herniation

Recurrent Ischemic Stroke

Question 4

Childhood Absense DX feature

JME Dx Feature

Answer 4

3 spikes/second - absence

4-6 / sec JME

Question 5

What is Apomorphine?

Answer 5

DA Agonist Rescue Therapy for Parkinson’s Disease Acts right away and can be given when run out of dosing for LDOPA

Question 6

What do you worry about w/ Dermatomyositis?

Answer 6

CANCER!! Also a paraneoplastic syndrome

Question 7

Most common death in people w/ movement disorder?

Answer 7

Pneunomia!! - from dysphagia

Question 8

Treatment for Huntingtons?

Answer 8

Tetrabenazine - DA blocker that suppresses Chorea but not other symptoms

Question 9

Lambert Eaton is what? Associated w what?

Answer 9

SMALL CELL CARCINOMA!!!! Paraneoplastic syndrome

Pre-synaptic Ca channel!!!

Pts are worse in morning and better throughout the day w/ activity

Question 11

Name the Taupathies.

Name the Synucleinopathies

Answer 11

Taupathies:

• AD
• FTD - Picks Disease
• PSP - Tau + Vertical Gaze PAral
• CBD - Tau + Alien Limb Phenomenon
• CTE

Alpha-Synuclein

• PKD
• LBD
• MSA - but Alpha synuclein in Oligodendrocytes in 3 places!!!

Question 12

Symptoms of Tabes Dorsalis?

Answer 12

No sense of proprioception, Charcot Joints, Rhomberg signe

Syphilis causes loss of myelin and axons in neurons of Dorsal column

Lose DTR

Question 13

what disease makes “ moth eaten white matter”?

Answer 13

PML - Oligod inclusions

PLaques are yellow-ish from lipid laden macrophages

Question 14

clues for Guillan Barre

Answer 14

“cytoalbuminogenic” CSF - normal cells but high protein from demyelination

Endoneurial lymphocytes

segmental demyualination

T cells and Macrophages

Question 15

6 yo girl w/ developmental delay, weakness and scoliosis goes in for surgery and dies from malignant hyperthermia - what does she have

Answer 15

Central Core Disease - Type 1 Fiber centers where NADH-reductase in mitochondira not reactive and central core looks pale

AD inheritance of RYR1

Question 16

17 yo girl w/ intractable migraine, ex intolerance, muscle pain and cramping

Left Homonymous hemianospia

Elevated CPK and LACTIC ACIDOSIS

Answer 16

MELAS = Migraine, Episodes that are stroke-like, Lactic Acisosis , Seizures

Ragged Red Fibers

Paracrystalline Parking lot mitochondrial inclusions

Encephalomyopathy, Lactici Acidosis, Stroke-like Episodes

Maternal Interhitance

Heteroplasmy - uneven segregation of mitochrondia w/in cells

Question 17

Treatments for AD

Answer 17

Cholinesterase Inhibitors: Donezapil, Rivastigmine, Galantamine

NMDA Antagonists - Memantine

DO NOT GIVE - AntiCholinergics

• Oxybutinin, Benztropine, Diphenhydramine, PAroxetine, Amitryptiline, Trihedyphenidryl

Question 18

what does neuroimaging of PTSD show?

Answer 18

Increased activity in Amygdala - threat processing

Decreased activity in Medial Prefrontal Cortex - Fear Regulation

Question 19

What is Prazosin? What is it used for?

Answer 19

Prazosin is a Anti-HTN Medicaiton that is an Alpha Adrenergic blocker but is used in PTSD to reduce nightmares

Question 20

Buprenorphine

Buprioprione

Buspirone

What are each of these and how do you use theM

Answer 20

Buprenorphine - Partial Mu Agonist used for opiate addictoin

Buspirone- 5HT1A Partial Agonist used to treat GAD

Bupropione - NDRI antidepressant used to quit smoking