USMLEWorld Flashcards by Caitriona McGovern

Status epilepticus (>5 mins) –> what type of brain damage?

Cortical laminar necrosis

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Lambert-Eaton = antibodies against

voltage-gated calcium channels in the presynaptic motor nerve terminal

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Tx Lambert-Eaton

Plasmapheresis and immunosuppressants

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Benign suprasella tumor that usually p/w signs of hypopit, headaches, and bitemporal blindness

craniopharyngioma

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Tx Acute exacerbation of MS

Methylprednisolone (high dose IV steroids)

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Tx acute MS exacerbation that doesn’t respond to steroids

plasma exchange

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first seizure workup

CBC, electrolytes, EKG, urine toxicology, brain CT without contrast

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anticholinergic med sometimes used in the tx of PD, generally in younger pts where tremor is the primary symptom

Trihexyphenidyl

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bilateral trigeminal neuralgia?

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Do CEA in pts with carotid artery stenoses of …

60-99%, esp men > 80%

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tx spinal cord compression

emergency MRI, IV glucocoricoids, neurosurg consult

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spinal shock

absence of reflexes, flaccid paraplegia

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acute onset eye pain, photophobia, and mid-dilated pupil =

glaucoma

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dx acute glacuoma

tonometry

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pronator drift =

UMN dz

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DOC trigeminal neuralgia

Carbamazepine

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first step w/ ? stroke

Non-contrast CT head

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unilateral motor weakness of face, arm, and leg on same side

posterior limb of internal capsule

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contralateral hemiplegia + ipsilateral cranial nerve

vertebrobasilar system supplying brainstem

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areflexic weakness in UE + anesthesia in a cape distribution

syringomyelia

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Rapidly progressive ascending paralysis (over hours), absence of fever and sensory abnormalities, normal CSF

tic-borne paralysis

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ascending symmetrical paralysis over days to weeks, with normal to mildly abnormal sensation, plus autonomic dysfunction, plus albuminocytologic dissociation (high protein with few cells in CSF)

GBS

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Tx GBS

IVIG or plasmapheresis

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T2-weighted MRI shows multifocal ovoid subcortical white matter lesions

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hemorrhage are seen as WHAT on CT

hyperdense (white) areas

infarcts are seen as WHAT on CT

hypodense (black) areas

Prevent vasospasm post SAH with

nimodipine

internuclear opthalmoplegia is a lesion in the

MLF

Tx cluster headache

100% oxygen

Dx MS

MRI

Dx GBS

LP: nl WBC (<10), elevated protein

Dx HSV encephalitis

CSF w/ lymphocytic pleocytosis, inc RBC, elevated protein, HSV PCR +

sites of spontaneous intracranial hemorrhage

basal ganglia, thalamus, pons, cerebellum, lobar

cerebral hemorrhage causes what defects?

motor defects opposite the site of the lesion but gaze deviation toward the side of the lesion

CJD on EEG?

sharp, triphasic, synchronous discharges on EEG

Dx acoustic neuroma

MRI w/ contrast

ipsilateral ataxia, nystagmus, intention tremor, loss of coordination, fall TOWARDs the lesion

cerebellar tumor

type of damage in diabetic mononeuropathy

ischemic

type of nerve fibers damaged in diabetic mononeuropathy

only somatic, not parasympathetic

ptosis and a down and out gaze with normal light and accommodation reflexes

diabetic CNIII neuropathy

SE sinemet

somnolence, confusion, hallucinations, dyskinesia

SE trihexyphenidyl or benztropine

dry mouth, blurred vision, constipation, nausea, urinary retention

SE amantadine

ankle edema and lived reticularis

SE apomorphine, crompocriptine, pramipexole, ropinirole

somnolence, hypotension, confusion, hallucinations

SE entacapone, tolcapone

dyskinesia, hallucinations, confusion, nausea, orthostatic hypotension

SE selegine

insomnia, confusino

mech sinemet

dopamine precursor

mech trihexyphenidyl, benztropine

anticholinergic

mech amantadine

unclear

mech apomorphine, bromocriptine, pramipexole, ropinirole

dopamine agonist

mech entacapone, tolcapone

COMT inhibitor

mech selegiline

MAO B inhibitor

apraxia is due to a lesion in the

dominant supplementary motor cortex

most frequent precipitant of GBS

campylobacter

multiple non-enhancing lesions with no mass effect on CT in HIV+ pt

Progressive multifocal leukoencephalopathy

multiple, spherical ring enhancing lesions in the basal ganglia in HIV+ pt

toxo, not in person on bactrim

solitary, weakly ring-enhancing periventricular lesion in HIV+ pt, +EBV DNA in CSF

primary CNS lymphoma

cortical and subcortical atrophy and secondary ventricular enlargement in HIV+ pt

AIDS dementia complex

occurs many years after antecedent measles infxn. CT shows scarring and atrophy

Subacute sclerosing panencephalitis

ataxia, right-sided facial weakness, and eyes to left

cerebellar hemorrhage

hemisensory loss, homonymous hemianopia, stupor coma, eyes away

putamen hemorrhage

glutatmate inhibitor for ALS

riluzole

SE riluzole

weight loss, elevates liver enzymes, skeletal weakness

ACA stroke

weakness in lower leg > weakness in upper leg

left hemi-neglect

right parietal

DOC RLS

pramipexole (dopamine agonist)

Alpha-2-delta calcium channel ligand

gabapentin

tx pseudotumor

weight reduction and acetazolamide +/- furosemide plus possible shunting of optic nerve sheath fenestration

most common site of median nerve entrapment

wrist

lacunar strokes are due to

microatheroma and lipohyalinosis in small penetrating arteries of the brain

drugs to decrease frequency of exacerbations in pts with relapsing-remitting or secondary progressive MS

beta-interferon or glatiramer acetate

lacunar infart in the posterior limb of the internal capsule

pure motor hemiparesis

stroke in the VPL of the thalamus

pure sensory stroke

lacunar infarction in the anterior limb of the internal capsule

ataxic-hemiparesis

lacunar stroke at the basis pontis

dysarthria-clumsy hand syndrome

what medication decreases the freq of relapse and may slow the long-term progression of relapsing-remitting MS?

interferon-beta

DOC myasthenia gravis

Pyridostigmine (anticholinesterase)

steppage gait = foot drop

neuropathy, L5 radiculopathy, traumatic damage to the common peroneal

loss of pain and temperature over ipsilateral face and contralateral body, ipsilateral bulbar muscle weakness, vestibulocerebellar impairment, and Horner's sydnrome

PICA infarct = Lateral medullary infarct

three types of anti emetics that can be used for migraines

chlorpromazine, prochlorperazine, metoclopramide

hemisensory loss with severe dysesthesia of the affected area

thalamic stroke

unilateral eye pain, redness, and a dilated pupil with poor light response

acute angle closure glaucoma

rupture of bridging veins -->

subdural

rupture of middle meningeal artery

epidural

alterations in alertness, visual hallucinations, extrapyramidal symptoms

Lewy body dementia

most common site of ulnar nerve entrapment

elbow where ulnar nerve lies at the medial epicondylar groove

fasiculations =

LMN