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Neurology > Uworld Neuro > Flashcards

Uworld Neuro Flashcards

1
Q

psychosis tx

A

-2nd generation antipsychotics
(preferred due to lower risk of extrapyramidal SE or tar dive dyskinesia)

  • 1st gen. antipsychotics
  • benzodiazepines (tx agitation)
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2
Q

2nd generation antipsychotics

A
  • risperidone
  • olanzapine
  • quetiapine
  • aripiprazole
  • ziprasidone
  • paliperidone
  • clozapine
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3
Q

clozapine

A
  • 2nd gen. antipsychotics
  • gold standard tx-resistant schizophrenia
  • SE: agranulocytosis
  • used for pts who have failed 2 trials of antipsychotics
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4
Q

lithium

A

= mood stabilizer

  • tx bipolar disorder
  • monitor blood levels to prevent toxicity
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5
Q

febrile seizure px

A
  • age: 6 months - 6 YO
  • temp > 100.4F
  • no hx of afebrile seizures, no CNS infection, no metabolic cause

-does NOT cause brain injury

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6
Q

febrile seizure tx

A
  • reassurance

- abortive therapy only if seizure >5 minutes

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7
Q

neurofibromatosis type 1 px

A

cafe-au-lair spots + macrocephaly + feeding problems + short stature + learning disabilities

-fibromas, neurofibromas, tumors

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8
Q

neurofibromatosis type 2 px

A

bilateral acoustic neuromas + cataracts

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9
Q
  • tearing bridging veins
  • ruptured middle meningeal artery
  • hypertensive hemorrhage
  • ruptured aneurysm
A
  • subdural hematoma (crescent)
  • epidural hematoma (lens)
  • intracerebral hemorrhage (putamen, thalamus)
  • subarachnoid hemorrhage
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10
Q

thalamic stroke

Dejerine-Roussy syndrome

A
  • VPL stroke
  • contralateral sensory loss
  • transient hemiparesis, athetosis
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11
Q

cavernous sinus thrombosis cause, px, tx

A

-cause: uncontrolled infection of skin/ sinuses/ orbit that spreads to cavernous sinus

-px: headache, intracranial HTN, periorbital edema, Cr III, IV, V, VI deficits
(travel thru cavernous sinus)

-tx: IV antibiotics (to prevent herniation)

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12
Q

primodone use, SE

A
  • seizures, benign essential tremors

- acute intermittent porphyria –> abdominal pain, confusion, headaches, hallucinations, dizziness

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13
Q

effects of anti-dopinergic drugs on pathways:

  • mesolimbic
  • nigrostriatal
  • tuberoinfundibular
A
  • antipsychotic effects
  • extrapyramidal symptoms (acute dystonia, akathisia, parkinsonism)
  • hyperprolactinemia –> amenorrhea, gynecomastia, dec libido
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14
Q

Cushing’s reflex

A

HTN + bradycardia + respiratory depression

-indicates elevated intracranial pressure

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15
Q

uncal herniation symptoms?

A
  • ipsilateral hemiparesis (contralateral crus cerebri compression)
  • ipsilateral Cr III palsy
  • contralateral homonymous hemianopsia (ipsilateral PCA compression)
  • coma (reticular formation compression)
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16
Q

anticholinergic excess symptoms? causes?

A

“red as beet, dry as bone, hot as a hare, blind as a bat, mad as a hatter, full as a flask”

  • flushing
  • anhidrosis/ dry mouth
  • hyperthermia
  • mydriasis/ vision changes
  • delirium/ confusion
  • urinary retention/ constipation

-excess benztropine, trihexyphenidyl

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17
Q

serotonin syndrome symptoms?

A
  • agitation
  • confusion
  • tachycardia
  • muscle rigidity
  • seizures

-selegiline + SSRI or TCA

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18
Q

uses for propranolol

A
  • benign essential tremor

- portal HTN

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19
Q

preeclampsia tx?

A

magnesium sulfate

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20
Q

Broca’s area

A
  • posterior inferior frontal gyrus

- expressive aphasia

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21
Q

foot drop cause, px

A
  • peripheral neuropathy
  • common perineal nerve injury
  • radiculopathy (L4-S2)
  • inability to dorsiflex the foot
  • patients overly flex the hip & knee to move foot forward
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22
Q

brain death definition

A
  • irreversible cessation of brain activities
  • absent cortical & brainstem functions

-spinal cord can still function –> DTR present

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23
Q

CT px of:

  • progressive multifocal leukoencephalopathy
  • cerebral toxoplasmosis
  • CNS lymphoma
A
  • non-enhancing lesions with no mass effect
  • ring-enhancing mass lesion
  • weakly ring-enhacing lesion; periventricular
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24
Q

positive drop arm test =

A

rotator cuff tear

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25
Q

botulism px

A

-descending flaccid paralysis
-constipation & drooling
(autonomic dysfunction)
-bilateral bulbar palsies: ptosis, sluggish pupillary reflex, poor suck & gag reflexes

26
Q

botulism tx?

infant vs foodbourne

A
  • human derived botulism Ig

- equine-derived botulism antitoxin

27
Q

peripheral vs central facial palsy

A

-peripheral = Bell’s palsy = upper AND lower facial weakness
-below pons
(can’t raise eyebrows, close eyes, drooping mouth, loss of nasolabial fold)

-central –> forehead muscle sparing; intracranial lesions (ischemia or tumor)

28
Q

glucocorticoid-induced myopathy px

A
  • painless muscle weakness & atrophy

- normal ESR & CK

29
Q

polymyalgia rheumatica px

A
  • muscle pain & stiffness
  • seen in 50% of temporal arteritis pts
  • responds to glucocorticoids
  • inc ESR, normal CK
30
Q

inflammatory myopathies px

A
  • muscle pain & tenderness
  • proximal muscle weakness
  • skin rash
  • inc ESR & CK
31
Q

statin-induced myopathy

A
  • prominent muscle pain & tenderness
  • rare rhabdo
  • normal ESR, inc CK
32
Q

hypothyroid myopathy

A
  • muscle pain, cramps, weakness
  • delayed DTRs
  • rare rhabdo
  • normal ESR, inc CK
33
Q

Wernicke-Korsakoff syndrome cause, px

A
  • thiamine (B1) deficiency
  • ophthalmoplegia + dementia + ataxia
  • irreversible amnesia, confabulation, apathy
34
Q

cauda equina syndrome px

A
  • unilateral, severe radiculopathy
  • saddle anesthesia
  • asymmetric motor weakness
  • hyporeflexia
  • late onset bowel/bladder dysfunction
35
Q

conus medullaris syndrome px

A
  • sunden onset severe back pain
  • perianal anesthesia
  • symmetric motor weakness
  • hyperreflexia
  • early onset bowel/bladder dysfunction
36
Q

2 types of rigidity?

A
  • uniform = lead pipe

- oscillating = cogwheel

37
Q

Parkinson’s dx

A
  • clinical dx
  • 2 of 3 symptoms: resting tremor, rigidity, bradykinesia

-resting tremor may start in one hand and move to other

38
Q

tx for agitation in elderly?

A

low dose haloperidol

-benzodiazepines are contraindicated in elderly due to risk of withdrawal, dependence, etc

39
Q

intracranial HTN px

A

> 20 mmHG

  • headache
  • visual changes
  • n/v, cr nerve deficits, confusion
  • Cushing’s reflex = HTN + bradycardia
40
Q

diabetic Cr III neuropathy cause, px

A

-ischemia

  • ptosis
  • “down and out” gaze
  • normal light & accommodation reflex

-only somatic fibers are affected; parasympathetic fibers are spared

41
Q

nerve compression of Cr III px

A

-somatic & parasympathetic fibers affected –> ptosis, “down & out” gaze, pupillary reflex deficit

42
Q

basal ganglia hemorrhage px

A
  • hemiplegia
  • hemi-sensory loss
  • homonymous hemianopsia
  • stupor, coma
43
Q

cerebellum hemorrhage px

A
  • facial weakness
  • nystagmus
  • ataxia
  • NO hemiparesis
  • stupor/coma from brainstem herniation
44
Q

thalamus hemorrhage px

A
  • hemiparesis
  • hemi-sensory loss
  • upgaze palsy
  • nonreactive miotic pupils
  • eyes deviate AWAY from lesion
45
Q

cerebral lobe hemorrhage px

A
  • contralateral homonymous hemianopsia, paresis

- eyes deviate TOWARD lesion

46
Q

pons hemorrhage px

A
  • deep coma
  • total paralysis within minutes of hemorrhage
  • pinpoint reactive pupils
  • decerebrate rigidity
47
Q

status epileptics can lead to?

seizure >5 minutes

A

cortical laminar necrosis –> persistent neurological deficits & recurrent seizures

48
Q

does hyperventilation stimulate complex partial seizures or absence seizures?
(during EEG)

A

absence

49
Q

Lennox-Gastaut syndrome

A
  • childhood onset epilepsy
  • multiple types of seizures
  • impaired cognitive function
50
Q

typical vs atypical absence seizures?

A

atypical lasts longer & EEG frequency <2.5Hz

51
Q

Todd’s paralysis

A

transient focal neurologic deficit following a seizure

52
Q

disease onset of frontotemporal dementia vs Alzheimer’s?

A

40-60 YO
vs
>60 YO

53
Q

hemi-neglect syndrome cause?

A

stroke to non-dominant parietal lobe

54
Q

major risk factor for stroke?

A

HTN

-smoking, DB (lesser risk)

55
Q

opiate overdose tx?

A

naloxone

= opiate antagonist; reverses respiratory suppression

56
Q

benzodiazepine overdose tx?

A

flumazenil

57
Q

tick-bourne paralysis px, cause, tx

A

-progressive ascending paralysis
-occurs over hours to
days
-sensation & autonomic function, CSF normal

  • cause: neurotoxin release by tick
  • tx: tick removal
58
Q

acute glaucoma px, dx

A
  • sudden onset eye pain/ photophobia/ mid-dilated pupil

- ocular tonometry

59
Q

SE of SAH

A

-cerebral salt-wasting syndrome –> hypoNa

60
Q

cerebral salt-wasting syndrome?

A

inc ADH –> inc ANP/BNP –> cerebral salt-wasting –> hypoNa

Neurology (10 decks)

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