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Step 2 Big Time Study Deck > Week 5 > Flashcards

Week 5 Flashcards

1
Q

what drugs dilate the eye

A

alpha angonists! like epinephrine etc.

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2
Q

what drugs constrict the pupil

A

any parasympathetic activators (pilocarpine)

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3
Q

describe parinaud syndrome

A

vertical gaze palsy, nystagmus, pupils that accomodate but do not react, eyelid retraction when looking up

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4
Q

what is the most common malignant brain tumor in children

A

medulloblastoma

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5
Q

how do meningiomas appear on T2 weighted MRI

A

hyperintense bordered well circumbscribed lesion

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6
Q

what is the order you give glucose and thiamine for wernicke encephalopathy

A

thiamine AND THEN glucose

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7
Q

what is commonly associated with paraplegic people

A

decubitous (positional) ulcers, treat with wound care and surgical debriedement if severe

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8
Q

what is neurogenic shock

A

this is when you have loss of all sympathetic tone and you have no sympathetic drive. So you have low HR, low BP, low RR, and flushed skin

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9
Q

what do you use to treat AIP exacerbations

A

hemin, glucose is for minor attacks

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10
Q

what is cabergoline

A

dopamine receptor agonists used for prolactinoma

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11
Q

manifestations of neuroleptic malignant syndrome

A

rigidity, high temp, hyporefflexia, leukocytosis, elevated creatinine kinase, diaphoresis

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12
Q

signs of ICH due to cerebral amyloid angiopathy on imaging

A

CAA can cause silent micro bleeds so you will see past hemorrhages.

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13
Q

besides bracing, what else do you do for treatment of carpal tunnel syndrome

A

corticosteroid injections

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14
Q

how do you treat SIADH

A

give hypertonic saline

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15
Q

in H flu meningitis what is a big complication

A

hearing loss!

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16
Q

what kind of bacteria is h flu

A

gram neg rod

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17
Q

what is a common cause of syncope in older adults that also have shortness of breath

A

aortic stenosis

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18
Q

what is first line treatment of restless leg syndrome

A

gabapentin! ropinerole is resevered for refractory RLS

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19
Q

for AIP what are common drugs that cause exacerbations

A

anything that induces CYP 450 enzyme synthesis because these enzymes contain heme products and so it depletes the heme

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20
Q

what drugs to you give for tardive dyskinesia

A

benztropine or trihexyphenidyl

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21
Q

how do you treat internal carotid dissection

A

short term heparin

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22
Q

CSF in a GBS patient

A

normal glucose, elevated protein, no cells

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23
Q

when can you not give propanolol

A

patients with asthma

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24
Q

when can hemorrhagic conversion occur

A

within the first 24-48 hours

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25
what is a common lesion in patients who wear lots of high heels
intermetatarsal neuroma
26
what is otosclerosis
this is when you have fixation of the stapes to the oval windo which causes conductive hearing loss
27
signs of otosclerosis
hearing better in loud environments, bilateral negative Rinne test
28
C5 sensory, motor and reflex changes
senory: deltoid // motor: deltoid and biceps // reflex: loss of biceps
29
C6 sensory, motor and reflex changes
sensory: radial arm and thumb // motor: biceps and brachioradialis // reflex: biceps
30
C7 sensory, motor and reflex changes
sensory: middle finger // motor: radial nerve (triceps, wrirst extensorys and flexors, pec major) // reflex: loss triceps
31
C8 sensory, motor and reflex changes
sensory: pinky and ring finger
32
L3 sensory, motor and reflex changes
sensory: n/a // motor: quads // reflex: patellar
33
L4 sensory, motor and reflex changes
sensory: medial leg below knee and medial malleolus // motor: quads and anterior tibial // reflex: patellra
34
L5 sensory, motor and reflex changes
sensory: dorsum of foot to great toe // motor: hallucis longus, extensor digitorum longus
35
S1 sensory, motor and reflex changes
sensory: lateral foot // motor: plantar flexion, toe flexion // decreased achilles reflex
36
how do you diagnose a plexopathy
EMG
37
what does Right sided heart failure look like
peripheral edema!!!
38
how do you differentiate between a craniopharngioma vs. pit adenoma on imaging
a cranio. will be calcified on imaging
39
If someone is an IV drug user and they have back pain what is likely happening
they likely have an abcess so they need antibiotics
40
what is happening in spinal muscular atrophy
destruction of the anterior horn cells I.e. lower motor neurons
41
what is conversion disorder
neurological symptoms in times of stress that arent caused by any structural deficits
42
what medication can you use for menieres disease
hydrachlorothiazide
43
what type of brain bleed do people have that have a longer period without any major neurological deficits
subdural hematoma
44
when is carpal tunnel syndrome worse and what is it relieved by
worse at night relieved by shaking hands
45
if a patient has referred pain to the butt where is the lesion
lumbar nerve root
46
describe risperidone
it is a second gen antipsychotic and has greater D2 antagonism than most antipsychotics so it can exacerbate parkinsonism in parkinsons patients
47
what is a functional tremor
tremor that is exacerbated by stress and can stop and start
48
how do you treat catatonia
you give a benzo
49
is forced vital capacity decreased in an ALS patient
yes its decreased
50
signs of myotonic dystrophy in an adult
myotonia and weakness, excessive daytime sleepiness, pharyngeal weakness, hypogonadism, frontal balding etc.
51
myotonic dystrophy inheritance
autosomal dominant CTG repeat disorder
52
signs of frontotemporal dementia
early personality changes, and hyperorality, no focal neurological deficits
53
what is cranial nerve III palsy look like
pupil is abducted so its going out of the head because it cannot be adducted
54
how do you treat migraines in children
NSAIDS
55
if a patient lesions the left hypoglossal nerve which way does the tongue go
it goes to the left! I.e. same side of the lesion
56
where are neuroblastomas often located
in the cervical spinal cord
57
if the patient has a stroke in the pons what kind of facial nerve palsy will be seen
lower motor neuron! so whole side of the face is paralyzed
58
signs of cervical radiculopathy
radiating pain to the shoulder or arm, pain when turning head, motor/sensory/dermatomal findings
59
causes of cervical radiculopathy
spondylosis (elderly) which is osteophyte formation
60
glucose level that causes hyperosmolar hyperglycemia
>600
61
what can give you toxic neuropathy
alcohol, medications, heavy metals
62
what is in the CSF if someone has CJD
14-3-3 protein titer
63
signs of wound botulism
facial weakness/neck weakness, longer time till onset (toxin is not preformed)
64
if someone has carotid artery stenosis do you have to put them on antiplatelet and statin
yes
65
signs of carotid artery dissection
hx of trauma to the neck, hemiplegia, aphasia, neck pain, headache
66
what can diminish sensitivity of the MMSE
education level
67
what do you do for treatment of tourrettes
often just counseling and watchful waiting
68
are cafe au lait spots hypo or hyper pigmented
they are hyperpigmented
69
what is an electrolyte imbalance seen in AIP vs. lead toxicity
AIP will show hyponatremia too
70
treatment for intracerebral hemorrhage
urgent surgical decompression
71
signs of central hernation
decorticate --> decerebrate posturing, bilateral mid sized fixed pupils,
72
signs of hyperorality
putting things in the mouth (cigarettes common)
73
what drug do you give to dementia patients
anticholinergic like donepezil, rivastigmine, galantamine
74
pharmacologic management for FTD
SSRIs!
75
where is the median nerve trapped if the patient only has sensory loss in ther finger tips
carpal tunnel
76
signs of bilirubin neurotoxicity in a newborn
choreathetoid movements, hypotonia, lethargy, sensorineuronal hearing loss, upward gaze palsy
77
causes of bilirubin neurotoxicity
forceps delivery, prematurity, hemolysis, exclusive breatfeeding
78
what is the cause of bilateral trigeminal neurlagiaI
MS!
79
what predisposes you to compression neuropathies
diabetes, pregnancy, obesity, etc.
80
signs of ulnar nerve entrapment at the elboy
paresthesias and pain of the firth and fourth digit, weakness and atrophy of FDI ADM
81
signs of radial nerve compression
triceps weakness, wrist drop, dorsal aspect of hand sensory loss
82
etiology of compression of the radial nerve
spiral groove fracture, compression at axilla. triceps spared in spiral groove fracture
83
femoral neuropathy signs
leg weakness with standing and walking, anterior thigh pain, diminished patellar reflex
84
femoral neuropathy etiology
surgery, childbirth, DM
85
peroneal neuropathy signs
foot drop, minimal sensory complaints
86
is there pain associated with GBS?
yes! typically back or leg pain
87
CIDP muscle weakness
symmetrical and upper and lower limbs
88
signs of hyperkalemic periodic paralysis
episodes fo generalized weakness lasting mintues to hours
89
signs of hypokalemic paralysis
episodes of generalized weakness lasting hours to days
90
signs of myotonic dystrophy
distal muscle weakness and stiffness, myotonia, systemic features
91
how do you treat a myasthenic crisis
intubation, IVIG, plasmapharesis
92
signs of dermatomyositis
symmetric proximal limb weakness, dysphagia, myalgias, arthralgias, interstitial lung disease, face rash
93
valproate use
first line for generalized tonic clonic seizures, can be used for absence if needed too
94
valproate AE
teratogenic, tremor, alopecia, weight gain
95
carbamazapine spectrum
first line for focal seizures, trigeminal neuralgia
96
cabamazapine AE
SIADH, DRESS syndrome, agranulocytosis
97
carbamazapine CYP450
strong inducer
98
phenytoin spectrum
tonic-clonic seizures, status epilepticus
99
phenytoin AE
gingival hyperplasia, hirsutism, nystagmus, drug induced lupus, teratogenic
100
phenytoin CYP450
strong inducer
101
levitiracetam spectrum
first line for focal seizures
102
what is a complication of IIH
blindness
103
where is wernickes area
dominant temporal lobe (almost always left)
104
what blood vessel supplies wernickes area
middle cerebral artery
105
when can patients go back to activity post concussion
2 days rest followed by gradual increase in activity level
106
will deep tendon reflexes still be present in brain death
yes! because this does not involve the brain
107
what neurons die in huntingtons
GABA neurons so this is why you have spasticity
108
how do you treat someone in an acute myasthenic crisis
IVIG
109
what are the hallucinations typically like when parkinsons patients have them
typically visual hallucinations - animals playing in the front yard, and they know they arent real
110
can aspergillus cause meningtitus
no! typically causes a focal mass
111
how do you tell the difference between central and peripheral nystagmus
central often is not fatiguable and there is no latency period, its not inhibited by fixation of gaze
112
what does central vertigo indicate
likely a stroke in the cerebellum or brainstem
113
what can you give MS patients for spasticity
baclofen or tizanidine

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