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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
Q

what is a common lesion in patients who wear lots of high heels

A

intermetatarsal neuroma

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26
Q

what is otosclerosis

A

this is when you have fixation of the stapes to the oval windo which causes conductive hearing loss

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27
Q

signs of otosclerosis

A

hearing better in loud environments, bilateral negative Rinne test

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28
Q

C5 sensory, motor and reflex changes

A

senory: deltoid // motor: deltoid and biceps // reflex: loss of biceps

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29
Q

C6 sensory, motor and reflex changes

A

sensory: radial arm and thumb // motor: biceps and brachioradialis // reflex: biceps

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30
Q

C7 sensory, motor and reflex changes

A

sensory: middle finger // motor: radial nerve (triceps, wrirst extensorys and flexors, pec major) // reflex: loss triceps

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31
Q

C8 sensory, motor and reflex changes

A

sensory: pinky and ring finger

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32
Q

L3 sensory, motor and reflex changes

A

sensory: n/a // motor: quads // reflex: patellar

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33
Q

L4 sensory, motor and reflex changes

A

sensory: medial leg below knee and medial malleolus // motor: quads and anterior tibial // reflex: patellra

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34
Q

L5 sensory, motor and reflex changes

A

sensory: dorsum of foot to great toe // motor: hallucis longus, extensor digitorum longus

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35
Q

S1 sensory, motor and reflex changes

A

sensory: lateral foot // motor: plantar flexion, toe flexion // decreased achilles reflex

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36
Q

how do you diagnose a plexopathy

A

EMG

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37
Q

what does Right sided heart failure look like

A

peripheral edema!!!

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38
Q

how do you differentiate between a craniopharngioma vs. pit adenoma on imaging

A

a cranio. will be calcified on imaging

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39
Q

If someone is an IV drug user and they have back pain what is likely happening

A

they likely have an abcess so they need antibiotics

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40
Q

what is happening in spinal muscular atrophy

A

destruction of the anterior horn cells I.e. lower motor neurons

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41
Q

what is conversion disorder

A

neurological symptoms in times of stress that arent caused by any structural deficits

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42
Q

what medication can you use for menieres disease

A

hydrachlorothiazide

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43
Q

what type of brain bleed do people have that have a longer period without any major neurological deficits

A

subdural hematoma

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44
Q

when is carpal tunnel syndrome worse and what is it relieved by

A

worse at night relieved by shaking hands

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45
Q

if a patient has referred pain to the butt where is the lesion

A

lumbar nerve root

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46
Q

describe risperidone

A

it is a second gen antipsychotic and has greater D2 antagonism than most antipsychotics so it can exacerbate parkinsonism in parkinsons patients

47
Q

what is a functional tremor

A

tremor that is exacerbated by stress and can stop and start

48
Q

how do you treat catatonia

A

you give a benzo

49
Q

is forced vital capacity decreased in an ALS patient

A

yes its decreased

50
Q

signs of myotonic dystrophy in an adult

A

myotonia and weakness, excessive daytime sleepiness, pharyngeal weakness, hypogonadism, frontal balding etc.

51
Q

myotonic dystrophy inheritance

A

autosomal dominant CTG repeat disorder

52
Q

signs of frontotemporal dementia

A

early personality changes, and hyperorality, no focal neurological deficits

53
Q

what is cranial nerve III palsy look like

A

pupil is abducted so its going out of the head because it cannot be adducted

54
Q

how do you treat migraines in children

A

NSAIDS

55
Q

if a patient lesions the left hypoglossal nerve which way does the tongue go

A

it goes to the left! I.e. same side of the lesion

56
Q

where are neuroblastomas often located

A

in the cervical spinal cord

57
Q

if the patient has a stroke in the pons what kind of facial nerve palsy will be seen

A

lower motor neuron! so whole side of the face is paralyzed

58
Q

signs of cervical radiculopathy

A

radiating pain to the shoulder or arm, pain when turning head, motor/sensory/dermatomal findings

59
Q

causes of cervical radiculopathy

A

spondylosis (elderly) which is osteophyte formation

60
Q

glucose level that causes hyperosmolar hyperglycemia

A

> 600

61
Q

what can give you toxic neuropathy

A

alcohol, medications, heavy metals

62
Q

what is in the CSF if someone has CJD

A

14-3-3 protein titer

63
Q

signs of wound botulism

A

facial weakness/neck weakness, longer time till onset (toxin is not preformed)

64
Q

if someone has carotid artery stenosis do you have to put them on antiplatelet and statin

A

yes

65
Q

signs of carotid artery dissection

A

hx of trauma to the neck, hemiplegia, aphasia, neck pain, headache

66
Q

what can diminish sensitivity of the MMSE

A

education level

67
Q

what do you do for treatment of tourrettes

A

often just counseling and watchful waiting

68
Q

are cafe au lait spots hypo or hyper pigmented

A

they are hyperpigmented

69
Q

what is an electrolyte imbalance seen in AIP vs. lead toxicity

A

AIP will show hyponatremia too

70
Q

treatment for intracerebral hemorrhage

A

urgent surgical decompression

71
Q

signs of central hernation

A

decorticate –> decerebrate posturing, bilateral mid sized fixed pupils,

72
Q

signs of hyperorality

A

putting things in the mouth (cigarettes common)

73
Q

what drug do you give to dementia patients

A

anticholinergic like donepezil, rivastigmine, galantamine

74
Q

pharmacologic management for FTD

A

SSRIs!

75
Q

where is the median nerve trapped if the patient only has sensory loss in ther finger tips

A

carpal tunnel

76
Q

signs of bilirubin neurotoxicity in a newborn

A

choreathetoid movements, hypotonia, lethargy, sensorineuronal hearing loss, upward gaze palsy

77
Q

causes of bilirubin neurotoxicity

A

forceps delivery, prematurity, hemolysis, exclusive breatfeeding

78
Q

what is the cause of bilateral trigeminal neurlagiaI

A

MS!

79
Q

what predisposes you to compression neuropathies

A

diabetes, pregnancy, obesity, etc.

80
Q

signs of ulnar nerve entrapment at the elboy

A

paresthesias and pain of the firth and fourth digit, weakness and atrophy of FDI ADM

81
Q

signs of radial nerve compression

A

triceps weakness, wrist drop, dorsal aspect of hand sensory loss

82
Q

etiology of compression of the radial nerve

A

spiral groove fracture, compression at axilla. triceps spared in spiral groove fracture

83
Q

femoral neuropathy signs

A

leg weakness with standing and walking, anterior thigh pain, diminished patellar reflex

84
Q

femoral neuropathy etiology

A

surgery, childbirth, DM

85
Q

peroneal neuropathy signs

A

foot drop, minimal sensory complaints

86
Q

is there pain associated with GBS?

A

yes! typically back or leg pain

87
Q

CIDP muscle weakness

A

symmetrical and upper and lower limbs

88
Q

signs of hyperkalemic periodic paralysis

A

episodes fo generalized weakness lasting mintues to hours

89
Q

signs of hypokalemic paralysis

A

episodes of generalized weakness lasting hours to days

90
Q

signs of myotonic dystrophy

A

distal muscle weakness and stiffness, myotonia, systemic features

91
Q

how do you treat a myasthenic crisis

A

intubation, IVIG, plasmapharesis

92
Q

signs of dermatomyositis

A

symmetric proximal limb weakness, dysphagia, myalgias, arthralgias, interstitial lung disease, face rash

93
Q

valproate use

A

first line for generalized tonic clonic seizures, can be used for absence if needed too

94
Q

valproate AE

A

teratogenic, tremor, alopecia, weight gain

95
Q

carbamazapine spectrum

A

first line for focal seizures, trigeminal neuralgia

96
Q

cabamazapine AE

A

SIADH, DRESS syndrome, agranulocytosis

97
Q

carbamazapine CYP450

A

strong inducer

98
Q

phenytoin spectrum

A

tonic-clonic seizures, status epilepticus

99
Q

phenytoin AE

A

gingival hyperplasia, hirsutism, nystagmus, drug induced lupus, teratogenic

100
Q

phenytoin CYP450

A

strong inducer

101
Q

levitiracetam spectrum

A

first line for focal seizures

102
Q

what is a complication of IIH

A

blindness

103
Q

where is wernickes area

A

dominant temporal lobe (almost always left)

104
Q

what blood vessel supplies wernickes area

A

middle cerebral artery

105
Q

when can patients go back to activity post concussion

A

2 days rest followed by gradual increase in activity level

106
Q

will deep tendon reflexes still be present in brain death

A

yes! because this does not involve the brain

107
Q

what neurons die in huntingtons

A

GABA neurons so this is why you have spasticity

108
Q

how do you treat someone in an acute myasthenic crisis

A

IVIG

109
Q

what are the hallucinations typically like when parkinsons patients have them

A

typically visual hallucinations - animals playing in the front yard, and they know they arent real

110
Q

can aspergillus cause meningtitus

A

no! typically causes a focal mass

111
Q

how do you tell the difference between central and peripheral nystagmus

A

central often is not fatiguable and there is no latency period, its not inhibited by fixation of gaze

112
Q

what does central vertigo indicate

A

likely a stroke in the cerebellum or brainstem

113
Q

what can you give MS patients for spasticity

A

baclofen or tizanidine

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