neuro cards Flashcards

1
Q

pharmacological management of bells palsy

A

-If onset <72h, Prednisone (60 to 80 mg/day) x 1 week
-If severe, consider addition of Valacyclovir 1g TID x 1 week
For persistent symptoms, consider imaging and ENT referral

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1
Q

if a patient has a TIA, what is the tool use to predict stroke?

A

ABCD2

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2
Q

does bells palsy spare the forehead?

A

no (frontalis effected, suggesting peripheral cause)

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3
Q

sparing of the forehead muscles with facial paralysis suggests a ____ cause

A

central

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4
Q

how should a patient manage the eye symptoms of bells palsy?

A

-artifical tears during the day, ointment at night
-protective goggles/glasses

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5
Q

a patient who has incomplete recovery of bells palsy at __ months should have be considered for brain imaging (CT, MRI, neuro referral)

A

3 months

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6
Q

how quickly does bells palsy develop?

A

hours to a couple days (if longer, another diagnosis should be considered)

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7
Q

what is the common virus that causes bells palsy?

A

HSV

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8
Q

what is the virus that causes ramsay hunt syndrome?

A

varicella zoster

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9
Q

do adults or adolescents have a risk for slower recovery from concussion?

A

adolescents

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10
Q

What are the ADLs and IADLS? DEATH SHAFT

A

ADLS: Dressing, eating, ambulating, toileting, hygeine, bath/shower

IADLS: shopping, housework, accounting/finances, food prep, transporation, taking medications

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11
Q

what are the core features of lewy body dementia?

A

-fluctuating cognition, detailed visual hallucinations, REM sleep behaviour disorder, parkinsonism

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12
Q

how to differentiate between parkinsons with dementia, and lewy body dementia?

A

Parkinsons has the symptoms for at least one year before onset of dementia, whereas LBD gets dementia and parkinsonism within the same year

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13
Q

in which patients should acetylcholine esterase inhibitors be AVOIDED?

A

Patients with LBBB, 2nd/3rd degree block, sick sinus, HR<50

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14
Q

triad seen in normal pressure hydrocephalus?

A

-ataxia
-dementia
-urinary incontinence

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15
Q

adverse effects of acetylcholine esterate inhibitors?

A

-GI (nausea, diarrhea, vomiting)
-bradycardia, hypotension, dizziness, syncope
-insomnia, sleep disturbance
-QT prolongation and torsades de pointes

16
Q

pharm management of frontotemporal dementia

A

SSRI, trazadone

17
Q

in which type of dementia should antipsychotics be AVOIDED

A

lewy body dementia - due to risk of NMS

18
Q

TIA vs stroke

A

Stroke symptoms last > 24 hrs

19
Q

within what timeframe from symptom onset should tpa be administered?

A

<4.5 hours

20
Q

What is the medication used for stroke thrombolysis?

A

alteplase

20
Q

Name 6 contraindications to TPA

A

History of intracranial hemorhage
Head trauma or other stroke within 3 months
Uncontrolled hypertension >185/110
Known AV malformation, neoplasm or aneurysm
Active internal bleeding
Bleeding disorder (platelets <100, DOAC, INR > 1.7)

21
Q

what MUST you rule out before giving TPA for stroke?

A

hemorhagic stroke

22
Q

what is the name of the scale for stroke severity?

A

NIHSS

22
Q

first line medication for parkinsons?

A

levodopa/carbidopa

23
Q

SE of levodopa-carbidopa?

A

-impulse control disorders
-dyskinesia
-somnolense
-orthostatic hypotension/dizziness
-nausea/dyspepsia
-psychotic symptoms and hallucinations

24
Q

what type of drug is pramipexole?

A

dopamine agonist

25
Q

what type of drug is amantadine?

A

NMDA-receptor antagonist

26
Q

what type of drug is MAOI?

A

selegiline

27
Q

should amantadine be used for treatment of patients wtih early PD?

A

no - insufficient evidence

28
Q

is deep brain stimulation effective for motor fluctuations and dyskinesia of parkinsons disease?

A

yes

29
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A
30
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A
31
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32
Q
A