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Flashcards in Continuum consults Deck (29)
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1

causes of abulia?

thalamic or orbitofrontal infarcts

2

causes of agitation

PCA and nondominant parietal infarcts

3

what is marchiafava bignami?

demyelination of corpus callosum due to nutritional deficiency in chronic alcoholics

4

what AED shouldnt be used with VPA?

topiramate: causes encephalopathy

5

what shouldn't you use antipsychotics in?

Lewy body dementia

6

what is the syndrome and treatment? spells of choreiform or dystonic movements for seconds-minutes during movement or with startle?

paroxysmal kinesigenic choreoathetosis: a paroxysmal dyskinesia.

7

Kernig test

meningitis with resistance to passive extension at knee when lying on back

8

brudzinski test

meningitis with neck flexion there is flexion of hips/knees

9

meningitis to give steroids in?

pneumococcal

10

What causes waterhouse friderichsen disease?

N. meningo, with hemorrhage / adrenal failure

11

bugs (2) causing basilar meningitis

Cryptococcus, TB

12

Guess the bug: meningo encephalitis with tremor, diarrhea, rash, flaccid weak limb or parkinsonian.
MRI findings? What is the dx lab test?

WNV, look for CSF IgM Abs, MRI hsows hyperintense thalami, BG, SN

13

EEG findings in HSV encephalitis?

periodic sharp/slow wave complexes at 1-3 sec intervals between 2-15 days

14

What test confirms EBV as cause of encephalitis?

Both CSF PCR AND EBV nuclear Ag negative AND EBV capsid antigen positive (positive EBNA only can be nonspecific)

15

worst endocarditis risk factor

prosthetic mitral valve

16

Risk of stroke if EF < 40%

18%!, each decr 5% EF increases 5yr stroke risk by 8%

17

what causes atrophy of type II fibers, fast twitch glycolytic muscles but with normal labs?

steroid myopathy

18

Dx for this EMG: / NCS: slow NC velocity, prolonged or absent F waves, conduction block?

GBS

19

What might you see in axonal type GBS on EMG/NCS?

spared sensory but low/absent CMAPs and early denervation

20

Mechanism in Botulism

Presynaptic toxin NM blockade preventing ACh release

21

EMG findings in botulism?

Decr CMAP, incremental response to tetanic stim

22

mechanism of ciguatera neurotoxin action?

ingestion of na-channel blocker ingestion, causing acute demyelinating neuropathy

23

two problems to think of when you get symmetric weakness no sensory, no demyelination?

1. Tick paralysis: NMJ problem or distal axon
2. AIP (porphyria), spares CNs, lots of autonomic issues

24

if a MG patient has poor response to acetylcholinesterase inhibitors, think of what?

anti-MUSK

25

best EMG test for MG?

single fiber EMG

26

what is the path and EMG finding in critical illness myopathy

path is loss of thick filaments
EMG is low amp CMAPs, preserved SNAPs, no decrement, small polyphasic MUPs

27

fibrillations and positive sharp waves are seen in what?

polyneuropathy

28

Where do you see shrinking lung syndrome?

neuropathy and diaphragmatic weakness in SLE

29

Treatment of periodic kinesthogenic choreoathetosis.

Treat with Carbamazepime (Na-channel blocker)