MKSAP Neuro V Flashcards
(19 cards)
The combination of parkinsonism, cerebellar ataxia, dysautonomia, and early postural instability characterizes _______.
Multiple system atrophy
Markedly asymmetric parkinsonism and frequent association with dystonia, myoclonus, cortical sensory deficits, prominent cognitive dysfunction, and apraxia (impaired motor planning). MRI typically shows asymmetric posterior parietal and frontal cortical atrophy.
Corticobasal degeneration
Prominent postural instability, impairment in vertical extraocular movements (supranuclear gaze palsy)
Progressive supranuclear palsy
Postthrombolytic BP goal (post tPA for stroke)
180/105 mm Hg
______ of the head is the most appropriate test to determine candidacy for endovascular therapy in patients with a cardioembolic stroke who have undergone thrombolysis.
CT angiography
Brain herniation in a patient with a malignant primary brain tumor should be emergently treated with _____.
Dexamethasone
(Also elevation of HOB to 30, artificial hyperventilation and possible osmotic diuresis with mannitol or hypertonic saline)
Cushing triad
Elevated BP, irregular respirations, bradycardia
Although evidence is limited, (3 abx groups) may lower the seizure threshold and thus should be avoided in patients with epilepsy.
- carbapenems
- FQ
- Fourth gen cephalosporins
What is the first thing you give when somebody has a cardioembolic stroke (i.e. from afib) and is outside tPA window?
Aspirin (not heparin/apixaban)
______ should be part of a comprehensive mild traumatic brain injury management strategy for patients with persistent symptoms.
neuropsychological testing
MOA of donepezile
acetylcholinesterase inhibitor
_____ has been shown to be effective in treating the severe apathy often associated with vascular cognitive impairment.
Methylphenidate
_________ is a form of statin myopathy that is associated with antibodies to hydroxymethylglutaryl coenzyme A reductase and biopsy evidence of muscle necrosis without inflammation; treatment with a glucocorticoid or other immunosuppressive agents can reverse the myopathy.
Immune-mediated necrotizing myopathy
Placement of an _____ is the initial treatment of choice for patients with intracranial hypotension; CT myelography is appropriate for those who do not respond to this treatment.
Epidural blood patch
Orthostatic headache (worse when standing) . Presentation may be thunderclap (maximum onset within 1 minute) or subacute. Associated features include tinnitus, diplopia, neck pain, nausea, photophobia, and phonophobia.
Clinical examination findings are typically normal but occasionally reveal a “falsely localizing” abducens nerve (cranial nerve VI) palsy. Female sex, middle age, and connective tissue disorders are risk factors.
Brain MRI with contrast is abnormal in 80% of affected patients, with possible findings of diffuse nonnodular pachymeningeal enhancement, cerebellar tonsillar abnormalities, and subdural fluid collections.
Intracranial hypotension
Result of cerebrospinal fluid (CSF) leakage that can arise as a result of lumbar puncture, surgery, or trauma or can occur spontaneously.
Because multiple sclerosis (MS) is the most common cause of transverse myelitis, ____ should be performed in patients with new-onset transverse myelitis to evaluate for MS lesions.
MRI of the brain (testing for oligoclonal bands is poorly specific and sensitive)
_________ can be started 48 hours after a hemorrhagic stroke to prevent development of deep venous thrombosis as long as there is no evidence of active bleeding on neuroimaging
P rophylactic heparin
_____ can be resumed in patients with intracerebral hemorrhage caused by hypertension 2 to 4 weeks after stroke onset if the hematoma has resolved on imaging and there is an appropriate high-risk indication.
Aspirin
Relative contraindications for the use of cholinesterase inhibitors in the treatment of dementia (donepezil)…. (5)
include sick sinus syndrome, left bundle branch block, uncontrolled asthma, angle-closure glaucoma, and ulcer disease
Use memantine instead
