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MS Neuro Flashcards

1
Q

What Cranial Nerve is affected in Trigeminal Neuralgia?

A

CN V

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2
Q

DOC for Trigeminal Neuralgia

A

Carbamazepine (Tegretol)

An anticonvulsant drug; used for analgesic effect for neuropathic pain by calming down the nerves

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3
Q

TSL of Carbamazepine (Tegretol)

A

5-12 mcg/mL

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4
Q

_________ pain indicates nerve damage

A

Neuropathic

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5
Q

Adverse Effect of Carbamazepine (Tegretol)

A

Agranulocytosis

WOF: Infection
Monitor: CBC

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6
Q

Surgery for Trigeminal Neuralgia

A

Retrogasserian Rhizotomy
- killing nerve fibers responsible for pain signals

2nd Option: Microvascular Decompression
- relocation of cerebral artery that compresses trigeminal nerve

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7
Q

Alternative Medications for Trigeminal Neuralgia

A

⭐ Baclofen (Lioresal)

Others: Gabapentin (anticonvulsant), Duloxetine (SNRI = antidepressant and for neuropathic pain), Lamotrigine

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8
Q

Alternative medication for Trigeminal Neuralgia which hits two birds in one stone (an antidepressant and for neuropathic pain)

A

Duloxetine (SNRI)

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9
Q

⭐ Temporary unilateral facial paralysis ⭐ affecting CNS ___ exhibited by exacerbations and remissions

A

Bell’s Palsy; VII

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10
Q

Gradual improvement in Bell’s Palsy occurs in how many weeks?

A

3-5 weeks

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11
Q

Full recovery usually takes up to in Bell’s Palsy?

A

3-6 months

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12
Q

Treatment in Bell’s Palsy should be initiated ____ hours of symptom onset

A

72 hours

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13
Q

⭐ In Bell’s Palsy, viral infection confuses immune system, thus triggering autoimmune. Give the 4 causative factors:

A
  • Herpes Simplex (STD)
  • Herpes Zoster (Shingles)
  • Epstein-Barr Virus (Mononucleosis; Kissing Virus)
  • Cytomegalovirus
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14
Q

⭐ It is characterized by a facial droop / sag / wrinkling / flaccid

A

Bell’s Palsy

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15
Q

Steroids for Bell’s Palsy

A

Prednisone (Strongest)

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16
Q

⭐ Vitamin B complex (B1, B6, B12) is a management for Bell’s Palsy. Enumerate all B complex

A
  • B1 (Thiamine)
  • B2 (Riboflavin)
  • B3 (Niacin)
  • B5 (Panthothenic Acid)
  • B6 (Pyridoxine)
  • B7 (Biotin)
  • B9 (Folic Acid)
  • B12 (Cyanocobalamin)

TIP: Ta Ra Na Pa Py BFC

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17
Q

In Bell’s Palsy, when should you wear eye patch and protective glasses (sunglasses, goggles)

A

AM - Protective Glasses
PM - Eye Patch

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18
Q

What kind of stimulation is done in Bell’s Palsy?

A

Electrical Stimulation; this wakes up the sleeping or paralyzed muscles which speeds up recovery

Other: Moist Heat & Gentle Massage

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19
Q

⭐ Earliest Sign of Myasthenia Gravis

A

Ptosis
- Descending manifestations

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20
Q

A neuromuscular condition affecting myoneural junction leading to generalized muscle weakness or voluntary muscle problem

A

Myasthenia Gravis

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21
Q

⭐ Primary cause of Myasthenia Gravis

A

Autoimmune

d/t damaged acetylcholine receptor sites

22
Q

⭐ Diagnostic Test for Myasthenia Gravis

A

Tensilon Test

23
Q

This is given for myasthenic crisis for stablization or to rule out cholinergic crisis

A

IV Edrophonium

24
Q

What does a relief of symptoms within 5-10 minutes after administration of Edrophonium mean?

A

(+) Myasthenia Gravis

25
Ice Test is a localized test for muscles in myasthenia gravis. Cold temperature is placed on an affected area for how many seconds or minutes?
60 seconds / 1 minute
26
Immunosuppressants for Myasthenia Gravis
Methotrexate & Azathioprine
27
Anticholinesterase or Long-Acting Cholinergic Drug (Maintenance Use) for Myasthenia Gravis
Pyridostigmine & Neostigmine Tip: -stigmine EXCEPT EDROPHONIUM because it is SHORT-ACTING
28
Best Time to Administer Anticholinesterase
AM, Before Meals (ADLs and prevention of dysphagia)
29
Initial sign that the drug is effective in Myasthenia Gravis
Increased strength in chewing and swallowing
30
Type of Crisis in Myasthenia Gravis caused by undermedication
Myasthenic Crisis
31
Type of Crisis in Myasthenia Gravis caused by overmedication
Cholinergic Crisis
32
Drug used for Myasthenic Crisis
Tensilon
33
Drug used for Cholinergic Crisis
Atropine (Fast-Acting Anticholinergic)
34
⭐ Always prepare this at the bedside of those with Myasthenia Gravis
Tracheostomy Set, Bag-Valve Mask, Endotracheal Tube
35
Dialysis of plasma wherein the antibodies are targeted
Plasmapheresis
36
⭐ Surgery for Myasthenia Gravis
Thymectomy (responsible for production of WBC)
37
Other Term for Gullain-Barre Syndrome
Acute Idiopathic Polyneuritis
38
⭐ A condition characterized by a temporary shutdown of motor and sensory nerves causing a temporary body paralysis
Gullain-Barre Syndrome
39
⭐ A person has ascending paralysis. What is the supporting history for diagnosis of GBS?
Recent history of viral or GI infection
40
⭐ The only bacteria causing GBS which causes *gastroenteritis*, an inflammation of stomach and intestines causing upper and lower GI symptoms
Campylobacter jejuni
41
⭐ This is characterized by paresthesia (pins & needles)
Gullain-Barre Syndrome
42
A permanent, irreversible condition exhibited by exacerbations and remissions characterized by a progressive, demyelination of CNS leading to infalmmation of myelin sheath
Multiple Sclerosis
43
Triad that confirms multiple sclerosis
Charcot's Triad - Stacatto - Intentional Tremors - Nystagmus
44
Electrical shock sensation along the spine and the arms upon neck flexion in people affected by Multiple Sclerosis
Lhermitte's Sign (Barber Shock Phenomenon)
45
Worsening s/sx of MS when the person is exposed to hot temperatures
Uhthoff's Phenomenon
46
⭐ Diagnostic Test for Multiple Sclerosis
Electroencephalogram (EEG) Electrodes are attached in the head to assess brain waves or activity
47
Lumbar puncture shows ______ gamma globulin levels and a ______ serum globulin Choices: Decreased, Normal, Increased
increased, decreased Rationale: Inflammation is in the brain, not in the blood
48
⭐ DOC for Multiple Sclerosis
Interferons TIP: INTERFERes progression of MS
49
Interferons for Multiple Sclerosis
- Avonex - Betaseron - Copaxone ⭐
50
Interferons for Multiple Sclerosis are best taken on?
Morning to perform ADLs
51
When administering interferons for multiple sclerosis, what should you watch out for?
Flu-Like Symptoms

PNLE (15 decks)

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