Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PANCE > Neuro > Flashcards

Neuro Flashcards

(58 cards)

Start Studying
1
Q

New unexplained migraine in female > or = 40 years old =

A

think patent foemen ovale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Migraine prophylaxis

A
  • Beta blockers (best)
  • CCB
  • TCA
  • AED
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Migraine abortives

A

-Ergotamine tartrate/caffeine
(avoid in pregnancy and cardiovasc dz)
-Sumatriptan
(contra = coronary/peripheral vascular dz)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When are imaging studies indicated for concussion?

A

-loss of consciousness
-evidence of skull fracture
-focal neuro deficits
-cervical spine injury
(CT of brain WITHOUT contrast = tx of choice)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Tx of concussion

A

Complete cognitive and physical rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

About post concussive headache

A
  • appears w/in a day or so
  • may worsen over time
  • disequilibrium, poor concentration, impaired memory, increased irritability, emotional lability (may last for months)
  • Tx: simple analgesics, amitriptyline, propranolol, ergot derivatives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Jacksonian March

A

Starts as a tremble in one limb and moves to other parts of body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

About Absence Seizures

A

-misses words in conversation
-brief impairment (<20sec)
impaired consciousness = blank stare
-starts in childhood
(Petit mal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

About Tonic-Clonic Seizures

A

Tonic is <1min

  • rigid, falls to the ground
  • *respiration is arrested

Clonic ~2-3min

  • lips or tongue bitten, urinary or fecal incontinence
  • flaccid coma, then consciousness, then sleep
  • sluggish postictal for min-hrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does status epilepticus cause harm?

A

-permanent brain damage secondary to hyperthermia, circulatory collapse, or excitotoxic neuronal damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tx of SE

A
  • ABCs
  • manage hyperthermia
  • break seizure w/ lorazepam or diazepam
  • give phenytoin to prevent further seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Valproic Acid SE

A

Teratogenic

blood monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Phenobarbital SE

A

blood monitoring

effects cognition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lamotrigine SE

A

skin rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Topirimate SE

A

weight loss

affects cognition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Oxcarbazepine SE

A

hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Most common type of stroke

A

85% = ischemic
15% = hemorrhagic
(A.A. have higher mortality than other ethnicities)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Ischemic Stroke-Thrombic

A

50-60% are thrombic

  • occurs during sleep, present upon awakening
  • *occur over time**
  • more progressive, worsens over several hours
  • often have TIA prodrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Ischemic Stroke-Embolic

A 
10-20% are embolic
-cardiac or atherothrombic
-occurs at anytime, progresses rapidly
**suden**
RF: afib, dilated cardiomyopathy, MI in previous 4-6wks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Anterior circulation =

A

Carotid Arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Posterior circulation =

A

Vertebral arteries

Basilar arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Carotid Artery occlusion =

A

contralateral body weakness

  • visual loss: amaurosis fugax (lamp shade over eye); gaze deviation toward infarcted hemisphere
  • numbness or parasthesias
  • lethargy, stupor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Anterior Cerebral Artery Occlusion

A
  • contralateral paralysis leg > arm
  • contralateral sensory loss leg > arm
  • apraxic gait
  • absent spontaneity, lack of initiative
  • lack of concern that something is wrong
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Middle Cerebral Artery Occlusion

Study These Flashcards
A

-contralateral motor and sensory loss
-cortical function loss:
Dominant hemisphere = aphasia, agarphia, aclaculia, alexia
Nondominant = neglect, apraxia, confusion
-gaze deviation toward infarcted hemisphere
-contralateral hemiplegia Arm > Leg
Homonymous Hemianopsia

25
tPA indications
- w/in 4.5hrs of symptom onset - 18years of age - not pregnant - significant neuro deficit, repeated exam - no improvement on repeated exam, no seizure activity at onset, no recent arterial puncture or LP
26
Contraindications to thrombolytics
- BP >185/110 - recent surgery - recent hemorrhage - admin of anticoagulants - arterial puncture at non-compressible site - internal bleeding - Hx ICH or suspicion of SAH - platelets <100,000 - head trauma, period stroke, cranial surgery
27
Tx of TIAs
- long term modification of risk factors | - surgery for focal carotid stenosis (70-98%)
28
About Hemorrhagic Strokes
- 15% of all strokes - 10% = ICH RF: HTN - 5% = SAH = aneurysm rupture RF: smoking
29
Subdural Hematomas
Concave lesions on brain CT -bleed btwn dura and arachnoid membranes -presentation = headache or confusion Tx: supportive care, monitor w/ CT, surgery in severe
30
Epidural Hematomas
Convex lesions on brain CT | Tx: supportive care, monitor w/ CT, surgery in severe
31
Essential Tremor
-cause unknown or may be autosomal dominant | =intention tremor
32
Tx of essential tremor
- propranolol - primidone - alprazolam - topirimate - gabapentin - or surgery (thalamotomy, deep brain stimulator)
33
Parkinson's Dz
-tremor at rest -rigidity -bardykinesia -progressive postural instablity (dementia and depression are very common)
34
First line tx of parkinsons
Dopaminergics | -Levodopa w/ carbidopa
35
Second line tx of parkinsons
Anticholinergics -benztropine -Amantadine (helpful in early, mild parkinsonism; reduces dyskinesias due to chronic levodopa therapy)
36
Other Meds for tx of parkinsons
COMT inhibitors (stop break down of levodopa) -entacapone -tolcapone Dopamine agonists (activate dopamine receptors in basal ganglia) -bromocriptine -pergolide MAOB Inhibitors (inhibits breakdown of domain in the brain) -selegiline
37
About Huntington's Dz
- Autosomal dominant - 100% penetrance - Chromosome 4 - insidiously after 30y/o - suicide is very common (psychosis then suicide, then chorea)
38
CT/MRI in Huntington's Dz
Cerebral atrophy
39
Myasthenia Gravis
Autoimmune disorder - PURE MOTOR SYNDROME - blockage of transmission at Ach receptors - young females > males @ 20-40y/o - worsens in evenings - especially in extra ocular, pharyngeal, facial
40
How to test for Myasthenia Gravis
-Ach receptor antibody assays for elevated levels
41
Tx of Myasthenia Gravis
- Anticholinesterase therapy (pyridostigmine bromide; neostigmine) - Steroids - Thymectomy (b/c 10% have thymoma cancer)
42
Guillian Barre Syndrome
- destruction of myelin and or axon by ganglioside antibodies - ascending paralysis - distal to central * *associated w/ campylobacter jejuni** - viral URI - diarrhea illness (campylobacter) - surgery - immunization - malignancies (lyphoma, leukemia)
43
Guillian Barre Syndrome workup
``` LP -albuminocytologic dissociation -increased protein >45 -pleocytosis, WBC normal Electrophysiology -marked slowing of conduction ```
44
Guillian Barre Tx
Symptomatic, immunosuppressive, supportive tx
45
MS
- inflammatory process - Multifocal demyelination of the white matter of the brain and spinal cord - relapsing-remitting pattern w/ chronic progressive course
46
Presentation of MS
- blurred, double vision in a single eye - ataxia - babinski sign - new neuro symptoms in a young person **key pres**
47
MS on MR/CT
``` MRI = Dawson's fingers CT = plaques ```
48
MS CSF
- increased IgG levels - increased lymphocytes - oligoclonal bands - myelin basic protein may be elevated - glucose is usually normal
49
Tx of MS
- Corticosteroids for acute attacks - to reduce freq and relapses = Interferon, IV gamma globulins - regular exercise
50
RF for Alzheimer's Dz
Advancing age, family history, head trauma | also possibly: HTN, hyperlipidemia, smoking, DM
51
Diagnosis of AD
- functional impairment - MRI to evaluate for vascular dz - brain biopsy = gold standard (post-mortem = neurfibrillary tangles, beta-amyloid plaques)
52
Tx of AD
``` Acetylcholinesterase inhibitors (donepezil, rivastigmine, glantamine) NMDA antagonist (memantine) ```
53
Bell Palsy
U/L paralysis or weakness of facial muscles supplied by CN 7w/o evidence of neuro dz or apparent cause U/L total or partial paralysis of facial muscles
54
Bell Palsy can be associated w/
- reactivation of HSV or Varicella Zoster - Viral infection - Lyme Dz - Cancer - DM - Pregnancy - Other
55
Tx of Bell Palsy
- most resolve spontaneously | - oral prednisone w/ acyclovir
56
Diabetic Peripheral Neuropathy
Occurs secondary to vascular insufficiency, nerve infarct; associated w/ hyperglycemia - stocking and glove distribution - rule out other causes of polyneuropathy
57
Other causes of polyneuropathy
- uremia - ETOH and nutritional deficits - connective tissue deficits - vasculitis - vitamin b12 deficiency - hypothyroidism - amyloidosis
58
Tx of diabetic neuropathy
- tight control of serum glucose - TCA (amitriptyline, nortriptyline) - AED (carbamazepine, gabapentin) - Aggressive Mgmnt (lidocaine patch, tramadol)

PANCE (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions