Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Step 2 CK > Neuro > Flashcards

Neuro Flashcards

1
Q

RF stroke

A

HTN
DM
Hyperlipidemia
Smoking

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

Causes of stroke

A

Ischemic - 85%

Hemorrhagic - 15%

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

Embolic origins of stroke

A 
#1 Heart - AF (MC), valvular disease, paradoxical DVT
#2 Carotid stenosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

MC artery occluded in stroke

A

Middle cerebral

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

Sx in MCA stroke

A

Weakness and sensory loss on opposite side
Homonymous hemianopsia (eyes look at lesion)
Aphasia

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

Sx in ACA stroke

A

Personality/cognitive defects (confusion)
Urinary incontinence
Leg more than arm weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Sx PCA stroke

A

LOC
Ipsilateral sensory loss in face and CN IX, X
Contralateral sensory loss of limbs
Limb ataxia

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

Best initial test for any stroke

A

CT head w/o contrast

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

Most accurate test for stroke

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why is CT done before MRI in stroke

A

R/O bleeding

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

Best initial therapy for stroke

A

3hrs - Aspirin

Hemorrhagic - Nothing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Patient on aspirin has stroke

A

Add dipyridamole
OR
Switch to clopidogrel

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

When is a Penumbra catheter indicated (clot retrieval)

A

Within 90min then thrombolytics if unsuccessful

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

Rx if damage valves caused stroke

A

Surgery

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

Rx if thrombi caused stroke

A

Heparin then warfarin to INR 2-3

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

How to determine heart source of stroke

A

Echo

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

Rx for AF on EKG which caused stroke

A

Warfarin to INR 2-3

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

EKG normal but suspected heart etiology of stroke

A

24-48hr Holter monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Sx cerebrovascular disease w/ >70% stenosis

A

Surgical correction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q
A

No CEA

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

100% carotid stenosis

A

No CEA (that side is “protected”)

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

Control DM to prevent stroke

A

HbA1c

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Control HTN to prevent stroke

A

140-160

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Control LDL to prevent stroke

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Control BP in Hemorrhagic stroke
Target - 140-160 | >170 give Nicardipine, Enalaprat, Labetalol
26
MC headache
Tension
27
Light causing photophobia
Bright | Natural
28
Inducing factors in Migraines
``` Visual disturbance Photophobia Aura Menses Food (men) Emotions (women) ```
29
Features of Cluster headaches
Frequent Short duration High intensity M 10x > W
30
Features giant cell arteritis
Visual disturbance Systemic sx Jaw claudication
31
Association with pseudotumor cerebri
Obesity Venous sinus thrombosis OCPs (taken off market) Vit A tox
32
Physical findings in migraines
Rarely aphasia/numbness/dysarthria/weakness | - Looks like stroke
33
PE results on cluster HA
Red tearing eye with rhinorrhea (ipsi) | Occasional Horner's
34
What must be evaulated for HA w/ red eye
Glaucoma
35
PE results for giant cell arteritis
Visual loss | Tenderness in temporal region (ipsi)
36
PE results for pseudotumor cerebri
Papilledema with diplopia from CN VI palsy
37
Dx test in 1st time migrain/cluster/pseudotumor cerebri presentation
Head CT to exclude masses
38
Features of tension HA
B/L Lasts 4-6hrs Temple/occipital pressure relieves
39
Dx sequence for pseudotumor cerebri
Head CT | LP for increased pressure
40
First step in management of giant cell arteritis
Steroids before Bx | Bx is most accurate test
41
NSAIDS AE
``` Aseptic meningitis ↑LTs → Bronchoconstriction and ↑Mucous Gastric ulcers Interstitial nephritis Papillary necrosis ```
42
Rx tension HA
NSAIDs and other analgesics
43
Rx Migraine
Triptans or ergotamine as abortive therapy | Proclorperazine for monotherapy w/ vomitting
44
Rx cluster HA
Triptans or ergotamine first 100% O2 Li
45
Rx temporal arteritis
Prednisone
46
Rx Pseudotumor cerebri
``` Weight loss Acetazolamide Steroids Repeated LP to lower pressure VP shunt Cut into optic nerve ```
47
Cluster HA PPx
Verapamil Li Prednisone
48
When to give PPx for migraines
3-14 per month
49
Best PPx for migraines
Propranolol
50
Other PPx for migraines
``` CCBs TCAs (not in elderly) SSRIs (only with concurrent anxiety/depression) Topiramate Botox (good for breakthrough) ```
51
What is trigeminal neuralgia
Idiopathic CN V disorder | Overwhelming facial pain
52
Precipitants of trigeminal neuralgia attacks
Chewing Touching face Pronouncing certain words
53
Dx test in trigeminal neuralgia
None
54
Best Rx trigeminal neuralgia
Oxcarbazepine | Carbemazepine
55
Other Rx trigeminal neuralgia
Baclofen | Lamotrigine
56
Rx trigeminal neuralgia if meds fail
Gamma knife surgery
57
What is postherpetic neuralgia
Zoster reactivation along CN V
58
Is their pain with resolution of zoster vesicles in postherpetic neuralgia
15%
59
Rx postherpetic neuralgia
Antiherpes meds | - Acyclovir
60
Pain reduction in postherpetic neuralgia
``` TCAs Gabapentin Pregablin Carbamazepine Phenytoin Topical capsaicin ```
61
Prevention of zoster
Zoster vaccine
62
Types of seizures
Partial → focal Absence Generalized Status epilepticus
63
Causes of generalized tonic/clonic seizures
``` ↓/↑ Na ↓ Glucose ↓ Ca ↓ Mg Hypoxia CNS infection/anatomic abnormality Uremia Hepatic failure EtOH/barb/benzo withdrawal Cocaine tox ```
64
When to do EEG for seizures
NL CT/MRI/metabolic panel
65
Confusion is to coma ans seizure as
Angina is to MI
66
What is epilepsy
Seizures of unclear origin
67
Best initial therapy for status epilepticus
Benzos
68
Subsequent status epilepticus meds if condition persists
``` Phenytoin Barbs NM blockage Generalized anaesthesia Intubate ```
69
AE IV Phenytoin
Hypotension | AV block
70
When to start Rx for 1st time seizure
Status epilepticus Abnormal EEG FHx seizures
71
Rx absence seizures
Ethosuximide
72
Alternative seizure meds
``` Gabapentin Topiramate Lamotrigine Oxcarbazepine Levetiracetam ```
73
When to discontinue seizure meds
Seizure-free for 2yrs
74
Best way to tell if there is possibility of seizure recurrence
Sleep deprivation EEG
75
Where are most aneurysms causing SAH
ACA in circle of willis
76
Most frequent conditions with brain aneurysms
``` PCKD Tobacco smoking HTN Hyperlipidemia Alcoholics ```
77
MC presentation of SAH
Severe HA with meningeal irritation - Stiff neck, photophobia, fever LOC in 50% Focal complications in 30%
78
Differences in SAH from meningitis
Very sudden | LOC
79
Best initial test for SAH
Head CT w/o contrast
80
Most accurate test for SAH
LP with blood
81
What is Xanthochromia
Yellowish discoloration of CSF 2/2 RBC breakdown
82
Normal WBC:RBC in CSF
1:500-1000
83
What does an elevated WBC:RBC in CSF indicate
Meningitis
84
How to locate aneurysm site
CT angiography
85
Rx SAH
Nimodipine - Prevent subsequent Embolization - Prevent repeat VP shunt - Only if there is hydrocephalus Seizure PPx - Phenytoin only if there is seizure
86
Why is preventing rebleading in SAH so important
50-70% who rebleed will die
87
Who gets ASA
MVA | High velocity trauma
88
Sx in ASA
No pain and temp Position and vibration intact Flaccid paralysis below infarct Loss of DTRs
89
Causes of subacute degeneration of the spinal cord
B12 def | Neurosyphilis
90
Sx in subacute degeneration of the spinal cord
Position and vibration lost
91
Features of spinal trauma
Acute limb weakness +/- sensory loss below lesion Sphincter function impaired Loss of DTRs at level Hyperreflexia below lesion
92
Rx spinal trauma
Steroids
93
Brown-Sequard features
Ipsi motor, position, vibration lost | Contra pain, temp lost
94
What is syringomyelia
Fluid-filled dilated central canal
95
Causes of syringomyelia
Tumor Severe trauma Congenital
96
Sx of syringomyelia
Loss of pain and temp cape-like | Loss of reflexes and muscle atrophy
97
Most accurate test for syringomyelia
MRI
98
Best rx syringomyelia
Removal of tumor | Drainage of fluid
99
Where do brain abscesses spread contiguously from
Sinuses Mastoid air cells Otitis media
100
Extracranial causes of brain absceses
PN or endocarditis leading to bacteremia
101
Sx of brain abscesses
``` HA N/V Fever Seizures Focal neuro deficits ```
102
Can CA give fever
Yes
103
Best initial test for brain abscess
CT or MRI | w/ and w/o contrast
104
Most accurate test for brain abscess
Brain bx
105
Rx duration of brain abscesses
6-8wks IV then 2-3mos oral
106
Empiric Rx brain abscesses
PCN + metro + ceftriaxone/cefepime
107
High risk organism causing brain abscess after neurosurgery
Staph epi and MRSA | Give vanco instead of PCN
108
Neuro abnormalities in tuberous sclerosis
Slowly progressing mental deterioration | Seizures
109
Skin abnormalities in tuberous sclerosis
Ash leaf patches Adenoma sebaceum Shagreen patches
110
Rx tuberous sclerosis
Control seizures
111
Features of Neurofibromatosis
Neurofibromas CN VIII tumors Cutaneous hyperpigmented lesions (Cafe-au-lait spots) Meningiomas and gliomas
112
Rx Neuro abnormalities in tuberous sclerosis
None | CN VIII decompression
113
Sturge-Weber presentation
``` Port-wine stain of face Seizures Homonymous hemianopsia Hemiparesis Mental subnormality ```
114
Skull XR in sturge-weber
Calcification of angiomas
115
Rx in sturge-weber
Control seizures
116
What is an essential tremor
Present at both rest and intention
117
What is the best therapy for essential tremor
Propranolol
118
What improves essential tremor
Alcohol
119
What makes essential tremor worse
Caffeine
120
What is parkinsonism
Loss of dopaniergic cells in the substantia nigra
121
Common etiologies of parkinsonism
``` Repeat head trauma (boxing) Antipsychotic meds Encephalitis Reserpine Metoclopromide ```
122
MCC parkinsonism
Idiopathic
123
Presentation of parkinsonism
``` 50-60 Tremor Cogwheel rigidity Bradykinesia Shuffling gait Hypomimia Micrographia Postural instability Orthostasis ```
124
Rx mild parkinsonism
Anticholinergics (benztropine, trihexyphenidyl) | Amantadine - release DA from substantia nigra
125
Who is most likely to get amantadine for parkinsonism
> 60 who is intolerant to anticholinergics
126
Anticholinergics AE
Dry mouth Worsening BPH Constipation Worse in older pts
127
What does severe parkinsonism mean
Can't take care of themselves
128
Best initial therapy in severe parkinsonism
DA agonists - Pramimexole - Ropinirole
129
Most effective med for severe parkinsonism
Levodopa/carbidopa
130
What is on/off phenomenon
Bradykinesia - not enough DA Dyskinesia - too much DA Seen in Levodopa/carbidopa
131
Rx on/off phenomenon in parkinsonism
COMT inhibitors
132
What do COMT inhibitors do
Extend Levodopa/carbidopa duration
133
What are the COMT inhibitors
Tolcapone | Entacapone
134
What do MAOIs do
Block DA metabolism
135
What are the MAOIs
Rasagiline Selegiline Use as single agent or adjuvant to Levodopa/carbidopa
136
What med class can slow the progression of parkinsonism
MAOIs
137
What causes psychosis in parkinsonism
Parkinsonism meds
138
Rx psychosis in parkinsonism
Antipsychotic like clozapine | Don't stop parkinsonism meds
139
What is Lewy-body dementia
Parkinsonism + Dementia
140
What is Shy-Drager syndrome
Parkinsonism with orthostasis
141
Rx spasticity
Baclofen Dantrolene Tizanadine
142
What should you always check in a pt with RLS
Ferritin (usually low)
143
Huntington's Triad
Memory Mood Movement
144
Defect in huntington's
CAG repeat on chromosome 4
145
Features of huntington's
Choreaform movement Dementia Behavioral changes 30-50 w/ FHx
146
Dx huntington's
Genetic test
147
Rx huntingtons's
Dyskinesia - Tetrabenazine | Psychosis - Haloperidol, Quetiapine
148
Features of Tourettes
Vocal tics, grunts, coprolalia Motor tics Obsessive compulsive behavior
149
Cause of Tourettes
Idiopathic
150
Rx Tourettes
``` fluphenazine Clonazepam Pimozide Methylphenidate ADHD rx ```
151
What is MS
Idiopathic demyelinating CNS disorder
152
Most common presentation of MS
Focal sensory sx w/ gait and balance problems
153
Other common MS presentations
Blurry vision from optic neuritis Fatigue Spasticity and hyperreflexia Cerebellar deficits
154
What is internuclear ophthalmopegia
Inability to adduct one eye w/ nystagmus in the other eye | Characteristic of MS
155
Dx test for MS
MRI - Best initial and Most accurate
156
What does LP show in MS
Mild protein elevation
157
When to do LP in MS
MRI is equivocal
158
Best initial therapy for acute exacerbations of MS
High dose steroids
159
Other Rx MS to prevent relapse and progression
``` Fingolimod Natalizumab Mitoxantrone Azathioprine Cyclophosphamide ```
160
Which MS med can cause worsening of neuro deficits with an MRI showing new white matter hypodense lesions
Natalizumab
161
What has Natalizumab associated with
PML
162
First choice Rx MS to prevent relapse and progression
Glatiramer | Beta-IFN
163
What is ALS
Idiopathic loss of upper and lower motor neurons
164
What to look for in ALS
20s-40s Weakness of unclear etiology Difficulty chewing and swallowing Decrease in gag reflex - pooling of saliva and aspiration
165
What is poor prognosis in ALS
Weak cough | Loss of swallowing
166
Electromyography results in ALS
Loss of innervation in muscle groups
167
Lab results in ALS
↓NIF | ↑CPK
168
Role of Riluzole in ALS
Reduce glutamate buildup
169
Role of Baclofen in ALS
Treat spasticity
170
Role of BIPAP/CPAP in ALS
Help with resp difficulties 2/2 muscle weakness
171
MCC death ALS
Respiratory failure
172
Management at end stage ALS
Tracheostomy and ventilator
173
Features of Charcot-Marie-Tooth disease
Distal weakness and sensory loss Wasting in the legs Decreased DTRs Tremor
174
Lower extremity appearance in CMT
Foot deformity with high arch | Legs look like inverted champagne bottles
175
Most accurate test for CMT
Electromyography
176
MCC peripheral neuropathy
DM
177
Other causes of peripheral neuropathy
Uremia Alcoholism Paraproteinemias (MGUS)
178
Best initial therapy for peripheral neuropathy
Gabapentin or Pregablin TCAs Seizure meds
179
Biker, pressure on palms, trauma to medial elbow
Ulnar Wasting of hypothenar eminence Pain in 4th and 5th digit
180
Pressure of inner, upper arm Saturday night palsy Pressure in axilla (crutches)
Radial | Wrist drop
181
Nerve damage in obesity, pregnancy, sitting cross legged
Lateral cutaneous nerve of the thigh | Pain/numbness of outer aspect of one thigh
182
Nerve damage that worsens w/ walking
``` Tarsal tunnel (tibial nerve) Pain/numbness in ankle and sole of foot ```
183
Nerve damage in high boots, pressure on back of knee
Peroneal | Weak foot with decreased dorsiflexion and eversion
184
Nerve damage in typists, carpenters, working with hands
Median Thenar wasting Pain/numbness in first 3 fingers
185
Identifiable causes of CN VII palsy
Lyme Sarcoidosis Zoster Tumors
186
Differentiate Bell Palsy with Stroke
Stroke - Can wrinkle forehead | CN VII - Cannot wrinkle forehead
187
2 specific features of Bell palsy
Hyperacusis - Stapedius can't deaden sound | Taste disturbances - Anterior 2/3 tongue
188
Most accurate test for Bell palsy
Electromyography and nerve conduction studies | Rare needed
189
Rx Bell palsy
Steroids - Best initial therapy | 60% resolve spontaneously
190
Why does corneal ulceration happen in CN VII palsy
Eye has difficulty closing leading to dryness and ulceration
191
What is GBS
Autoimmune demyelination of peripheral nerves
192
What is GBS associated with
Campylobacter jejuni
193
Features of GBS
Ascending weakness | Loss of DTRs
194
What is the danger of GBS
Hitting the diaphragm - resp muscle weakness | Autonomic dysfunction - hypo/hypertension, tachy
195
Most specific Dx test in GBS
Electromyography and nerve conduction studies
196
CSF in GBS
Increased protein | NL cell count
197
What values tell who may die from GBS
PFTs - Peak inspiratory pressure - FVC
198
Rx GBS
IVIG | Plasmapheresis
199
MCC death from GBS
Dysautonomia and Resp failure
200
What is myasthenia gravis
Muscle weakness 2/2 autoAbs to acetylcholine receptors in NMJ
201
Features of MG
Double vision Difficulty chewing Dysphonia - weakness of muscles at end of day
202
PE findings of MG
Ptosis Weakness in sustained activity NL pupillary response
203
Best initial test for MG
Acetylcholine receptor Abs
204
Best test for MG pts w/o Abs
Anti-MUSK Abs
205
Most accurate test for MG
Electromyography
206
What imaging should be done in MG
Chest CT - Thymoma
207
Best initial treatment for MG
Neostigmine or Pyridostigmine
208
Most appropriate next step in MG if meds fail
60 - Prednisone
209
Presentation of acute myasthenic crisis
Profound weakness or respiratory involvement
210
Rx Acute MG crisis
IVIG or plasmapheresis
211
What to give to MG pts to ween off steroids
Azathioprine Cyclophosphamide Mycophenolate

Step 2 CK (21 decks)

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