Neuro Path (other)

Question 1

Which two headaches are unilateral?

Answer 1

Cluster and Migraine

Question 2

Duration of cluster headache

Answer 2

15 min- 3 hrs; repetitive, but brief

Question 3

What kind of headache is characterized by steady pain, no photophobia, phonophobia, or aura?

Answer 3

Tension

Question 4

Excrutiating periorbital pain with lacrimation and rhinorrhea?

Answer 4

Cluster

Question 5

Tx for Cluster headache

Answer 5

Acute: Sumatriptan and 100% O2
Prevention: Verapamil

Question 6

What headache lasts between 4-72 hours?

Answer 6

Migraine

Question 7

Duration of tension headache?

Answer 7

Constant for an avg of 4-6 hours

Question 8

Tx for Tension headache

Answer 8

Analgesics, NSAIDs, acetaminophen

Chronic pain: amitriptyline

Question 9

Characteristics of migraine

Answer 9

1) Pulsating pain
2) Nausea, photophobia, or phonophobia
3) Aura

Question 10

Vasoactive peptides, __ and ___, are released during a migraine.

Answer 10

Substance P and Calcitonin gene-related peptide (CGRP)

Question 11

Acute tx of migraines

Answer 11

Dihydroergotamine, NSAIDS, triptans,

Question 12

ABC TV prophylactic meds for migraines

Answer 12

Amitriptyline
B-blockers
Calcium ch. blockers

Topiramate
Valproate

Question 13

First-line therapy for trigeminal neuralgia

Answer 13

carbamazepine

Question 14

Akathisia

Answer 14

restlessness and intense urge to move

with neuroleptic use or Parkinson’s

Question 15

Dystonia

Answer 15

SUSTAINED, involuntary muscle contractions

ie. Writer’s cramp, blepharospasm (eyelid), torticollis

Question 16

Non-alcoholic tx for essential tremor

Answer 16

Non-selective b-blockers or primidone (barbituate)

Question 17

What enzyme metabolizes MPTP into MPP+ leading to dopaminergic neuron damage?

Answer 17

MAO B

inhibit process with selegiline

Question 18

____ are characteristic of Parkinson disease. They are composed of _____ inclusions.

Answer 18

Lewy bodies; a-synuclein

Question 19

Trinucleotide repeat on chromosome 4

Answer 19

Huntington Disease:

Caudate loses Ach and GABA (CAG)

Question 20

What NT is increased in Huntington’s?

Answer 20

Dopamine

Question 21

NMDA-R binding and glutamate excitotoxicity cause __.

Answer 21

Neuronal death in Huntington’s

Question 22

___ increases the risk and ____ decreases the risk of sporadic form of Alzheimers.

Answer 22

ApoE4 increases risk

ApoE2 decreases risk

Question 23

What proteins are associated with the familial form of AD?

Answer 23

APP increase and presenilin 1/2

Question 24

Senile plaques composed of ____ may cause ___ leading to intracranial hemorrhage in AD.

Answer 24

Beta-amyloid; amyloid angiopathy

Question 25

Insoluble ___ ____ protein leads to ____, the number of which correlates with the degree of dementia in AD.

Answer 25

hyperphosphorylated tau protein; neurofibrillary tangles

Question 26

Histological changes in frontotemporal dementia

Answer 26

intracellular inclusions of hyperphosphorylated tau = ROUND Pick bodies OR ubiquitinated TDP-43

Question 27

If you have parkinsonian features with an unusually early onset of dementia and/or visual hallucinations, you are more likely to have...

Answer 27

Lewy body dementia (haLewycinations) Look for intracellular Lewy bodies still Note: this is NOT Parkinson's

Question 28

2nd most common cause of dementia in elderly?

Answer 28

Vascular dementia (MRI/CT will show multiple cortical and/or subcortical infarcts)

Question 29

Startle myoclonus is associated with ___.

Answer 29

Creutzfeldt-Jakob disease

Question 30

EEG and CSF findings with CJD

Answer 30

Periodic sharp waves on EEG and increased 14-3-3 protein in CSF

Question 31

What are some risk factors of pseudotumor cerebri?

Answer 31

``` Vitamin A excess Tetracycline Danazol Female Obesity ```

Question 32

Tx for IIH?

Answer 32

Weight loss, Acetazolamide, Topiramate

Question 33

Lhermitte phenomenon

Answer 33

Neck flexion may cause sensation of electric shock running down spine (in MS)

Question 34

Tx for MS spasticity

Answer 34

``` Baclofen = GABA B agonist Tizanide= alpha-2 agonist ```

Question 35

Disease modifying therapies for MS

Answer 35

beta-IFN Glatiramer Natalizumab