neuro stuff Flashcards
(51 cards)
What are symptoms of tuberous sclerosis
Neuro= Seizures, possibly slowing mental deterioration Skin= Adenoma Sebacium ( reddened facial nodule) Shagreen patches ( lethary patches on trunk) Ash leaf ( hypopigmented patches) Retinal lesions Cardiac Rhabdomyomas
Things seen in Neurofibromatosis
- Neurofibromas - skin colored lesions attaches to peripheral nerves
- 8th cranial nerve tumors ( ringing or hearing loss)
- Hyperpigmented spots ( cafe au lait spots)
- Meningioma or glioma
Things seen with Sturge- Weber syndrome
port wine stain on face Seizures Homonomous hemianopsia Hemiparasis Calcification of angiomas leptomeningeal capillary-venous malformation (leptomeningeal angioma) involving the brain and eye
What makes an essential tremor worse and what makes it better
- Caffeine makes it worse
- Propranolol makes better as well as alcohol
What do you need to diagnose Parkinsons disease
- no test so have to do it baised on symptoms.
- gait
- Orthostasis ( light headed when stand up)
- tremor
What are causes of Parkinsonism
- trauma such as boxing
- Antipsychotics such as Thorazine
- Reserpine
- Metaclopromide ( dopamine antagonist)
What is med that should be used for patients with mild symptoms who cant handle anticholinergic medications due to its side effects.
- Amantadine
What are drugs you can use for severe Parkonsins disease
Dopamine agonists- ( use bec less side effects)
Pramipaxol
Ropinirole
Bromocriptine or cabergoline
Levodopa carbadopa
What drugs do you use to extend duration of levodopa/carbodopa
- COMT inhibitors = Tolcapone or Entacapone
- blocks metabolism of dopamine
- when response therapy is inadequate or pt is experiencing on/ off phenomenon
or can give MAO inhibitors rasagiline/ selegaline
- cant give red wine with this because inc blood pres
What is the problem in people with Huntington disease
- CAG trinucleotide repeat on chrom 4
What are symptoms of Huntington disease
- Choreaform movement (dyskinesia)
- Dementia
- Behavioral changes- irritability, moodiness
- Onset ages 30-50
What are treatment options for dyskinesia and psychosis in a Huntington disease pt
- tetrabenazine
- Haloperidol or Quetiapine
What does Internuclear ophthalmoplegia
It is when you cant adduct one eye with nastagmus of the other eye.
What is the disease where it will be a young girl in cold area with either eye pain, blurred vision, INO
MS
What is best initial and most accurate test for MS
MRI
What are drugs used to prevent relapse of MS
Glatiramir Beta- interferon Natalizumab Mitoxatrone Fingolamod- Only oral Dalfampridine- Is used to increase walking speed
What does ALS impair
It impairs both upper and lower motor neurons. Spares the sensory system.
What are common symptoms to see in a Pt with ALS
weakness starting in 20-40s upper and lower motor signs Trouble chewing and swallowing Decrease in gag reflex frequent episodes of aspiration which can cause pneumonia
What is an abnormal lab value that you will see in ALS
CPK elevation
What is the reason to give Riluzole in pts with ALS.
Delays disease progression
Reduces glutamate buildup in Neurons.
What are the possible treatments for pts with ALS
Riluzole
Baclofen (spacticity)
CPAP machine ( increase energy and moves uvula out of way)* very important
Tracheostomy when disease progresses because you could put someone on ventilator at night.
What are losses and symptoms with Charcot-Marie-Tooth Disease
- Both motor and sensory innervation (wasting in legs, dec DTR, Tremor)
- Foot deformity with high arch (pes cavus)
- legs look like inverted champagne bottles
What is most accurate test for charcot-marie-tooth disease
Electromyography
What are causes of Peripheral Neuropathy
- DM
- Uremia
- Alcoholism
- paraproteinemias (MGUS)
