Neurology

Question 1

types of lesions involved in alzheimers

Answer 1

-amyloid plaques
-neurofibrillary tangles

Question 2

s/s of alzheimers

Answer 2

-difficulty learning and recalling information
-visuospatial problems
-language impairment
-behavior changes

Question 3

diagnosis of alzheimers

Answer 3

clinical
-cerebral atrophy on imaging

Question 4

treatment of alzheimers disease

Answer 4

donepezil
rivastigmine
memantine

Question 5

s/s of bells palsy

Answer 5

acute onset facial weakness
loss of taste
hyperacusis

Question 6

bells palsy vs stroke

Answer 6

bells palsy: forehead does NOT wrinkle with raising eyebrows
stroke: forehead DOES wrinkle with raising eyebrows

Question 7

diagnosis of bells palsy

Answer 7

clinical

Question 8

treatment of bells palsy

Answer 8

-prednisone
-valacyclovir

Question 9

types of stroke

Answer 9

-ischemic: thrombotic or embolic (MC d/t afib)
-hemorrhagic: intracerebral or subarachnoid

Question 10

etiology of intracerebral hemorrhage

Answer 10

prolonged uncontrolled hypertension

Question 11

s/sx of stroke

Answer 11

-facial drooping
-hemiparesis
-vision loss
-aphasia
-ataxia
-HA
-LOC

Question 12

most important piece of info for stroke

Answer 12

last known normal

Question 13

stroke workup

Answer 13

CT w/o contrast

Question 14

treatment of ischemic stroke

Answer 14

-determine tpa eligibility
-bp less than 185/110 before tpa can be administered
-if not eligible for tpa, cant treat until bp is 220/120

IV nicardipine, IV clevidipine, IV labetalol

DO NOT LOWER MORE THAN 15% in 24HRS

Question 15

treatment for intracerebral hemorrhage

Answer 15

SBP 150-220: reduce SBP to 130-140

If >220, not enough evidence to provide specific recommendations

Elkins slides

Question 16

treatment of subarachnoid hemorrhage

Answer 16

reduce bp to 160

labetalol, nicardipine, or enalapril

Prevent vasospams w/ Nimodipine PO or NG for 3 weeks

Question 17

TIA

Answer 17

stroke like symptoms that resolve in 1-2 hours

Question 18

workup and treatment of TIA

Answer 18

same as stroke

Question 19

s/s of vascular dementia

Answer 19

white matter lesions on MRI

Question 20

management of vascular dementia

Answer 20

same as alzheimers

Question 21

s/s of dementia with lewey bodies

Answer 21

-fluctuating cognitive impairment
-tremors
-bradykinesia
-gait changes
-visual hallucinations

Question 22

diagnosis of dementia with lewy bodies

Answer 22

autopsy

Question 23

treatment of dementia with lewy bodies

Answer 23

same as alzheimers

Question 24

s/s of delirium

Answer 24

-acute onset
-attention deficits
-cognitive impairment

usually only lasts hours to weeks

Question 25

treatment of delirium

Answer 25

treat underlying cause

Question 26

s/s of essential tremor

Answer 26

-**bilateral** -both postural and kinetic -resolves with rest -**exacerbated by stress** -**improves with alcohol**

Question 27

management of essential tremor

Answer 27

propranolol and primidone

Question 28

s/s of migraine

Answer 28

-prodrome: euphoria, hunger, yawning -aura: scotoma, flashing lights, sounds -**unilateral throbbing HA** -photophobia and phonophobia

Question 29

treatment of migraine

Answer 29

-triptan -preventative therapy (topamax or BB or antidepressant)

Question 30

s/s of tension headache

Answer 30

-**band like**, non-pulsating, bandlike pain across forehead -tenderness to back of neck musculature -usually caused by stress **MC type of HA**

Question 31

treatment of tension HA

Answer 31

NSAIDs or tylenol

Question 32

s/s of cluster HA

Answer 32

-Sudden onset, brief, **unilateral** repetitive headaches localized behind one eye -**ipsilateral conjunctival injection, lacrimation, rhinnorhea** (autonomic symptoms)

Question 33

treatment of cluster HA

Answer 33

-100% O2 with a nonrebreather -sumatriptan

Question 34

s/s of parkinsons | caused by dopamine depletion in basal ganglia

Answer 34

-resting **pill rolling** tremor -rigidity -bradykinesia -shuffle gait -**cogwheeling of extremeties**

Question 35

treatment of parkinsons

Answer 35

carbidopa/levadopa

Question 36

focal seizure with retained awareness

Answer 36

no LOC or memory loss

Question 37

focal seizure with impaired awareness

Answer 37

altered consciousness

Question 38

which type of generalized seizure is not associated with LOC

Answer 38

myoclonic

Question 39

absence seizure

Answer 39

-spacing out

Question 40

myoclonic seizure

Answer 40

sudden, irregular jerks or twitches

Question 41

atonic seizures

Answer 41

drop attacks

Question 42

tonic seizures

Answer 42

-muscles tighten and stiffen

Question 43

clonic seizures

Answer 43

-rhythmic jerking

Question 44

tonic clonic seizures

Answer 44

-both tonic and clonic -**bowel or bladder incontinence**

Question 45

diagnosis of seizures

Answer 45

EEG

Question 46

treatment of seizures focal: generalized: generalized pregnant: absense:

Answer 46

-absense: ethosuximide -focal: lamictal -generalized: depakote (valproate) -generalized pregnant: keppra

Question 47

status epilepticus

Answer 47

seizure lasting more than 5-10 minutes or several seizures occurring in a 30 minute timeframe

Question 48

treatment of status epilepticus

Answer 48

IV lorazepam

Question 49

etiology of BPPV

Answer 49

-calcium deposit in semicircular canal

Question 50

s/s of BPPV

Answer 50

-recurrent brief episodes of vertigo -occurs after change in head position

Question 51

diagnosis of bppv

Answer 51

Dix-Hallpike maneuver

Question 52

treatment of BPPV

Answer 52

-reposition otolith with **epley maneuver**