Neurology Flashcards

1
Q

what is thiamine used for

A

wernickes encephalopathy

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2
Q

What makes up the Glasgow Coma Scale?

A

Eye-opening
Verbal
Motor

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3
Q

a GCS of less than 9 is indivative of what?

A

coma

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4
Q

what is the presentation of Bells Palsy

A

sudden onset unilateral facial nerve paralysis with no other focal neurologic or systemic findings

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5
Q

what is the treatment of Bells palsy

A

prednisone
artificial tears
tape eyelid shut

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6
Q

how does encephalitis present

A

begins wtih flu-like symptoms
fever, HA, AMS, Seizure, personality changes and exanthema

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7
Q

how is encephalitis differentiated from meningitis

A

altered brain functioning

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8
Q

what is Reye’s syndrome

A

rapid progressive encephalopathy with hepatic dysfunction, usually post-flu/URI
babinski positive and hyperreflexia noted

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9
Q

what are diagnostic tests used for diagnosing reye’s syndrome

A

Liver enzymes (elevated)
PTT (elevated)
Hyperammonemia
hypoglycemia
metablic acidosis

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10
Q

how is encephalitis diagnosed

A

LP and MRI
PCR for virues
Kernig and Brudzinski is usually absent

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11
Q

what is the treatment of encephalitis

A

supportive care and acyclovir 10mg/kg IV Q8hrs

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12
Q

what is the treatment of status epilepticus

A

Benzo (lorazepam, diazepam, midazolam)
phenytoin/fosphenytoin
phenobarbital and lacosamide

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13
Q

what is the treatment of focal seizures

A

pheytoin and carbamazepine

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14
Q

what are diagnostic tests for seizure workup

A

check electrolytes
glucose
pregnancy test
ECG
EEG
neuroimaging for adults with first seizure (CT/MRI)

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15
Q

a 27yo mountain biker strikes a tree and was not wearing a helmet. he loses consciousness for several minutes but later regains consciousness and reports feeling fine. several hours later his neurological state decompensates acutely.
what is his most likely diagnosis

A

epidural hematoma

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16
Q

what is the treatment of epidural hematoma

A

surgical craniotomy / medical management of increased ICP (mannitol, hyperventilate, steroids/ventricular shunt)

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17
Q

what is the most common artery involved with epidural hematoma

A

middle meningeal artery - blood fills space between dura and skull

18
Q

what type of head injury occurs when there is injury to the bridging veins

A

subdural hematoma

19
Q

where does blood collect with subdural hematoma

A

between dura and arachnoid mater

20
Q

how is subdural hematoma diagnosed

A

non-con head CCT (crescent-shaped, concave hyperdesnisty)

21
Q

what is anterior cord syndrome

A

loss of pain/temperature below the level of the lesion preserved joint position/vibration

22
Q

what is central cord syndrome

A

loss of apin and temperature sensation at the level of the lesion, where spinothalamic fibers cross the cord with other modalities preserved (dissociated sensory loss)

23
Q

what is complete cord transection

A

rostral zone of spared sensory levels (reduced sensation cuadally, no sensation in levels below injury); urinary retention and bladder distention

24
Q

what is Brown-sequard syndrome

A

semisection of cord
loss of joint position and vibration sense on the same side as the lesion and pain/temp on opposite side as a few levels below the lesion

25
what presents as ascending paralysis beginning in distal limbs
guillain-Barre syndrome
26
how is guillain-barre syndrome diagnosed
lumbar puncture - elevated CSF protein with normal CSF WBC
27
what is the treatment of GBS
plasma exchange (remove circulating antibodies) and IVIG
28
what is the diagnostic test for stoke evaluation
emergent brain imaging essentail for ischemic stroke - non-contrast CT scanning transcranial doppler US, echo for ischemic stroke
29
what is the treatment of stroke
thromolysis, IV admin for rtPA for occlusive disease treat with IV tPA within 3-4.5 hours onset
30
what is the diagnostic test for subaarachnoid hemorrhage
non-contrast head CT, LP (elevated opening pressure / grossly blod fluid in all 4 tubes) Cerebral angiogrpahy may be done EEG may show the site of hemorrhage/diffuse changes
31
what is the treatment of subarachnoid hemorrhage
prevention of elevated arterial/intracranial pressure - manage HTN surgial clipping/wrapping of aneurysm
32
how are TIA diagnosed?
CT (without contrast) MRI more sensitive carotid doppler US CT angiography MR angiography
33
what is the treament for TIA
aspirin + dipryidmole or clopidogreal monotherapy (antiplatelet therapy )
34
how is alzheimers disease diagnosed
Folstein Mini-Mental state examination (NMSE) or memory impairment screen
35
what are treatment options for alzheimers disease
cholinesterase inhibitors (donepazil) NMDA antagonist (memantine)
36
what is the classic triad of meningitis
fever > 38C, nucal rigidity (stiff neck) and headache (no mental status change)
37
what is Kernig sign
neck pain with knee extension
38
what is brudzinski sign
leg raise with a bent neck
39
how is meningitis diagnosed
lumbar puncture - first check for increased ICP (papiledema) CT if unsure
40
what is seen on LP with bacterial meningitis
increase protein decreased glucose marked increase in opening pressure