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STEP 3 COPY > Neurology > Flashcards

Neurology Flashcards

1
Q

A patient presents with sudden onset of weakness on one side of their body and face (sparing upper 1/3 from eyes up), aphasia and partial/total loss of vision. What is the most likely diagnosis?

A

Stroke or Transient Ischemic Attack (TIA)

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2
Q

What is the difference between stroke and transient ischemic attack (TIA)?

A

Stroke lasts for 24 hours or longer (associated with permanent residual neuro deficits)
TIAs last less than 24 hours (symptoms resolve)

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3
Q

What is amaurosis fugax?

A

transient loss of vision in one eye

occurs in TIAs

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4
Q

What is the best initial step for a patient presenting with symptoms suggesting stroke?

A

Head CT without contrast

rule out hemorrhage before thrombolytics

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5
Q

What cerebral arterial lesion results in profound lower extremity weakness, mild upper extremity weakness, personality changes/ psychiatric disturbances, and urinary incontinence?

A

Anterior cerebral artery

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6
Q

What cerebral arterial lesion results in profound upper extremity weakness, aphasia, apraxia/ neglect, eyes deviating towards lesion, and contralateral homonymous hemianopsia with macular sparing?

A

Middle cerebral artery

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7
Q

What cerebral arterial lesion results in prosopagnosia (inability to recognize faces)?

A

Posterior cerebral artery

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8
Q

What cerebral arterial lesion results in vertigo, N/V, “drop attack” (loss of consciousness), vertical nystagmus, dysarthria, dystonia, sensory changes in face & scalp, and ataxia?

A

Vertebrobasilar artery

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9
Q

What cerebral arterial lesion results in ipsilateral face symptoms, contralateral body symptoms, vertigo and Horner’s syndrome?

A

Posterior inferior cerebellar artery

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10
Q

What cerebral arterial lesion results in ataxia, parkinsonian signs, sensory deficits, hemiparesis (mostly in face), and bulbar signs without cortical deficits?

A

Lacunar artery

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11
Q

What cerebral arterial lesion results in amaurosis fugax (transient loss of vision in one eye)?

A

Ophthalmic artery

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12
Q

What is the best initial diagnostic test for suspected stroke/ TIA?

A

Head CT without contrast

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13
Q

What is the most accurate diagnostic test for suspected stroke/ TIA?

A

Magnetic resonance angiogram (MRA)

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14
Q

What is the best initial treatment for a patient with a non-hemorrhagic stroke/ TIA?

A
  1. Thrombolytics (TPA) if within 3 hours of onset

2. aspirin if after 3 hours of onset

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15
Q

What are the two alternate treatments for patient who develop a non-hemorrhagic stroke/ TIA while on aspirin?

A
  1. switch to clopidogrel

2. add dipyridamole with aspirin

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16
Q

Other than an anti-platelet (aspirin, clopidogrel, dipyridamole), what other treatment should be initiated for a patient with a non-hemorrhagic stroke/ TIA?

A

Statin (to control hyperlipidemia)

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17
Q

What are the contraindications to thrombolytic (TPA) treatment? (8)

A
  1. hx of hemorrhagic stroke
  2. presence of intracranial neoplasm/mass
  3. active bleeding/ surgery within 6 weeks
  4. bleeding disorder
  5. traumatic CPR within 3 weeks
  6. suspected aortic dissection
  7. stroke within 1 year
  8. cerebral trauma/ brain surgery within 6 months
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18
Q

What are the diagnostic tests that should be performed in a stroke patient after head CT, thrombolytics and aspirin are given? (3)

A
  1. Echocardiogram (assess for clots/ valve vegetation)
  2. Carotid Dopplers/ duplex (assess for stenosis)
  3. EKG and Holter monitor (assess for a-fib)
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19
Q

What are additional diagnostic tests for young patients (

A
  1. ESR (sedimentation rate)
  2. VDRL/ RPR (assess for syphillis)
  3. ANA, double-stranded DNA (assess for lupus)
  4. protein C
  5. protein S
  6. Factor V Leiden mutation
  7. antiphospholipid syndrome

(rule out vasculitis or hypercoaguable state)

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20
Q

What is the blood pressure goal for patients who had a stroke?

A
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21
Q

What is the LDL goal for patients who had a stroke?

A
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22
Q

What is the treatment for paradoxical emboli through a patent foramen?

A

closure with catheter device

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23
Q

What is the treatment protocol for status epilepticus?

A
  1. Benzo (lorazepam)
  2. Fosphenytoin (after 10-20 mins)
  3. Phenobarbital (after 10-20 mins)
  4. general anesthesia (after 10-20 mins; pentobarbital, thiopental, midazolam, propofol)
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24
Q

What are the diagnostic tests that should be performed initially for a patient having a seizure? (4)

A
  1. electrolytes (sodium, calcium, glucose, oxygen, creatinine & magnesium level)
  2. urgent head CT
  3. urine toxin screen
  4. liver & renal function test
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25
Q

What should be done for a patient having a seizure after initial diagnostic testing is negative? (2)

A
  1. EEG

2. neuro consult

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26
Q

What are the four indications for chronic anti-epileptic drug therapy after a single seizure?

A
  1. strong family history of seizures
  2. abnormal EEG
  3. status epilepticus
  4. non-correctable precipitating cause (brain tumor)
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27
Q

What is the best initial treatment for absence (petit mal) seizures?

A

Ethosuximide

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28
Q

What anti-epileptic medication is associated with Stevenes-Johnson syndrome?

A

lamotrigine

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29
Q

What is the most likely diagnosis for a tremulous patient with a slow, abnormal festinating gait and orthostasis?

A

Parkinson’s Disease

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30
Q

What are 6 physical findings associated with Parkinson’s disease?

A
  1. cogwheel rigidity
  2. resting tremor
  3. hypomimia (masklike, under-reactive face)
  4. micrographia (small writing)
  5. orthostasis
  6. intact cognition and memory
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31
Q

What is the best treatment for a younger patient (

A

anticholinergics (benzotropine, hydroxyzine)

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32
Q

What is the best treatment for an older patient (>60) with mild symptoms of Parkinson’s disease?

A

Amantadine

anticholinergics worsen memory and increase side effects in elderly

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33
Q

What is the first line treatment for patient with severe symptoms (inability to perform activities of daily living) of Parkinson’s disease? (2)

A
  1. Carbidopa-levodopa

2. dopamine agonist (pramipexole, ropinirole, cabergoline)

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34
Q

What are the 3 second line treatments for patient with severe symptoms (inability to perform activities of daily living) of Parkinson’s disease)?

A
  1. COMT inhibitors (tolcapone, entacapone w/ dopamine drugs)
  2. MAO inhibitors (selegiline, rasagiline)
  3. deep brain stimulation
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35
Q

What treatment can be added when levodopa causes psychosis in a Parkinson’s patient?

A

Quetiapine

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36
Q

What is the most likely diagnosis for a patient with a tremor at rest and with intention (action)?

A

Essential tremor

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37
Q

What is the best treatment for a patient with essential tremor?

A

Propranolol

can also use alcohol if only option

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38
Q

A patient presenting with multiple neurological deficits developing at different times (months to years apart) most likely suffers from …

A

Multiple sclerosis

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39
Q

What is the most common abnormality associated with multiple sclerosis?

A

optic neuritis

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40
Q

What is the best initial diagnostic test for a patient with suspected multiple sclerosis?

A

MRI

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41
Q

What is the most accurate diagnostic test for a patient with suspected multiple sclerosis?

A

MRI

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42
Q

What is the next best diagnostic tool for a patient with suspected multiple sclerosis if an MRI is nondiagnostic?

A

CSF (lumbar tap showing oligoclonal bands)

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43
Q

What is the best initial therapy for multiple sclerosis?

A

steroids (for acute exacerbation)

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44
Q

What is the best therapy for fatigue associated with multiple sclerosis?

A

amantadine

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45
Q

What is the best therapy for spasticity associated with multiple sclerosis? (2)

A
  1. baclofen

2. tizanidine

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46
Q

What is long term treatment for multiple sclerosis?

A

disease modifying therapy (beta interferon, glatiramer, mitoxantrone, natalizumab, fingolimod, dalfampridine)

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47
Q

What adverse side effect is associated with the use of natalizumab?

A

PML

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48
Q

What diagnostic tests should be performed in a patient presenting with memory loss? (4)

A
  1. head CT
  2. vitamin B12 level
  3. thyroid function testing (TSH, T4)
  4. RPR/ VDRL
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49
Q

What is the only abnormal test result in a patient with Alzheimer’s disease?

A

head CT showing diffuse, symmetrical atrophy

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50
Q

What is the best initial treatment for a patient with Alzheimer’s disease?

A

anticholinesterase (donepezil, rivastigmine, galantamine)

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51
Q

A patient presenting with personality and behavioral changes followed by memory loss most likely suffers from …

A

Frontotemporal dementia
(focal atropy of frontal and temporal lobes)
(treat like Alzheimer’s)

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52
Q

A patient presenting with rapidly progressive dementia and myoclonus most likely suffers from ..

A

Creutzfledt-Jakob Disease (CJD)

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53
Q

What is the CSF finding associated with Creutzfeldt-Jakob disease?

A

14-3-3 protein

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54
Q

What diagnostic tests should be performed in a patient with suspected Creutzfeldt Jakob disease? (3)

A
  1. EEG
  2. MRI (no abnormality)
  3. CSF (14-3-3 protein)

(however brain biopsy is most accurate)

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55
Q

A patient presenting with resting tremor, cogwheel rigidity, wide based gait, vivid & detailed hallucinations, and dementia most likely suffers from …

A

Lewy Body Disease

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56
Q

A patient presenting with urinary incontinence, dementia, and wide-based gait/ ataxia most likely suffers from …

A

Normal Pressure Hydrocephalus

wet, wacky, wobbly

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57
Q

What is the best treatment for normal pressure hydrocephalus?

A

shunt placement

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58
Q

What diagnostic test should be performed in a patient with suspected normal pressure hydrocephalus? (2)

A
  1. head CT

2. lumbar puncture

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59
Q

A young patient presenting with dementia, psychiatric disturbances, personality changes, dance-like movements and a family history of similar symptoms most likely suffers from…

A

Huntington’s disease

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60
Q

What is the best diagnostic test for suspected Huntington’s disease?

A

specific genetic testing

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61
Q

What is the best treatment for the movement disorder associated with Huntington’s disease?

A

tetrabenazine

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62
Q

What are 4 common triggers of migraine headaches?

A
  1. cheese
  2. caffeine
  3. mensruation
  4. oral contraception
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63
Q

A pt presents with a unilateral/bilateral headache associated with abnormal smells, aura, flashing lights, photophobia and visual changes most likely suffers from ..

A

migraine

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64
Q

When should a head CT or MRI be performed for a patient presenting with a headache? (3)

A
  1. sudden or severe
  2. onset after age 40
  3. associated with focal neurological findings
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65
Q

What is the best initial abortive therapy for migraines?

A

Triptans or ergotamine

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66
Q

What is the best initial prophylactic therapy for migraines?

A 
Beta Blockers (propanolol)
(second line includes calcium channel blockers, TCAs, SSRIs)
67
Q

A male pt presents with unilateral excruciating headache associated with eye redness, lacrimation, and rhinorrhea most likely suffers from …

A

Cluster headache

68
Q

What is the best initial abortive therapy for cluster headaches?

A

100% oxygen and/or triptans

steroids can also be used

69
Q

Whats is the best initial prophylactic therapy for cluster headaches?

A

verapamil

70
Q

A pt presents with severe headache, temporal area tenderness, visual disturbances and jaw claudication most likely suffers from …

A

Temporal (giant cell) arteritis

71
Q

What is the most accurate diagnostic test for temporal arteritis?

A

Temporal artery biopsy

72
Q

What is the best initial step in management for a patient with suspected temporal arteritis?

A

steroids (then perform biopsy) to prevent permanent vision loss

73
Q

An obese young women presents with a severe headache, double vision, papilledema and history of vitamin A use most likely suffers from….

A

Pseudotumor Cerebri

74
Q

What is the most accurate diagnostic test for a pt with suspected Pseudotumor Cerebri?

A

lumbar puncture with opening pressure measurement (elevated pressures)

75
Q

What are the 3 treatment options for patients with Pseudotumor cerebri?

A
  1. weight loss
  2. acetazolamide
  3. surgery (VP shunt, optic nerve sheath fenestration)
76
Q

What is the best initial diagnostic test for all patients with vertigo (room spinning)?

A

MRI of internal auditory canal

77
Q

A pt presenting with vertigo that occurs when quickly changing positions most likely suffers from …

A

Benign Positional Vertigo (BPV)

otoliths in ear

78
Q

What disorder is associated with a positive Dix-Hallpike maneuver?

A

Benign Positional Vertigo (BPV)

79
Q

What is the best initial treatment for Benign Positional Vertigo (BPV)?

A
  1. head maneuvers

2. meclizine

80
Q

A pt presenting with vertigo and dizziness that is not associated with changing positions, hearing loss or tinnitus most likely suffers from …

A

Vestibular Neuritis (inflammation of vestibular portion of 8th cranial nerve)

81
Q

What is the best initial treatment for vestibular neuritis?

A

meclizine

82
Q

A pt presenting with a single episode vertigo, hearing loss and tinnitus after a recent viral illness most likely suffers from…

A

Labyrinthitis (inflammation of cochlear portion of inner ear)

83
Q

What is the best initial treatment for Labyrinthitis?

A

meclizine and steroids

84
Q

A pt presenting with multiple episodes of vertigo, hearing loss and tinnitus most likely suffers from …

A

Meniere’s disease (overproduction of endolymphatic fluid in ear)

85
Q

What is the best initial treatment for Meniere’s disease?

A

salt restriction and diuretics

surgery ablation of 8th cranial nerve if needed

86
Q

A pt presenting with vertigo, hearing loss, tinnitus, and ataxia who may have a history of neurofibromatosis or Van Recklinhausen’s disease most likely suffers from…

A

Acoustic Neuroma

8th cranial nerve tumor; tx surgically

87
Q

What is the best initial step in management for a pt with suspected acoustic neuroma?

A

MRI of internal auditory canal

88
Q

A pt presenting with vertigo and hearing loss after head trauma or barotrauma most likely suffers from …

A

perilymph fistula (rupture in tympanic membrane)

89
Q

An alcoholic pt presenting with confusion, confabulation, ataxia, memory loss, gaze palsy (ophthalmoplegia) and nystagmus most likely suffers from …

A

Wernicke-Korsakoff syndrome

90
Q

What is the best initial treatment for a pt presenting with suspected Wernicke-Korsakoff syndrome?

A

thiamine followed by glucose

91
Q

what is the next best step in management for a pt presenting with symptoms suggestive of meningits?

A

administer antibiotics

followed by blood cultures and lumbar puncture

92
Q

When should you obtain a head CT before a lumbar puncture? (6)

A
  1. history of central nervous system disorder
  2. focal neurological deficit
  3. papilledema
  4. seizures
  5. altered consciousness
  6. significant delay in ability to perform lumbar puncture
93
Q

A CSF gram stain showing gram positive diplococci in suspected meningitis case is suggestive of ….

A

Pneumococcus

94
Q

A CSF gram stain showing gram negative diplococci in suspected meningitis case is suggestive of …

A

Neiserria

95
Q

A CSF gram stain showing gram negative pleomorphic, coccobacillary organisms in suspected meningitis case is suggestive of…

A

Haemophilus

96
Q

A CSF gram stain showing gram positive bacilli in suspected meningitis case is suggestive of …

A

Listeria

97
Q

What is the best initial test for the diagnosis of meningitis?

A

CSF cell count (elevated neutrophils suggest bacterial meningitis

98
Q

What CSF glucose level findings are consistent with bacterial meningitis?

A

glucose levels below 60% of serum levels

99
Q

What is the best step in management of a pt with suspected meningitis who has elevated CSF neutrophils?

A

start IV ceftriaxone, vancomycin, and steroids

100
Q

An HIV pt presents with subtle signs of neck stiffness, headache, fever, and photophobia and found to have a CD4 count less than 100 most likely suffers from ..

A

Cryptococcus

101
Q

What is the best initial test for suspected Cryptococcus?

A

India Ink

102
Q

What is the most accurate test for suspected Cryptococcus?

A

Cryptococcal antigen

103
Q

What is the best initial therapy for Cryptococcus infection?

A

Amphotericin and 5-flucytosine (5FC)

104
Q

What determines whether 5-FC is continued in an HIV pt with recent Cryptococcus infection?

A

CD4 cell count (if less than 100, continue until above 100)

105
Q

A pt presenting with headache and meningeal signs alone with a history of joint pain, 7th cranial nerve palsy, a rash with central clearing after camping/hiking most likely suffers from …

A

CNS Lyme disease

106
Q

What is the treatment for CNS lyme disease?

A

IV ceftriaxone or penicillin

107
Q

What is the most accurate diagnostic test for CNS lyme disease?

A

specific serologic or western blot testing on CSF

108
Q

A pt presenting with fever, headache and malaise followed by a rash that starts on wrists and ankles then moves towards the trunk after camping or hiking most likely suffers from….

A

Rocky Mountain Spotted Fever

109
Q

What is the most effective therapy for Rocky Mountain Spotted Fever?

A

doxycycline

110
Q

An immigrant pt with a history of lung tuberculosis that develops a fever, headache, and stiff neck over weeks to months and CSF from lumbar puncture shows extremely high protein levels most likely suffers from…

A

TB Meningitis

acid fast stain of CSF positive in 10%; acid-fast culture requires 3 high volume taps

111
Q

What is the treatment for TB Meningitis?

A

RIPE plus steroids

rifampin, isoniazid, pyrazinamide, ethambutol and steroids

112
Q

A pt presenting with fever, headache, stiff neck, photophobia and a lymphocytic pleocytosis in the CSF most likely suffers from …

A

Viral meningitis

113
Q

An adolescent/ military/ asplenic/terminal complement deficient pt presents with fever, headache, stiff neck, photophobia, petechial rash and elevated neutrophils most likely suffers from …

A

Neisseria meningitis

114
Q

What is the next best step in management of a pt with suspected Neisseria meningitis? (3)

A

start antibiotcs (IV ceftriaxone and vancomycin) and enforce respiratory isolation and prescribe rifampin to close contacts

115
Q

An elderly/ neonate/ HIV or immunocompromised pt presents with headache, fever, stiff neck, photophobia and elevated neutrophils in the CSF most likely suffers from ….

A

Listeria meningitis

116
Q

What is the best initial step in a patient with suspected Listeria meningitis?

A

add ampicillin to antibiotic treatment

117
Q

A pt presenting with fever and altered mental status developing over a few hours most likely suffers from …

A

Encephalitis (herpes encephalitis is most common in US)

118
Q

What is the best initial test for suspected Herpes encephalitis?

A

Head CT scan

119
Q

What is the most accurate test for suspected Herpes encephalitis?

A

PCR of the CSF

120
Q

What is the best initial therapy for suspected herpes encephalitis?

A

acyclovir (foscarnet if acyclovir resistant pt)

121
Q

A pt presents with a fever, headache and focal neurological deficits, what is the next best step in management?

A

CT scan (look for abscess- ring enhancing lesion)

122
Q

What is the next best step in management of a non-HIV pt who presented with fever, headache and focal neuro deficits and was found to have a ring enhancing lesion on CT scan?

A

brain biopsy

123
Q

What is the next best step in management of a HIV pt who presented with fever, headache, and focal neuro deficits and was found to have a ring enhancing lesion on CT scan?

A

treat for Toxoplasmosis (pyrimethamine and sulfadiazine)

124
Q

What is the best treatment for a HIV patient with brain lesions (non enhancing and no mass effect) suggestive of progressive multifocal leukoencephalopathy (PML)?

A

anti-retrovirals to treat HIV and raise CD4 count

125
Q

A pt from Mexico presenting with seizures and is found to have multiple cystic lesion on CT scan most likely suffers from …

A

Neurocysticercosis

126
Q

What is the best initial therapy for Neurocysticercosis?

A

albendazole and steroids (prevent reaction to dying parasite ) if lesions are active and uncalcified

127
Q

What is the next best step in management for a pt presenting with loss of consciousness or altered mental status after head trauma?

A

Head CT scan

128
Q

A pt presenting with loss of consciousness or altered mental status after head trauma and a lens shaped collection of blood on CT scan most likely suffers from….

A

Epidural hematoma

129
Q

A pt presenting with loss of consciousness or altered mental status after head trauma and a crescent shaped collection of blood on CT scan most likely suffers from….

A

Subdural hematoma

130
Q

What is the best step in management for a pt presenting with a large intracranial hemorrhage with mass effect? (3)

A
  1. Incubate/ hyperventilate (pCO2 to 28-32)
  2. Mannitol
  3. Surgical evacuation
131
Q

What are the three indicators for use of proton pump inhibitors as prophylaxis against stress ulcers?

A
  1. Head trauma
  2. Burns
  3. Endotracheal intubation with mechanical ventilation
132
Q

A pt presenting with sudden onset severe headache, stiff neck, loss of consciousness, and focal neuro deficits most likely suffers from…

A

Subarachnoid hemorrhage

Blood irritates meninges and bowel

133
Q

What is the most accurate diagnostic test for subarachnoid hemorrhage?

A

Lumbar puncture (greater ratio than 500 RBC to 1 WBC) if CT negative

134
Q

What is the treatment protocol for a subarachnoid hemorrhage? (4)

A
  1. Angiogram (detect site of bleed)
  2. Embolize site
  3. Insert VP shunt if hydrocephalus
  4. Nimodipine
135
Q

A pt presenting with loss of sensation of pain and temperature in the upper extremities bilaterally in a cape like distribution over the neck, shoulders and down both arms most likely suffers from…

A

Syringomyelia

136
Q

What is the best diagnostic test and best treatment for Syringomyelia?

A

MRI; surgery

137
Q

A pt presents with back pain and tenderness of the spine and may have a history of cancer most likely suffers from…

A

Cord compression

138
Q

What is the best initial diagnostic test and most accurate diagnostic test?

A

MRI; biopsy

139
Q

What is the best next step for a patient with suspected cord compression?

A

Steroids (to decrease swelling from inflammation)

140
Q

A pt presenting with back pain, spinal tenderness and fever most likely suffers from …

A

Spinal epidural abscess

141
Q

A pt presents with back and leg pain that is worse when walking downhill and leaning backward but improved with walking uphill most likely suffers from …

A

Spinal stenosis

142
Q

A pt presents with sudden loss of all sensation except position and vibratory sense from a spinal level down most likely suffers from …

A

Anterior spinal artery infarction (no treatment)

143
Q

A pt presents with loss of ipsilateral position and vibration sense and loss of contralateral pain and temperature sense after traumatic injury most likely suffers from …

A

Brown Sequard syndrome

144
Q

A pt presents with hyperreflexia, up going toes on plantar reflex, spasticity, weakness, muscle wasting, and fasciculations most likely suffers from…

A

Amyotrophic Lateral Sclerosis (upper and lower motor neurons)

145
Q

What is the only treatment available for amyotrophic lateral sclerosis (ALS)?

A

Riluzole (blocks accumulation of glutamate)

146
Q

What is the best initial treatment for diabetic peripheral neuropathy?

A

Gabapentin or pregabalin

147
Q

A pt presents with pain and weakness in the first three digits of the hand and worsened by repetitive use most likely suffers from …

A

Carpal tunnel syndrome

148
Q

What is the best initial therapy for carpal tunnel syndrome?

A

Splinting

149
Q

What is the next best step in management of carpal tunnel syndrome if splinting is not helpful?

A

Steroid injections

150
Q

A pt presents with wrist drop after falling asleep with pressure on the arms underneath the body or arms outstretched/ draped over back of chair most likely suffers from….

A

Radial nerve palsy (Saturday night palsy)

151
Q

A pt presents with foot drop and inability to evert the foot after wearing high boots that press at the back of the knee most likely suffers from ….

A

Perineal nerve palsy (resolves on own)

152
Q

A pt presents with hemifacial paralysis of both the upper and lower parts of the face, loss of taste of the anterior 2/3 of the tongue, hyperacusis and inability to close the eye at night most likely suffers from….

A

Bell’s Palsy (7th cranial nerve palsy)

153
Q

What is the treatment for Bell’s palsy (7th cranial nerve palsy)?

A

Steroids

154
Q

A pt with a history a previous injury to the extremity presents with extreme burning like pain with light touch of the extremity most likely suffers from…

A

Reflex sympathetic dystrophy (chronic regional pain syndrome)

155
Q

What is the treatment for reflex sympathetic dystrophy (chronic regional pain syndrome)?

A

NSAIDs, Gabapentin, nerve block

156
Q

A patient’s partner complains of pain and bruises in the legs and the patient complains of uncomfortable feelings in the legs relieved by movement most likely suffers from..

A

Restless legs syndrome

157
Q

What is the treatment for restless legs syndrome?

A

Pramipexole or ropinirole

158
Q

A pt presenting with ascending weakness with loss of deep tendon reflexes after a recent illness most likely suffers from …

A

Guillian Barre syndrome

159
Q

What is the most urgent step in a patient with suspected Giillian Barre syndrome?

A

Peak inspirations pressure (diminishes as diaphragm weakens; detect respiratory failure)

160
Q

A pt presents with difficulty finishing meals, blurry vision, and drooping of eyelids as the day progresses most likely suffers from …

A

Myasthenia gravis

161
Q

What is the best initial test and most accurate test for myasthenia gravis?

A

Anti-acetylcholine receptor antibodies (ACHR)

Clinical presentation and ACHR

162
Q

What is the best initial therapy for myasthenia gravis?

A

Pyridostigmine or neostigmine

163
Q

Who should receive a thymectomy for myasthenia gravis?

A

Patients

STEP 3 COPY (19 decks)

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