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USMLE Step 3 > Neurology > Flashcards

Flashcards in Neurology Deck (24):
1

PICA stroke symptoms

Wallenberg syndrome (lateral medullary)
- Ipsilateral face
- Contralateral body
- Vertigo and Horner's syndrome

2

Stroke imaging sensitivities

Head CT: >95% sensitivity in 3-5 days

3

Initial tests in patient's with memory loss

- Head CT
- VDRL/RPR
- Thyroid function tests
- B12 levels

4

Alzheimer's treatment

acetylcholinesterase inhibitors:
- Donepizil (central-acting), rivastigmine, galantamine, memantine

5

Frontotemporal dementia (Pick's disease)

- Changes in personality and behavior come first followed by memory changes
- Same treatments as Alzheimer's disease but with less response

6

Normal pressure hydrocephalus

WWW (weird, wet, wobbly)
- Dementia, urinary incontinence, wide-based gait/ataxia

7

Diagnostic tests to order for Normal pressure hydrocephalus

- Head CT and LP

8

Treatment for Huntington's disease

Tetrabenazine for movement disorder
Antipsychotics for symptomatic control

9

Migraine triggers

- OCPs, menstruation, cheese, caffeine

10

When to order head CT/MRI with CC of headache

- Sudden or severe onset
- onset after 40
- Focal neurologic findings

11

Migraine treatment

Abortive therapy: sumatriptan or ergotamine

Prophylaxis: propranolol (with >4 headaches/month)
- alternate therapy CCBs, tricyclic antidepressants, SSRIss

12

Triptans

Work by vasoconstricting cerebral blood vessels
- Migraines are thought to be vasoconstriction followed by vasodilation and pain
- can be dangerous in hypertension and CAD

13

Cluster headache

exclusively unilateral
Treatment: sumatriptan, 100% oxygen, steroids (abortive)
Verapamil (preventative)

14

Temporal arteritis

- temporal tenderness and jaw claudication
Diagnosis: ESR and temporal artery biopsy
Treatment: steroids first and fast (blindness)

15

Pseudotumor cerebri

Headache + sixth nerve palsy, visual field loss, pulsutile tinnitus
- Vitamin A use can cause

16

Diagnosis of pseudotumor cerebri

LP with elevated opening pressure

17

Treatment of pseudotumor cerebri

- weight loss, acetazolamide, surgery for failure (VP shunt, optic nerve sheath fenestration)

18

Benign positional vertigo

no hearing loss or tinnitis or ataxia
-responds modestly to meclizine

19

Vestibular neuritis

Viral-induced inflammation of the vestibular portion of the eighth cranial nerve
no relation to position changes, no hearing loss, tinnitis
- Treat with meclizine

20

Labyrinthitis

acute inflammation of the cochlear portion of the inner ear
- hearing loss, tinnitis
- Treatment with meclizine and steroids

21

Meniere's disease

hearing loss and tinnitis that is remitting and relapsing
- Treatment with salt restriction and diuretics

22

Acoustic neuroma

Hearing loss, tinnitus, vertigo, and ataxia
- Seen in neurofibromatosis and von Recklinghausen's disease
Diagnosis: MRI of the internal auditory canal

23

Perilymph fistula

Barotrauma lading to rupture of the tympanic membrane

24

Wernicke-Korsakoff Syndrome

Symptoms: confusion with confabulation, ataxia, memory loss, gaze palsy and opthalmoplegia, nystagmus
Treatment: IV thiamine and then glucose