Neurology Flashcards
(106 cards)
what are symptoms or Lower motor neuron disease?
wasting, weakness, hypotonia, loss of reflexes, fascinations, changes to hair and skin.
What does asterixis indicate?
metabolic encephalitis or disease of thalamus.
what are symptoms consistent with Upper Motor Nueron lesions?
flaccid, loss of reflexes increase tone/spascity, clonus + babinski
List 6 medications that can be used for migraine prophylaxis
beta blockers, tricyclics, calcium channel blockers, NSAIDs, and valproic acid
A patient present with what appears to be an inability to understand speech Which aphasia should be at the top of your differential
Wernicke’s aphasia
A patient presents with facial paresis, arm drift and abnormal speech pattern. What are the first 3 tests to order?
Thinking it is a stroke - Noncontrast CT of the brain or MRI, serum glucose and Oxygen saturation.
A patient is brought in following a seizure in which she did not lose consciousness. What is the most likely diagnosis?
Simple partial seizure.
A patient is having a stroke and there is no evidence of hemorrhage. What is the first line medical treatment?
If its in the first 4 hours and no contraindications - Thrombolytics should be given.
A patient presents with a painful ipsilateral third nerve palsy. What is the most likely diagnosis?
Posterior comminicating artery aneyrysm.
What seizure medication can given the overgrowth of gums (gingival hyperplasia)
Phenytoin
A sudden thunder clap headache should make you think of what diagnosis?
subarachnoid hemorrhage
Describe KErnig’s sign
patient lies supine. flex the hip while keeping the same knee strain. If it elicits back pain, test is positive.
Imaging is negative for blood, but you strongly believe there is a subarachnoid hemorrhage. What test can you order that will be definitive?
Lumbar puncture.
What percentage of strokes are ischemic? What percentage are hemorrhagic?
80% ischemic 20% hemorrhagic
You believe that a patient has had a stroke. He presents with aphasia, loss of hearing in one ear and loss of vision in the left eye. IS the blockage in the anterior or posterior circulation?
Anterior circulation
Under what conditions would aspirin or clopidogrel be used following a TIA as prophylaxis?
These are antiplatlet medications. They would be used unless there is a known cardiac etiology for the embolism. Patient with a cardia cause should use heparin or Coumadin.
A patient who is asymptomatic should consider having an endarterectomy at what percent blockage of the carotid after? what about a symptomatic patient?
70% in asymptomatic, and greater than 60% in a symptomatic patient.
A patient presents complaining of the worst headache of her life.What might you be expecting their blood pressure to be?
This is typically the description of a subarachonoid hemorrhage. You would expect the blood pressure to be elevated.
Name one abortive drug for migraines
sumitriptan, zolmitriptan, ergotamine.
An EEG showing focal rhythmic discharges at the onset of the seizure should make you think of what diagnosis
Simple partial seizure
What is the single most important thing to be concerned about in a patient in status epilepticus?
Airway, airway airway, followed by management of hyperthermia.
Describe Brudzinski’s sign.
When you lift a patient’s head, the patient automatically flexes at the hips. Found in patients with meningitis.
A patient presents with a lateralized throbbing headache. She is also complaining of nausea, vomiting and photophobia What type of headache is this likely?
Migraine.
MIDDLE AGE MAN PRESENTS with a unilateral periorbital headaches that have been occurring daily for several weeks. Therese headaches are extremely painful. Which type of headache is this?
Cluster headache
