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PANCE > Neurology (7%) > Flashcards

Neurology (7%) Flashcards

(79 cards)

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1
Q

Positive Tinel sign and Positive Phalen sign would indicate what condition

A

Carpal Tunnel Syndrome

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2
Q

What is a positive Phalen sign

A

flexing the wrist to 90 degrees for 1 minute elicits symptoms in the median nerve distribution

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3
Q

What is the distribution of the median nerve

A

1st-3rd digits and half of the 4th

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4
Q

first line treatment of carpal tunnel syndrome

A

NSAIDs and Volar wrist splint at night

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5
Q

what is the most common cause (organism) of Guillain-Barré syndrome

A

Campylobacter jejuni

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6
Q

pathophysiology of Guillain-Barré syndrome

A

Destruction of the myelin in Schwann cells following respiratory or GI illness (acute immune mediated polyneuropathy)

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7
Q

what dx study is used to dx Guillain-Barré syndrome

A

Lumbar puncture: elevated CSF protein

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8
Q

Treatment of Guillain-Barré syndrome

A

Hospitalization +
Plasmapheresis or IVIG

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9
Q

Abortive treatment for cluster headaches

A

High flow 100% Oxygen
(and sub q sumatriptan)

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10
Q

Prophylaxis for cluster headaches

A

Non-dihydropyridine CCB such as verapamil

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11
Q

Abortive treatment for Migraine headaches

A

NSAIDs or acetaminophen
or Triptans (ergotamines)

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12
Q

Preventative treatment for Migraine headaches

A

BBs: propranolol
TCAs: amitriptyline

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13
Q

Most common cause (organism) of Encephalitits

A

HSV type 1

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14
Q

What two PE findings would make you think encephalitis over meningitits?

A

Altered mental status
And focal neurological deficits (hemiparesis / hyperreflexia)

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15
Q

Initial step in the diagnosis of encephalitis

A

Head CT to r/o lesion or stroke

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16
Q

An MRI with temporal lobe edema is suggestive of

A

encephalitis

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17
Q

Lumbar puncture findings suggestive of encephalitis

A

Normal glucose,
Elevated protein,
Elevated lymphocytes

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18
Q

Tx of encephalitis

A

IV acyclovir

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19
Q

Neisseria meningitidis can present with what skin finding?

A

Petechiae or ecchymotic rash

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20
Q

What is a positive kernig sign

A

elicitation of pain or resistance with passive extension of the patient’s knees past 135 degrees

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21
Q

What is a positive brudzinski sign

A

when neck flexion causes the individual to flex their hips and knees automatically

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22
Q

Lumbar puncture findings suggestive of bacterial meningitis

A

Elevated opening pressure,
Leukocytosis,
Low glucose,
Elevated Protein count

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23
Q

Treatment of bacterial meningitis in Neonates

A

Cefotaxime or Ceftriaxone PLUS Ampicillin

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24
Q

Treatment of bacterial meningitis in children and older adults

A

Cefotaxime or Ceftriaxone PLUS
Vancomycin

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25
Treatment to add for bacterial meningitis for listeria coverage
Ampicillin
26
degeneration of neurons in the substantial nigra and depletion of dopamine is what neurological condition
Parkinson's disease
27
What are the four cardinal symptoms of Parkinson's disease
1. Resting "pill-rolling" tremor 2. Bradykinesia (shuffling gait, masked facies) 3. Muscular rigidity (cogwheel rigidity) 4. Postural instability
28
what is the post mortem pathology indicative of Parkinson's disease
Lewy bodies (eosinophilic intracellular inclusions)
29
Pharmacologic treatment of Parkinson's disease in older pts or more severe cases
Carbidopa-Levodopa (does wear off with prolonged use)
30
Pharmacologic treatment of Parkinson's disease in younger pts or less severe cases
Dopamine agonists (pramipexole, ropinirole)
31
Most common primary malignant brain tumor in adults
Glioblastoma
32
postmortem definitive diagnosis of Alzheimer disease
Neurofibrillary tangles and amyloid plaques
33
postmortem definitive diagnosis of frontotemporal dementia
round, silver staining inclusions (Pick bodies)
34
What is the most common immune mediated inflammatory demyelinating disease of the CNS
Multiple sclerosis
35
The most common type of multiple sclerosis is
Relapsing remitting
36
Optic neuritis and internuclear ophthalmoplegia are symptoms of what neurological condition?
Multiple sclerosis
37
Explain Marcus Gunn pupil or relative afferent pupillary defect that can be a PE finding of MS
when a light is shined into the affected eye it will not constrict (as it should)
38
Gold standard diagnostic test of MS
MRI with gadolinium: hyperintense T2 plaque (periventricular) and Dawson's fingers
39
Treatment of acute exacerbations of MS
IV high dose corticosteroids
40
Long term pharmacological therapy of MS
IV monoclonal antibodies: -"mab"
41
Fatigable muscle weakness that worsens with use and improves with rest is
Myasthenia gravis
42
Pathophysiology of
IgG antibodies against the acetylcholine receptors at the postsynaptic membrane
43
Bulbar symptoms (difficulty chewing/swallowing) and ocular (ptosis/diplopia) that worsens throughout the day and improves with rest is likely
Myasthenia gravis
44
A positive ice pack test (ptosis improves) is indicative of
Myasthenia gravis
45
General treatment of Myasthenia gravis
AChE inhibitors - Pyridostigmine
46
Treatment of acute exacerbations of Myasthenia gravis
plasmapheresis and IVIG
47
Amaurosis fugax is
temporary vision loss
48
In order to be a TIA, symptoms must resolve within (how long?)
24 hours
49
Imaging studies for suspected TIA
initial - Head CT Best - Head/neck CTA/MRA
50
Pharmacology general treatment of TIA
High intensity statin + dual antiplatelet therapy (ASA+clopidogrel)
51
Carotid TIA treatment
Carotid endarterectomy
52
MC cause of ischemic stroke
Thrombosis
53
MC artery impacted with Ischemic stroke
Middle cerebral artery
54
Initial imaging with ischemic stroke
Non-contrast CT
55
Best imagining with ischemic stroke
CT angiography
56
Pharmacologic therapy for ischemic stroke
Thrombolytic therapy (alteplase or TPA) *IF presenting within 4.5 hrs and no contraindications*
57
Pharmacologic secondary stroke prevention
High intensity statin + dual antiplatelet therapy (ASA+clopidogrel)
58
MC cause of hemorrhagic stroke
HTN
59
Acute management of hemorrhagic stroke
1) lower BP as quickly as possible (IV labetolol) 2) Elevate HOB to 30 degrees 3) reversal of anticoagulation therapy or coagulopathy
60
Etiology of Subarachnoid hemorrhage
saccular aneurysm of circle of willis rupture
61
Sudden onset of thunderclap headache "worst headache of my life" is suggestive of
Subarachnoid hemorrhage
62
CSF analysis showing xanthochromia (hemoglobin degradation products) is suggestive of
Subarachnoid hemorrhage
63
Gold standard test for Subarachnoid hemorrhage
Cerebral angiography (CTA)
64
what two populations are at risk for subdural hematoma
Alcohol use disorder Older population
65
Describe subdural hematoma
Pt fell and hit their head. Was fine but now is declining
66
Describe CT finding of subdural hematoma
Crescent shaped hematoma that does cross suture lines.
67
Tx of subdural hematoma
Neurosurgical emergency
68
Epidural hematoma is more common in
Men > women Older // younger adults
69
Postauricular ecchymosis (Battle sign) and Raccoon eyes are indicative of
Basilar skull fracture
70
Describe CT finding of epidural hematoma
Biconvex/lens shaped and does not cross suture lines
71
Tx of epidural hematoma
Neurosurgical emergency
72
Seizure that involves both hemispheres of the brain
Generalized (different types tonic-clonic, absence, atonic, ect)
73
Seizure that does NOT involve both hemispheres of the brain
Focal (impaired awareness or retained awareness)
74
Tx of active seizure
1st line: Benzodiazepines
75
Prophylactic treatment of seizures
Anticonvulsants (valproic acid, carbamazepine)
76
Tx of absence seizures
Ethosuximide
77
what shoulder dislocation is MC from seizures
Posterior shoulder dislocations
78
what is status epilepticus
single seizure lasting >5 mins OR repeated seizures without return to consciousness
79
First line treatment for status epilepticus
First line: Benzodiazepines (IV lorazepam, IM midazolam, or rectal diazepam)

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