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MKSAP > neurology > Flashcards

neurology Flashcards

1
Q

In MS, ensure Vitamin D supplementation.

A

linked to higher disease activity and more relapses

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2
Q

mild cognitive impairment

A

score lower than 26/30 without significant functional decline
can get brain CT/MRI to rule out structural cause

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3
Q

TIA eval

A

ABCD^2 score, =>3: admit

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4
Q

incidental meningioma

A

lightbulb sign, calcification, dural tail
benign, repeat MRI 3-6 months after initial discovery
if growing/symptomatic->surgery->radiation

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5
Q

first seizure eval

A

auras: deja vu (simple partial seizure)
changes in awareness, periods of inattention
any aura before seizure=focal

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6
Q

migraine MRI

Migraine frequency/ use of acute medications> 2 days/wk

A

white matter signal abnormalities
if NSAIDs dont cut it->oral triptan ->subq triptan

timolol for ppx, topimarate also for ppx

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7
Q

Temporal lobe epilepsy

frontal lobe seizures

A

rising epigastric sensation, fear and anxiety, fidgety
normal EEG and MRI
if refractory to 2 AEDs->surgery (lobectomy)

motor symptoms that awaken from sleep

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8
Q

Myotonic dystrophy

diagnosis

A

weakness+ fatigue+ waddling gait+ muscle stiffness+ delayed grip relaxation

EMG

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9
Q

Primary progressive aphasia

treatment

A

progressive loss of language function with other cognitive functioning intact

speech and language therapy

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10
Q

tardive dyskinesia

caused by

A

chorea and dystonia

dopamine antagonists such as metoclopramide, risperidone

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11
Q

Interferon beta side effects

natalizumab
fingolimod
teriflunomide

A

LFTs q3-6 months (autoimmune hepatitis)
screen for JC virus (PML)
eye exams
amylase and lipase (pancreatitis)

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12
Q

secondary stroke prevention

A

aspirin+ dipyridamole

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13
Q

Antiepileptic in woman taking OCPs/preggo

A

keppra

failure of OCPs otherwise

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14
Q

newly diagnosed stroke admit to

A

stroke unit, reduces mortality

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15
Q

unknown epilepsy syndrome (gen vs focal) treatment

A

broad spectrum AED such as topiramate, lamotrigine, keppra, valproic acid, zonisamide

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16
Q

NPH treatment

A

lumbar puncture to assess response before VP shunt

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17
Q

acute headache+ neck pain+ transient vision loss+ miosis+ ptosis+ anhidrosis

diagnosis
treatment

A

carotid artery dissection

MRI of soft tissue of neck
aspirin

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18
Q

essential tremor treatment

A

propranolol->primidone->topiramate (not of kidney stones/glaucoma)->deep brain stim

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19
Q

spinal cord compression 2/2 plasmacytoma/ myeloma

A

steroids, radiation (if stable spine and minimal neuro deficits)
surgical decompression if unstable/severe neuro deficits

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20
Q

spinal cord compression 2/2 plasmacytoma/ myeloma

A

steroids, radiation (if stable spine and minimal neuro deficits)
surgical decompression if unstable/severe neuro deficits

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21
Q

GI effects on cholinesterase inhibitor (donepezil, rivastigmine)

A

stop

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22
Q

small fiber neuropathy

diagnosis

A

pain and paresthesia with no neuro deficits

glucose tolerance test

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23
Q

psychogenic nonepileptic seizures

diagnosis

A

long, closed eyes, can be incontinent, >2 AEDs,PTSD (no Keppra)
video EEG monitoring

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24
Q

MS urge incontinence 2/2

treatment

A

spasms

oxybutynin

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25
seizures in oldies
lamotrigine, Keppra, gabapentin
26
asymptomatic carotid artery stenosis
statin, no CEA
27
cerebral vasoconstriction syndrome | treatment
recurring thunderclap headaches, stroke on imaging | normalize BP
28
CNS lymphoma diagnosis | treatment
surgical biopsy without resection | methotrexate and radiation
29
Afib in setting of stroke anticoag
wait for 2 weeks
30
solitary metastatic brain tumor treatment
resection followed by radiation
31
myasthenic crisis | relapse without crisis
plasmapheresis or IVIG | high dose steroid
32
Cluster headache treatment | ppx
oxygen, subq sumatriptan | verapamil (can cause heart block, monitor ECG)
33
cognitive dysfunction in multiple sclerosis
counseling and therapy
34
med overuse headache
>10 days/month
35
persistent facial nerve palsy after 3 months
MRI of brain
36
first seizure in setting of risk factors (previous head injury, focal brain lesion, postictal Todd's paralysis
AED
37
MS diagnosis MS preventive care *associated with trigeminal neuralgia*
MRI of brain | routine vaccinations
38
Patient with resolving headache a week after trauma
no imaging, restrict contact sports
39
parkinsonism+ cerebellar ataxia+ early postural instability+ falls +impairment in vertical eye movements Parkinson diagnosis
multiple system atrophy progressive supranuclear palsy bradykinesia (slowing with repetitive movements)+rigidity/resting tremor/postural instability
40
active denervation+ muscle weakness and atrophy in carpal tunnel syndrome
decompression surgery
41
intracranial hemorrhage + SBP >180
lower to 160 with IV labetalol
42
progressive weakness+ areflexia+ sensorimotor neuropathy for more than 8 weeks treatment
chronic inflammatory demyelinating polyradiculopathy steroids
43
idiopathic intracranial hypotension treatment
elevated opening pressure with no CNS lesion (headache, papilledema, visual symptoms) acetazolamide->optic nerve fenestration
44
cryptogenic stroke with PFO
prolonged cardiac monitoring to detect a fib
45
meds wearing off in Parkinson's
increase carbidopa-levo or add entacapone | if can't be tolerated (dyskinesia, visual hallucinations)->DBS
46
restless legs syndrome vs spasticity
discomfort, urge to move, periodic limb movements while sleeping vs tonic leg spasms and cramps
47
parkinsonian-hyperpyrexia syndrome
AMS, hyperthermia, rhabdo, rigidity, dystonia | medication withdrawal, restart levodopa
48
Refractory migraine (>72 hours)
dihydroergotamine+ prochlorperazine/metoclopramide
49
MS preggo
no fingolimod, mitoxantrone, teriflunomide
50
aneurysmal subarachnoid hemorrhage complication prevent with treat with diagnose with
vasospasm (also rebleeding, hydrocephalus) oral nimodipine (21 days) IV dopamine CTA Brain
51
UMN+ LMN symptoms | treatment
ALS | riluzole
52
UMN+ LMN symptoms | treatment
ALS | riluzole
53
Secondary headache management
Escalation in frequency and intensity, neuro symptoms> 1 hr *med overuse headache is milder, no new neuro sx* brain MRI
54
unruptured intracranial aneurysms | coiling when
smoking cessation, BP control >12 mm *nimodipine only when there's hemorrhage*
55
hyperdensity on CT | post TPA neuro changes
infarct | CT without contrast
56
Tics
suppressible
57
Seizure treatment in patient with brain tumor
AED that is not cleared by liver (chemo drugs) | valproic acid, lacosamide, lamotrigine, keppra
58
persistent myopathy on steroids
taper steroid to distinguish between steroid induced myopathy (stable CK) and inflammatory myopathy (elevated CK)
59
Chronic migraine | treatment
headache >15 days/month for >3 months | topiramate/ onabotilumtoxin A
60
paraneoplastic limbic encephalitis diagnosis treatment
inflammation of emotional and memory structures, subacute, personality change,psychosis, seizures, cancer related serum/CSF paraneoplastic antibodies immunotherapy
61
treatment of fatigue in MS
modafinil->meth
62
statin related myopathy, which statin to give
hydrophilic: rosuvastatin, pravastatin, fluvastatin
63
Creutzfeldt-Jakob MRI
hyperintensities in cortex/thalamus/ganglia | subacute, rapidly progressive
64
persistent AMS after convulsive status epilepticus
continuous EEG monitoring
65
dalfampridine contraindication
for MS, any kidney disease

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