Flashcards in Neurology Review Deck (68)
List six medications that can be used for migraine prophylaxis?
Beta blockers, tricyclics, calcium channel blockers, NSAIDs and valproic acid.
A patient presents with what appears to be an inability to understand speech. Which aphasia should be at the top of your differential?
A patient presents with signs of a stroke to the ED what is the most important test to get?
A patient is brought in following a seizure in which she did not lose consciousness. What is the most likely diagnosis?
Simple partial seizure
What is the medical treatment for a stroke in which the CT has shown no evidence of a hemorrhage?
Heparin/coumadin, thrombolytics, steroids, hyperosmotics.
A patient presents with a painful ipsilateral third nerve palsy. What is the most likely diagnosis?
Posterior communicating artery aneurysm (PCOM).
What siezure medication may cause overgrowth of the gums?
A sudden thunderclap headache should make you think of what diagnosis?
Describe Kernig's sign.
The patient lies supine, flex hip while keeping knee straight. Back pain is positive.
If CT is negative and you still believe there is a stroke what is the next best test to order?
A patient presents with lateralized throbbing headache. He is also complaining of nausea, vomiting and photophobia. What type of headache is most likely?
A middle age male presents with unilateral periorbital headaches occurring daily for several weeks. These headaches are extremely painful. Which type of headache is the most likely cause?
List three drugs that treat cluster headaches.
Oxygen, sumatriptan, butoprophal
A 34 year old presents symptoms which are relapsing and remitting over the past few weeks. These include visual problems and weakness in her right arm. What is the most likely diagnosis?
A patient has a tremor with motion in his hands. What medication might you prescribe?
This patient has an active tremor. A beta blocker like propranolol is a good start.
A shuffling gait should make you think of what diagnosis?
Give two classes of drug therapy for a treating Parkinson's.
Dopaminergic (levodopa), anticholinergics are second line.
Decreased GABA and substance P should make you think of what diagnosis?
Is Huntington's autosomal dominant or recessive?
A patient presents with weakness that he has felt in his lower legs and now feels in his knees and hips bilaterally. He has decreased deep tendon reflexes. This has been getting progressively worse. What is the most likely diagnosis?
What percentage of strokes are ischemic? What percentage are hemorrhagic?
You believe a patient has had a stroke. He presents with aphasia, loss of hearing in one ear and loss of vision in his left eye. Is the blockage likely in the anterior or posterior circulation?
Under what conditions would aspirin or clopidogrel be used following a TIA as prophylaxis?
These are antiplatelet medications. They would be used unless there is a known cardiac etiology for the embolism. Patients with a cardiac cause should use heparin or coumadin.
A patient who is asymptomatic should consider having an endarterectomy at what percent blockage of the carotid artery? How about in a symptomatic patient?
70% in an asymptomatic patient and greater than 60% in a symptomatic patient.
A patient presents complaining of the worst headache of his life. What might you expect their blood pressure to be?
Typically this is the description for a subarachnoid hemorrhage. You would expect the blood pressure to be elevated.
Name one abortive drug for migraines.
Triptans (sumatriptan, 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 with a patient in status epilepticus?
Airway, followed by management of hyperthermia.
Describe Brudzinski's sign.
When you lift the patient's head the patient bends his hips.