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neuroUworld2 Flashcards

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1
Q

what condition is seen in up to half of patients with temporal arteritis

A

polymyalgia rheumatica- present with pain and achiness in the morning; ESR is elevated and sx improve with steroids

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2
Q

migraine prophylaxis

A

amytriptaline

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3
Q

migraine treatment

A

prochlorperazine (IV antiemetic); can be used as monotherapy or in combo with tryptans or NSAIDs

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4
Q

IV antiemetics that can be used for migrains

A

chlorpromazine, prochlorperazine, metoclopramide

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5
Q

definition of heat stroke

A

AMS and temp over 40 degrees C

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6
Q

malignant hyperthermia

A

affects genetically susceptible individuals during anesthesia with halothane and succinylcholine

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7
Q

INO

A

defect in the MLF in the dorsal pontine tegument

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8
Q

destruction of the frontal lobe causes what kind of deviation of the eye

A

ipsilateral

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9
Q

best treatment for schizophrenia

A

clozapine; used for those who have failed other treatments

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10
Q

mood stabilizers for bipolar disorder

A

lamotrigine and lithium

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11
Q

infarcts in mutliple different vascular territories

A

think embolic, though can be thrombotic in like the internal carotid

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12
Q

symptoms in embolic disease

A

abrupt and usually maximal at onset; think of it as the clot gets pushed somewhere and stops there and then gets pushed out of the way somewhat

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13
Q

where are frontal eye lobes?

A

right above brocas, on the lateral side of the frontal lobe; supplied by MCA

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14
Q

right frontal eye field

A

allows you to do conjugate gaze to the left

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15
Q

hyperglycemic nonketotic state

A

happens in diabtetics with glucose over 600; causes AMS and focal neuro deficits

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16
Q

PCKD is assoc with what

A

increased risk of berry aneurysms that can rupture and cause a SAH

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17
Q

typical locations for the plaques in MS

A

periventricular, deep white matter, basal gang, corpus callosum

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18
Q

what does CSF show in MS?

A

so this is counterintuitive bc it is a demyelinating disease like GB, but in MS, the CSF is normal protein and WBCs; you do see elevated IgG and oligoclonal bands

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19
Q

where in the circle of willis are aneurysms most likely to rupture

A

anterior circ

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20
Q

amyloid angiopaty

A

second most common cause of intracerebral hemorrhage; abnormal amyloid deposition in the blood vessels that makes them fragile; typically lobar location

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21
Q

AVM can cause what kind of brain bleed

A

intracerebral or subarachnoid depending on the location

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22
Q

venous sinus thrombosis

A

progressively worsening headache over several days

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23
Q

symptoms of opiate intox

A

parasymp is activated; pinpoint pupils, respiratory depression

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24
Q

naloxone

A

opiate antag used to treat opiate overdose

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25
flumazenil
antidote for benzo overdose; antagonist of the GABA receptor
26
clonidine
anti-hypertensive drug that acts on alpha receptors
27
Meniere's disease
vertigo, tinnitus, ear pain unilateral
28
BPPV
dix hallpike maneuver causes nystagmus
29
vestibular neuritis
severe vertigo but no hearing loss
30
how to releive sx of BPPV
Epley maneuver
31
increased CSF erythrocytes in HSV encephalitis
that's right
32
herpes encephalitis
can have focal neuro findigns, and will affect the CSF content
33
pinpoint reactive pupils
hemorrhage in the pons
34
where do hypertensive bleeds usually occur
basal gang (putamen); the cerebellum, thalamus, and pons are also common locations
35
unlike FEF lesions, pontine and thalamic lesions cause eye deviation where
away from the lesion
36
anisocoria
can be due to uncal herniation; from mass effect on the left compressing the lef CN3 parasymp fibers
37
acute exacerbations of MS are treated with what?
IV steroids
38
long term therapy for MS
beta interferons or glatirimir acetate
39
arreflexic weakness in the upper extremities and loss of pain and temp with preserved dorsal columns in a cape distrib
syringomyelia (cord cavitation)
40
syringobulbia
when syringomyelia starts in the C-region of the cord and extends proximally to involve the medulla
41
causes of syringomyelia
trauma, inflamm spinal cord disorders, or SC tumors
42
caudal displacement of the cerebellar tonsils through the foramen magnum
arnold-chiari malformaiton; neuroimaging may show caudal displacement of the fourth ventricle; often assoc with syringomyelia
43
what CN palsy is sometimes seen in pseudotumor cerebri
sixth nerve palsy
44
what can make pseudotumor cerebri worse?
vit A or glucocorticoid
45
in what direction does GBS move
ascending weakness
46
reflexes and sensory in GBS
sensory affected but not as much as motor; reflexes are lost (unlike in MG)
47
absent rectal tone, urinary incontinence, motor and sens loss in the lower extremities
cauda equina syndrome
48
MMSE score less than what means ementia
24 out of 30
49
CT scans in Alzheimers
normal initially, but then some atrophy in the temporal and parietal lobes and hippocampus
50
difference between FTD and alzheimers
FTD has onset earlier (40-60yo); FTD initially presents with more personality/social disinhib stuff and AD presents first with more memory stuff
51
treatment for trigeminal neuralgia
carbamazepine
52
SE of prolonged carbamazepine
aplastic anemia
53
what to do when carbamazepine fails to control trigeminal neuralgia
surgical options
54
treatment of herpetic neuralgia
acyclovir
55
diabetic neuropathy
sensation goes first, and motor is a late finding
56
difference bt conus medullaris and cauda equina
conus is the end of the cord and cauda equina is the roots that are hanging down
57
causes of cauda equina syndrome
compression of spinal nerve roots from metastatic prostate cancer; disc herniation, spinal stenosis, tumors, infxn, hemorrhage, or injury
58
cauda equina
sensory to the saddle region, motor to anal and urethral sphincters, parasymp innerv to the bladder and lower bowel
59
main diff between CE and conus
CE is only LMN, whereas conus is both UMN and LMN
60
sensory differences in CE vs conus
CE has saddle and conus has perianal
61
motor weakness in CE vs conus
CE is assym whereas conus is symm
62
reflexia in conus vs CE
conus has hyperreflexia and CE is hypo
63
radiating pain
more likely nerve root
64
management of CE and conus
steroids and surgery
65
causes of IIH
growth hormones, tetracyclines, and excessive vit A
66
homonymous hemianopia- what major vessel is involved
MCA or PCA
67
MCA occlusion of non-dominant lobe
contralat neglect
68
alexia without agraphia
localizes to posterior brain on the dominant side
69
visual hallucinations localize where?
calcarine cortex
70
sumatriptan
seratonin agonist used for migraines
71
tremors increase at the end of goal directed activities
essential tremor
72
treatment for huntington's chorea
haloperidol
73
first step in treatment for pseudotumor cerebri
acetazolamide
74
tx of patients in myasthenic crisis
endotrach intubation and withdrawal of acetylcholesterase inhib for several days; then ivig and plasmapheresis
75
most common early side effects of levadopa/carbidopa
hallucintions, confusion, agitation; the dyskinesias don't happen until about 5-10 years of treatment
76
side effects of anti-cholinergics
urinary retention
77
which gender is more likely to get alzheimers
female
78
pick's disease
aka FTD
79
visual spatial defects in Alzheimers versus FTD
alzheimers impaired, FTD intact
80
drugs in dementia with lewy bodies
worsening with neuroleptic drugs; poor response to dopamine agonists
81
bilaeral trigeminal neuralgia can be seen in what
multiple sclerosis
82
prolonged seizures is bad why?
can lead to cortical necrosis
83
cerebellar atrophy
can be caused by longterm use of antiepileptic drugs or alcohol
84
where do toxo brain lesions typically occur?
basal gang and the gray white matter junction junction at the cortex
85
most common cause of brain abscesses in immunocompetent hosts
strep and bacteroides (anaerobes)
86
IV drug users endocarditis on what side
right must be IV drug user; left can happen to anyone

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