1. radial nerve palsy but triceps strength is intact... where is the lesion 2. radial nerve-sensory loss in the hand 3. radial nerve- triceps are weak and they have crutches

1. below the spiral groove 2. at the wrist... most likely due to hand cuffs 3. axilla

Shelf Review Questions Flashcards by Wen Xu

eye finding in cavernous sinus thrombosis

extra ocular movement abnormalities

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pizza fundus

central retinal vein occlusion- can present with TIA like episodes

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risk of stroke in pts who have migraine with aura

OR 2.0-3.0

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prevalence of PFO in general population

25% (this is higher ~ 35-50% in pts with unexplained stroke)

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most common arteries affected in lateral medullary syndrome

vertebral > PICA

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how to tx lateral medullary syndrome

heparin to prevent clot propagation

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basilar occlusion causes what?

locked in syndrome

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a mass in the cerebellopontine angle causes what?

issues with CN V, VII, VIII

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an acute treatment for spinal injury is _______

IV mannitol

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far lateral disk herniation at L4-5 could cause issues with which root

loss of patellar reflex
weakness of foot dorsiflexion
weakness of knee extension
sensory loss in the calf

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which nerve root is in charge of extensor hallicus longus (EHL)

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central disk herniation at L4-5 could cause issues with which root

L5 (EHL weakness)

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2 causes of dorsal root ganglion disease

cisplatinum

anti-Hu paraneoplastic disease

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what differentiates inclusion body myositis from polymyositis and dermatomyositis

inclusion body affects both proximal and distal muscles

-poly and dermato affect proximal muscles more

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4 manifestations of diabetic neuropathy

distal small fiber
proximal amyotrophy
mononeuropathies single and multiplex
pupil sparing 3rd nerve

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tx for GBS vs CIDP

GBS- plasmapheresis and IVIG

CIDP- steroids

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copper deficiency causes neuropathy that mimics ________

B12 deficiency

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familial neuropathy… think _______

Charcot Marie Tooth

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anti-Hu paraneoplastic syndrome

paraneoplastic subacute sensory neuropathy and/or limbic encephalitis
-assoc with small cell lung cancer

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weakness of biceps
absent biceps reflex
sensory loss to lateral aspect of velar forearm from wrist to forearm

lesion of musculocutaneous nerve

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axillary nerve innervates which major muscle

deltoid

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radial nerve palsy but triceps strength is intact… where is the lesion
radial nerve-sensory loss in the hand
radial nerve- triceps are weak and they have crutches

below the spiral groove
at the wrist… most likely due to hand cuffs
axilla

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unexplained pain in extremity after remote injury

complex regional pain syndrome

this is due to abnormal sympathetic response
possible txs: sympathetic ganglion nerve block, sympatholytics (propranolol, prazocin, AEDs, TCAs)

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transtentorial herniation with 3rd nerve palsy/lateral tenurial herniation is also known as _______

uncal herniation

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comatose, vague dizziness, slurred speech --> unresponsive, ocular bobbing, pinpoint reactive pupils, absent VORs, quadriplegic... what is the insult?

basilar artery thrombosis | -in locked in, they would still be responsive

what might still be present in brain death?

DTRs

6 months of worsening bioccipital HA precipitated by running, sneezing, coughing, etc. in an older woman

chiari malformation and syrinx | "cough HA" --> needs decompression of the posterior fossa

treatment order for bacterial and tuberculous meningitis

dexamethasone --> abx --> CT --> LP

differential for hypoglycorrhacia (low glucose in CSF)

bacterial, cancer, TB!!!, neurosarcoidosis

meningococcal ppx

rifampin and cipro

bacterial meningitis 1 month-15 years

H flu --> meningococcus --> strep pneumo

bacterial meningitis 15-50 years

strep pneumo --> meningococcus --> staph

bacterial meningitis > 50 years

strep pneumo --> listeria --> gram negative rods

empiric tx for bacterial abx

ceftriaxone + ampicillin for listeria + vancomycin for staph

India ink identifies which organism

cryptococcus

nerve gas, organophosphate causes what

cholingergic toxicity

TCAs, urologic agents, benztropine causes what

anticholinergic

metaclopramide, other anti-emetics, antipsychotics, valproic acid causes what

extrapyramidal sxs

how to tx neuroleptic induced dystonia

anticholinergic - benztropine - diphenhydramine (benadryl) - tetrabenazine - trihexyphenidyl

chemo drug that causes leuko-encephalopathy

methotrexate

seizure about 1 week into admission is usually due to _____ withdrawal

benzo (except lorazepam) | -alcohol seizures usually occur in first 24 hours

hyperthermia, rigidity, rhabdo after antipsychotic (typical and atypical)

neuroleptic malignant hyperthermia caused by DA antagonism

med that commonly causes action tremor

lithium

familial ET treatment

propranolol or topiramate

cytarabine can cause _______ toxicity

cerebellar

which drug that treats neuropathic pain can cause urinary retention

TCAs

risk of seizure recurrence in a low risk patient

20-30%

AED + OCPs... what happens? - lamictal - gabapentin - oxcarbazepine, carbamazepine - topiramate

- lamictal: OCP drops lamictal levels - gabapentin: no interaction - oxcarbazepine, carbamazepine: these drop OCP levels - topiramate: in large enough doses (>200mg), it can drop OCP levels as well

broad spectrum AEDs (3)

depakote/valproate- only this can be loaded quickly topiramate lamictal

which AEDs make generalized seizures worse?

carbamazepine, oxcarbazepine, phenytoin- these may precipitate childhood absence status epileptics

tx for absence seizures

ethosuximide

tx for REM behavior disorder

clonazepam

how to tx RLS

r/o iron deficiency | pramipexole or other direct DA agonist

associated with cerebral aneurysm and SAH

ADPKD

what must you give in a child s/p craniopharyngioma resection

hormone replacement therapy

alpha synuclein

Parkinson's

tau proteins, amyloid beta

Alzheimer's

superoxide dismutase

ALS

areas of abnormalities in Wernicke's encephalopathy

mammillary bodies and periaqueductal grey matter

cause of incontinence in NPH

failure to inhibit voiding reflex

Cushing's reflex

high blood pressure, decreased pulse... this suggests raised ICP. Tx with mannitol infusion and emergent operation

soft tissue sarcoma, white matter lesions, skin findings

NF I

what to give for delirium

haldol. .. possibly quetiapine in smaller populations - reserve benzos for pts going through benzo/alcohol withdrawal, those with PD, and those with neuroleptic malignant syndrome

success rate with 3rd AED

5% | start considering surgery

low back pain with pretty much normal exam... what to do?

pain control and activity as tolerated

episodes of hypersomnia, hyperphagia, dissociative states lasting several days with normal inter-event behavior

Kleine-Levin syndrome

patients who respond well to AEDs with completely controlled seizures are good candidates for therapy discontinuation trial (T/F)

epileptics have a higher rate of suicide (T/F)

there is no difference in mortality between epileptics and normal ppl (T/F)

women with epilepsy have a reduced fertility rate (T/F)

what med treats prolactin producing adenomas

bromocriptine

diabetic pupil-sparing 3rd nerve palsy... what's the prognosis

good... will likely recover R eye movement

stopping which med might cause irritability, anxiety, labile affect and loose associations with vivid dreams

SSRI withdrawal

why don't you stop baclofen abruptly?

it can cause withdrawal seizures since it has GABA activity

one cause of pseudo tumor cerebra is _______

cerebral venous thrombosis... get an MRV

zaleplon (sonata), eszoplicon (lunesta)

non benzo sedatives

pramipexole

direct dopamine agonist for PD and for RLS

what do you give for dystonia?

diphenhydramine

tx bladder dysfunction

tolterodine, oxybutynin, solefenacin

how to tx vasospasm

nimodipine

tx dementia

rivastigmine, galantamine, memantine, donepezil

interferons, glatiramer, natalizumab, dalfampridine, fingolimod

MS drugs

tx alcohol withdrawal

chlordiazepoxide

Lamictal side effect (major one)

Stevens Johnson

Treatment for juvenile myoclonic epilepsy

Valproic acid (depakote)

Shelf Review Questions Flashcards

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