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Flashcards in Uworld Neuro Deck (60):
1

psychosis tx

-2nd generation antipsychotics
(preferred due to lower risk of extrapyramidal SE or tar dive dyskinesia)

-1st gen. antipsychotics
-benzodiazepines (tx agitation)

2

2nd generation antipsychotics

-risperidone
-olanzapine
-quetiapine
-aripiprazole
-ziprasidone
-paliperidone
-clozapine

3

clozapine

-2nd gen. antipsychotics
-gold standard tx-resistant schizophrenia

-SE: agranulocytosis

-used for pts who have failed 2 trials of antipsychotics

4

lithium

= mood stabilizer
-tx bipolar disorder
-monitor blood levels to prevent toxicity

5

febrile seizure px

-age: 6 months - 6 YO
-temp > 100.4F
-no hx of afebrile seizures, no CNS infection, no metabolic cause

-does NOT cause brain injury

6

febrile seizure tx

-reassurance
-abortive therapy only if seizure >5 minutes

7

neurofibromatosis type 1 px

cafe-au-lair spots + macrocephaly + feeding problems + short stature + learning disabilities

-fibromas, neurofibromas, tumors

8

neurofibromatosis type 2 px

bilateral acoustic neuromas + cataracts

9

-tearing bridging veins
-ruptured middle meningeal artery
-hypertensive hemorrhage
-ruptured aneurysm

-subdural hematoma (crescent)
-epidural hematoma (lens)
-intracerebral hemorrhage (putamen, thalamus)
-subarachnoid hemorrhage

10

thalamic stroke
(Dejerine-Roussy syndrome)

-VPL stroke
-contralateral sensory loss
-transient hemiparesis, athetosis

11

cavernous sinus thrombosis cause, px, tx

-cause: uncontrolled infection of skin/ sinuses/ orbit that spreads to cavernous sinus

-px: headache, intracranial HTN, periorbital edema, Cr III, IV, V, VI deficits
(travel thru cavernous sinus)

-tx: IV antibiotics (to prevent herniation)

12

primodone use, SE

-seizures, benign essential tremors

-acute intermittent porphyria --> abdominal pain, confusion, headaches, hallucinations, dizziness

13

effects of anti-dopinergic drugs on pathways:
-mesolimbic
-nigrostriatal
-tuberoinfundibular

-antipsychotic effects
-extrapyramidal symptoms (acute dystonia, akathisia, parkinsonism)
-hyperprolactinemia --> amenorrhea, gynecomastia, dec libido

14

Cushing's reflex

HTN + bradycardia + respiratory depression

-indicates elevated intracranial pressure

15

uncal herniation symptoms?

-ipsilateral hemiparesis (contralateral crus cerebri compression)
-ipsilateral Cr III palsy
-contralateral homonymous hemianopsia (ipsilateral PCA compression)
-coma (reticular formation compression)

16

anticholinergic excess symptoms? causes?

"red as beet, dry as bone, hot as a hare, blind as a bat, mad as a hatter, full as a flask"

-flushing
-anhidrosis/ dry mouth
-hyperthermia
-mydriasis/ vision changes
-delirium/ confusion
-urinary retention/ constipation

-excess benztropine, trihexyphenidyl

17

serotonin syndrome symptoms?

-agitation
-confusion
-tachycardia
-muscle rigidity
-seizures

-selegiline + SSRI or TCA

18

uses for propranolol

-benign essential tremor
-portal HTN

19

preeclampsia tx?

magnesium sulfate

20

Broca's area

-posterior inferior frontal gyrus
-expressive aphasia

21

foot drop cause, px

-peripheral neuropathy
-common perineal nerve injury
-radiculopathy (L4-S2)

-inability to dorsiflex the foot
-patients overly flex the hip & knee to move foot forward

22

brain death definition

-irreversible cessation of brain activities
-absent cortical & brainstem functions

-spinal cord can still function --> DTR present

23

CT px of:
-progressive multifocal leukoencephalopathy
-cerebral toxoplasmosis
-CNS lymphoma

-non-enhancing lesions with no mass effect
-ring-enhancing mass lesion
-weakly ring-enhacing lesion; periventricular

24

positive drop arm test =

rotator cuff tear

25

botulism px

-descending flaccid paralysis
-constipation & drooling
(autonomic dysfunction)
-bilateral bulbar palsies: ptosis, sluggish pupillary reflex, poor suck & gag reflexes

26

botulism tx?
(infant vs foodbourne)

-human derived botulism Ig

-equine-derived botulism antitoxin

27

peripheral vs central facial palsy

-peripheral = Bell's palsy = upper AND lower facial weakness
-below pons
(can't raise eyebrows, close eyes, drooping mouth, loss of nasolabial fold)

-central --> forehead muscle sparing; intracranial lesions (ischemia or tumor)

28

glucocorticoid-induced myopathy px

-painless muscle weakness & atrophy
-normal ESR & CK

29

polymyalgia rheumatica px

-muscle pain & stiffness
-seen in 50% of temporal arteritis pts
-responds to glucocorticoids
-inc ESR, normal CK

30

inflammatory myopathies px

-muscle pain & tenderness
-proximal muscle weakness
-skin rash
-inc ESR & CK

31

statin-induced myopathy

-prominent muscle pain & tenderness
-rare rhabdo
-normal ESR, inc CK

32

hypothyroid myopathy

-muscle pain, cramps, weakness
-delayed DTRs
-rare rhabdo
-normal ESR, inc CK

33

Wernicke-Korsakoff syndrome cause, px

-thiamine (B1) deficiency
-ophthalmoplegia + dementia + ataxia
-irreversible amnesia, confabulation, apathy

34

cauda equina syndrome px

-unilateral, severe radiculopathy
-saddle anesthesia
-asymmetric motor weakness
-hyporeflexia
-late onset bowel/bladder dysfunction

35

conus medullaris syndrome px

-sunden onset severe back pain
-perianal anesthesia
-symmetric motor weakness
-hyperreflexia
-early onset bowel/bladder dysfunction

36

2 types of rigidity?

-uniform = lead pipe
-oscillating = cogwheel

37

Parkinson's dx

-clinical dx
-2 of 3 symptoms: resting tremor, rigidity, bradykinesia

-resting tremor may start in one hand and move to other

38

tx for agitation in elderly?

low dose haloperidol

-benzodiazepines are contraindicated in elderly due to risk of withdrawal, dependence, etc

39

intracranial HTN px

>20 mmHG
-headache
-visual changes
-n/v, cr nerve deficits, confusion
-Cushing's reflex = HTN + bradycardia

40

diabetic Cr III neuropathy cause, px

-ischemia

-ptosis
-"down and out" gaze
-normal light & accommodation reflex

-only somatic fibers are affected; parasympathetic fibers are spared

41

nerve compression of Cr III px

-somatic & parasympathetic fibers affected --> ptosis, "down & out" gaze, pupillary reflex deficit

42

basal ganglia hemorrhage px

-hemiplegia
-hemi-sensory loss
-homonymous hemianopsia
-stupor, coma

43

cerebellum hemorrhage px

-facial weakness
-nystagmus
-ataxia
-NO hemiparesis
-stupor/coma from brainstem herniation

44

thalamus hemorrhage px

-hemiparesis
-hemi-sensory loss
-upgaze palsy
-nonreactive miotic pupils
-eyes deviate AWAY from lesion

45

cerebral lobe hemorrhage px

-contralateral homonymous hemianopsia, paresis
-eyes deviate TOWARD lesion

46

pons hemorrhage px

-deep coma
-total paralysis within minutes of hemorrhage
-pinpoint reactive pupils
-decerebrate rigidity

47

status epileptics can lead to?
(seizure >5 minutes)

cortical laminar necrosis --> persistent neurological deficits & recurrent seizures

48

does hyperventilation stimulate complex partial seizures or absence seizures?
(during EEG)

absence

49

Lennox-Gastaut syndrome

-childhood onset epilepsy
-multiple types of seizures
-impaired cognitive function

50

typical vs atypical absence seizures?

atypical lasts longer & EEG frequency <2.5Hz

51

Todd's paralysis

transient focal neurologic deficit following a seizure

52

disease onset of frontotemporal dementia vs Alzheimer's?

40-60 YO
vs
>60 YO

53

hemi-neglect syndrome cause?

stroke to non-dominant parietal lobe

54

major risk factor for stroke?

HTN

-smoking, DB (lesser risk)

55

opiate overdose tx?

naloxone

= opiate antagonist; reverses respiratory suppression

56

benzodiazepine overdose tx?

flumazenil

57

tick-bourne paralysis px, cause, tx

-progressive ascending paralysis
-occurs over hours to
days
-sensation & autonomic function, CSF normal

-cause: neurotoxin release by tick
-tx: tick removal

58

acute glaucoma px, dx

-sudden onset eye pain/ photophobia/ mid-dilated pupil

-ocular tonometry

59

SE of SAH

-cerebral salt-wasting syndrome --> hypoNa

60

cerebral salt-wasting syndrome?

inc ADH --> inc ANP/BNP --> cerebral salt-wasting --> hypoNa