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50 Cards in this Set

  • Front
  • Back
MCA stroke
– Aphasia if dominant, neglect if non-dominant
– contra pareisis
– gaze preference
– homo hemianopsia
ACA stroke
– leg paresis, foot drop, gait dysfunction
– amnesia/personality change
– cognitive change
PCA stroke
– Homo hemianopsia
– memory
– dyslexia/alexia
Basilar stroke
– locked in, apnea, drop attacks
– CN palsy, dysphagia
Lacunar stroke
– Pure motor or sensory
– dysarthria/clumsy hand
– ataxic hemiparesis (you fall to that side a lot)
– from hyaline membranes form HTN and DM
– wont see immediately on non-contrast study
Stroke Tx
– TPA w/in 3 hrs
– ASA w/in 2 days
– Long term w/ ASA, clopidogrel
Berry aneurism Sx
– CN 3 palsy w/ pupil involvement
Parynchmal hemorrhage
– HTN, tumor, amyloid, AVM
– lethargy and H/A
– elevate head and do anti seizure
– only operate if mass effect
Complex partial seizure
– usually temporal lobe
– impaired LOC
– hallucinations and automatoisms (don’t confuse w/ atypical absence)
Partial seizure Tx
– phenytoin, oxycarbazepin, tegretol, phenobarbitol, VPA
– Phenobarb in kids
Complex seizure EEG and Tx
– 10 Hz during tonic, slow wave during clonic
– Phenytoin (phos) VPA
– can do lamotrigine or topomax as adjuvants
Status Epilepticus Tx
– benzo plus loading phenytoin
– then do phenobarbitol w/ midazolam or pentobarbital
Infantil spasm tx
– ACTH, prednisone, colnazepam, or VPA
– very high slow waves
Myasthenia Abs
– Ach in 80%
– MuSK is 5%
– striated muscle w/ thymoma
– EOM and bulbar are spared
– Ab’s to presynaptic Ca channels
– you loose DTRs
– give guanidine hydrochloride
Huntington Tx
– haldol for psychosis
– reperpine for movements
Parkinson’s Tx
– bromocriptine for early
– Levodopa mainstay
– Selegine (MAO-B) neruoprotective
– Entacapone (COMT inhibitor) for motor problems
– give antichlinergics to pts younger than 70 w/ minimal bradykinesia
– steroids for acute
– IFNa, b, and copolymer
– Mitoxantrone for worsening
Guillian Barre Tx
– plasmapheresis and IVIG
– don’t give steroids!
Brain Mets
– Gliomas like killing my brain
– GI, lung, kidney, melanoma, breast
– unilateral paralysis if 5-7 and 10
Acoustic neruoma
– cerebellar dysfunction
Brain mets that cause hemorrhage
– melanoma, RCC, thyroid, choriocarcinoma
– optic glioma and iris hamartomas
– bone abnormality’s
– type 2 is the acoustic neuromas
Tuberous Sclerosis
– sebaceous adenoma
– mulberry tumors on nerve head
– phakomas are gray round and near disc
– rhabdomyoma
– skin enhanced by woods
– renal hamartomas or PKD
– angiomyolipomas w/ Cystic or fibrous pulmonary changes
Broca’s vs. Wernickes
– fronal lobe from L superior MCA stroke
– temporal lobe from inferior/posterior MCA stroke
Closed angle glaucoma Tx
– Acetazolamide, then pilocarpine
– laser iridotomy
– never give atropine!
Open able glaucoma Tx
– topical B-blockers or pilocarpine
– CA inhibitors
– later trabeulopasty
Central retinal artery Tx
– Cherry red fovea
– do thrombolysis w/in 8 hrs
– can drain anterior chanmber or give IV actezolamide
– very 1st thing is ocular massage
Central retinal vein Tx
– cotton wool and edema
– Laser photocoagulation
Pregant migraines
– can’t give triptans
Trigeminal neuralgia tx
– carbemazepine
Lewey body dementia
– like parkinson’s but doesn’t respond to drugs
– motor parkinsons w/ visual hallucinations
Cerebellar hemorrhage
– N and V, vertico
– occipital HA
– 6th CN and conjugate deviation
Paraneoplastic myopathy
– may look like lambert eaton, but DTR’s are preserved
Pimodine SE’s
– for benign essential tremor
– can lead to acute intermittent porporyia
– Ab pain, H/A, hallucinations)
Steppage Gait
– neuropathy, L5 radiculopathy
– common peroneal nerve
Medial Medulla syndrome
– contra spastic hemipalegia
– vibratory loss
– ipsi tonge deviation
Thalmic stroke
– hemi sensory loss
– severe dysesthesia
Putamen hemorrhage
– most common
– next to internal capsule so can cause hemiparesis
– inflammation of lacrimal sac
– can express purulent material
Cerebellar tumor
– ipsi ataxia and intention tremor
– nystagmus and bad coordination
– posterior fossa syndrome (N and V and ataxia)
Parkinsons, hemiparesis, Tabes dorsalis, NPC gait
– fenestrating
– arm ADduction and semicircle leg
– wide gain w/ high feet
– gait ataxia
Psuedotumor cerebri
– give acectozolamide
– can lead to vision loss!
– weight loss might help
Vitreous hemorrhage
– sudden loss of vision and floaters
– hard to see fundus
– in diabetics
Sympathetic opthalmia
– antigens unmasked
– floaters and blurred vision
Pronator drift
– from UMN lesions
– SSRI’s might help
– they are concerned about their memory loss unlike Alzheimer’s
Acoustic neuroma Dx
– MRI w/ Gad
Lesion in posterior column vs. Supratentorial
– ataxia and hemiparesis