Nervous System

Front 1

Acute exacerbations of MS:Rx

Back 1

IV methyl prednisone Beta Interferon or Glatiramer Acetate used to decrease frequency of exacerbations in Pts with relapsing-remitting or secondary progressive form of MS.

Monitor by MRI after 3 months of initiation of treatment

Front 2

MS Prognostic indicators

Back 2

Pts with sensory or cranial nerve involvment(Optic Neuritis) have better prognosis. Onset at an early age,female sex,relapsing form of disease associated with better prognosis

Front 3

ALS: involvement, earliest signs.preserved signs

Back 3

both motor neurons(consisting of anterior horn cells in spinal cordand brainstem neurns innervating bulbar muscles)

-Initial sign is insidiously developing asymmetric weakness usually first evident distally in one of the limbs.

-Ocular Motility,sensory,bowel,bladder and cognitive functions are preserved even with advanced disease.

Front 4

Drunken sailor gait(jerky gait)

Back 4

Pt is hesitant and walks in zig-zag pattern-seen in cerebellar ataxia

Front 5

Distal Motor neuron disease

Back 5

Steppage gait,foot drop,excessive elevatin of foot during walking(toes touch the flooe before the heels)

Front 6

Pt drags legs forward with every step.(scissor gait)

Back 6

Pt drags legs forward with every step.(scissor gait)

Front 7

Lewy body dementia features

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-hx of frequent falls with gait dysfunction and mild bradykinesia.

-fluctuation of cognitive symptoms

-visual halucinations,parkinsonism features,

-upto half pts have severe reaction to neuroleptics(haloperidol)

Front 8

Meralgia Paresthitica features

Back 8

common syndrome caused by entrapment of lateral femoral cutaneous nerve. Decreased sensation of anterolateral thigh without muscle weakness .

Front 9

Femoral Nerve lesion features

Back 9

anterior and anteromedial thigh paresthisia,accompanied by Quadriceps muscle weakness and decresed knee jerk reflex.

Front 10

Obturator Nerve Lesion

Back 10

sensory loss over medial thigh and weakness in leg adduction

Front 11

dx of NPH-dx and treatment

Back 11

Assesses Gait before and after removal of 30 ml of CSF. Long term Treatment-Ventriculoperitoneal shunting

Front 12

HIV and syphilis treatment

Back 12

Pts with HIV and syphilis of unknown duration withneurlogic symptoms should have LP before treatment

Front 13

Opioid withdrawal treatment

Back 13

Methadone,Buprenorphine(agonists)or non opioids such as clonidine. Opioid agonists to be only used for detox in supervised inpatient or outpatient settings

Front 14

Cluster Acute management and prophylaxis

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100 % Oxygen Long term Prophylaxis-Verapamil

Front 15

Cataplexy Rx

Back 15

serotonin NE reuptake inhibitors(venlafaxine,TCA's and sodium oxybate)

Front 16

Head CT indications after Head Trauma

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GCS < 14 *Signs of Basilar skull fracture -battle sign(mastoid ecchymoses)

-raccoon eyes(orbital echymoses)

-CSF Rhinorrhea or Otorrhea

-Hemotympanum

-Cranial Nerve deficits

*AMS

*Bledding Diathesis(eg hemophilia)

Front 17

Wernicke korsakoff syndrome affected area

Back 17

diencephalon,particularly thalamus and mammilary bodies

Front 18

Unilateral headache with horners syndrome dx

Back 18

Carotid artery dissection until proven otherwise. Initial mnagement-head and neck vasculature imaging

Front 19

Myasthenia Gravis clinical features

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double vision and ptosis that worsens at the end of the day.(weakness in extraocular Muscles) next involved muscles are bulbar muscles-dysphagia,dysarthia

Front 20

Cerebral Palsy clinical features, dx and first intitial test

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Cerebral Palsy- typical hx-premature birth,gross motor delay within first year of life and early hand preference.

Phy-hypotonia but later progresses to spasticity. dx-based on hx and phy exam.

MRI is test of choice to look for abnormailities and possible etiology

Front 21

Alzheimers neurotransmitter involved

Back 21

Decreased levels of acetylcholine due to degeneration of basal nucleus of Meynert

Front 22

Stroke rx with fibrinolytics

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If Non Hemorrhagic -presents < 3-4.5 hrs to hospital. Oral medications are held in stroke pts till swallowing evaluation is performed.

Front 23

Tuberous sclerosis evaluation

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MRI,,Funduscopy for hamartomas.EEG is indicated as seizures are predominant symptom and gradually worsen over time.Abdominal imaging for renal lesions.

Rhabdomyomas are asymptomatic and resolve spontaneously during infancy(develop in utero)

Front 24

Tuberous sclerosis most common cause of death

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Most coomon cause of death-Neurologic impairment.

Second most common Renal involvement.