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82 Cards in this Set
- Front
- Back
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What is the cause of complex regional pain syndrome? |
Idiopathic but generally begins after trauma or surgery |
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What are some symptoms of complex regional pain syndrome? |
Temperature changes pain in affected limb pain out of proportion to touch/temp |
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How do you manage complex regional pain syndrome? Is it curable? |
Manage stage 1 symptoms with steroids No cure |
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What is a key neurological symptom of diabetes mellitus? |
"stocking and glove" sensory neuropathy |
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Causes of diabetes mellitus? |
Either pancreas no longer produces insulin or insulin receptors have become insulin resistant |
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Signs or labs found in diabetes mellitus |
High blood glucose Order these labs: fasting blood glucose and A1C |
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what are the four "P"s - symptoms of diabetes mellitus? |
Parethesia Polydipsia Polyuria Polyphagia |
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What is the mechanism of Guillian Barre syndrome? What symptoms does it cause? |
Autoimmune disorder in which the immune system attacks the PNS Tingling and weakness in LE, progressing to ascending paralysis |
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What are some common treatments for Guillian Barre syndrome? |
Physical therapy Plasmapheresis High does immunoglobulin therapy |
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What is the best dx test for Guillian Barre syndrome? |
Lumbar puncture, look for elevated protein in CSF wo WBC elevation |
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Describe tension HA |
feels like a "tight band" around head mild/moderate dull generalized pain caused by stress or eye strain |
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Describe migraines |
unilateral throbbing sensation aura/sound sensitivity more common in women |
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Describe cluster HA |
severe unilateral pain behind one eye abrupt onset lasts up to 3 hours |
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What is the cause of huntington's and what movements is it characterized by? |
Autosomal dominant disorder Choreiform movements |
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What will be seen on neuroimaging of huntington's disease? |
Atrophy of caudate nucleus Atrophy of putamen of basal ganglia |
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When do symptoms of Huntington's usually manifest? How many years until terminal outcome? |
age 30-50 Usually die 15 yrs after onset most common cause of death is aspiration pneumonia |
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How can your use MRI as a diagnostic for MS? |
See destruction of myelin sheath as a lighter color |
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What do you look for in a CSF test for MS? |
Oligoclonal bands blood test is normal |
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What are symptoms in a pt presentation of MS? |
Distal extremity sensation changes Vision changes Unsteady gait Fatigue |
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What are two risk factors of MS? |
Living in the north family history |
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What drug for Parkinson's works as a tx and a dx? |
Levadopa |
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What is the mechanistic cause of Parkinson's? |
Dopamine depletion in substantia nigra |
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Characteristic symptoms of Parkinson's |
Peripheral resting tremor Bradykinesia Rigidity Shuffling gait En Bloc Turns Masked facies |
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What is the most common type of schizophrenia? |
Paranoid schizophrenia |
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What is the most common differential dx of schizophrenia? |
Schizoid personality disorder |
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What are some factors that increase risk of schizophrenia? |
Prenatal factors like exposure to toxins, virus or malnutrition while in utero |
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What will you see on the CT/MRI for a schizophrenic pt? |
decreased grey matter in the brain |
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What causes Wernicke-Korsakoff? What can that be a result of? |
Thiamine deficiency can be caused by alcohol abuse, diet deficiency, prolonged vomiting, eating disorder, or chemotherapy |
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What are symptoms of Wernicke-Korsakoff? |
Mental confusion Vision problems Lack of muscle coordination trouble establishing new memories difficulty retrieving memories |
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How do you treat Wernicke-Korsakoff? |
Give thiamine Provide proper nutrition/hydration stop alcohol use |
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What are symptoms of Alzheimer's? |
progressive, oscillating memory loss resulting in decreased life function |
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What are some mechanistic causes of Alzheimer's? |
Beta-amyloid plagues and Tau tangles caused by misfolded proteins |
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When does late onset Alzheimer's start? Early onset? |
After 65 before 65 |
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Cruetzfeldt-Jacob Disease |
rare, autosomal dominant disorder, very rapid degenerative brain disorder that results in death within one year of onset |
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Risk factors for Cruetzfeldt-Jacob disease |
Family history human growth hormone use consuming contaminated beef |
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Common symptoms of Cruetzfeldt-Jacob disease |
Personality changes Memory loss Anxiety and depression impaired thinking Blurred vision/blindness insomnia difficulty speaking difficulty swallowing impaired movements |
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3 tests to dx Cruetzfeldt Jacob disease and what you are looking for |
MRI: T2 hypersensitivity in basal ganglia, thalamus, cortex, and white matter CSF: high in protein 14-3-3 EEG: sharp wave complexes |
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3 components of Glasgow coma scale lowest score, highest score |
Motor, Verbal, Eye opening 3 15 |
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What is a mild range on glasgow coma scale? Moderate? Severe? |
13-15: LOC for less than 30 minutes 9-12: LOC for more than 30 minutes 3-8: unconscious or coma |
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What is the leading cause of childhood disability? |
Cerebral palsy |
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What is cerebral palsy? When does it usually occur? |
Progressive lesions of the brain that involve the motor systems Before 3 yrs of age |
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What are typical symptoms of cerebral palsy? |
Motor abnormalities Seizures Sensory disturbances Cognitive impairment communication/perception disabilities behavioral disorders |
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Is cerebral palsy progressive? |
No - symptoms do not get worse with time |
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What are some characteristics of chronic fatigue syndrome? What groups does it most commonly affect? |
Extreme fatigue NOT relieved by rest exhibit symptoms for 6+ months Affects women age 40-50, with history of depression and low socioeconomic status |
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How do you dx chronic fatigue syndrome? |
No specific diagnostic, but use dx tests to rule out fibromyalgia and MS |
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How do you treat chronic fatigue syndrome? |
No known treatment, usually manage depression and insomnia with medications |
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What is fibromyalgia? |
Painful noninflammatory nerve disease correlated with trigger points, sleep deprivation, depression, genetic component, affects mostly women |
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How do you dx fibromyalgia? |
No specific tests, It's a dx of exclusion - rule other things out; often misdiagnosed |
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How do you treat fibromyalgia? |
Treating the symptoms only - manage depression, improve sleep and increase exercise |
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Is Tourette disorder hereditary? |
No specific hereditary pattern, but we see males in the same family affected |
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What is required to dx someone with Tourette's? |
One vocal and one motor tic (both) for at least 1 year, pt under 18 yrs of age |
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How do you treat Tourette's? |
Habit reversal training Medication: Clonidine Usually goes away on its own by age 18 |
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What causes diabetes insipidus? |
Decreased ADH or insensitivity to ADH leading to increased urination and thirst |
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What is the difference between central diabetes insipidus and neurological diabetes insipidus? |
Central: caused by destruction of posterior pituitary, head trauma, tumor, or infection - leading to NO ADH production Neurological: inability of kidney to concentrate urine |
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What is the tx for central and neurological diabetes insipidus? |
Central: give synthetic ADH Neuro: Na/protein restriction |
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What is epilepsy? |
a syndrome causing multiple seizures due to abnormal/unregulated electrical activity in cortical gray matter of brain, disrupts normal brain function |
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Difference between focal and general epilepsy: |
Focal: a specific, single portion of the brain is affected General: both hemispheres of brain are affected and LOC may result |
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When do tonic seizures occur? What group has the highest incidence of these? |
Occur mostly during sleep Mostly in children |
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What type of tremor is an essential tremor? What test can you use? |
Postural tremor - not resting finger to nose test |
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How can you treat essential tremors? |
Propranolol Beta-blockers anti-seizure meds botox DBS stereotactic surgery |
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What makes essential tremors better? Worse? |
Alcohol
Stress |
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How does a pituitary adenoma cause vision change and what type of change does it cause? |
Compresses optic chiasm Causes bitemporal hemianopia |
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What happens to the pituitary hormones when there is a pituitary adenoma? |
can have hypo- OR hyper-secretion of any or all pituitary hormones |
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What is the most common pituitary adenoma and how do you treat it? |
Prolactinoma Bromocriptine |
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How can you dx sleep apnea? |
Polysomnography |
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How do you treat sleep apnea? |
CPAP machine to keep airways open |
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What requirements does a pt meet before they are dx with mild OSA (obstructive sleep apnea)? |
has 5-15 AHIs (apnea-hypopnea index) each hour for at least 10 seconds |
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When do hemorrhages lead to death? |
If brainstem herniates |
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What complaint makes you think of a subarachnoid hemorrhage? Which vessels could that involve? |
"Worst HA of my life" ACA, MCA, PCA |
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Risk factors for cerebral hemorrhages |
male atherosclerosis anticoagulation medications tobacco use Obesity |
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When does the bull's eye rash appear in lyme's disease? |
Early on, it disappears by late state lyme disease |
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What bacterium causes lymes disease? |
B. burgdorferi from a tick |
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What neurological effects does lymes disease have? |
Neurologically debilitating, involves PNS and ANS |
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How/when does neurosyphillis develop? |
develops when syphillis is left untreated, may develop within first few months of infection or take decades to appear |
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What populations is neurosyphillis most common in? |
Those who are HIV positive or have high risk sexual behaviors |
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How do you dx neurosyphillis? |
Complete social/sexual history Gold standard: CSF-VDRL |
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Difference between hemorrhagic and ischemic stroke? |
Hemorrhagic: Rupture of a blood vessel, blood accumulates in surrounding tissues Ischemic: obstruction of blood flow in a vessel, lack of oxygen to tissues |
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How do you treat an ischemic stroke? |
Give a tPA (tissue plasminogen activator) to dissolve the clot |
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Family history and past medical history that increase risk of stroke |
Fam history of CVA or MI PMH of diabetes, HTN, hypercholesteremia |
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Does depression affect more women or men? |
twice as many women as men |
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Signs of depression |
pt feels guilty/hopeless, lost of interest in things they used to enjoy, pain wo physical cause, change in weight or appetite, low energy |
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Risk factors of depression |
Personal/family history negative life changes illnesses/medications alcohol/drug abuse |
