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100 Cards in this Set
- Front
- Back
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What is the mean term of years of death in an Alzheimer's patient upon onset?
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10 years
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What are the clinical manifestations in a patient with Alzheimer's in the early stage?
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1. Memory loss
2. word-finding 3. visuospatial disturbance |
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What are the clinical manifestations in a patient with Alzheimer's in the intermediate stage?
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1. aphasia,apraxia, behavior problems
2. sleep-wake cycle disturbances 3. wanders, gets lost, more falls |
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What are the clinical manifestations in a patient with Alzheimer's in the terminal stage?
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1. cognitive decline, motor abnormalities, urinary and fecal incontinence.
2. recent and remote memory totally lost. 3. May be unable to swallow and eat. |
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When can Alzheimer's disease be diagnosed?
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At autopsy by neurofibrillary tangles and senile plaques.
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What are some medications used for an Alzheimer's patient with delusions?
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1. risperidone
2. olanzapine 3. quetiapine |
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What are some medications used for an Alzheimer's patient with agitation?
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1. Trazadone
2. divalproex 3. carbamezapine |
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What are some medications that are contraindicated in an Alzheimer's patient with agitation?
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anticholinergics (may increase dementia)
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Name some medications that are acetylcholinesterase inhibitors used in the tx of Alzheimer's disease.
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1. donepezil
2. rivastigmine 3. galantamine |
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What is the most common movement disorder in children?
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Cerebral palsy
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What are the four types of pyramidal spasticity in cerebral palsy?
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1. Diplegia
2. Quadriplegia 3. Hemiplegia 4. bilateral hemiplegia |
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What are some risk factors for cerbral palsy?
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1. premature birth
2. birth asphyxia 3. intrauterine growth retardation 4. infection 5. trauma |
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What are the three types of extrapyramidal cerbral palsy?
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1. ataxic
2. choreathetoid 3. dystonic |
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Which nerve is involved in Bell's palsy?
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Cranial Nerve VII (facial)
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Which virus may be linked to Bell's palsy?
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Herpes simplex virus
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What syndrome must be ruled out in Bel's palsy?
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Ramsey-Hunt syndrome
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A patient presents with loss of taste on the anterior two thirds of the tongue, hyperacusis, and paralysis of the face comes on over night. What is your dx?
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Bell's Palsy
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What medication can be considered in Bell's Palsy?
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Acyclovir
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What is the most common neurological syndrome seen in diabetes?
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sensorimotor polyneuropathy
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Another name for numbness or tingling in the hands or feet of a diabetic.
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stocking-glove pattern
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A patient presents with ascending weakness following an infection of walking pneumonia from Mycoplasma. CSF shows normal cell count with elevated total protein. What is the most likely dx?
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Guillain-Barre syndrome
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A 25 year old female presents with eye weakness, slurred speech, and difficulty chewing that becomes easier with periods of rest. What is the most likely diagnosis?
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Myasthenia gravis
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What is the medication used in Myasthenia gravis to diagnose? What medication is used to tx?
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1. edrophonium or neostigmine to dx
2. pyridostigmine bromide or neostigmine bromide for tx |
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What medication may exacerbate Myasthenia gravis?
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1. Aminoglycosides
2. B-blockers |
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30 year old man presents with complaints of headache of multiple daily episodes. Unilateral in nature, what is the most likely dx?
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Cluster headache
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What is the medicinal tx for cluster headaches?
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Ergotamine tartrate
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Name some migraine triggers.
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1. Stress
2. Foods containing tyramine, MSG, or nitrates 3. alcohol 4. OCPs 5. Glare 6. lack of sleep |
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Migraine Aura that includes homonymous visual disturbances, what are these called?
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Scotoma
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What is the medicinal treatment for mild migraines?
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Acetaminophen
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What is the medicinal treatment for moderate migraines? (BASE)
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1. Butalbital with caffeine
2. Aspirin 3. Sumatriptan 4. Ergotamine |
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What 5-HT receptor agonists should be avoided in patients with uncontrolled hypertension or coronary artery disease?
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Sumatriptan
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What is the medicinal treatment for severe migraines?
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1. Dihydroergotamine
2. Meperidine |
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What is the most common type of headache?
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Tension headache
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What is the drug of choice for prophylactic treament of tension headaches?
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tricyclic antidepressants
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What is the name of an infection of the brain parenchyma?
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Encephalitis
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What is the most common cause of encephalitis. Hint it is also know to cause olfactory hallucinations and personality changes.
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HSV
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What is the number one CNS lesion in AIDS?
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Toxoplasmosis
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What is the most common cause of encephalitis in a Latin American immigrant?
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Neurocysticerosis
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What is the name of an infection of the brain parenchyma?
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Encephalitis
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What is the most common cause of encephalitis. Hint it is also know to cause olfactory hallucinations and personality changes.
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HSV
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What is the number one CNS lesion in AIDS?
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Toxoplasmosis
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What is the most common cause of encephalitis in a Latin American immigrant?
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Neurocysticerosis
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What is the most common cause of menningitis in adults?
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Streptococcus pneumoniae
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What organism is suspected in a soldier that lives in barracks and has petechaie on trunk, legs, conjunctivae?
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Neisseria meningitis
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What is the number one cause of meningitis in neonates?
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Streptococcus agalactiae
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What sign is a patient that cannot touch his chin to his chest when meningitis is suspected?
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meningismus
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Which organism causes encephalitis that causes multiple ring enhancing lesions?
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Toxoplasmosis
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What virus is collectively california encephalitis, Eastern and Western encephalitis, St. Louis and West Nile encephaltis?
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Arboviruses
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At what season is encephalitis at its highest outbreak?
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late summer
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What organism will be shown if india ink is used in CSF and is positive?
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Cryptococcus
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Patient is supine and hip and knee flexed to 90 degrees, further extension of the knee causes pain in the neck or hamstring. What sign is this?
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Kernig's sign
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Flexing the neck of a supine patient resulting in flexion of the hip and knee. What sign is this?
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Brudzinski's sign
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What cranial nerves are typically abnomal when a patient has meningitis?
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CN 3,4,6 and 7.
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What is the Abx of choice in a patient with menigitis from Streptococcus pneumoniae?
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1. Penicillin G 10-14 days
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What is the Abx of choice in a patient with meningits from Neisseria meningitidis?
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1. Penicillin G 7 days
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What is the Abx of choice in a patient with meningitis from Haemophilus influnzae?
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1. Ampicillin 10 days
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What is the Abx of choice in a patient with meningitis from Listeria monocytogenes?
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1. Penicillin G 14-21 days
2. Ampicillin |
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What is the Abx of choice in a patient with meningitis from Staphylococcus aureus?
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Nafcillin 14 days
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What is the most common organism in meningitis in a neonate?
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Streptococci group B
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What organism is the most common form of meningitis in patients from 6-60 years old?
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Niesseria meningitidis
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What is the empiric treatment of bacterial meningitis in an adult?
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Vancomycin IV and ceftriaxone
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How can a PA detemine that the patient has Meningococcal meningitis from other organisms?
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Petechial rash on trunk, lower extremities, conjunctivae, and sometimes on palms and soles.
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What is the drug of choice in the close contacts of a patient with meningococcal meningitis?
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Oral Rifampin
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45 year old man presents with spasticity, hyperreflexia, and no fasiculations. Where is the damage located? What dx? What tx to slow progression for 6 months?
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1. Upper motor neurons
2. ALS (Lou Gehrig's) 3. Riluzole |
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What is the most effective way to treat essential tremors?
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Beta-Blockers
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A meiningitis patient presents with low glucose, high proteins, and polymorphic neutrophils(PMNs) that are less than 300/mm3. What is the organism?
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Tuberculosis meningitis
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Patient with a "dancelike" gait. psychosis, irritability, memory loss. Involuntary choreic movements that dissapear with sleep. Dx?
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Huntingtons disease
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What is the first line treatment in a patient with painful Diabetic neuropathy?
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1. Amitryptiline (Elavil)
2. Gabapentin (Neurontin) |
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In a patient with Parkinsons disease what medication can be given to prevent Levodopa from being metabolized?
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Carbidopa
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Influenzae A medication commonly used in treatment of Parkinson's disease.
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Amantadine
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When must bromocriptine be avoided in a parkinson's disease patient?
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1. mental retardation
2. recent MI |
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30 year old female from New England that c/o weakness, spasticity, and tingling in her legs. Has been having problems recently with blurry vision. States that since she has come to Florida the symptoms have become worse. Labs show oligoclonal bandsin CSF. What is her dx? How would you tx her spasticity?
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1. Multiple Sclerosis
2. diazepam |
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What is the treatment of MS related fatigue?
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amantadine
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What medication can reduce the frequency and severity of MS replapses and reduce the number of brain lesions?
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interferon B-1b (Betaseron)
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What is the name of a transient neurological paralysis from a partial simple seizure called?
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Todd's paralysis
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What is the most important test to diagnose a seizure? What should you look for?
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Electroencephalography (EEG)
epileptiform abnormalities |
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What is the treatment protocol of a patient with status epilepticus?
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1. Thaimine and glucose
2. Lorazepam or diazepam 3. Phenytoin or fosphenytoin >30 mins.intubate and propofol |
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What is the most common intracranial aneurysms?
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Saccular
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What type of aneurysms are due to infected emboli and found in the distal cerebral arteries?
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Mycotic
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What type of aneurysms are typically found in the basilar artery and are associated with atherosclerosis?
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Fusiform
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What is the treatment for saccular aneurysms?
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surgical clipping
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What is the treatment for fusiform aneurysms?
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Total occlusion
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Which antiepileptic drug stabalizes neuronal cells by decreasing flux of sodium ions?
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Phenytoin
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Which antiepileptic drug blocks sodium channels, reducing abnormal impulses?
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Carbamazepine
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Which antiepileptic drug enhances GABA action at inhibitory synapses, reducing abnormal discharge in the brain?
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Valproic Acid
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Which antiepileptic drug causes a cleft lip and palate in newborns?
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Phenytoin
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What must be monitored in a patient on Valproic Acid?
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LFTs
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What is the most common cause of Lacunar strokes?
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Chronic Hypertension
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What must the blood pressure be at to start thrombolytic therapy for a stroke?
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>180/110 mmHg
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What is the most common cause of SAH?
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Trauma; the second most common is berry aneurysm.
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A patient presents with a significant history for initial altered mental status with an intervening lucid interval. Dx? Most likely source?
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Epidural hematoma.
Middle meningeal artery Neurosurgical evacuation |
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What is the most common pituitary tumor?
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Prolactinoma
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A 55 year old man presents with " broken speech". What type of aphasia? What lobe and vascular distribution?
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Broca's aphasia
Frontal Lobe left MCA distribution |
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Albuminocytologic dissociation
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Guillan-Barre syndrome (increase protein in CSF without a significant increase in cell count)
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Combined UMN and LMN disorder.
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ALS
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port-wine stain in V2 the distribution, mental retardation, seizures, and ipsilateral leptomeningeal angioma
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Sturge-Weber syndrome
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More than 6 cafe au lait spots on skin
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Neurofibromatosis type 1 (von recklinghausen)
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hyperphagia, hypersexuality, hyperorality, and hyperdocility.
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Kluver-Bucy syndrome (amygdala)
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What is the most common cause of seizures in children?
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Infection, febrile seizures, trauma
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What is the most common cause of seizures in young adults?
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Trauma, alcohol withdrawal, brain tumor
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