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35 Cards in this Set
- Front
- Back
Kleine-Levin
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- "sleeping beauty"
- Hypersomnolence - Hyperphagia - Hypersexuality - Mood and behavior changes |
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Kluver-Bucy
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- Bilateral medial temporal lobes (amygdala)
- Docility - Hyperorality - Hyperphagia - Hypersexuality - Visual agnosia |
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Thallium toxicity
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- Axonal peripheral neuropathy, ascending
- Alopecia - Pain and paresthesias starting with soles of feet - Distal>proximal weakness - MRI normal |
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Serotonin syndrome
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- Site of disorder: CNS
- Caused by SSRIs with or without MAOi, TCA, meperidine - Tachycardia/HTN, diaphoresis/shivering, nausea/diarrhea, myoclonus, hyperreflexia, hyperthermia, seizures, coma - Treatment is supportive |
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Bechet's disease
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- Mucocutaneous, ocular, cardiovascular, renal, GI, pulmonary, and CNS
- Presence of oral aphthous ulcers and 2 other ulcers or vasculitidities |
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Sturge-Weber disease
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- Neurocutaneous disorder involving leptomeninges, skin of face in V1 and V2
- Port-wine stain - Ocular manifestations include ocular choroidal angiomas and glaucoma |
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Organophosphate poisoning
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- Cholinergic syndrome
- Pinpoint pupils - SLUDGE: salivation, lacrimation, urination, diaphoresis, GI motility, emesis - Otherwise known as "fluid coming out of everywhere" |
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Lead
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- Peripheral neuropathy
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Giant cell arteritis
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- Systemic symptoms are protective against CNS involvement
- Visual loss occurs in 8% - Stroke occurs in 7% |
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Toxins: Botulism
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- Presynaptic membrane (SNARE protein cleavage, no Ach release)
- Nausea, vomiting, diarrhea -> constipation, generalized weakness. - Foodborne develops over 12-36 hours - Wound borne develops over days to weeks. |
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Toxins: Tick paralysis
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- Block NMJ transmission, or block Na channels at Nodes of Ranvier
- Rapidly ascending weakness - Remove tick |
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Toxins: Tetrodotoxin
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- Presynaptic Na+ channel blocker
- Found in pufferfish |
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Toxins: Saxitoxin
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- Presynaptic Na+ channel blocker
- Dinoflagellates (red tide), shellfish that feed on them |
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Toxins: Ciguatoxin
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- Presynsaptic Na+ channel blocker
- Dinoflagellates, reef fish - Abdominal pain, oral and acral paresthesias, altered temperature sensation |
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Toxins: Aminopyradines (dalfampridine)
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- Presynaptic K+ channel blocker
- Slows repolarization and promotes Ach release - Used in treatment of Lambert Eaton syndrome |
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Toxins: Dendrotoxin
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- Presynaptic K+ channel blocker
- Black or green mamba snake |
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Toxins: Notexin
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- Presynaptic K+ channel blocker
- Australian tiger snake |
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Medications which worsen myasthenia
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- Ca2+ blockers
- Antibiotics (aminoglycosides) - Mg2+ |
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Toxins: Conotoxins
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- Presynaptic Ca2+ channel blocker
- Found in marine snails |
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Toxins: Organophosphates
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- Include weaponized nerve agents such as soman, sarin, VX
- Insecticides - Hypercholinergic state - Treat with atropine |
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Toxins: Curare
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- Postsynaptic AchR blocker
- Vec, pancuronium have similar mech of action |
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Toxins: alpha bungarotoxin
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- Postsynaptic AchR blocker
- Banded krait (cobratoxin by siamese cobra) |
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Manganese toxicity
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- Bilateral basal ganglia and midbrain lesions on MRI
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Neuroleptic malignant syndrome
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- Site of disorder: CNS
- Antipsychotics, especially depot - Rigidity, encephalopathy, autonomic instability, dystonia, tremor, chorea, hyperthermia - Treat with dantrolene, dopaminergic agents, withdraw medication |
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Malignant hyperthermia
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- Site of disorder: muscle
- Halogenated anesthetics or depolarizing anesthetics in patients with ryanodine receptor mutation - Jaw clenching, respiratory acidosis, cyanosis, myoglobinuria - Withdraw medication, dantrolene, bicarbonate |
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Acute lethal catatonia
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- Site of disorder: CNS
- Exacerbated psychotic disorder - Psychosis, dyskinesia, waxy flexibility (not true rigidity) - treat with ECT |
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Neuroleptic malignant syndrome
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- Site of disorder: CNS
- Antipsychotics, especially depot - Rigidity, encephalopathy, autonomic instability, dystonia, tremor, chorea, hyperthermia - Treat with dantrolene, dopaminergic agents, withdraw medication |
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Malignant hyperthermia
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- Site of disorder: muscle
- Halogenated anesthetics or depolarizing anesthetics in patients with ryanodine receptor mutation - Jaw clenching, respiratory acidosis, cyanosis, myoglobinuria - Withdraw medication, dantrolene, bicarbonate |
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Acute lethal catatonia
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- Site of disorder: CNS
- Exacerbated psychotic disorder - Psychosis, dyskinesia, waxy flexibility (not true rigidity) - treat with ECT |
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Causes of head drop
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myasthenia
ploymyositis ALS |
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Causes of head drop
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myasthenia
ploymyositis ALS |
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Causes of head drop
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myasthenia
ploymyositis ALS |
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Spastic paraplegia
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Focal spinal cord disease
SCD tethered cord DOPA responsive dystonia Leukodystrophies SCA-3 Friedreich's ataxia |
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Episodic ataxia I
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- voltage gated K+ channel
- Onset 20-30 years - Ataxia only lasting 1-2 minutes, emotion or change in position - without nystagmus - Treat with antiepileptics, avoid acetozolamide |
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Episodic ataxia II
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- mutations of p/q type voltage gated ca2+ channel (CACNA1A)
- lasts more than 10 minutes to hours - triggered by exercise or stress - with nystagmus - Treat with acetazolamide |