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225 Cards in this Set

  • Front
  • Back
Sx/Mnemonic for SLE
Discoid Lupus
Oral Ulcers
Photosensitivity
ANA
Malar rash
Immunologic
Neuro changes
ESR

Renal Dz
Arthritis
Serositis
Hematologic changes
What sx differentiate drug-induced SLE from non-drug induced form?
renal and cns involvement
pulmonary findings in SLE
pleuritis
pneumonitis
pleural effusion
pHTN
joint involvement in SLE
symmetric, small joint involvment

non-erosive / non-deforming
Behcet's syndrome
arthralgias, fatigue, oral/genital ulcers (painful)
Felty's syndrome
cytopenia in setting of RF+ nodular RA
rx that can cause DI-SLE
HIPP

quinidine
etanercept
methyldopa
skin manifestations in systemic sclerosis
thickening
pigmentation changes
digital pitting
ulceration
telangiectasia
Pathophysiology of digital pitting in systemic sclerosis
2/2 vascular injury --> raynaud's
vascular injury is 2/2 proliferation of the intimal layer
course of skin thickening in systemic sclerosis
thickens for 2 yrs before atrophy occurs
tx of raynaud's
DCCBs (nifedipine, amlodipine)
dipyridamole
nitrates
3 gi manifestations of systemic sclerosis
dysmotility --> dysphagia
decreased pressure in LES --> GERD
dysmotility --> pseudo-obx
tx of gi dysmotility sx in systemic sclerosis
nitroglycerine/nitrates
pain control
tx of ILD in systemic sclerosis
cyclophosphamide
tx of PAH in systemic sclerosis
coumadin
O2
bosentan
epoprostenol, iloprostenol
sildenafil
if a pt is + anti-Scl70, what are they at increased risk for?
difffuse cutaneous systemic sclerosis

ILD
what malignancy are systemic sclerosis pts with at an increased risk of?
lung ca
cardiac complications in systemic sclerosis
restrictive CMP
pericarditis
arrhythmia 2/2 myocardial fibrosis
renal complications in systemic sclerosis
hyperreninemic renal crisis that resembles malignant HTN
tx for renal crisis in systemic sclerosis?

why is this tx effective?
ACEi - captopril is fast-acting and is the mainstay (keep using even if cr worsens, and continue even if pt is on HD 2/2 renal crisis)

effective b/c the crisis is caused by hyperreninism
describe use of steroids in systemic sclerosis
NOT often used b/c process is NOT inflammatory

* steroids can INDUCE renal crisis in scleroderma *
pathophys of takayasu's arteritis
granulomatous
exam findings in takayasu's arteritis
bruits
tenderness when palpating large arteries
decreased pulses
aortic insufficiency
normal presentation of pt with takayasu's
constitutional sx
arterial insuff
SCA increases risk of what type of arthritis?
gout

b/c high rbc turnover and renal dz --> hyperuricemia
s/sx PMR
* PAIN *
morning stiffness in axial joints / prox muscles (limb girdle involvement)

NO weakness
NO joint swelling
which lab is usually elevated in pts with PMR?
CK
which dz is associated with PMR

what are the incidences of each in each?
40-50% pts with GCA have PMR

10-15% pts with PMR have GCA
tx of PMR
steroids
when to tx for GCA if bx of temp art has NOT been done
if there are NO visual sx, then it is OK to start steroids AFTER bx is taken; do not have to wait for results

if there ARE visual sx, tx IMMEDIATELY, should not affect the bx results (up to 2 wks)
which rheumatologic condition can be associated with subclavian steal?
takayasu's arteritis
potential GI complication in systemic sclerosis

tx?
bacterial overgrowth -> malabsorption

abx - cover anaerobes, GNRs, B. frag. (CIPRO)
SE of an elevated ESR in GCA?
75-90% (NOT all cases!)
malignancies associated with RA?
Large B-cell NHL

NHL (44x greater than general public)
what is the imaging study of choice to dx RA
XR

(earlier joint damage can be seen on MRI)
what is anti-CCP AB?
IgG rxn to altered synovial membrane peptides

indicates an increased SEVERITY in RA

"Citrulline indicates Severity"
what is the association btw RA and heart dz
premature atherosclerosis
(esp. in pts with poorly-controlled dz for > 6 wks)

100% increased risk of MI
70% increased risk of stroke
DMARDs used in mild RA
hydroxychloroquine
sulfasalazine
MTX +folate
etanercept/infliximab/adalimumab
what defines mild RA
5-10 joints involved + mild impairment
how to treat SEVERE RA
DMARDS (MTX is best) + anti-TNFa
s/sx of adult-onset Still's Dz
Arthritis, arthlagias and myalgias (100% of pts)
Daily high fevers
Salmon-colored rash
pharyngitis
serositis
splenomegaly

elevated ferritin, LFTs, LDH
tx of adult-onset Still's Dz
NSAIDs (usually work)

Steroids and DMARDs if Sx are life-long
Dz course of adult-onset Still's dz
self-limited, chronic, or intermittent

Chronic dz - assoc with severe reactive arthritis
Sx of Parvovirus B19 infx in an otherwse healthy adults

mimics what other adult disease?
(mimics RA):
symmetric polyarthritis of wrist, MCP, PIP, and similar joints in feet

rash possible (not common)
course of adult Parvovirus B19 infection
sx resolve in 1-2 mos, helped w/ NSAIDS

if last > 3 mos, then dx of RA
what should be prescribed to pts who are on steroids long-term
any pt who is on prednisone for >3 mos:
- Ca, vit D, and bisphosphonate
- PPI
- +/- TMP/SMX for PCP ppx _____?
teriparatide

indications?

contraind?
severe osteoporosis tx; limit use <2 yrs

contraind: Paget's hypercalcemia, h/o bone malignancy or XRT
upper limit of urate that will cause precipitate (gout)
6.7 mg/dl
side effects of colchicine
neuropathy
myopathy

(esp in pts with liver or kidney dz)
is colchicine used to treat or prevent gout
both!
allopurinol

SE?
Steven-Johnson syndrome (if rash develops, STOP!)
what is livedo reticularis?

when do you see it?
painless, net-like rash on extremities

seen in SLE
Jaccoud's arthropathy
hand deformity that is similar to RA...

...BUT it is reversible and NON-erosive :)
other than arthritis and arthropathy, what other joint or MSK complaints might a pt wth SLE have?
avascular necrosis (5-10%)
fibromyalgia
Most common renal manifestations in SLE
Glomerulonephritis (--> casts, dysmorphic RBC in UA)
Interstitial nephritis
Renal vein thrombosis
Neuro/psych manifestations of SLE
Sz
encephalitis
CVA
Transverse myelitis
Psychosis
Aseptic meningitis
Demyelinating dz
HA and cognitive dysfxn
what is shrinking lung syndrome?

findings on CXR?

when do you see it?
diaphragmatic dysfxn --> restrictive lung dz

CXR: lungs fields normal but elevated hemidiaphragm

seen in SLE
Libman-Sacks Endocarditis

complication?
STERILE vegetations on valve margin (usually mitral or tricuspid)

Cx: can --> infx endocarditis
Heme findings in SLE
mild cytopenias

Coomb's + AIHA (15%)
complement levels during SLE flare
LOW C3 and C4
which lab test has + prognostic value for lupus nephritis
ds-DNA
Tx of SLE
NSAIDs
low-dose steroids
hydroxychloroquine
what are the benefits of hydroxychloroquine
steroid-sparing
lowers cholesterol
anti-thrombotic
SE of hydroxychloroquine
IRREVERSIBLE retinopathy (pts must have annual eye exams!)
when can MTX be used in SLE
if there is joint involvement


"Mobility problems? Give MTX!"
What rx can be added to tx SEVERE SLE
high-dose (pulse) steroids
cyclophosphamide
AZA
mycophenolate
how is neonatal lupus syndrome prevented
hydroxychloroquine during pregnancy
what are the major causes of death in SLE
CKD
CAD
infx
lab findings of TB infiltration in liver
isolated elevated AP

nl AST, ALT
elevated AP + unexplained pruritis
primary biliary cirrhosis
pathophsy of pbc

prognosis/time course?
autoimmune destruction of small- and medium-sized bile ducts --> fibrosis

ESLD within 5-10 yrs
tx of pbc
ursodeoxycholic acid (slows progression)

transplant is definitive tx
sx of pbc
jaundice, pruritis
steatorrhea
HLD, xanthomas
ADEK deficiencies
what add'l labs to order if HBcAb is elevated
repeat test

If repeat is +, get anti-HBc IgM titer, LFTs
how long can HBc IgM titers be elevated
up to 2 yrs after infx
when to treat Asx, subclinical hypothyroidism
if anti thyroid ab present (b/c will likely become overt)
abnl lipid profile
AUB/anovulation
TSH >10 (?)
DKA: what is the timing to switch a pt to subQ insulin once blood sugar has normalized?
30-60 mintues BEFORE insulin drip is stopped.

otherwise, DKA can occur again!
best way to manage DM during elective c/s?
nl dose of insulin the night before surgery

then start insulin gtt + D5/NS

keep glucose < 160
when should incidental thyroid nodules have FNA?
if > 1cm, FNA
if < 1cm, follow with annual U/S
which of these is the most common cx of hypothyroidism?
HLD
HTN
Myxedema
Glossitis
Angina
HLD
Schmidt syndrome
polyglandular autoimmune failure type II

= addison's, type I DM, autoimmune thyroid dz
clinical picture of MODY
modest hyperglycemia
no DKA
+FHx
what happens to blood sugar in delayed gastric emptying
post-prandial hypoglycemia

(b/c the peak insulin level does not correspond with the the food absorption)
methimazole in pregnancy

cx?
teratogenic (aplasia cutis)
cx of hyperthyroidism during pregnancy
thyroid storm
(if thyroid dz is not controlled. added stress of labor is a trigger)
what triglyceride level warrants tx
>200
tegaserod

moa?

uses?
serotonin agonist

used to tx constipation in IBS
clinical presentation of subacute lymphocytic thyroiditis
painless nodule/goiter, sx <2 mo
transient hyperthyroidism b/c T4 is released from inflamed gland

if severe, tx: propranolol
who gets subacute lymphocytic thyroiditis
pts on IFN, amiodarone, or IL-2
causes of subclinical thyrotoxicosis
#1 = Rx-induced (levothryoxine)

nodular thyroid dz
Graves
thyrotoxicosis
how to manage Asx subclinical thyrotoxicosis
if pts are Asx: recheck TSH (b/c they have a high chance of normalization)

DON'T Tx unless Sx
Conn's syndrome

lab findings?
primary hyperaldo

aldo:renin ratio >30

(also, aldo must be >15)
tx of graves dz

contraindication to this tx
radioactive iodine ablation

CI: large retrosternal goiter
--> inflammation from tx --> airway obstruction!
mgmt of orbital myxedema / proptosis in graves dz
steroids (+ radioactive iodine)

to prevent ophthalmoplegia 2/2 CN III, IV, VI inflamm
what rx inhibit T4 -----> T3 conversion?
propranolol (B-blockers)
PTU
steroids
amiodarone
what dz is risk factor for thyroid lymphoma
hashimoto's thyroiditis
tx of thyroid lymphoma
XRT + chemo
are oral medications effective in preventing diabetic retinopathy
no
PROVOKED (underlying risk factor), 1st DVT

how long to tx?
3 months
toxic thyroid nodule

s/sx?

dx test of choice?
s/sx hyperthyroidism

focal uptake on scan
3 GI cx of somatostatinoma?
gallstones (ST inhibits gallbladder contraction)

malabsorption (ST inhibits motility)

DM (ST inhibits pancreatic secretions)
Glucagonoma

how do pts present?
Pts present with mild DM + rash

necrolytic migratory erythema, rash that clears from center
thryoid nodule

w/u algorithm?
+ --> FNA
TSH
- --> thyroid scan --> +hot --> OBSERVE
--> -cold --> surgery
electrolyte abnormalities in rhabdo
hyperkalemia
hypocalcemia
hyperphosphatemia
hyper-CK
causes of rhabdo
cocaine use
EtOH use
trauma/exertion
Rx-induced
how to manage rhabdo
IVF
alkalinize urine
how to manage hyperkalemia with rhabdo
monitor EKG

K will likely correct as renal fxn improves

+/- kayexylate / no tx if no arrhythmias
appearance of Paget's dz of bone on ct
"cotton wool" appearance on ct
tx of Paget's dz of bone
calcitonin + bisphosphonates
t or f:
ergonomic keyboards are useful in management of carpal tunnel syndrome
false
SLE

DOC DMARD?

2nd line if that fails?
MTX

if fails --> anti-TNFa
#1 cause of MI in SLE
premature atherosclerosis / CAD
how do steroids lead to osteopenia?
decreased intestinal absorption of Ca

increased Ca excretion in urine
screening procedure for bone health in pts on steroids
if on steroids >3 mo

DEXA: baseline at initiation, then annually
how to dx spinal stenosis

study of choice?
MRI
best screening test for SLE
ANA

(ds-DNA only 70% SE, good SP)
definition of mixed connective tissue dz (MCTD)
+anti-RNP + 3 clinical features of SLE, PM or scleroderma
clinical features of hemochromatosis
central hypogonadism
DM
arthropathy
skin pigmentation
liver disease
how to dx Sjogrens

Screening?
Confirmation?
anti-Ro/La

Bx minor salivary glands: focal collection of lymphocytes
tx for renal failure in SLE... by WHO Type 1-5
WHO types 1 or 2: no tx

WHO types 3, 4, 5: steroids; if fail, cyclophosphamide
t or f:
levels of anti-dsDNA and C' correlate with severity of SLE
true
first line tx for acute gout flares?
indomethacin
clinical presentation of ankylosing spondylitis
LBP, morning stiffness -> improves with exercise
sx > 3 mo

decreased flexion in L-spine
how to dx ankylosing spondylitis

test of choice?
XR of SI joints

If XR - but suspicion HI --> CT
associated lung problems in ankylosing spondylitis
pulmonary fibrosis

restrictive lung dz 2/2 decreased costo-vertebral joint movement
t or f:
there is decreased life expectancy in ankylosing spondylitis
false
best way to dx osteonecrosis of hips

test of choice?
MRI
carpal tunnel syndrome has increased association with what other things
trauma
DM
RA
hypothyroidism
acromegaly
pregnancy
menopause
ESRD
fibromyalgia
obesity
tx of papillary ca of thyroid
near-total thyroidectomy --> then radioactive therapy
blood sugar cx in chronic pancreatitis
"Brittle DM"

(increased risk of hypoglycemia b/c loss of a-cells too)
contraindications to metformin
renal failure
CHF
EtOH-ism
contraindications to thiazoladinadiones (glitazones)
CHF (class III/IV)
contraindications to exercise in dm
bs >250
no weightlifting if retinopathy present
endocrine cx of angiography
thyrotoxicosis

(b/c high IODINE load can act as a substrate)
tx for sulfonylurea overdose
D5

If fails...
octerotide (inhibits insulin release)
Ca/Phos cx s/p gastric bypass surgery
malabsorption --> Vit D def --> Hi PTH --> phosphate wasting (in urine)

LOW phosphate BEFORE Low Ca
what BP rx increase the risk of DM (with prolonged use)
B-blockers
HCTZ
tx of choice for a non-secreting pituitary tumor
trans-sphenoidal surgery
heme cx in adrenal failure
eosinophilia
how to dx adrenal insufficiency
cosyntropin (ACTH) stimulation test
how to manage levothyroxine doses in pts with h/o thyroid ca, now in remission
Suppress TSH to goal:

0.1-0.3 if non-metastatic
<0.1 if + distant mets
can dx of DM be made with 1 abnl glucose level
yes, but ONLY IF there are OVERT S/Sx of dm at the time of the reading
after how many wks on steroids does a pt need a taper?
> 3 wks
increased risk of which malignancy in acromegaly
colon ca

colonoscopy q 3-5 yrs
tx of prolactinoma with visual sx
bromocriptine or cabergoline (will shrink tumor)

no surgery is needed!

Sx resolve more quickly than MRI
men 2a
medullary thryoid ca
pheochromocytoma
hyperparathyroidism
what must be done before surgery in a pt with pheo

... for how long?
a-blockade for 10-14 days before surgery
apathetic thyrotoxicosis
seen in elderly
p/w apathy, depression, weight loss
pattern on RAIU scan: subacute thyroiditis
diffuse, decreased uptake
pattern on RAIU scan: toxic multinodular goiter
diffuse, increased uptake
pattern on RAIU scan: painless thyroiditis
diffuse, decreased uptake
pattern on RAIU scan: post-partum thyroiditis
diffuse, decreased uptake
pathophys of sx in thyrotoxicosis in the setting of subacute thyroiditis

implication for tx?
sx result from release of PRE-formed T4

Thus, will NOT respond to PTU/methimazole
tx for subacute thyroiditis
NSAIDs
propranolol

rarely, prednisone
course of subacute thyroiditis
thyrotoxic phase x wks, hypothyroid x months
suppurative thyroiditis

s/sx?

test of choice?
non-thyrotoxic
overlying skin is erythematous

Thyroid U/S may reveal abscess
tx of suppurative thyroiditis
ABx + I&D
which rx displace T4 and T3 from TBG
ASA
furosemide

heparin (in vitro)
indications to tx Paget's dz of bone?
involvement of weight-bearing bones
neurologic sx
hypercalcemia
chf (high-output)
refractory pain)
vitamin d deficiency
ca?
po4?
pth?
25-D?
Dx___?
Ca nl ---> low (late)
Ph low
PTH high
25-D low
hypo-PTH
ca?
po4?
pth?
25-D?
Dx___?
Ca low
Ph high
PTH low
25-D nl
pseudo-hypo-PTH Type 2 (PTH-resistance, Gs-alpha mut)
ca?
po4?
pth?
D-25?
Dx___?
Ca low
Ph high
PTH high
25-D nl
how often should fT4 and TSH be checked during pregnancy in a patient on tx?
q2-3 mo
how long will a single subQ steroid dose stay in the body and continue to have effects
5-7 days
euthyroid sick syndrome

labs early/mild?
labs late/severe?
seen in hospitalized pts

Early in course/mild: low t3, nml t4 and tsh

Late in course/severe: low t3, t4, and tsh
pseudo-hypo-PTH Type I (PTH-resistance, Albright's hereditary osteodystrophy)
S/Sx?___
Ca ?
Ph ?
PTH ?
25-D ?
TSH ?
fT4 , fT3 ?
Dx: ____
S/Sx: short 4th/5th metacarpals, round facies, Auto Dom
Ca low
Ph high
PTH high
25-D nl
TSH high
fT4, fT3 low (b/c resistance to TSH!)
pt with osteoporosis resistant to bisphosphonates

w/u? dx?
SPEP and UPEP

suspect multiple myeloma!
indication for parathyroidectomy in pts with hyperparathryoidism
Ca >10.5 or very high po4 and not responding to conservative management
PTH >1000
Bone pain, pruritis
calciphylaxis
soft tissue calcification
sx of ethylene glycol toxicity
tachypnea, agitation, slurred speech, confusion, flank pain, ataxia, nystagmus
--> coma
what lab test will confirm organophosphate poisoning
plasma cholinesterase levels
sx of organophosphate poisoning
SLUDGEM
tx of ethylene glycol toxicity

how does it work
fomepizole

inhibitor of ADH
what is the first step to tx of heat stroke
evaporative cooling
complication associated with nitroprusside

who in particular is at risk?
cyanide toxicity

esp in pts with renal failure
sx of cyanide toxicity
lactic acidosis
tachycardia
MS changes, sz, coma
cardiac issues associated with hypothermia
bradycardia
PVCs
sx of salicylate intoxication
tinnitus
restlessness
n/v/abd pain
decreased consciousness
fever
metabolic acidosis
hyperventilation w/o subj feelings of sob
AKI
transient hepatotoxicity
coagulopathy
encepalopathy
non-cardiogenic pulmonary edema
tx of ASA o/d
gastric lavage
activated charcoal
alkalization of urine to enhance secretion
adverse rxn to metoclopramide

how to tx
acute dystonic rxn in high doses

diphenhydramine -> benztropine if that doesn't work
how to tx organophosphate poisoning
atropine - to reverse nicotinic receptors

pralidoxime (2-PAM) - regenerates cholinesterase by binding the organophosphate)
indications for carotid endarterectomy
Sx and >70 % stenosis
how to manage TIA with <30% carotid stenosis
ASA or other anti-platelet
infections associated with Guillan-Barre
Campylobacter
CMV
EBV
HIV
HSV
what % of G-B pts will develop respiratory failure?

how to monitor?
25-30%

check bedside spirometry FVC
sx dominant temporal lobe lesion
homonymous upper quadrantanopsia

aphasia (receptive or transcortical > expressive)
sx NON-dominant temporal lobe lesion
homonymous upper quadrantanopsia

impaired perception of complex sounds
sx dominant parietal lobe lesion
geistmann syndrome
(acalculia, finger agnosia, agraphia, r/l confusion)
sx NON-dominant parietal lobe lesion
APRAXIA (construction apraxia, difficulty dressing)

confusion
tick paralysis

sx?
from neurotoxin-secreting tick

5-6 days after exposure --> ascending paralysis in hours to days
how to tx tick paralysis
remove the tick!

sx resolve in hours
Pt c/o dementia

w/u labs?
CBC - anemia? infx?
TSH
B12
UA - infx
sx of subcortical dementia
EPS
parkinsonism
visual hallucinations
gaze palsies
adverse effects to L-dopa

if severe, what should you suspect?
visual hallucinations
confusion
agitation

if this occurs, suspect lewy body dementia
when should BP be lowered in ischemic stroke
if >220/120 or evidence of end-organ damage
adverse effects of carbamazepine
neutropenia / cytopenias
renal failure
constipation
glaucoma
acute tx of migraine
triptans
-triptans

MOA?
5ht agonist --> vasoconstriction, and decreased plasma extravastation
ppx rx for migraines

1st line?

menstrual?
#1 = topiramate, valproate, metoprolol, propranolol
#2 = timolol, amitriptyline, venlafaxine

frovatriptan (menstrual migraine)

(WITHDRAWN: methysergide - retroperitoneal/pulm fibrosis)
s/sx of phenytoin toxicity

earliest s/sx?
1st = lateral gaze nystagmus

blurred vision, diplopia
ataxia, slurred speech
--> coma
interaction btw phenytoin and coc
increases metabolism of coc
how to tx acute ms exacerbation
#1 = IV steroids (methylprednisolone)


(no role for steroids in chronic mgmt)
how to prevent ms relapses in RRMS (DMARDs)

Rx -> SE
#1 IFN-B -> flu-like, flushing, hepatotox, SI
#1 glatiramer (myelin "decoy") -> lipoatrophy at injection site

#2 natalizumab (Tysabri) (anti-a4-integrin, prevents lymphocyte adhesion) -> PML (MUST CHECK JC virus)

#3 mitoxantrone -> systolic dysfunction, AML!

fingolimod
teriflunomide
how to follow sx of ms
repeat MRI 3 mos after initial imaging

neurologic s/sx improvement LAGS MRI improvements
rx in women with MS who would like to get pregnant

which are teratogenic?
Teratogenic: IFN-B, glatiramer

(should be stopped several months before conception)
riluzole

moa?
uses?
anti-glutamatergic
(may increase re-uptake, may inhibit depol by acting on Na or Ca channels)

prolongs survival in ALS, delays need for tracheostomy
Describe neurologic s/sx in B12 deficiency / subacute combined degeneration
dorsal column impairment

lat column impairment (--> brisk reflexes)

LE > UE involvement
meralgia paresthetica
= lateral cutaneous femoral nerve entrapment
what cells do glial tumors arise from
astrocytes
medial medullary syndrome
contralateral spastic hemiplegia

contralateral vibratory / proprioception impairment

tongue deviation TOWARD side of the lesion
effect of transfusion of pRBCs in pt with... renal failure, liver failure, shock or hypothermia

how to monitor for?

how to prevent this complication?
HYPOCALCEMIA!

occurs b/c inability of citrate to be metabolized into lactic acid ---> citrate binds Ca --> hypoCa

Monitoring: must check IONIZED Ca

PPx: 10% Ca-gluconate (for every 500 ml pRBCs)
describe senile gait
"walking on ice"

(wide stance, hip and knees flexed, arms flexed and extended)
describe spastic paresis gait
"scissoring gait"

foot drags with every step
describe drunken sailor gait
cbl ataxia

jerky, zig-zag pattern
describe distal LMN dz gait
"steppage gait"

foot drop
what happens to bilirubin in ineffective erythropoeisis
defective DNA synthesis -> megakaryoblastic changes in bone marrow + hemolysis --> hyperbili (indirect)
adverse effects of valproic acid
abnl LFTs
increased urinary frequency
n/v/d
hair loss
weight gain
tx of delirium in elderly
haldol > bdz


(bdz --> may increase confusion/agitation)
2 CT findings in NPH
big ventricles
NO effacement of sulci
miller fischer test
pre-post LP gait assessment

used to clinically dx NPH
Cluster HA, PPx?
lithium
CCB
t or f:
ASA is contraindicated in pts with ulcer dz
true

(to prevent GIB)
tx of spasticity after stroke

DOC?

2nd line?
#1: dantrolene

#2: BDZ and baclofen
(but they have CNS effects as well --> drowsy, not alert)
tx of superior saggital sinus thrombosis
heparin (even in setting of hemorrhagic infarct)
who gets saggital sinus thrombosis
pregnancy
trauma
infx
vasculitis
sx of saggital sinus thrombosis
hemiparesis
papilledema
sz