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30 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Name the four signs and symptoms of Parkinson’s |
1 resting tremor 2 rigidity and flexed posture 3 retarded movement such as Bradykinesia & hypokinesia 4 loss of postural reflexes |
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Parkinson’s patient with vertigo gaze palsy, can’t look down or up |
Progressive supranuclear palsy PSP |
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Parkinson’s patient with autonomic insufficiency, dizzy spell, passing out , balance probs, orthostatic hypotension |
Multi system atrophy or Shy-Drager |
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Parkinson’s patient with cerebellar signs, ataxia |
OPCA OLIVOPONTOCEREBELLAR ATROPY |
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Tardive dyskinesia Which antipsychotics are less likely to cause this? What is effective treatment? What is G.I. medicine that might cause this? Treatment |
Clozapine & quetiapine Tx clonazepam Reglan stop med |
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Hyperthermia, rigidity, diaphoresis, autonomic instability, and altered mental status with the risk of rhabdomyolysis induced renal failure |
Neuroleptic malignant syndrome |
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Treatment for neuroleptic malignant syndrome |
Dopamine agonist, such as bromocriptine or dantrolene, supportive therapy, may need intubation |
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What medications may cause neuroleptic malignant syndrome |
NMS is an Unusual response to antipsychotics. Occasionally Reglan or promethazine can cause this. Syndrome can occur days weeks or months after treatment was started |
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Cause of hemifacial spasms |
80% tortuous dilated basilar artery or Basilar dolichoectasia Also consider MS or acoustic neuroma |
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What is the treatment for hemifacial spasms? |
Carbamazepine gabapentin Botox Surgery To separate the facial nerve from direct contact with the basilar artery |
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Young or old PT New onset sz Personality chg or hallucinations Temporal lobe hemorrhage & necrosis |
Herpes encephalitis |
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Dx herpes encephalitis |
HSV PCR CSF RX acyclovir |
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Flaccid paralysis w encephalitis |
West Nile |
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Dx PML |
CSF JC virus PCR Or brain bx |
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What med can cause PML |
Natalizumab or Tysabri |
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Difficulty standing on toes Ankle reflex preserved (absent in S1 radiculopathy) |
Sciatica |
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Foot drop E version and dorsiflexion weak |
Peroneal n compression prox end of fibula |
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Bell’s palsy treatment |
Look at house-brackmann grading system to determine steroid dose. Give prednisone 60 mg and an antiviral, protect the eye |
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Causes of Bell’s palsy |
Idiopathic, HSV, varicella zoster, Lyme disease, acute HIV, parotid tumor, cerebral Pontine angle tumor |
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Bilateral Bell’s palsy |
MS, Neurosarcoidosis Lyme dx |
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On forward gaze, if one eye is looking laterally and downward Can happen in diabetes |
Diabetic third nerve palsy if pupils are normal If pupils are dilated, this means third nerve compression, possible aneurysm |
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Findings of LP on Guillain-Barre also called AIDP Acute inflammatory demyelinating polyneuropathy |
LP high protein normal cells |
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Tx Guillain-Barré syndrome |
IVIG or. Plasma exchange |
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GBS which did not resolve in 8 weeks |
CIDP |
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Hereditary neuropathy Myelin poorly formed High arched foot hammer toes |
Charcot Marie tooth disease EMG demyelinating Progressive neuropathy since childhood |
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Acute thiamine deficiency |
Wernickes encephalopathy |
Give big dose thiamine IV |
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Pt w myasthenia gravis & enlarged thymoma |
Take thymoma out! |
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What else should you consider in a patient with myasthenia gravis |
Autoimmune disorders such as lupus, 30% of patients with MG have autoimmune thyroiditis |
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Treatment for MG Testing |
Symptomatic: Pyridostigmine which is a ACh inhibitor Also steroids, cyclosporine to help spare steroids ACh Receptor Ab |
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Classically after what type of infection Guillain-Barré syndrome develop? |
Campylobacter, or other G.I. bug |
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