FAM EOR - Neurology
Terms in this set (70)
What are the 5 classic signs of parkinsons disease?
1. resting tremor
2. Bradykinesia - slow body movements
3. Rigidity - flexed posture
4. Immobile or fixed facial expressions
5. Postural instability
what is the pathophysiology of parkinsons disease?
its due to a dopamine depletion. Acetylcholine is an excitatory NT and typically dopamine inhibits it. However, if you get idiopathic loss of dopamine, the dopamine is unable to inhibit the excess acetylcholine
Most effect tx for parkinsons disease?
What types of drugs are often used in younger pt's with parkinsons to delay the use Levodopa?
dopamine agonists - bromocriptine
Difference b/t dementia and delirium?
Delirium is acute and rapid onset of fluctuating mental status
Dementia is progressive, slow and chronic progression of memory loss, impulse controls, motor/cognitive fxns
MC type of dementia?
5 different types of dementia
Dementia with lewy body
Parkinsons induced dementia
symptomatic tx for alzheimers?
Acetylcholinesterase inhibitor drug for alzheimers?
NMDA antagonist drug for alzheimers?
What is the 2nd MC type of alzheimers?
dementia that is associated with marked personality changes and later aphasia?
which type of dementia is associated with hallucinations (often little children)?
dementia with lewy bodies
which type of dementia happens 1 year or less after the onset of parkinsonism symptoms?
dementia with lewy bodies
unilateral, debilitating pain around the eye or temporal region that lasts ~2hrs?
unilateral headache with ipsilateral ptosis, miosis, anhydrosis (horner syndrome)?
Tx for cluster headaches?
Prophylactic tx for cluster headaches?
pulsatile/throbbing headaches associated with N/V, photophobia?
Abortive/symptomatic tx for migraines?
Dopamine blockers - metoclopramide, promethazine
Prophylactic tx for migraines?
calcium channel blockers
Bilateral, band/vise like headache worsened by stress?
tx for tension headaches ?
sudden headache with confusion and speech changes?
what do we use to rule out hemorrhage in cases of TIA?
what do we use to dx suspected TIA ?
CT angiography/MR angiography
Tx for TIA?
Aspirin or clopidogrel
What percent of patients with TIA will have a stroke within 1-2 days after the initial TIA?
which cranial nerve is involved in Bells palsy?
facial nerve or CNVII
what virus is associated with Bells Palsy?
Unilateral facial paralysis?
Tx for for Bells Palsy?
1. Prednisone - decreases nerve inflammation
2. Artificial tears
3. Acyclovir if severe
MC cause overall of bacterial meningitis?
Symptoms of bacterial meningitis?
fever, chills, headache, nuchal rigidity, N/V, seizures
What two special physical exam signs are associated with meningitis?
Brudzinskis sign- neck flexion produces knee/hip flexion
Kernigs sign- inability to straighten knee with hip flexion
what diagnostic tool is definitive for meningitis?
LP for CSF analysis
MC bacteria to cause meningitis when <1 month old?
Group B strept - strept. agalactiae
Tx for bacterial meningitis in pt < 1month old?
Ampicillin + Cefotaxime
MC bacteria to cause meningitis 1 month-18 years old?
2. Strept pneumo
Tx for patients with bacterial meningitis when 1 month - 50 years odl?
Ceftriaxone + Vancomycin
MC bacteria to cause meningitis 18-50 y/o?
1. Strept pneumo
2. Neisseria meningitidis
MC bacteria to cause meningitis >50 y/o?
1. Strept pneumo
Tx for patients with bacterial meningitis when > 50 y/o?
Ampicillin + Ceftriaxone
CSF shows turbid colored CSF?
CSF shows high protein (>200)?
CSF shows markedly decreased glucose?
CSF shows increased neutrophils/PMNs?
CSF shows clear colored CSF?
CSF shows normal glucose?
CSF shows increased lymphocytes?
If glucose is normal on CSF, what type of meningitis is most likely?
if WBC is predominantly Neutrophils/PMNs, what type of meningitis is most likely?
MC cause of viral meningitis?
tx for viral meningitis?
antipyretics, IV fluids
MC cause of encaphalitis?
Headache, fever, profound lethargy, altered mental status and cranial nerve deficits?
Tx for encephalitis?
supportive care - antipyretics, IV fluids
how do we distinguish encephalitis from meningitis?
encaphalitis causes sensory/motor deficits, speech/movement problems and altered mental status, while meningitis does not
When a seizure is confined to a small area of the brain, what is it called?
When a seizure has diffuse brain involvement, what is it called?
what are the two types of partial/focal seizures? how are they different?
Simple partial - consciousness fully maintained
Complex partial - consciousness impaired
Brief staring episodes in childhood?
loss of consciousness with rigidity then repetitive, rhythmic jerking?
sudden, brief, sporadic involuntary twitching?
"drop attacks" with sudden loss of postural tone?
repeated generalized seizures without recover for > 30 minutes?
1st line tx for absence seizure? 2nd line?
2. valproic acid
grand mal seizure tx?
1. valproic acid
status epilepticus tx?
Lorazepam then phenytoin (for seizure prevention)
Myoclonus seizure tx?