Neurological Problems

jennifer12345's version from 2018-10-27 22:54

Section 1

Question Answer
Ischemic strokeobstruction from atherosclerosis, embolus, thrombus or vasospasm. Most common type
Hemorrhagic strokeintracerebral hemorrhage from ruptured aneurysm, AV malformation, HTN disease, amyloid

Section 2

Question Answer
Therapy for ichemic stroke or TIA includesaspirin and clopidogrel, persatine is the combo product
Therapy for pts at risk for cardiac embolization (a fib, artifical valve, LVD with CHF)warfarin
Therapy for stenosis greater than 50%carotid endarterectomy or stenting

Section 3

Question Answer
red flags for dizziness for emergent referral to rule out strokediplopia, somatosensory changes, weakness, dysarthria, incoordination, decreased LOC
pathology of parkinson's diseaseloss of dopamine containing neurons
classic presentation of parkinson's diseaseresting tremor, rigidity, bradykinesia

Section 4

Question Answer
dix hallpike maneuverdistinguishes between benign vertigo and vertigo from CNS lesion
ice pack testapplied to ptosis- improvement in symptoms supports diagnosis of myasthenia gravis

Section 5

Question Answer
benign paroxysmal positional vertigo (BPPV)rotational nystagmus usually occuring in 1 direction: resolves quickly and cannot be reproduced
CNS lesionvertical nystagmus is of longer duration and continues with each repetiiton

Section 6

Question Answer
Treatment of benign paroxysmal positional vertigoepley maneuver, PT. Avoid use of meclizine, antihistamines, scopalamine
Treatment of vestibular neuritis/labyrinthitisantibiotics if bacterial cause, corticosteriods, anti-emetics, meclizine, antihistamine
Treatment of Meniere's diseasereferral to ENT, low salt diet, diuretics, vestibular suppressants (meclizine, phenergan)
Treatment of Alzheimers diseasecholinesterase inhibitors (donepezil, rvastigmine, galantamine) and NMDA receptor antagonist (memantine)
Treatment of Multiple Sclerosisinterferon B for RRMS (avonex, betaseron), corticosteroids (exacerbations), methotrexate for progressve
Treatment of Myasthenia gravischolinesterase inhibiting drugs (pyridostigmine, neostigmine, prednisone) or thymectomy
Treatment of Guillian Barre syndromesupportive care/rehab, inpatient plasma exchange and IVIG
Treatment of Parkinson's diseaselevodopa, anticholinergic, dopamine agonists, MAO-B inhibitors like selegiline
Treatment of Bell's palsysupportive care, corticosteroids (pred taper) and valacyclovir x 10 day
Treatment of trigeminal neuralgiacarbamazepine (first line), baclofen, clonazepam, gabapentin, duloxetine, amitriptyline

Section 7

Question Answer
Absence- petit mal seizurenon-convulsive
Myoclonic seizureabrupt muscle twitches or jerks
Clonic seizuremuscle contraction and relaxation movements
Tonic seizureincreased tone, ridigity

Section 8

Question Answer
Interaction of steroids with seizure medsmay require increased dose
Interaction of anticoagulants with seizure medsunpredictable coagulation control
Interaction of radiation therapy with seizure medsincreased risk of rash
Interaction of chemotherapy with seizure medshasten effect of chemotherapy
Interaction of antibiotics with seizure medsinteract with antiepileptic drug metabolism
Interaction of oral contraceptives with seizure medspossible contraceptive failure

Section 9

Question Answer
Stage 1 Alzheimersrecent memory loss, forgetfulness, decreased concentration, changes in mood/personality
Stage 2 Alzheimersincreasing inability to comprehend conversation, restlessness, loss impulse control
Stage 3 Alzheimerstotal inability care for self, incontinence, depressed immune system

Section 10

Question Answer
Relapsing-remitting MS (RRMS)clinical relapses followed by remission, most common type
Secondary progressive MS (SPMS)progressive worsening of MS after years of having RRMS
Primary progressive MS (PPMS)steadily progressive course from the onset
Progressive relapsing MS (PRMS)steadily progressive from onset with acute exacerbations