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2014-05-21 16:41:40
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  1. best initial test for tia or stroke
    ct w/o contrast
  2. contraindications to thrombolytics
    • hemorrhagic stroke
    • intracranial mass
    • brain surgery or cerebral trauma
    • bleeding disorder
    • surgery within 6 months
    • cpr
    • stroke in 1 year
    • aortic dissection
  3. when is asprin given for stroke
    • after tpa
    • and if its too late for tpa
  4. when do you give clopidogrel
    clopidogrel if pt has a stroke while on aspirin

    dipyrimadole is added if patient got stroke on aspirin
  5. when is ticlopidine given?
    never unless pt is intolerant of aspirin and clopidogrel
  6. what is used to visualize the brainstem
  7. what studies are done after a stroke or tia
    • carotid duplex
    • ekg, echo, holter monitor
  8. pt is <50 and has a stroke/tia what studies are oreded
    • sed rate
    • ana, anti-dsdna
    • protein c, antithrombin 3, factor 5 mutation, antiphosholopid study
    • vrdl/rpr
  9. rx for status epilepticus
    • benzo
    • phenytoin
    • phenobarbital
    • anesthesia
  10. what tests are ordered for a siezue
    • urine tox
    • head ct
    • serum electrolyte--sodium, calcium, bun/cr, glucose, magnesium, oxygen
  11. when is eeg done for seizures
    • after urine tox
    • head ct
    • sodium, calcium, mg, oxygen, cr, oxygen have been ordered and are normal
  12. when is a neurology consult ordered,
    after initial testing
  13. long term seizure treatment is not required for a single seizure unless
    • eeg is abnormal
    • benzo were needed to stop seizure
    • family history of seizure
    • brain tumor
  14. many antie-seizure drugs are associated with what
    • steven johnsons
    • osteoporosis
  15. 1st line agents for chronic seizure prophylaxis
    • depakote
    • phenytoin
    • carbamezapine
    • leviteracem
    • lamotriginebe
  16. what anti seizure is not given during pregnancy
    when is ethosuxamide given
    valproic acid

    for absence or petit mal seizures
  17. diagnsosis of parkinsons
    clinical constellation of symptoms
  18. rx for mild parkinsons

    • <60--acetylcholine blockers
    • >60--- amantadine

    severe- carbidope/levidopa or dopamine agonist--carbergoline
  19. next step when levidopa gives psychosis
    add quiatepine
  20. when is deep brain stimulation done for parkinsons
    when medical therapy doenst control symptoms
  21. entacapone are used when
    with levidope
  22. what do you use selegiline for
  23. rx for resting tremor
    tremor of intention
    tremor both at rest and intention
    • amantadine
    • cerebellar
    • propranolol
  24. when is lumbar tap done for ms
    if mri is non diagnostic
  25. best initial and accurate tests for ms
  26. rx for ms
    rx for ms not in acute exacer
    rx for fatigue in ms
    rx for spasticity in ms

    interferon, glutarimer, natulizumab, mitoxantrone

    • fatigue amantadine
    • spasticity- baclofen
  27. all pts with memory loss get
    • ct of head
    • vit b12
    • tsh
    • vdrl
  28. rx for alzheimes
    • rivastigmine
    • donepezil
    • galatamine
  29. how does picks present
    with personality changes

    same as alzheimers
  30. most accurate test for cjd
    what does lp shows
    on ccs what is ordered for cjd
    • brain biopsy
    • 14-3-3 protein spares pt from biopsy

    mri, lp
  31. on ccs, what is ordered for normal pressure hydrocephalus
    • head ct
    • lp
  32. what drug causes pml
  33. rx for normal pressure hydrocephalus
  34. dx of huntingtons
    • genetic testing
    • no rx
  35. when do you do ct/mri for migraines
    • sudden severe onset
    • after 40
    • neurolgical deficits
  36. rx for migraine head
    when do you give propranolol or ccb, tca, ssri
    sumatriptan or ergotamine

    if you have more than 4 headaches permonth
  37. rx for cluster headaches
    triptan drugs or 100% oxygen

    with verapamil
  38. best initial test for temporal arteriris
    most acccurate
    • esr
    • biopsy
  39. rx for temporal arteriris
  40. most accurate test for pseudotumor cerebri
    lumbar puncture with elevated pressures
  41. rx for ptc
    • weightloos
    • acetazolamide
    • surgery with vp shunt, optic nerve shearth fenestration
  42. all patients with vertigo should have what test done
    mri of internal auditory canal
  43. what 4 causes give vertigo and tinnintus/hearing loss
    • labiryntisi
    • meniere
    • perilymph fistula
    • acoustic neuroma
  44. rx for benign positional vertigo
  45. most cases of vertigo are treated with
  46. rx for menieres
    • salt restriction
    • diuretics
  47. dx of acoustic neuroma
    • mri
    • resection
  48. best initial test for meningitis
    csf cell count
  49. best initial test for cryptocccus
    most accurate
    • india ink
    • cryptococcus antigen test
  50. best initial therapy for cryptococcus meningitis
    • amphotericin and 5 flucytosine and then oral fluconazole
    • c/w fluconazole if cd<100
  51. most accurate test for lyme disesae
    serology or western blot of csf fluid
  52. rmsf presents how,
    rash that starts at the hands and feet and proceeds centrally
  53. tb meningitis vs regular meningiits
    rx for
    tb is slow and regular is fast

    ripe + steroids for a long time
  54. hiv pt with meningitis and high neutrophils, etiology??
    listeria--add amoxacillin to ceftriaxone and vanco
  55. petechial rash and meningitis
  56. who needs prophylaxis for niesseria menigitis
    people with saliva close type of contact
  57. how you prophylax against neisseria
    with rifampin, ceftriaxone or cipro
  58. best initial test for encehaitis
    most accurate
    • ct of head
    • pcr for dna of csf
  59. best initial rx for herpes encephalitis
    • acyclovir
    • foscarnet
  60. brain absecess for hiv neg and hiv pos?
    hiv neg- brain biopsy

    hiv pos--treat with pyrimethamine and sulfadiazene for 2 weeks and
  61. diagnostic test for pmlr
    • none
    • rx raise cd4
  62. best initial test for neurocystisercosis
    most accurate
    ct with 1cm cystic lesions

  63. rx for active neurocystisercosis
  64. large intracranial hemorrhage rx
    • hyperventilate
    • mannitol
    • intubate
    • surgical intervention
  65. mx of concussion
    • nothing
    • admit
  66. best initial for sah
    most accurate
    • ct scan
    • lumbar puncture
  67. normal wbc :rbc count in csf
  68. rx for sah
    • angiography
    • embolize¬†
    • shunt if hydrocephalus develops
    • nimodipine to prevent stroke
  69. dx of syringomyelia
    • mri
    • surgery
  70. dx of cord compression
    • mri
    • steroids
  71. dx of epidural abcess
    • mri
    • oxacillin
    • nafcillin
  72. rx for ams
  73. on ccs, best intiial step for carpal tunnel?
    if refracotry
    • splint
    • steroids
  74. rx for bells palsy
  75. rx for reflex sympathetic dystrophy
    • nsaids
    • gabapentin
  76. rx for restless leg syndrome
    pramiprexole or ropinorole
  77. what determines respiratory distress in gbs
    peak inspiratory pressued

    • ivig
    • or plasmapharesis
  78. best initial test for mg
    most accurate
    acetylcholine receptor antibodies

    clinical presnetation and acra
  79. when do you do thymectomy for mg
    if pt <60 and neostigmine did not work
  80. when are azathioprine and cyclosporine used for mg
    between acute exacerbations