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43 Cards in this Set
- Front
- Back
most sensitive test for detecting the thrombus and the occluded dural sinus or vein and thus is the test of choice for diagnosing dural sinus venous thrombosis
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magnetic resonance venography
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characteristic of headache produced by increased ICP
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headache, which is worse in the morning and with performing the Valsalva maneuve
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positive apnea test
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increase in arterial PCO2 is greater than 20 mm Hg (2.7 kPa) without observed respirations
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disease-modifying agent used in the treatment of multiple sclerosis (MS)
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glatiramer
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how is concussion graded?
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grade 1 and 2 no LOC; symptoms of grade 1 concussion resolving within 15 minutes and those of grade 2 lasting longer than 15 minutes; grade 3 concussions = LOC
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when can an athlete return to game after concussion?
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grade 1 can return to game; grade 2 cannot for the day; grade 3, 1 week.
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when should imaging be done for concussion?
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grade 2 or 3 concussion with persistent neurologic defects
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AED of choice for female patient with seizures who is desirous of pregnancy
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carbamazepine
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BP goal for patient on TPA
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180/105; can do tPA if <185/110
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diagnostic test for LEMS
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NCV
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treatment of cluster headaches
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oxygen 10l/min x 10 minutes; intranasal sumatriptan may be considered but not oral
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self-limited chorea that happens in pregnancy
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chorea gravidarum (results from elevated estrogen levels and will resolve after pregnancy)
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group of disorders characterized by recurrent thunderclap headache associated with transient segmental cerebral vasoconstriction, severe headaches of the thunderclap variety occurring over a few days or weeks, often without abnormalities on clinical examination
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reversible cerebral vasoconstriction
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most likely etiology of Bell's palsy?
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human herpesvirus 1
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what is the interaction between OCP and lamotrigine?
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lamotrigine is metabolized by the process of glucuronidation which is induced by estrogen; so patients on lamotrigine started on OCPs should have their AED dose increased
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disease condition suggested by visual hallucinations, dream enactment behavior (rapid eye movement [REM] sleep behavior disorder), and atremulous parkinsonism
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dementia with Lewy bodies
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treatment of dyskinesia in Parkinson disease patient on high doses of levodopa
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deep brain stimulation of subthalamic nucleus or globus pallidus, not withdrawal and reintroduction of meds
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when to intervene with antihypertensives in patients with acute stroke not going for tPA?
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if BP >220/120
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delusion that family member is an impostor or living area is a replica of real home
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Capgras syndrome
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what is anosognosia?
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unawareness of neurologic deficit
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current definition of status epilepticus
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old definition >30mins; most seizures last 1-3 mins so treat as status if longer than 5 minutes
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usual presentation of idiopathic intracranial hypertension or pseudotumor cerebri
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obese, young women, presents with headache, visual changes and tinnitus
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when is anticoagulation indicated post-stroke with intracranial bleed?
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if stable, on day 4
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treatment of MS-related fatigue
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amantadine / modafinil
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AEDs used for migraine prophylaxis that carry an increased risk of kidney stone formation
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topiramate and zonisamide
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first-line drug for treating partial and generalized epilepsy that is well tolerated in older patients. It has been shown to have the highest rate of retention and best efficacy in this population.
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lamotrigine
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diagnostic criteria for migraine
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at least two of four pain features (unilateral location, pulsatile nature, moderate to severe intensity, and aggravation by routine activity) and at least one of two associated features (nausea or photophobia/phonophobia).
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drugs that inhibit cytochrome P3A4
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macrolides, fibrates, and protease inhibitors (such as itraconazole)
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meds with documented the efficacy for chronic migraine prophylaxis
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topiramate and injectable onabotulinumtoxinA
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should be considered first-line preventive medications for episodic migraine
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topiramate, propranolol, timolol, amitriptyline, and divalproex sodium
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only two neurologic conditions can produce rapid deterioration in cognition and behavior (not including, infection, trauma, intoxiccation)
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prion disorder (such as Creutzfeldt-Jakob disease) and a paraneoplastic syndrome (such as limbic encephalitis).
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potential complication of natalizumab in the treatment of multiple sclerosis
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progressive multiforcal leukoencephhalopathy
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treatment of tardive dystonia
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gradual discontinuation of the offending agent, treatment with anticholinergic or dopamine receptor-depleting agents, and the judicious use of botulinum toxin injections
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these drugs have strongest evidence for prophylaxiis against migraaine
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TCAs s.a. amitriptylline; propranolol, timolol, divalproex sodium, and topiramate
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agent used for prophylaxis against cluster headache
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verapamil
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characterized by excessive, compulsive, repetitive complex activity that serves no essential purpose
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punding (caused by ropinirole)
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why pick keppra as first lline agent in treatment of seizures for Asians?
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In an Asian patient with the HLA-B*1502 allele, the risk of Stevens-Johnson syndrome is increased with exposure to carbamazepine, lamotrigine, oxcarbazepine, and phenytoin
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what is the ABCD2 score?
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one point for an Age of 60 years or greater, one point for a Blood pressure of 140/90 mm Hg or greater, two points for the Clinical symptom of hemiparesis, two points for Duration of 60 minutes or greater, and one point for the presence of Diabetes mellitus
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how to use ABCD2 score?
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American Heart Association guidelines recommend hospital admission for all patients with probable TIAs whose ABCD2 scores are 3 or greater within 72 hours of symptom onset
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what to monitor with interferon therapy
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LFTs q6 monnths
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treatment of spasmodic torticollis
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botulinum toxin injection, not bacloofen
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first line trreatment for trigeminal neuralgia
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carbamazepine
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myelopathy that localizes to dorsal columns and CS tracts
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vitamin B12 deficiency, neurosyphilis, and copper deficiency
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