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Flashcards in Neurology Deck (280)
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Difficulty standing on toes, reflexes dec'd



Wrist drop -

Radial neuropathy


Foot drop

Peroneal nerve comopression


Antibody induced acute polyneuropathy - occurs in

Guillain-barre syndrome


Yound pt with ankle sprain - takes NSAIDs - extreemm tenderness when bed sheet touchs - exam bluish discoloration - dx?

Complex regional pain syndrome - reflex sympathetic dystrophy
If pt with patchy deminralization - bisphosphonates are effective - treatment even in absense of osteoporosis


19yo playing football has a sudden imopact and falls to ground - appears confused upon immediate exam - no LOC, 15 minute later normal cognition and vision and finger -nose test - wtd?

Can go back and play (no LOC)


20yo playing football - concussive injury - no LOC - in daze on immediate exam - 20 min later alert and oriente but with some amnesia which resooles 15 min later

Monitor closely, if no sx for week then can play again


24yo had a concussioni playing ice hockey - lost conciousness x 30 sec - upon waking alert, oreient, figner to nose normal - vision fnorma - WTD (less than 1 min LOC with normal physical exam)

Send hoem with family observation withold from competition - if remains asx can back to play in 1 week


24yo had concussion playing contact sports, lost consiounes x 20 sec and waking up was in daze which cleared up on wya to ER (less than one min LOC, abn physical exam upon awakening

ER eval with CT/MRI - withdraw from competition - if asx can go back to play in 2 weeks


Concussion with LOC > 1 min with nromal phsyical

ER eval with CT/MRI - withold from competition - if still asyxmt back to play in 2 weeks



1. Tonic Clonic - valproate, lamotrigine, levetiracetam, topriamate
2. Absense/Petit mal:
without aura or post ictal sx, 3 sec spike and wave patternon EEG
tx: ethosuximide, valproate, lamotrigine

1. Simple - focal seizure affects small volume of cortex, no LOC (psychic sensation, deja vu
2. Complex - involves large enough cortex to cause loss of conciousness
tx: Carbamazepine, phenytoin, valproate, levetiracetam, lamotrigine, gabapentin(adjunctive)


Medications that cause seizures

Imipenum, tramadol, bupropion, haldol, meperiridine, PRBC
Partial: Carbamazepine, phenytoin, valproate, levetiracetam, lamotrigine, gabapentin


Best Anti-sz med for elderly



Best anti-Sz med for with liver dz

Keppra (Levetrcetam)


Best anti Sz medication in pregnancy



What antiseizure medication causes kidney stones



After the first seizure - best dx imaging is...

CT if neg -> MRI
Then do EEG (epileptiform spike +- slow waves
NORMAL EEG does NOT r/o seizure d/o


Pt makign presentation to supervisor slumps over in chair, diaphretic, has jerks of arms nad legs several times - completely recovers in 30 sec and has pallor, BP normal, cardiac/neuro exam normal dx?

Syncopal convulsions


Pt in dental chair passes out andhas jerky movement o arms and legs, completely recovers in 30 sec - diaphoretic - similar episode once before

neurocardiogenic syncope


22yo h/a, smells of burnign rubber, feels strange, no convulsions seen dx?

partial seizure/psychomotor epilepsy


Pt has generalized seuzures not better with dilantin - serum Ca low, ca cl injections don't help wtd?

Iv Mg SO4


22yo with weird sensation in stomach followed by sudden freezing, swallowing chewing, lip smacking - minute later she starts talking and doesn't recall eepsode

Partial seizure


30yo F brought to office - say having recurrent spells of starting for several seconds the haveing intense familiarity with surrounding sand strangers most likely affected lobe is?

Temporal lobe


Young woman with epigastric rising sensation - most likely dz?

simple partial seizure
temporal lobe (deja vu)


22yo F with husband and narrating complaint then her leg starts jerking which gets wors and on /off x several minutes - then SOB, then holds head tight afte r3 min jerking stops and feels dizzy and has headache dx?

dec'd Ca+


55yo brought in by family - having episodes when staring blankly for several seconds then shakes hand repeately fo rfew minutes then feels tired - no focal neuro deficits, MRI normal wtd?

Sleep deprived EEG
dx: Complex partial


Pt with onset of seziure of left arm and then spreads to left leg - after episode wk of left arm and leg dx?

Jacksonian seizure
frontal lobe
starts at arm and marches toward leg in terms of sx (begin with fingers - end with legs) - NO LOC


Treatment of status epilepticus (sz >30min or LOC between 2 mor more seizures

1. IV glucose + thiamine
2. Lorazepam
3. Loading dose Phenytoin or Fosphenytoin
4. Maximize Phenytoin
5. Phenobarb/Midazolam
6. General anaestheia/neruomuscular blockade


Pt with new monset seizure - post ictal state recommendation?

No driveing
No swimming



Mid dilated - glaucoma
Mid constricted - uveitis (iridocylitis)
b/l dilated - anti-cholinergics, botulism, cocaine
unilateral dilated - CN III compression
b/l constriction - Opiates, pontine infarct, organophosphate poisoning