This is giving me a migraine
This is the duration of headache needed to define it as a migraine
4-72 hours in adults and 2-72 hours in children, at least 5 overall attacks
The superior oblique muscle does these two eye movements
intorsion and depression
This was previously the time window to give tPA to suspected stroke patients.
3 hours
A patient with new MS flare (optic neuritis) is admitted to the hospital and started on pulse steroids. Why are steroids used for MS flares?
to accelerate recovery but does not change the prognosis
3hz spike and wave is typically seen in this type of seizure
Absence
This medication is ideal for patients who have migraines and are overweight
Topiramate
A patient with MS is having double vision. When looking to the right, her left eye cannot adduct and her right eye has nystagmus. Where would the lesion be?
Left MLF= Left INO= Left eye can't adduct
This patient comes in with somnolence only and yet the ED doctor is concerned about a stroke. Where would the lesion be?
Juxtacortical, periventricular, spinal cord and infratentorial are the locations for common MS plaques, however, a new fifth location was added.
Optic nerve
HSV patients will typically have this finding on EEG
PLEDs
This is the earliest known step in the pathophysiology of a migraine headache
Cortical spreading depression
This cranial nerve tends to be affected in patients who have hydrocephalus, increased intracranial pressure, papilledema and headache.
CN 6
Daily Double:
A patient was riding a roller coaster and developed anisocoria, nystagmus, left ptosis and decreased sensation on left face.
What is the gold standard diagnostic test?
Catheter angiogram
How does pregnancy affect the disease course of MS.
It does not affect it appreciably (may have less exacerbations during pregnancy and more 6 months post partum)
This ASM is great to be used in pregnancy
Lamotrigine
I will not take Keppra as an answer
This medication for migraines is known to cause weight gain
Valproic acid
Patients with optic neuritis tend to develop a specific color desaturation.
Red
A patient comes in with a right homonymous hemianopia suspected to be from a left PCA infarct. You think it also affected the splenium of the corpus callosum. This would cause what additional symptom?
Alexia with agraphia
Dalfampridine is an FDA approved medication used in MS to improve what.
Speed of walking
Phenytoin has this kind of pharmacokinetics
Non-linear, zero order
This CGRP medication binds directly to the CGRP molecule rather than the receptor
Galcanezumab OR Fremanezumab
Daily Double:
When looking right--> both eyes stay in the middle
When looking left--> only left eye abducts
Where is the lesion?
List the arteries that supply the Thalamus (and their origin).
Thalamoperforator (p1)
Posterior choroidal and thalamogeniculate (p2)
Tuberothalamic (pcomm)
Natalizumab works in this mechanism
alpha 4 integrin molecule inhibitor
How does Valproic acid affect Lamotrigine metabolism
Synergistic effect, valproic acid increases amount of Lamotrigine in body (increases its half life)