On CT, there is a ring-enhancing mass that looks like a "butterfly." This grade 4 tumor shows necrosis with nuclear palisades and microvascular proliferation.
glioblastoma
Vitals: 135/90, 80 bpm, 16 RR, 32 BMI
idiopathic intracranial hypertension
These bones make up the asterion
(Bonus: what about the pterion?)
Asterion: Parietal, mastoid process of the temporal bone, occipital bone
Pterion: frontal, parietal, greater wings of sphenoid, squamous portion of temporal
Altaria
pokemon
Infant comes to the ER with flaccid paralysis, diplopia, and ptosis. Parents notes child consumes honey frequently
Bonus: What is the pathogenesis?
clostridiodes botulinum, neurotoxin (protease) that blocks Ach release
6 y/o male presents to the ER c/o neck pain. Pt is unable to answer questions, but upon taking vitals, fever is present. You perform this
Bonus: What is your next step?
Brudzinski or Kernig
LP
Palpate the cranium using a vault hold
Thumbs: loose contact on head
Index: greater wings of sphenoid
Middle: temporal bones, anterior to ears
Ring: temporal bones, close to mastoid process
Pinky: squama of occiput
Zomig
selective agonist for serotonin in cranial arteries and sensory nerves of trigeminal system
46 y/o female gets a biopsy that shows a whorl pattern and psamma bodies
meningioma
Pt comes to the clinic c/o of HA that began an hour ago. "It's the worst!" he says. No fever but neck stiffness present. CT is negative. Your next step is this
lumbar puncture
TCOM was established in the year of the Stonewall riot
1970
Reyvow
brand name for lasmiditan: high-affinity, highly selective 5-HT receptor agonist
tx migraines w/ or w/o aura
5 y/o male with CT revealing solid mass involving cerebellar vermis and 4th ventricle. Histology shows Homer-Wright rosettes. The best prognosis
WNT pathway activation
Pt is a 26 y/o obese female c/o of HA to her forehead that has been constant for the past few months. On exam, papilledema is present and vision loss is constricted. After making immediate referral to an opthalmological surgeon, you begin this drug
Bonuse - MoA?
acetazolamide: carbonic anhydrase inhibitor
The motions of the ribs
Ribs 1-5: pump-handle motion
Ribs 6-10: bucket handle motion
Ribs 11-12: caliper motion
Lunesta
Drug: Interacts with GABA-receptor complexes at binding domains located close to or allosterically coupled to benzodiazepine
Sedative that treats insomnia
40 y/o male comes to clinic presenting with heliotrope rash and gottron's sign. Histology shows this
perimysial inflammation with perifascicular atrophy
32 y/o female with PMHx of MS presents to the clinic c/o severe HA. You find that her exam is normal except when you touch her face. You prescribe her this drug that blocks the voltage-gated Na+ channels
carbamazepine
Chapman points are discrete, palpable tissue areas resulting from a neuro lymphatic congestion caused by underlying visceral dysfunction. They are commonly located between the skin and subcutaneous tissue. With a diagnosis of Conjunctivitis, you would contact this point
lateral aspect of the humerus
Vigoroth
pokemon