Stroke
A ventral pontine stroke can result in which disorder?
Locked in syndrome
Retained: vertical eye movements, blinking, and consciousness
Status epilepticus is defined as?
2 or more seizures within 30 minutes without return to baseline or a seizure lasting more than 5 minutes (permanent brain damage around 20-30 minutes)
What is the most common type of action tremor?
Essential Tremors
What is the first line pharmacotherapy for essential tremors?
Propranolol or primidone
What lab should be obtained in patients complaining of RLS (restless leg syndrome) symptoms?
What is the location of the stroke if the patient presents with headache, vomiting, balance changes, nystagmus and vertigo?
Cerebellar stroke/Cerebellum
What is the most common cause of seizures in the elderly?
Stroke
The 4 cardinal signs used to diagnose Parkinsons disease?
TRAP: tremor (pill rolling/resting), rigidity (cogwheel) athesia/bradykinesia, and postural instability.
For a patient in status epilepticus what is the first line treatment in those who have IV access?
PLUS
Keppra, fosphenytoin, or valproate
The most reliable historical feature to distinguish syncope from seizure?
Post ictal confusion
What percentage of strokes are due to ischemic causes?
80%
What labs should be included in the initial workup of new onset seizures?
POCT glucose, CBC, CMP, Mg, UA, toxicology, lactate, pregnancy test
+/- CPK, cortisol, LDH
What are some common nonmotor symptoms seen in Parkinson's disease? (name at least 4)
Psychotic symptoms, mood disorders, dementia, olfactory symptoms, fatigue, sleep disorders (REM, RLS, insomnia), autonomic dysfunction, pain and sensory disturbances, derm findings (melanoma, seborrheic dermatitis).
Which Anticonvulsant drug (AED) is most likely to lead to thrombocytopenia and hepatotoxicity?
Valproic acid
What is the mutation seen on genetic testing in Huntington's disease?
Cytosine-adenine-guanine (CAG) trinucleotide expansion of ≥36 repeats in the HTT gene
What lab/labs do you need to get before thrombolysis in the setting of an acute stroke.
Blood glucose
Correct if <60mg/dL
What is Todd's Paralysis?
Transient paralysis following a seizure which can include aphasias, sensory deficits, and visual deficits.
What is the average age range for developing Huntington's disease?
30-50 years
You have a patient with mild Parkinson symptoms who wants treatment but can only remember to take medications once daily. What first-line monotherapy could you offer him?
MAO B Inhibitors (rasagiline, safinamide, selegiline)
Common ways to decrease increased intracranial pressure in stroke patients? (name at least 2)
Osmotic therapy, Hyperventilation, Pharmacologic coma (pentobarbital, propofol), Hypothermia
After alteplase is given, BP should be maintained at </= ______mmhg for at least ______ hours?
180/105mmHg and 24 hours.
Which metabolic disturbances can lead to seizures? (list at least 4)
Hyperglycemia/hypoglycemia, hypomagnesemia, hypocalcemia, hypernatremia/hyponatremia, hyperthyroidism, and uremia.
What is the treatment for restless leg syndrome in patients with normal ferritin and moderate to severe symptoms?
DA agonist (ropinirole, rotigotine, pramipexole) or gabapentin/pregabalin
How many milligrams of carbidopa are recommended in the total daily dose to prevent the early conversion of low doses of levodopa?
70-100mg
What condition can occur when Parkinson's medications are suddenly withdrawn or the dose is reduced?
Parkinsonism-hyperpyrexia syndrome, neuroleptic malignant syndrome in the context of sudden withdrawal or dose reductions of levodopa or DAs.