Neurology USMLE
Terms
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- What is Multiple scelerosis?
- Neurological lesions separated by space and time. More than one area of the CNS is involved in more than one attack.
- What is the best INITIAL test for multiple Scelerosis?
- MRI.
- When do we use Lumbar puncture in Multiple scelerosis?
-
-When MRI result are equivocal and non reliable to reach a diagnosis.
-"Oligoclonal bands" - Multiple sclerosis treatment?
-
-During relapses I.V steroids
-Inbetween attacks: (slow progress of the disease.
a)Beta 1a Interferon( Avonex)
b)Beta 1b Interferon( Betaseron)
c)Copolymer A (Copaxone)
Chronic progressive MS: No effective drug. - Managment of Multiple sclerosis patient+ pain
- Phenytoin
- Managment of Ms patient + Spasticity
- Baclofen or Zanaflex.
- Managment of Ms patient+ fatigue
- Amantadine or provigi.
- Hot climate effect on MS
- Promotes weakness.
- What is the most efficient anti-parkinson's drug?
- L-dopa/Carbidopa
- What is the side effects of L-dopa/carbidop( Sinemet)
-
-Acute:
a)Psychosis: Due to increased level of dopamine.
b)Hypotension.
c)GIT upset.
Late side effects /response fluccations
a)On/off symptoms
b)Dyskenisea: Abnormal Movements.
c)Akinesia: Restless. - How do you treat the functioning or reasonably functioning parkison's patient?
-
a)Age>60------> Amantadine.
b)Age<60------>Anti-cholinergic
which would may caue confusion, dry mouth, urine retention. - How do you treat the non-functioning parkinson's patient?
- L-dopa/carbidop.
- What to do if patient starts to exhibit L-dopa/cabridop side effects?
-
Add:
1)Dopamine agonists
Pergolide, Pramipexole,Ropinirole.
2)COMT inhibitor : Tolcapone.
Dopamine agnoists is better to than COMT. - What the drug that can slow the progress of parkinson's disease?
- MAO-B inhibitor: Selegline.
- How to Diagnois huntington Chorea?
-
-presentation:
a)Abnormal movments(chorea)
b)Abnormal Behavior.
C)Postive family history (autosomal dominant)
-Tests:
a)Chromosomal analysis:Huntington protien on chromsome4
b)CT may show boxcar ventricle "enlarged" (from loss of caudate)with cortical atrophy