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Neurology NP

Info & Q: NP EXAM

QuestionAnswer
Most headaches are primary or secondary? Primary
Headache Red Flag: Neck stiffness think? Meningitis
Headache Red Flag: Papilledema, blurred disc margin, swelling of the optic nerve think? Increased Intracranial Pressure
Elderly pts that present with new onset of severe headache there is increase risk that it is primary or secondary? Secondary so they will require 1. thorough neuro exam 2. expensive testing
Tension headaches typically are unilateral or bilateral? Bilateral
The two most important factors in establishing a headache diagnosis is? 1. History of the Headache 2. Family history of Headache
Migraine HA are more common in male or female? Female
Migraine HA are more often unilateral or bilateral? Unilateral
Migraine HA might be described as crescendo which means? Gradual onset getting worse
Migraine HA associated symptoms include: 1. N&V 2. Aura 3. Photophobia (light) 4. Phonophobia (sound)
What is prodrome? The symptoms hours or days before that lead up to the Headache
Migraine HA usually last about how long? 4 to 72 hours
What is postdrome? The symptons that occur after the Headache
What are the first line drugs to tx Migraine HA? 1. NSAID 2. ASA 3. Acetominophin
During a Migraine HA what happens to the cerebral arteries? They dilate
Mechanism of action for triptans? Vasoconstriction
What is the oldest triptan on the market? Imitrex
What is other class of drug is good to give with a triptan for the treatment of Headaches? NSAID
What are 2 typical pts we should be very cautious when RX triptans to Headaches and Why? 1. Cardiac pts because triptans vasoconstrict 2. Psych pts because of serotonin syndrome
When pts need prophylaxis tx for Migraine HA we should use what? 1. Beta Blockers (lol) 2. Calcium Channel Blockers (dipine)
HA accompanied by cloudy vision and eye pain think? Glaucoma
Why do we do an eye exam on pt with c/o HA? Looking for papilledema which might indicate increased intracranial pressure
Cluster HA are unilateral or bilateral? Unilateral
Cluster HA last about how long? 30 to 90 minutes
Cluster HA affect which nerve? CN V: Trigeminal Nerve
Tension HA are unilateral or bilateral? Bilateral
Tension HA characteristics include? 1. pressure 2. tightness 3. bandlike
What is the classic triad for meningitis? 1. Fever 2. Altered mental status 3. Nuchal Rigidity 4. HA
When you see nuchal rigidity think? Meningitis
Anybody in your office that may have been exposed to meningitis should take what for prophylaxis? 1. Ciprofloxacin if not pregnant 2. Rifampin
What is the name of the vaccine for meningitis? Menactra
If a pt present with c/o of low back pain and incontinence think? ER - cauda equina syndrome
MRIs are good for assessing? 1. soft tissue that stays still
CTs are good for assessing? 1. a cavity 2. something that moves that can't stop; ie chest
When assessing low back pain that radiates we think sciatica, do this test to assess for nerve root compression which means a disc problem. 1. Straight leg raise to assess L4/L5 and L5/S1 2. Positive confirms
A pt with a hx of TIA should take what prophylactic? ASA daily
Which Cranial Nerves are responsible for eye movement? CN III: Oculomotor CN IV: Trochlear CN VI: Abducens
Which Cranial Nerve is for vision? CN II: Optic
Which condition increases the risk of TIA; atrial fib or v-tach? 1. Atrial fib yes 2. Vtach death
A pt c/o HA but misses his appt then calls you for meds, what should you do? Get more info because it is cheap, quick and noninvasive
A pt c/o HA associated with vomiting but has no nausea, you should think this diff dx and do assessment test? 1. increased intracranial pressure 2. fundoscopic exam
A pt with Bell's palsy may not be able to do what? blink
Drug-Drug Interaction: Ciprofloxacin and ? 1. theophylline (increase theophylline level) 2. coumadin (increase bleed time) 3. sevelamer (reduce the absorption of cipro - milk and OJ will reduce absorp also)
Created by: dprest
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