Doctoring NSB (Need Sweet Birdie) Review #FreeBirdie #LLB #StolenButNotForgotten

What's a big component of a patient's reported outcome? (survey based usually)

Patient experience (not just whether they live/die/are treated)

What type of study can determine prognosis of a disease (KEY)

Prospective Cohort Studies
note- prove association but not causation

What does network meta-analysis allow for

"Compare the efficacy and adverse effects of different treatments on the same disease/condition"

What is the Achilles heel bias of meta-analysis systematic reviews

publication bias

Most important cause for bias in a cohort study? (KEY)

Attrition bias (loss to follow-up)

What's the key component to a regional Quality Initiative

good data

what vitamin excess/deficiency is accompanied with excess alcohol use disorder

thiamine (B1)

what vitamin deficiency is correlated with wernicke encephalopathy

thiamine (B1)

What's the difference between euthanasia, physician assisted suicide, and withdrawal of care? (KEY)

euthanasia - physician pushes the bolus of X to kill the person
PAS - physician basically tells them how they could do it themselves
withdrawal - removing ventilator/unplug

what artery supplies the thalamic area

middle cerebral artery

what is the function/symptoms associated with loss of head of caudate

apathy and disinhibition

what does a superior cerebellar artery stroke cause

ipsilateral cerebellar ataxias
contralateral loss of pain/temp sensation over whole contralateral body
(similar to Wallenberg)

someone has wide based and ataxic gait issues and alcohol use disorder. what CN is likely also palsied

CN 6. associated with Wernicke's encephalopathy!

why give thiamine before glucose for Wernicke's?

thiamine is a cofactor in glucose metabolism, if given glucose without it you'll cause lactic acidosis and worsen neuronal damage

what does an anticholinergic OD look like?

confusion, dry mouth, dilated pupils, dry/red/warm skin
"Hot as Hades, Blind as a Bat, Dry as a Bone, Red as a Beet, Mad as a Hatter"

ear drum perforation associated with funny taste change... why?

chorda tympani --> facial nerve affected

whats the underlying mechanism of Ataxia Telangectasia

defective DNA repair enzymes (ATM gene)
clumsy walking, spider-web like blood vessels, frequent mucosal infections

loss of pain and temperature. what are the two possible spinal sites for a specific dermatome?

either ipsilateral at the level, or contralateral 2 levels higher (due to decussation!)

Dermatomes of hand review: Thumb? Middle finger? Little finger?

thumb: C6
middle: C7
little: C8

dermatomes of inner forearm and upper inner arm?

inner forearm: T1
upper inner arm: T2

what's the mechanism of acyclovir

inhibition of microbial DNA polymerase

What's PICO in study design

Patient group
Intervention/Comparison
Outcome

for a pregnant woman with diabetes, at what point is hyperglycemia detrimental to neural tube defects?
Bonus: what A1c should be aimed for?

hyperglycemia shortly after conception (pregestational diabetes)
A1c optimally less than 6.5%

whats the common pain radiation for sciatica?

pins and needles down the butt and backside down the leg below the knee

what's caused by vitamin B12 (cobalamin) deficiency

subacute combined neurodegeneration

what tremor is high frequency and associated with sustained posture (like outstretched arms)? how can these people self-treat the symptoms?

essential tremor. clinically distinguish from Parkinson's!
can be familial and people can drink alcohol to reduce tremors (or propranolol/primidone, which is the proper medical treatment)

Is essential tremor symmetric or unilateral?

symmetric

what is dystonia?

Involuntary sustained muscle contractions, producing twisting or squeezing movement and abnormal postures

what lab is different in Wilson's disease, and how?

ceruloplasmin is LOW

what is "double panda sign of the pons" a buzzword for? It's associated with ataxia, tremor, liver issues/labs, etc.

Wilson's disease
+ Kayser Fleischer rings in eyes

treatment for Wilson's disease

D-penicillamine, trientine (chelators)

what can metoclopramide cause (relevant to neuro)?

parkinsonism (not parkinsons, just the symptoms)

what findings can a posterior communicating artery aneurysm cause?

ipsilateral CN 3 palsy (down and out)

what could an anterior communicating artery compress?

optic chiasm

why's the MLF so vulnerable in things like MS?

highly myelinated

what's the treatment for an aneurysm (like the PCom one in previous card?)

clipping or coil (urgent, before rupture)

what issue of the carotid can be indicated by horner syndrome?

carotid dissection/aneurysm, especially following neck trauma

duration of meniere's vs. duration of labrynthitis?

meniere's will be for hours, labrynthitis is for days. labrynthitis follows URI usually and will also have severe vertigo

what's the cause of benign positional vertigo

displaced canaloliths (calcium carbonate otoliths)

what's amourosis fugax?

AKA central retinal artery obstruction
painless, transient vision loss in one eye, with curtain shade over vision
symptom of TIA, embolism to retinal artery
ASSOCIATED with carotid disease

hat does optic neuritis with headaches point to

giant cell arteritis

role of biologics such as Lecanemab?

for alzheimers, anti-plaques

does exercise reduce risk of alzheimers?

yes! by like 20% apparently if you do for 150+ mins

treatment for delirium?

haloperidol (D2 receptor antagonist antipsychotic)

what patients are super sensitive to and have potentially deadly reactions to haloperidol/antipsychotics?

lewy body dementia patients --> neuroleptic malignant syndrome

whats HIT (Head Impulse Test)

test for peripheral vs central vertigo
jerk the head around, with vestibular system dysfunction (peripheral cause), the eyes saccade and will fix back
in central cause, the eyes will stay fixed on the examiner

what kind of vertigo is HIT positive

peripheral