MKSAP – Neurology 100% Accurate A+ Review Q&A 2023/2024

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MKSAP – Neurology 100% Accurate A+ Review Q&A 2023/2024 Haldol is absolutely contraindicated in Dementia with Lewy bodies. What medication is a safer alternative in these patients? - Answer-Donep... ezil. May improve behavioral and cognitive symptoms with dementia. Parkinson's: medication used is carbidopa-levodopa What are common levodopa-related complications? - Answer-Motor fluctuations (caused by wearing off of the beneficial effects before next dose is administered) Medication-induced dyskinesia (involuntary choreic movements) Can also have nausea and orthostatic hypotension What is indicated for pts who have advanced Parkinson's who derive continued benefit from carbidopalevodopa but have med-related side effects? - Answer-Deep brain stimulation Meds that wouldn't be so great here... Apomorphine = fast-acting subq dopamine agonist. Indicated for rapid relief of sx caused by sudden wearing off of Parkinson's meds Droxidopa = for neurogenic orthostatic hypotension Rotigotine= a dopamine agonist, can worsen both nausea and orthostatic hypotension. Additionally, an overall increase in dopaminergic medication dosing is likely to aggravate dyskinesia. Fever worsens outcomes after stroke and possibly after severe head injury, most likely by promoting secondary brain injury. So tylenol is useful. Don't give dexamethasone (worsens outcomes). - AnswerIn ischemic stroke 2/2 intracranial atherosclerosis, high-intensity statin therapy for secondary stroke prevention is associated with a reduced long-term risk of ischemic stroke. Stenting patients with symptomatic intracranial atherosclerotic disease is a/w two-fold higher risk of stroke when compared with best medical therapy. Warfarin is indicated in patients with other stroke subtypes, such as those resulting from afib - AnswerLevetiracetam and other antiepileptic drugs are not rec'd for first-time seizures until the results of further testing (eg HCT, MRI, EEG) are known [Show More]

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