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UWorld step 2 > neurology UWorld > Flashcards

neurology UWorld Flashcards

1
Q

acute severe periorbital pain with ipsilateral mitosis, lacrimation lasts 90 min
dx
tx

A

cluster headache
100% oygen
subcutaneous sumatriptan
ppx: verapamil, lithium

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2
Q

headache, eye pain, nausea, decreased visual acuity, seeing halos, fixed mid-dilated pupil conjuctival redness

A

angle closure glaucoma

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3
Q

obese patient on OCP;s, headache n/v papilledema**

A

idiopathic intracranial hypertension
can cause blindness
do a lumbar puncture or imaging to rule things out

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4
Q

young obese female pt with transient episodes of blindness and pulsatile headaches, b/l papilledema
tx

A

intracranial htn
weight loss and acetazolamide

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5
Q

migraine ppx

A

topiramate

OCP’s are contraindicated: increased estrogen increases risk of thromboembolism

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6
Q

intraparenchymal hemorrhage likely d/t htn
what symptoms?

A

ipsilateral hemiataxia

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7
Q

management of carotid atherosclerotic disease

A
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8
Q

non pupil sparring CN III palsy vs pupil sparring management

A

ct- angiography

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9
Q

old lady with headache, visual disturbance, and elevated ESR

A

giant cell arteritis
start prednisone and then obtain artery biopsy

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10
Q

lobar intracranial hemorrhage

A

d/t amyloid

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11
Q

pt usually takes warfarin, gets a cold, takes OTC and then gets brain bleed
next step

A

prothrombin complex concentrate (vitamin K + factor 2, 7, 9, 10)

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12
Q

contralateral hemiparesis and hemianesthesia and conjugate gaze deviation toward the side of the lesion

A

putaminal hemorrhage
– always involve the adjacent internal capsule
hemiparesis + hemianesthesia d/t posterior limb corticospinal and somatosensory fibers
gaze deviation d/t anterior limb

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13
Q

conjugate eye

A
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14
Q

management of ischemic stroke

A

more than 4.5hrs –> anti platelet agents

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15
Q

severe paroxysmal burning pain over affected areas, exacerbated by light touch. after a stroke neuropathic pain

A

allodynia – thalamic pain syndrome – after a stroke neuropathic pain

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16
Q

right hemiparesis stroke

A
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17
Q

pure motor stroke

A
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18
Q

vertigo + nausea + nystagmus + sensation defects of the left side of the face and right extremities

A

dissection of left vertebral artery

19
Q
A

left medulla

20
Q

Alzheimer disease what will see on mri

A

Temporal Lobe Atrophy (prominent in the hippocampi and medial temporal lobes)

21
Q

initial workup for suscepted cognitive impairment

A

B12

22
Q

old lady with cognitive decline and then behavioral changes
tx

A

Alzheimers disease
mild to moderate : rivastigmine, donepezil, galantamine
mod to severe: Memantine an NMDA receptor antagonist

23
Q

als

A

upper and lower motor neuron
corticospinal tract degeneration
anterior horn cell

24
Q

ALS
tx

A

Riluzole
NIPPV

25
Q
A

will also see postural tremor

26
Q

gait abnormalities, cognitive impairments (executive function, memory deficits), urinary incontinence (urgency)

A

Normal pressure hydrocephalus
**decreased CSF ABSORPTION by the arachnoid granulations
**large ventricles with normal sulci on CT scan
**next step: get an MRI brain

27
Q

behavioral changes, (irritability, social inappropriateness, rudeness) + cognitive impairments (math errors, Montreal cognitive assessment) + Neuro signs ( chorea involuntary movements, hyperreflexia**)

A

huntingtons disease

caudate nucleus atrophy

28
Q

ptosis, fluctuating and fatiguable proximal muscle weakness
ice pack test positive

A

myasthenia graves
tx: pyridostigmine

29
Q

progressive muscle weakness affecting proximal (standing up) and distal (buttoning shirt) muscles, with LMN hyporeflexia and muscle atrophy and sensation deficits

A

chronic inflammatory demyelinating polyneuropathy
decreased peripheral nerve. conduction velocity

30
Q

GBS ascending polyradiculoneuropathy
csf:
protein:
WBC:
RBC:
GLUCOSE:

A

protein: HIGH
WBC: normal
RBC: normal
GLUCOSE: normal

tx: IVig or plasmapheresis

31
Q

metformin after 5 years, develops sensory ataxia (gait unsteady, positive Romberg), lateral corticospinal tracts (babinksi), myelinated peripheral nerves – parasthesisia extremities, neuropsychiatric manifestations

A

vitamin b12 deficiency

32
Q

sudden symptoms of upper and lower facial drooping, disappearance of nasolabial fold, prodrome of ear pain

A

bells palsy
no additional tests needed
tx: high dose glucocorticoids

33
Q

old guy who takes pyridostigmine outpatient, suddenly gets respiratory failure and is intubated
what next ?

A

dx: myasthenia crisis
give plasmapheresis or IVIG

34
Q

excessive hip and knee flexion while walking, slapping down the foot, frequent falls
dx
d/t

A

motor neuropathy steppage – common perineal neuropathy
usually due to L5 radiculopathy (back pain radiating to foot, weakness foot eversion and dorsiflexion)
or
Common Peroneal nerve neuropathy: d/t compression of nerve at lateral aspect of fibula (crossing legs for long time( paresthesias and sensory loss over dorm of foot

35
Q

hand weakness, stiffness,, atrophy, with flat affect and ptosis (male or female)

A

myotonic dystrophy
CTG trinucleotide repeat
DMPK gene

36
Q

ALS
diagnosis:

A

EMG

37
Q

diffuse abdominal pain, peripheral neuropathy (upper extremity weakness, areflexia) and positive urobilinogen

A

AIP

38
Q

unpleasant sensation of crawling in the legs, relieved temporarily with walking
dx
tx
moa

A

restless legg syndrome
gabapentin: alpha 2 delta calcium channel ligand

39
Q

malignancy small cell lung cancer, proximal limb muscle weakness (combing hair, standing), deep tendon reflexes are absent, autonomic dysfunction (dry mouth, ED)

A

Lambert eaton
autoantibodies on presynaptic voltage-gated calcium channels

40
Q

essential tremor tx

A

beta blockers: propanolol

41
Q

pronator drift
lesion?

A

Upper motor neuron lesion, in pyramidal/corticospinal tract

42
Q

multiple sclerosis spasticity muscle spasms tx

A

baclofan or Tizanidine

43
Q

young girl with monocular vision changes, “washed out” color vision afferent pupillary defect

A

optic neuritis

44
Q

trigeminal neuralgia d/t

A

demyelinating plaques in the pons
compression of nerve root

UWorld step 2 (16 decks)

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