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MKSAP KEY POINTS > Neurology Qs > Flashcards

Neurology Qs Flashcards

1
Q

adjunctive treatment in multiple sclerosis?

A

Vit D

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2
Q

In order to meet criteria for dementia, a patient’s cognitive deficits must?

A

interfere with daily functioning and result in some loss of independence.

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3
Q

Managemetn of asymptomatic meningiomas without evidence of invasion of other intracranial structures and without surrounding edema?

A

followed clinically and radiographically

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4
Q

signal abnormalities typically seen on MRIs of patients with migraine? Significance?

A

White matter signal abnormalities in the posterior circulation

benign and unrelated to neurologic examination abnormalities or cognitive anomalies

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5
Q

most common epileptic aura if originates in the temporal lobe?

A

rising epigastric sensation

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6
Q

Classically, frontal lobe seizures cause?

A

motor manifestations (focal jerking, bicycling movements) that awaken patients from sleep.

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7
Q

Myotonic dystrophy type 1 v 2. Which is more common? Preferentially involves?

A

1

distal limb and facial muscles VS proximal muscles

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8
Q

Differentiating hallmark of myoonic dystrophy?

A

Difficulty with relaxation

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9
Q

Inclusion body myositis - time of progression? predominantly affects? Not a feature?

A

slow

distal upper extremity flexors and quadriceps

myotonia

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10
Q

Primary progressive aphasia is most commonly associated with what type of dementia?

A

frontotemporal dementia

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11
Q

shown to be superior to aspirin alone in reducing the risk of recurrent stroke

A

aspirin and dipyridamole

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12
Q

dual antiplatelet agents - role post-stroke?

A

don’t use - increased risk of hemorrhagic complications that offset any potential clinical benefit

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13
Q

narrow-spectrum AEDs used to treat partial-onset epilepsies? may provoke?

A

Carbamazepine, gabapentin, and phenytoin

absence status epilepticus.

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14
Q

Typical features suggestive of partial onset seizures?

A

specific auras (déjà vu or a rising epigastric sensation) and unilateral clonic shaking before onset

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15
Q

Topiramate - broad or narrow spectum AED?

A

Broad

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16
Q

Horner syndrome?

A

miosis, ptosis, and anhidrosis

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17
Q

characteristic of carotid artery dissection?

A

ipsilateral neck pain and ischemic complications (monocular visual loss and Horner syndrome)

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18
Q

Oxcarbazepine - side effect?

A

hypoNa

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19
Q

First line medications for essential tremor?

A

propranolol and primidone

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20
Q

Spinal cord compression by skeletal lesions resulting from plasmacytoma should be treated with? unless?

A

Radiation (even with minor neurologic deficits); spinal instability

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21
Q

combat veterans, particularly those with posttraumatic stress disorder (PTSD), are at high risk for?

A

nonepileptic seizures

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22
Q

levetiracetam should be avoided patients with PTSD because?

A

exacerbate anxiety and irritability

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23
Q

Tx for urgency, frequency, and incontinence in MS?

A

anticholinergic agents (oxybutnin) - decrease bladder spasms

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24
Q

Antiepileptic drugs that are better tolerated in the elderly?

A

lamotrigine, levetiracetam, and gabapentin

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25
Q

hunderclap headaches that recur over several days or weeks - dx? May also present with? CTA shows?

A

reversible cerebral vasoconstriction syndrome

focal neurologic deficits

multifocal areas of vasospasm without evidence of aneurysm

26
Q

Primary stabbing headache - usually lasts for how long? responds to?

A

seconds; indomethacin

27
Q

Treatment for primary CNS lymphoma?

A

Methotrexate-based chemotherapy and whole brain radiation

28
Q

Standard-of-care treatment of an accessible solitary brain metastasis in patients with good functional status?

A

Complete resection followed by radiation therapy

29
Q

can initially aggravate symptoms of myasthenia gravi? when to start them?

A

High-dose glucocorticoids;

These agents can be started after therapy with plasmapheresis or IVIG has been initiated.

30
Q

most effective acute cluster headache treatments?

drug of choice for cluster headache prevention?

A

Oxygen therapy and subcutaneous sumatriptan

verapamil

31
Q

How many days/month of opiates does it take to develope medication overuse headache?

A

10

32
Q

standard of care for multiple sclerosis relapses?

A

IV methlyprednisone

33
Q

Treatment guidelines advise treatment of hypertension in patients with acute ischemic stroke only if blood pressure is greater than?

A

220/120 mm Hg or evidence of other end-organ damage exists

34
Q

appropriate next step in management for patients with incomplete recovery 3 months after onset of facial nerve palsy?

A

MRI Brain

+ evaluation for lyme, DM, vasculitis, HIV, sarcoid, Sjogren

35
Q

Antiepileptic drugs that should not overlap due to risk of Stevens Johnson syndrome?

A

Lamotrigine and valproic acid

36
Q

Anti-epileptic drugs that are safe in pregnancy?

A

levetiracetam and Lamotrigine

37
Q

Progressive supranuclear palsy - PSP is defined by parkinsonism with? Characteristic appearance?

A

oculomotor abnormalities, including impairment of vertical saccades and supranuclear vertical gaze palsy

exhibit facial dystonia (with a characteristic surprised appearance)

38
Q

BP med that should be avoided in this patient with a likely intracerebral hemorrhage? Why?

A

Intravenous nitroprusside can increase intracranial pressure

39
Q

Goal blood pressure after intracerebral hemorrhage?

A

< 160/90

40
Q

Physical exam findings of chronic inflammatory demyelinating polyradiculoneuropathy? EMG findings? of conduction velocities) detected on nerve conduction studies

A

diffuse areflexia and sensory and motor neuropathy; conduction blocks and slowing

41
Q

Guillain-Barré versus chronic inflammatory demyelinating polyradiculoneuropathy?

A

GBS has a faster progression and reaches its nadir within 4 weeks,

CIDP progression continues beyond 8 weeks from onset.

42
Q

Only reliable medication for idiopathic intracranial hypertension?

A

Carbonic anhydrase inhibitors, such as acetazolamide,

43
Q

when to consider a lobectomy for epilepsy?

A

persistence of disabling seizures for longer than 1 year despite treatment with adequate doses of two or more antiepileptic drugs

44
Q

In hospitalized patients with Parkinson disease, sudden withdrawal of dopaminergic medications can lead t?

A

parkinsonian-hyperpyrexia syndrome, an acute syndrome resembling neuroleptic malignant syndrome

45
Q

Definition of status migrainosus?

A

migraine attack extending beyond 72 hours and is the most common complication of acute migraine.

46
Q

Treatment of status migrainosus?

A

Repetitive administration of intravenous dihydroergotamine

47
Q

Fingolimod?

A

sphingosine-1-phosphate receptor modulator that restricts activated lymphocytes to lymph nodes

Disease-modifying threrapy for MS (decreases relapse rate and acumulation of new lesions on MRI)

48
Q

Nimodipine? When (timing, dose, duration) to give?

A

L-type calcium channel blocker that decreases vasospasm (and death) in patients with SAH

49
Q

Best options for migraine without aura? Preferred option?

A

NSAIDs, triptans, and dihydroergotamine

NSAIDs are preferred as initial treatment because of their greater cost-effectiveness.

50
Q

Treatment for ALS with a survival benefit?

A

Riluzole

51
Q

ALS mimickers?

A

Lyme disease, hyperparathyroidism, vitamin B12 or copper deficiency, lead intoxication,

52
Q

Cerebral vasospasm after SAH most often occurs when? and is best detected by?

A

5 to 10 days after the hemorrhage; CT angiography of the brain.

53
Q

first-line treatment for restless legs syndrome?

A

Dopamine agonists, such as ropinirole, pramipexole, or rotigotine

54
Q

INR that is a contraindication to TPA?

A

1.7

55
Q

Blood pressure go after TPA?

A

< 180/105

56
Q

appropriate as therapy for migraine without aura in patients not responding to NSAIDs or oral triptans?

A

Subcutaneous sumatriptan

57
Q

Dissection of the left internal carotid artery typically results in? What is spared?

A

ipsilateral Horner syndrome with ptosis, miosis, and anhidrosis but not oculomotor nerve (cranial nerve III) palsy.

58
Q

Antiepileptic drugs that do not affect liver enzymes, and are therefore used in patients getting chemotherapy?

A

Valproic acid, lacosamide, lamotrigine, and levetiracetam.

59
Q

Chronic paroxysmal hemicrania - nerve affected? Duration of attacks compared to trigeminal neuralgia? Diagnosis also requires?

A

V1;

15 mins v seconds

concomitant ipsilateral autonomic findings, such as tearing, nasal congestion, or rhinorrhea

60
Q

method to distinguish between a flare of inflammatory myopathy and glucocorticoid-induced toxic myopathy in a patient with persistent myopathy?

A

Steroid tapering

61
Q

How long after administration of TPA before starting antiplatelet agents?

A

24 hours until a repeat head CT scan shows no hemorrhage,

62
Q

only agents that have shown efficacy in studies of chronic migraine? Definition of chronic migraine?

A

Topiramate and onabotulinumtoxinA; >15 days a month for > 3 months

MKSAP KEY POINTS (19 decks)

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