Adult - Neuro

Question 1

Which gender more typically develops migraine?

Answer 1

female

Question 2

Which gender more typically develops cluster?

Answer 2

male

Question 3

Headache described as “vise-like”

Answer 3

tension

Question 4

Are focal neurological symptoms such as flashes of light or zig zags in the vision associated with tension headache? Migraine?

Answer 4

not with tension

yes with migraine

Question 5

When is the typical age of onset of migraine?

Answer 5

adolescence or early adulthood

Question 6

What foods contain nitrates?

Answer 6

pickles

bologna

Question 7

Is migraine usually unilateral or bilateral?

Answer 7

unilateral

Question 8

What are some drugs that can be used prophylactically for migraine?

Answer 8

amitriptyline (Elavil) - anti-depressant
propranalol (Inderal) - beta blocker
gabapentin (Neurontin) - analgesic, anti-seizure
topiramate (Topamax) - anti-seizure

Question 9

In new onset migraine what are the four laboratory studies to consider?

Answer 9

ESR
BMP
CBC
VDLR

Question 10

In new onset migraine what are the imaging studies to consider? why?

Answer 10

CT to r/o brain tumor

Question 11

What is the patho of migraine?

Answer 11

dilation and pulsation of branches of external carotid artery

follows the trigeminal nerve pathway (CN V)

Question 12

What is the standard management of acute migraine?

Answer 12

sumatriptan (Imatrex) - subcutaneously

Question 13

What is the standard management of an ugly migraine?

Answer 13

JUST KIDDING!! :-)

Question 14

Which is more likely to be associated with family history - migraine or cluster?

Answer 14

migraine

Question 15

What is the pattern of cluster headache?

Answer 15

severe, unilateral, periorbital pain occuring daily for several weeks

Question 16

For which two types of headache is sumatriptan (Imatrex) used?

Answer 16

migraine and cluster

Question 17

Prior to a triptan, what is a therapy that may help relieve a cluster headache?

Answer 17

100% O2

Question 18

Does TIA have any residual effects?

Answer 18

no

Question 19

What is TIA indicative of?

Answer 19

in many cases, an impending stroke

Question 20

What vision symptoms may be present with TIA?

Answer 20

IPSilateral monocular blindness = same side, one eye

Question 21

What motor symptoms may be present with TIA?

Answer 21

CONTRAlateral paresthesia of arm, leg, or face = opposite side of the body

Question 22

How are vertibrobasilar TIAs characterized?

Answer 22

more “neuro” presentation - vertigo, ataxia, dizziness

Question 23

How are carotid TIAs characterized?

Answer 23

more traditional “stroke-like” - altered LOC, aphasia, dysarthria

Question 24

What imaging test is best for distinguishing between infarct, tumor, or hemorrhage?

Answer 24

CT

Question 25

What imaging test is best for detecting ischemic infarcts?

Answer 25

MRI

Question 26

If a CT is negative but the patient can't move part of the body, what is a likely cause?

Answer 26

ischemic infarct (not bleed)

Question 27

What is the number one cause of heart failure?

Answer 27

hypertension

Question 28

When is endarterectomy indicated?

Answer 28

in cases of > 70 - 80 % stenosis in symptomatic patients

Question 29

What are pharm management options for TIA?

Answer 29

aspirin clopidogrel (Plavix) ticlopidine (Ticlid)

Question 30

With what side effects is ticlopidine (Ticlid) associated?

Answer 30

agranulocytosis thrombotic thrombocytopenia purpura GI intolerance ** requires lab monitoring, not used as much as aspirin and plavix **

Question 31

What is the most important diagnostic test for establishing the classification of a seizure disorder?

Answer 31

EEG

Question 32

Why are imaging studies done following an initial seizure?

Answer 32

MRI or CT to r/o brain tumor

Question 33

Which type of seizure does NOT involve loss of consciousness?

Answer 33

simple partial

Question 34

What differentiates a complex partial seizure from a simple complex?

Answer 34

complex partial involves loss of consciousness

Question 35

What neurotransmitter is lacking in Parkinson's disease?

Answer 35

dopamine

Question 36

What is the trio of symptoms in Parkinson's disease?

Answer 36

rigidity tremor bradykinesia (slow movement)

Question 37

What are the two categories of medication in Parkinson's disease?

Answer 37

those which increase available dopamine and anticholinergics which alleviate tremor and rigitity

Question 38

Parkinson's complaint - "my feet are sticking to the floor" adjust which type of med?

Answer 38

dopamine

Question 39

Parkinson's complaint - "I have to rock several times to get up" adjust which type of med?

Answer 39

dopamine

Question 40

Parkinson's complaint - "my tremor is much worse" adjust which type of med?

Answer 40

anticholinergic

Question 41

Parkinson's complaint - "I'm feeling very rigid" adjust which type of med?

Answer 41

anticholinergic

Question 42

What is the marker for Parkinson's disease?

Answer 42

none known

Question 43

Bell's palsy - | able to move forehead?

Answer 43

NO

Question 44

Stroke - | able to move forehead?

Answer 44

YES

Question 45

Bell's palsy - | theory on causation

Answer 45

reactivation of herpes virus

Question 46

Bell's palsy - | abrupt or insidious onset?

Answer 46

abrupt

Question 47

Bell's palsy - | which cranial nerve?

Answer 47

facial - CN VII

Question 48

Bell's palsy - | treatment?

Answer 48

prednisone taper | acylcovir

Question 49

Bell's palsy - | typical side of the face?

Answer 49

R

Question 50

stabbing or electric shock type of pain on one side of the face

Answer 50

trigeminal neuralgia

Question 51

Trigeminal neuralgia - | which cranial nerve?

Answer 51

trigeminal - CN V

Question 52

Trigeminal neuralgia - | can be related to what other disorder?

Answer 52

MS

Question 53

Trigeminal neuralgia - | management

Answer 53

anti-seizure drugs muscle relaxants tricyclic antidepressants