MKSAP Neuro

Question 1

Tx of menstrual migraine

Answer 1

mefenamic acid

Question 2

migraine w/ aura is CI for what medication

Answer 2

OCPs

Question 3

sxs more associated with hemorrhagic, not ischemic stroke

Answer 3

HA
vomiting
HTN
impaired LOC

Question 4

sxs of Lambert Eaton

Answer 4

proximal UE and LE weakness
autonomic sxs (dry eyes, ED)
no DTRs

Question 5

proximal limb weakness
autonomic sxs (dry eyes, ED)
no DTRs

Answer 5

Lambert Eaton

Question 6

inclusion body myositis usually affects what muscles

Answer 6

quadriceps

deep finger flexors

Question 7

tx of myasthenia crisis (extreme m weakness that might need intubation)

Answer 7

plasma exchange

Question 8

med CI in myasthenia gravis

Answer 8

fluoroquinolones
aminoglycosides
mcrolides
lithium
Mg

Question 9

dx of guillain barre

Answer 9

EMG

Question 10

CSF results of guillain barre

Answer 10

albuminocytologic dissociation (spinal fluid cell count normal but spinal fluid protein level elevated)

Question 11

severe, acute onset headache is called

Answer 11

thunderclap headache

Question 12

causes of thunderclap headaches

Answer 12

subarachnoid hemorrhage
carotid or vertebral a dissection
venous sinus thrombosis
reversible cerebral vasoconstriction

Question 13

INR level for rtPA

Answer 13

1.7 or less

Question 14

BP must be below ___ for rtPA

Answer 14

185/110

Question 15

preferred meds to lower BP in stroke

Answer 15

IV labetalol or nicardipine

Question 16

anti nausea med that can cause EPS

Answer 16

prochlorperazine

metoclopramide

Question 17

acute unilateral headache with Horner syndrome

Answer 17

acute carotid dissection

Question 18

things to do if suspect SAH

Answer 18

CT

if neg, LP

Question 19

tx for MS related fatigue

Answer 19

amantadine (DA rec agonist)

Question 20

tx for primary progressive MS

Answer 20

symptomatic tx

Question 21

big diff among SUNCT, paroxysmal hemicrania and cluster HA

Answer 21

SUNCT lasts 30-120 seconds
paroxysmal hemicrania lasts 15 min
cluster lasts an hour

Question 22

tx of SUNCT, paroxysmal hemicrania, and cluster HA

Answer 22

SUNCT: lamotrigine
paroxysmal hemicrania: indomethacin
cluster: O2, verapamil

Question 23

meds to tx essential tremor

Answer 23

propranolol (#1)
primidone
gabapentin
topiramate

Question 24

drugs of choice for epilepsy in pts with liver dz

Answer 24

levetiracetam
gabapentin
pregabalin
(all renally excreted)

Question 25

anti epileptic that's highly protein bound

Answer 25

phenytoin

Question 26

myeloneuropathy and anemia in a patient with gastric bypass, check for

Answer 26

copper deficiency too much zinc (which can decrease copper levels) B12 deficiency

Question 27

neuromyelitis optica has predilection for

Answer 27

optic nerves | spinal cord

Question 28

defn of medication overuse HA

Answer 28

HA more than 15 times a month | med use of more than 10 days a month

Question 29

reasons not to do CEA in large stenosis (and do carotid angioplasty and stenting instead)

Answer 29

stenosis above C2 medical conditions that are risky for surgery radiation induced stenosis restenosis after CEA

Question 30

2 things to order with new onset seizure

Answer 30

EEG | MRI

Question 31

symmetric spasticity especially of lower limbs | muscle weakness

Answer 31

primary lateral sclerosis

Question 32

weakness sensory loss decr DTRs

Answer 32

chronic inflammatory demyelinating polyradiculoneuropathy

Question 33

children and adolescents with seizures in sleep

Answer 33

rolandic epilepsy

Question 34

child with myoclonic and generalized tonic clonic seizures when waking up

Answer 34

juvenile myoclonic epilepsy

Question 35

med if SAH

Answer 35

nimodipine (prevent vasospasm)

Question 36

tx of status epilepticus

Answer 36

IV lorazepam or diazepam

Question 37

solitary mass in deep white matter, and next step

Answer 37

primary CNS lymphoma (do stereotactic brain biopsy, then tx with MTX then whole brain radiation)

Question 38

ADR of DA agonists (ropinirole, pramiprexole, bromocriptine)

Answer 38

incr compulsive bx sleep attacks orthostatic HoTN

Question 39

when can you withdraw seizure meds

Answer 39

what seizure free for 2 years (and doesn't have exception of lifelong seizure d/o)

Question 40

BP goal if use tPA

Answer 40

less than 180/105 for 24 hours after giving tPA

Question 41

migraine with aura, don't use what med

Answer 41

OCPs!

Question 42

migraine tx in breastfeeding mother

Answer 42

sumatriptan | frovatriptan