N5

Question 1

contralateral hemiparesis and hemisensory loss
homonymous hemianopsia
gaze palsy

Answer 1

basal ganglia hemorrhage

Question 2

usually no hemiparesis
facial weakness
ataxia and nystagmus
occipital headache and neck stiffness

Answer 2

cerebellum hemorrhage

Question 3

contralateral hemiparesis and hemisensory loss
nonreactive miotic pupils
upgaze palsy
eyes deviate towards hemiparesis

Answer 3

thalamus hemorrhage

Question 4

contralateral hemiparesis (frontal)
contralateral hemisensory loss (parietal lobe)
homonymous meianopsia (occipital lobe)
eyes deviate away from hemiparesis
high incidence of seizures

Answer 4

cerebral lobe hemorrhage

Question 5

deep coma and total paralysis within minutes

pinpoint reactive pupils

Answer 5

pons hemorrhage

Question 6

intraparenchymal brain hemorrhage versus subarachnoid hemorrhage or embolic stroke

Answer 6

onset of symptoms for intraparenchymal hemorrhage is not maximal - it gets worse - not the case for subarachnoid hemorrhage or embolic stroke

Question 7

most hypertensive hemorrhages occur in what blood vessels

Answer 7

most except cerebellar occur in the same blood vessels responsible for lacunar strokes

Question 8

where do hypertensive hemorrhages occur more frequently than lacunar strokes

Answer 8

cerebellum

Question 9

cerebellar hemorrhages present with

Answer 9

occipital headache
vomiting
dizziness
gait ataxia
-usu NO HEMIPARESIS

Question 10

dense hemiplegia and facial palsy indicate

Answer 10

a lesion/pressure on the internal capsule with resultant disruption of the corticospinal tract

Question 11

pontine hemorrhage present with

Answer 11

• complete paraplegia followed by deep coma within a few minutes
• pupils are pinpoint but reactive to light
• decerebrate rigidity is present

Question 12

brief - minutes - episodes of impaired consciousness, failure to respond to various stimuli during the episode, staring spells, automatisms, post ictal confusion

Answer 12

complex partial seizure

Question 13

automatisms

Answer 13

lip smacking, swallowing, picking movements of the hand

Question 14

EEG pattern for complex partial seizures

Answer 14

usually normal or may show brief discharges

Question 15

hyperventilation during the EEG stimulates seizure

Answer 15

absence not complex partial seizure

Question 16

brief (seconds) periods of impaired consciousness with or without automatisms

Answer 16

absence seizures - no post ictal state -

Question 17

hyperventilation on EEG reveals a generalized 3Hz spike and wave pattern on a normal background

Answer 17

absence seizure

Question 18

EEG pattern of slow spike and wave acitivity with a frequency of less than 2.5 Hz

Answer 18

atypical absence seizure

Question 19

adolescent with unilateral or bilateral myoclonic jerks

Answer 19

juvenile myoclonic epilepsy

Question 20

juvenile myoclonic epilepsy symptoms

Answer 20

take place in the morning and may be precipitated by sleep deprivation

Question 21

seizures of multiple types, impaired cognitive function and slow spike and wave activity on EEG

Answer 21

Lennox Gastaut syndrome

Question 22

diabetic neuropathy and a feeling of imbalance

Answer 22

involvement of the nerves that control proprioception

Question 23

diabetic neuropathy and motor symptoms

Answer 23

motor is usually a late manifestation of severe diabetic neuropathy

Question 24

diabetic neuropathy is UMN or LMN

Answer 24

LMN

Question 25

questioning a diabetic patient with UMN signs about fever

Answer 25

prone to epidural abscesses that may impact the spine | MRI of the spine to evaluate for cord compression

Question 26

contralateral hemianesthesia that can be accompanied by transient hemiparesis, athetosis or ballistic movements

Answer 26

thalamic stroke

Question 27

thalamic stroke aka

Answer 27

Dejerine Roussy syndrome

Question 28

Dejerine Roussy syndrome is caused by

Answer 28

a stroke involving ventral posterolateral nucleus of the thalamus

Question 29

job of VPL

Answer 29

transmits sensory information from the contralateral side of the body

Question 30

dysesthesia of the area affected by the sensory loss

Answer 30

is characteristic of Dejerine Roussy syndrome and = thalamic pain phenomenon

Question 31

sensory stroke due to involvement of somatosensory cortex vs those due to VPL involvement

Answer 31

somatosensory cortex stroke are not characterized athetosis or significant dysesthesia

Question 32

hemi-sensory loss with severe dysesthesia of the affected area is typical for

Answer 32

a thalamic stroke

Question 33

signs and symptoms of heat stroke

Answer 33

``` temperature > 40 or 105 altered mental status hypotension tachycardia tachypnea ```

Question 34

volume status for heat stroke patients

Answer 34

moist or dry skin | usually not volume depleted

Question 35

body temperature of 41 may cause

Answer 35

rhabdomyolysis and organ system damage

Question 36

large blood on dipstick with no red blood cells by microscopy on urinalysis suggests

Answer 36

rhabdomyolysis - the result of muscle breakdown

Question 37

cause of heat stroke

Answer 37

thermoregulatory center fails to dissipate heat at the rate necessary to maintain a euthermic state inadequate fluid and salt replacement may contribute to heat stroke but it does not cause it

Question 38

underlying pathophysiology of fever

Answer 38

cytokine activation during inflammation

Question 39

underlying pathophysiology of malignant hyperthermia

Answer 39

uncontrolled efflux of calcium from the sarcoplasmic reticulum

Question 40

malignant hyperthermia inheritance

Answer 40

autosomal dominant

Question 41

malignant hyperthermia drugs

Answer 41

halothane and succinylcholine

Question 42

inadequate sodium and water replacement during physical activity

Answer 42

can lead to heat exhaustion due to the body's inability to maintain adequate cardiac output -core body temp

Question 43

hypertrophic cardiomyopathy causes

Answer 43

cardiac outlet obstruction

Question 44

hypertrophic cardiomyopathy often occurs in

Answer 44

young physically active individuals

Question 45

presenting symptoms for hypertrophic cardiomyopathy

Answer 45

dyspnea, palpitations, syncope and sudden cardiac death

Question 46

MS may present with

Answer 46

bilateral trigeminal neuralgia

Question 47

MS age of presentation

Answer 47

third or fourth decade of life

Question 48

Parkinson's age of presentation

Answer 48

during the 5th or 6th decade of life and is a progressive disorder

Question 49

parkinson's presentation

Answer 49

mask like face with decreased spontaneous movements

Question 50

Huntington chorea age of presentation

Answer 50

during the third or fifth decade of life

Question 51

huntington disease inheritance

Answer 51

autosomal dominant

Question 52

huntington disease presentation

Answer 52

depression, choreiform movements and subcortical dementia | caudate atrophy on CT

Question 53

usually occurs in the summer months and is caused by an echovirus

Answer 53

aseptic meningitis

Question 54

aseptic meningitis presentation

Answer 54

flu like illness, malaise, vomiting, photophobia, stupor and fever

Question 55

bilateral trigeminal neuralgia

Answer 55

in a young female suspect MS