Neuro

Question 0

What is the dominant sx of Alzheimer’s?

Answer 0

Anterograde amnesia

Question 1

Most common cause of dementia in adults?

Answer 1

Alzheimer’s

Question 2

What shows cortical atrophy with neurofibrillary tangles and senile plaques on biopsy?

Answer 2

Alzheimer’s

Question 3

Loss of recent memory, word finding problems, mood swings, personality changes, issues with drawing and driving see what stage of Alzheimer’s?

Answer 3

Early

Question 4

Inability to recall information, diminished memory of remote events, behavioral changes, loss of sense of time and place, help with getting dressed and feeling are signs of what stage of Alzheimer’s?

Answer 4

Intermediate

Question 5

When can definitive dx of Alzheimer’s be done?

Answer 5

Autopsy

Question 6

What is a medication to treat Alzheimer’s?

Answer 6

Acetylcholinesterase inhibitors Donepezil

Question 7

Avoid what typed of Meds in Alzheimer’s?

Answer 7

Anti cholinergic , haldol, OTC cold Meds

Question 8

What is the hallmark sign of cerebral palsy?

Answer 8

Delay in normal milestones

Question 9

What causes. Cerebral palsy?

Answer 9

Some hypoxic event during fetal growth, treat with therapy

Question 10

What is Bell’s palsy?

Answer 10

Facial paresis of lower motor neuron of 7 th cranial nerve.

Question 11

What is a progressive, ascending, symmetric weakness with variable paresthesias?

Answer 11

Giullian-barre syndrome

Question 12

What is Gillian barre associated with?

Answer 12

Viral, flu vaccine, stress, campylobacter jejuni

Question 13

What does the EMG show with Gillian barre?

Answer 13

Demyelination

Question 14

What is the treatment for Gillian barre?

Answer 14

IV immunoglobin, plasma exchange, DO NOT GIVE STEROIDS

Question 15

What is an autoimmune disease that blocks acetyalcholine receptors?

Answer 15

Myasthenia gravis

Question 16

What are the common sx of myasthenia gravis?

Answer 16

Diplopia, dysphagia, facial weakness, difficulty swallowing, early stage affects the eye muscles, activity increases weakness.

Question 17

How to dx myasthenia gravis?

Answer 17

Test for acetylcholine recptor antibodies, or improvement with the Tensilon test. Treat with corticosteroids.

Question 18

This is a severe unilateral headache with facial issues.

Answer 18

Cluster headache. Common with injection, lacrimination, rhinorrhea, miosis, ele edema. Treat with oxygen or ergotamine.

Question 19

This is a headache which is unilateral, severe, aggravated by activity, 4-72 hrs and associated with photophobia and nausea and vomiting.

Answer 19

Migraine

Question 20

when do you give prophylactic treatment for a migraine and what are the options?

Answer 20

If it limits normal activity greater than 3 days a month, severe or has complications. Give propranolol or amitriptyline.

Question 21

This had a band like pain, bilateral pain, photophobia, nausea, no vomiting, and activity does not change the sx.

Answer 21

Tension headache. Most common caused by stress.

Question 22

How to treat tension headaches.

Answer 22

Acetaminophen, NSAIDs, amitriptyline

Question 23

What is an idiopathic increase in intracranial pressure causing headache, visual disturbance and CN 6 palsy?

Answer 23

Pesudotumor cerebri

Question 24

What is encephalitis and the number one cause?

Answer 24

Infection of brain parenchyma..... Herpes. Other causes are enters iris, EBV, CMV, etc.

Question 25

Patient t presents to clinic with complaint of fever, stiff neck, nausea, confusion, exaggerated DTR, spastic paralysis ( upper motor neuro n sx). What is the dx?

Answer 25

Encephalitis

Question 26

He do you treat encephalitis?

Answer 26

Supportive, acyclovir or gancyclovir if needed. NO steroids.

Question 27

A patient presents to clinic with complaint of headache, nucal rigidity, fever, confusion, seizures, brudzinski or kernig sign. Dx?

Answer 27

Meningitis

Question 28

CSF with mostly polymorphic neutrophils?

Answer 28

Bacterial meningitis

Question 29

CSF with high lymphocytes?

Answer 29

Viral meningitis

Question 30

Bacteria common in meningitis in neonates?

Answer 30

Gram neg bacilli, strep, listeria

Question 31

Bacteria common in meningitis in kinds up to 15?

Answer 31

H. Flu, n. Meningitidis, s. Pheumonae

Question 32

Bacteria causes meningitis in adults?

Answer 32

S. Pneumonaie, n. Meningitidis, listeria in over 60

Question 33

Meningitis empiric treatment for neonates!

Answer 33

Ampicillin + cefotaxime

Question 34

Meningitis empiric tx for kids/adults?

Answer 34

Cefotaxime + vancomycin

Question 35

Meningitis emperor tx for elderly?

Answer 35

Cefotaxime + amp + vanc

Question 36

A patient complains of a sudden headache, severe, altered mental status , vomiting. What do you suspect?

Answer 36

Ruptured cerebral aneurysm.

Question 37

How do you treat a cerebral aneurysm?

Answer 37

Nimodipine, surgery

Question 38

How long are the deficits of a CVA?

Answer 38

Over 24 hrs

Question 39

If deficit is less than 24 hrs?

Answer 39

TIA

Question 40

Most common site for CVA and sx?

Answer 40

Middle cerebral artery: contra lateral hemiplegia, sensory loss, aphasia

Question 41

CVA do the internal carotid causes?

Answer 41

Ipsilateral blindness

Question 42

CVA of the anterior cerebral artery causes?

Answer 42

Upper motor neuron weakness, urinary incontinence,

Question 43

CVA of the vertebral artery causes?

Answer 43

Vertigo, nausea vomiting, nystagmus

Question 44

CVA of the basilar artery causes?

Answer 44

Bilateral sensory, paralysis, impaired vision, cranial nerve dysfunction

Question 45

Where does the lacunar disease stem from and what is a common causes?

Answer 45

Circle of Willis, HTN

Question 46

Test of choice for suspected CVA?

Answer 46

Non contrast CT

Question 47

What is an essential tremor?

Answer 47

Involves hand or head, tremor without the rigidity of Parkinson's. Alcohol improves tremor, treat with propranolol.

Question 48

What are the manifestations of Huntington's chorea?

Answer 48

Flicking movement of extremities, lilting gait, facial grimace, ataxia,

Question 49

What is the dx and treatment. For Huntington's chorea?

Answer 49

Dx by genetic testing, supportive care only. May give haldol early.

Question 50

What causes Parkinson's disease?

Answer 50

Dopamine depletion in the basal ganglia.

Question 51

Patient has pill rolling tremor, mask like fancies, cog wheel extremities, shuffling gait. Think?

Answer 51

Parkinson's

Question 52

Most common treatment for Parkinson's?

Answer 52

Levodopa or bromocriptine

Question 53

This neuro disease presents with upper motor neuron sx and lower motor neuron sx. Describe these sx and what disease is it?

Answer 53

ALS or Lou gherigs dz. upper motor neuro. | N sx are spasticity, hyper reflexes, babinski up, and lower motor neuron are muscle atrophy, progressive weakness.

Question 54

What is the presenting sx of ALS?

Answer 54

Weakness and atrophy in the hands

Question 55

This is a slow likely autoimmune progressive CNS disease with patches of demyelination in the brain and spinal cord.

Answer 55

Multiple sclerosis

Question 56

Symptoms of MS?

Answer 56

Blurred vision, sensory abnormalities, weakness. Heat may worsen sx ( hot shower).

Question 57

What does the MRI of MS show?

Answer 57

Abnormal white matter in brain stem, cerebellum and spinal cord

Question 58

What is the treatment for MS?

Answer 58

No cure. Corticosteroids is the treatment with possible IV gamma globulins

Question 59

This seizure is from a single locus in the brain, consciousness is preserved, and had focal motor sx.

Answer 59

Simple partial seizure

Question 60

This seizure may have. Impaired consciousness, chewing movements or lip smacking.

Answer 60

Complex partial seizure.

Question 61

This seizure has imparted consciousness with mild components in kids staring is common.

Answer 61

Absence

Question 62

Seizure with no loss of consciousness but single or multiple myoclonus jerks.

Answer 62

Myoclonic

Question 63

Sudden loss of consciousness and rigid fall to the ground is classic for this seizure.

Answer 63

Tonic-colonic

Question 64

Most important test for seizures?

Answer 64

EEG.

Question 65

This head injury is a transient loss of consciousness followed by complete resolution in 7-10 days.

Answer 65

Concussion

Question 66

Key to dx a simple concussion?

Answer 66

No focal neurological findings on exam

Question 67

This is cause d by a rupture of the middle meningeal artery from a skull fracture. CT reveals a lens shaped hematoma.

Answer 67

Epidural hematoma

Question 68

This is an accumulation of blood in the brain for venous bleeding. CT shows a crescent shaped hematoma

Answer 68

Subdural hematoma

Question 69

Which hematoma has a brief period of unconsciousness the resolve, the returns again?

Answer 69

Epidural hematoma

Question 70

What hematoma can cause spinal fluid rhinorrhea?

Answer 70

Epidural

Question 71

This is the worst headache of life, stiff neck and delirium?

Answer 71

Subarachnoid hemorrhage.

Question 72

What is the most common brain neoplasm in adults?

Answer 72

Glioblastoma