NEURO 4

Question 1

pseudotumor cerebra classically presents as a waxing and waning HA and intermittent visual obscuration.

What is the diagnostic test of choice?

Answer 1

Diagnosis = LP with opening pressure >20 mmHg is diagnostic.

Question 2

What is the mainstay treatment for Pseudotumor cerebra?

Answer 2

Pharmacological = mainstay

Acetazolamide OR Prednisone.

• other option include serial LP, VP shunt or LumbarPeritoneal shunt.

Question 3

What is the criteria for Migraine without AURA?

Answer 3

WITHOUT AURA:

1. At least 5 HA lasting 4-72 hours (treated or not)
2. And at least 2/4 of following:
   - unilateral
   - pulsatile
   - Mod - Severe intensity
   - aggravated by walking up stairs of similar activity.

Question 4

What are the 3 inclusion criteria for T-PA administration in the stroke?

What are the exclusion criteria for T-PA administration?

Answer 4

Inclusion Criteria:

1. stroke within 3 hours.
2. CT excluded intracranial hemorrhage
3. Neurological deficit measurable on NIH stoke scale.

Exclusion Criteria:

1. Rapidly improving stroke symptoms
2. Prior ICH
3. BP >185/110
4. Major surgery <14 days
5. stroke of head injury in 3 months
6. GI or GU bleed in 3 weeks
7. PT >15 or INR >1.7 (anticoagulant use)
8. Heparin use in 72 hours
9. PLatelet <100
10. Blood Glucose <50 or >400
11. Seizure with stroke.

Question 5

What is the only FDA approved treatment for Restless Leg Syndrome?

What are the three other non-fda approved meds for RLS?

What is the MOA of these drug?

Answer 5

Ropinirole (Requip)

Bromocriptine, Pergolide, Premipexole

Dopamine Agonist.

Question 6

RLS is usually idiopathic but are associated with what three conditions?

Answer 6

1. Iron deficiency
2. Polyneuropathy
3. Uremia

Question 7

Describe left medullary syndrome? Also called Wallenberg’s Syndrome.

Answer 7

Brain stem stroke usually due to vertebral artery stroke affecting the L medulla. Resulting in syndrome of…

1. Ipsilateral Horners
2. Ipsilateral loss of pain and temp sensation of FACE
3. Contralateral loss of pain and temp sensation in BODY
4. Cerebellar Ataxia
5. Weakness of vocal cords, pharynx, palate (dysarthria).

Question 8

What is the most common cause of AIDS related retinopathy (visual disturbance)?

Answer 8

Cytomegalovirus

Accounts for 30 % of HIV-related retinopathy

Question 9

What are the common treatments for STATUS EPILEPTIUS?

Answer 9

1. RECAL OR IV DIAZEPAM
2. IV LORAZEPAM
3. IV PHENYTOIN OR FOSPHENYTOIN (Not IM, bc erratic absorption)
4. IV VPA

Question 10

What is the classic presentation of Guillain Barre Syndrome

Answer 10

1. Ascending motor paralysis starting in LE
2. Diminished DTR
3. Variable sensory deficits/paresthesias

Following URI or GI infection..