Neuro

Question 1

obese female w/HA and diplopia

Answer 1

Psuedotumor Cerebri

Question 2

how to tx SAH

Answer 2

Decrease the incidence of rebleed keep MAP <130 (IV Labetalol, PO Nimodipine [decreases vasospasm])

Question 3

HA in a pregnant pt you have to r/o this

Answer 3

venous thrombosis

Question 4

how to tx a CSF leak

Answer 4

Lay flat, IV Caffeine, Blood Patch

Question 5

abortive migraine tx

Answer 5

Triptans, IV Reglan, Chlorpromazine (Thoazine), Prochlorperazine (Compazine), DHE(DihydroErgotamine) IV Infusion, NSAIDS

Question 6

how to tx eclampsia (Pregnancy, Headache, Proteinuria, Elevated BP, Seizure)

Answer 6

Mag Sulfate

Question 7

Retro-orbital/Temporal, Suicidal Ideation, occurs daily for weeks then resolves, Lacrimation, Rhinorrhea, Conjunctival Injection

Answer 7

cluster HA

Question 8

how long till you cant give TPA

Answer 8

3 hours

Question 9

anterior cerebral artery stroke will affect the

Answer 9

legs

Question 10

middle cerebral artery stroke will affect the

Answer 10

arm, face, speech

Question 11

posterior circulation stroke will affect

Answer 11

visual, dizziness, diplopia, ataxia, CN deficits, vertigo, Cranial Nerve Deficits, B/L limb weakness, Locked in Syndrome (they are aware of what is going on they just have all these defcicits)

Question 12

chiropractic manipulation, lifting weights, straining

can result in

Answer 12

cervical artery dissection,

Treated with Antiplatelets (Aspirin, Plavix) Anticoagulation

Question 13

nervous system response to increased intracranial pressure (ICP) that results in

Answer 13

Cushing’s triad of increased blood pressure, irregular breathing, and bradycardia

Question 14

Dysdiadochokinesia

Answer 14

-clumsy/rapidly alternating movements

Question 15

-over/undershoot (heel to toe, can’t feel it)

Answer 15

dysmetria

Question 16

can be impaired in syphilis and Vitamin B12 deficiency

Answer 16

Impaired vibratory/position sense-posterior column

Question 17

how to dx and tx vertigo

Answer 17

*Dix Halpike for diagnosis
*Epley Maneuver is curative
Tx: Benadryl, Meclizine, Reglan, Scopolamine Patch, Benzos

Question 18

Tonic (rigid) Clonic (rhythmic jerking movements

Answer 18

grand mal

Question 19

LOC, without loss of postural tone, appear confused

Answer 19

petit mal

Question 20

Hallucinations, Memory Complaints, Disoriented Perception

Answer 20

complex partial

Question 21

> 5 minutes continuous or intermittent without recovery of consciousness

Answer 21

status epilepticus

Question 22

HTN, Seizure, Headache, Proteinuria, >20 weeks gestation or 3 weeks postpartum

Answer 22

eclampsia

Question 23

Symmetric Ascending Weakness, Decreased DTRs

CSF elevated Protein, Normal Cell Count

Answer 23

GBS

Question 24

UMN LMN dysfunction

Answer 24

ALS

Question 25

Proximal Muscle Weakness, Fatigue, Ptosis, Diplopia, progress to Respiratory Muscle Weakness (Dyspnea/Fatigue) Symptoms get worse throughout the day

Answer 25

MG

Question 26

how to dx and tx MG

Answer 26

Dx: Ach receptor Antibodies! EMG rep stim, Edrophonium (Tensilon Test)- administer Edrophonium, if symptoms get worse it indicates cholinergic crisis and you may have to intubate. What?! No change in symptoms, assume Myasthenia gravis Treatment Neostigmine, Pyridostigmine (Mestinon, Timespan)

Question 27

Motor, Sensory, Visual (Optic Neuritis) | Relapsing and remitting (90%)

Answer 27

MS

Question 28

how to tx MS

Answer 28

Methylprednisolone (acute exacerbation), Interferon (chronic)

Question 29

Resting Tremor, Cogwheel Rigidity, Bradykinesia, Pill Rolling, Orthostatic Hypotension, Masked Face, Shuffling Gait

Answer 29

PD

Question 30

bacterial meningitis blood count

Answer 30

high protein, low glucose

Question 31

viral meningitis blood count

Answer 31

Glucose elevated, Protein elevated

Question 32

how to tx miningitis

Answer 32

cef/vanco | >50 add ampicillin

Question 33

HSV-affects frontotemporal region bilaterally. Can be seen as enhancement on MRI and EEG reveals bitemporal epileptiform discharges

Answer 33

encephalitis