Neuro

Question 1

Meniere’s disease –> triad of ssx?

Answer 1

• vertigo
• hearing loss/fullness/tinnitus
• unrelated to movement

Question 2

Meniere’s disease –> vertigo episodes –> duration?

Answer 2

~30min

Question 3

BPPV –> vertigo episodes –> duration?

Answer 3

<1min

Question 4

labyrinthitis/vestibular neuritis –> why is it a diagnosis of exclusion?

Answer 4

• pontine strokes/tumors also feature chronic vertigo

- recent URI often goes unnoticed

Question 5

labyrinthitis/vestibular neuritis –> how long to resolve?

Answer 5

months

Question 6

Meniere’s disease –> tx?

Answer 6

• thiazide diuretics
• low salt diet
• meclizine

Question 7

central vertigo from posterior fossa lesion –> etiology ddx (6)?

Answer 7

• MS
• CVA
• tumor
• abscess
• migraine
• sz

Question 8

pseudotumor cerebri –> occurs in who?

Answer 8

young obese F taking isotretinoin & OCPs

Question 9

drug overdose –> hyperNa, met acidosis, hypoCa, elevated ammonia, mild elevated AST/ALT –> what drug?

Answer 9

valproic acid

Question 10

what allele increases risk for Alzheimer’s?

Answer 10

apolipoprotein E4

Question 11

Alzheimer’s –> volumetric MRI finding

Answer 11

• hippocampal asymmetry

- medial temporal lobe asymmetry

Question 12

pseudotumor cerebri –> tx

Answer 12

• carbonic anhydrase inh (acetazolamide)

- systemic steroid

Question 13

pseudotumor cerebri –> trt w acetazolamide –> goal of treatment

Answer 13

prevent blindness

Question 14

L temporal AVM ruptures –> what condition?

Answer 14

subarachnoid hemorrhage

Question 15

B12 deficiency –> presentation

Answer 15

• peripheral sensory neuropathy (stocking-glove)
• decreased DTR
• fatigue

Question 16

B12 deficiency –> causes (3)

Answer 16

• pernicious anemia
• surgical resection of terminal ileum
• achlorhydria

Question 17

34F –> hearing loss for 6mo –> Rinne test shows bone conduction is longer than air conduction –> mother also has hearing loss

what condition?

Answer 17

otosclerosis

Question 18

Rinne test –> bone conduction is longer than air conduction –> what type of hearing loss?

Answer 18

conductive hearing loss

Question 19

otosclerosis –> what reflex is abnormal?

Answer 19

loss of stapedial reflex

Question 20

MCC of headache in children

Answer 20

migraine

Question 21

cluster HA –> tx

Answer 21

O2

Question 22

cluster HA –> 2nd line tx

Answer 22

triptan

Question 23

cluster HA –> prophylaxis

Answer 23

verapamil

Question 24

cluster HA –> workup

Answer 24

MRI head

Question 25

pseudotumor cerebri (idiopathic intracranial HTN) --> dx

Answer 25

LP --> opening pressure >25

Question 26

pseudotumor cerebri (idiopathic intracranial HTN) --> finding on imaging

Answer 26

normal

Question 27

mercury poisoning --> tx

Answer 27

chelating agent: - succimer - penicillamine - dimercaprol

Question 28

exam shows fluid behind L ear --> Weber test shows louder vibration on left dx?

Answer 28

L conductive hearing loss

Question 29

conductive hearing loss --> Weber test result

Answer 29

affected ear --> detect sound longer

Question 30

sensorineural hearing loss --> Weber test result

Answer 30

affected ear --> detect sound shorter

Question 31

Rinne test --> tuning fork at mastoid --> switch to air --> patient does not hear dx?

Answer 31

conductive hearing loss

Question 32

status epilepticus --> mult doses of lorazepam --> but sz continues --> next step

Answer 32

phenytoin

Question 33

status epilepticus --> mult doses of lorazepam --> phenytoin --> but sz continues --> next step

Answer 33

midazolam + propofol

Question 34

generalized sz --> tx

Answer 34

- valproate (cheapest --> probably correct answer on exam) - lamotrigine - levetiracetam (less AE)

Question 35

generalized sz vs myoclonic sz

Answer 35

generalized: - whole body shaking - LOC myoclonic: - no LOC - increased muscle tone

Question 36

myoclonic sz --> tx

Answer 36

valproate

Question 37

atonic sz --> tx

Answer 37

valproate

Question 38

pseudosz --> dx

Answer 38

24hr EEG w video monitoring --> induce sz w stimuli and sleep deprivation

Question 39

status epilepticus --> dx

Answer 39

- sz >5min | - post-ictal state >20min

Question 40

50M homeless --> h/o esophageal varices --> ER --> lethargy, absent lateral gaze, ataxia condition?

Answer 40

Wernicke's encephalopathy

Question 41

Wernicke's encephalopathy --> presentation (triad)

Answer 41

- confusion - ophthalmoplegia - ataxia

Question 42

Wernicke's encephalopathy --> cause

Answer 42

thiamine (B1) def

Question 43

lumbar stenosis --> sit or lean forward --> pain worse or better?

Answer 43

pain is better

Question 44

red flag ssx of cord compression --> next step

Answer 44

dexamethasone give steroid BEFORE get imaging!

Question 45

- painless progressive vision loss - color desaturation what condition?

Answer 45

vitB12 def

Question 46

Guillain-Barre synd --> tx

Answer 46

- plasmapheresis | - IVIG

Question 47

vertical nystagmus, myoclonus, 3+ reflexes bilaterally what vit/electrolyte deficiency?

Answer 47

Mg def

Question 48

Mg def --> presentation

Answer 48

muscular & neurologic hyperactivity

Question 49

differentiate: cauda equina synd vs conus medullaris synd

Answer 49

cauda equina: - unilat - LMN signs only conus medullaris: - bilat - UMN & LMN signs

Question 50

cauda equina synd --> surgical decompression must be performed within how many hours of symptom onset?

Answer 50

48hr

Question 51

CN III palsy --> persentation

Answer 51

- ptosis | - eye down & out

Question 52

CN III palsy --> can be caused by aneurysm of what?

Answer 52

posterior communicating artery aneurysm

Question 53

post-dural puncture HA (spinal HA) --> worsening despite conservative measures (bed rest, tylenol, caffeine, fluids) --> tx?

Answer 53

epidural blood patch --> inject venous blood into epidural space --> immediate relief

Question 54

Guillain-Barre synd -> how dx?

Answer 54

- nerve conduction study | - LP

Question 55

Guillain-Barre synd -> CSF results

Answer 55

- increased protein | - normal WBC