Neuro

Question 1

Posterior reversible encephalopathy syndrome

Answer 1

B/l vasogenic edema
HA, AMS, visual disturbance, seizure
Treat: Lower blood pressure (labetolol or nicardipine)

Question 2

Dix-Hallpike

Answer 2

Pt upright, head 45 degrees, lay down. (+ if nystagmus)

Question 3

CSF fungal menigitis

Answer 3

Elevated opening pressure
Lymphocyte predominance
Low glucose (<60% serum level)

Question 4

Anterior cord syndrome

Answer 4

Caused by flexion of vascular injury
Loss of motor, pain and temp below injury
Retain proprioception and vibratory
Poor prognosis

Question 5

Central cord syndrome

Answer 5

Caused by forced hyperextenion
UE > LE sensory and motor deficits

Question 6

Brown-Sequard syndrome

Answer 6

Caused by penetrating trauma
Ipsilateral loss of motor, vibratory and proprioception
C/L loss of pain and temperature
Good prognosis

Question 7

Dementia with parkinson’s features

Answer 7

Lewy body

Question 8

Cerebral venous sinus thrombosis

Answer 8

Pts with prothrombic states
Headache, visual changes, papilledema
MRI with venography
Give heparin

Question 9

Stroke in right frontal cerebral cortex

Answer 9

Leg weakness and numbness (ACA)

Question 10

Stroke of middle cerebral artery

Answer 10

Temporal, parietal, internal capsule and posterior frontal lobe
CL hemiparesis, facial droop, sensory loss
Dominant lobe involvement will cause aphasia

Question 11

Posterior stroke

Answer 11

Ataxia, nystagmus, dysarthria

Question 12

CSF viral meningitis

Answer 12

Normal opening pressure, lymphocytic predominance, normal glucose, negative cultures

Question 13

Epidural hematoma

Answer 13

Side blow
Middle meningeal
Talk and die
Reduce IC pressure, seizure prophylaxis

Question 14

Wernicke-Korsakoff

Answer 14

Wernicke leads to Korsakoff
Thiamine (B1), pyridoxine (B6), and folate deficiency
Confabulation, gait disturbance, opthalmaplegia
Korsakoff had amnesia

Question 15

What to give in hyporeflexia etc in refeeding syndrome

Answer 15

IV phosphorus

Question 16

Normal pressure hydrocephalus treatment?

Answer 16

High volume CSF removal

Question 17

Classic presentation of headache associated with tumor

Answer 17

Worse upon awakening, worsened by Valsalva maneuver, positional, and associated with N/V

Question 18

Idiopathic intracranial hypertension

Answer 18

Obese women ages 20 to 44
HAs, transient vision disturbances, back pain, and pulsatile tinnitus
Can lead to permanent vision loss
Oral acetazolamide 250 to 500 mg twice a day

Question 19

Criteria to diagnose temporal arteritis
What to do in ER

Answer 19

> 50, new headache, temporal artery abnormality, ESR >50
Empiric treatment with oral prednisone 60 mg daily, consult optho

Question 20

Symptoms of anterior cerebral artery stroke

Answer 20

Contralateral leg weakness and sensory changes

Question 21

Symptoms of middle cerebral artery stroke

Answer 21

Contralateral hemiparesis (arm > leg), facial plegia, and sensory loss

Question 22

Symptoms of basilar artery occlusion

Answer 22

Oculomotor signs, Horner’s syndrome, and rarely, a “locked-in” state

Question 23

Dosing tpa

Answer 23

0.9 mg/kg IV, with a maximum dose of 90 mg; 10% of the dose is administered as a bolus, with the remaining amount infused over 60 minutes

Question 24

ICP reduction

Answer 24

Head elevation to 30°, analgesia, and sedation
Osmotic diuretics or intubation with neuro- muscular blockade with mild hyperventilation

Question 25

Glioblastoma on imaging

Answer 25

Irregular, heterogenous lesion with peripheral enhancement
Spread along corpus colosum: butterfly glioma

Question 26

Medulloblastoma

Answer 26

Most common malignant tumor in kids
Form in cerebellum: dizziness, N/V, CN VI palsy

Question 27

Glioblastoma

Answer 27

Most common tumor in adults
Rapid onset of symptoms (<3 months)

Question 28

Korsakoff

Answer 28

Due to thiamine deficiency
Confabulations, apathy, short term memory loss

Question 29

Decompression sickness

Answer 29

In 6 hours of diving
Bends/chokes/staggers
Hyperbaric chamber