neurogeneral2

Question 1

patient with n. meningitidus; treat close contacts with what?

Answer 1

rifampin or cipro

Question 2

facilal palsy new jersey in the summer versus chicago in the winter

Answer 2

new jersey lyme; chicago herpes

Question 3

treatment of herpes facial palsy

Answer 3

steroids; the addition of antivirals is less clear but many would add one of the cyclovirs

Question 4

raw honey fed to a new born

Answer 4

tetanus

Question 5

congenital CMV

Answer 5

hearing loss, spasticity, hyperintensities along ventricular margins on MRI

Question 6

which is more mild- becker’s or duchenne’s muscular dystrophy

Answer 6

becker’s

Question 7

subependymal nodules

Answer 7

tuberous sclerosis

Question 8

treatment of tourette’s

Answer 8

haloperidol or risperidone

Question 9

treatment for acute intermittent porpyria

Answer 9

IV hematin

Question 10

what drugs ppt acute intermittent porphyria

Answer 10

sulfonamides, hormones, barbituates

Question 11

McArdle’s disease

Answer 11

this is a glycogen storage disease; exercise-induced muscle cramping, weakness, dark urine

Question 12

balance problems, kyphoscoliosis, and pes cavus

Answer 12

freidrich’s ataxia (inherited); chrom 9q13; visual loss can occur later;

Question 13

features of myotonic dystrophy

Answer 13

failure of muscles to relax, ptosis, type 2 DM, hypothyroidism, frontal balding; and a slow course compatible with presentation in mid-adult life

Question 14

taking isoniazid for TB prophylaxis puts you at risk for deficiency of what?

Answer 14

pyridoxine (B6); causes a polyneuropathy

Question 15

organophospate poisoning presentation

Answer 15

nausea, vomitting, diaphoretic, and diffusely weak with pinpoint pupils; has both muscarinic and nicotinic effects;

Question 16

how do organophosphates work?

Answer 16

they are anti-acetylcholinesterases (can’t break down ach, so too much of it)

Question 17

PCP and cocaine pupils

Answer 17

dilated

Question 18

Vit E def

Answer 18

spinal and cerebellar signs; maybe associated with colectomy

Question 19

lead poisoning

Answer 19

autonomic signs and extensor muscle weakness

Question 20

phenytoin or carbamazepine excess

Answer 20

cerebellar signs

Question 21

manifestations of manganese excess

Answer 21

tremulous and cogwheeling

Question 22

how do you get manganese excess?

Answer 22

goes to the basal ganglia; seen in cirrhosis

Question 23

microcytic anemai

Answer 23

lead poisoning

Question 24

syringomyelia assoc with what

Answer 24

arnold chiari malformation

Question 25

arnold chiari malform

Answer 25

cerebellar tonsils lie low in the posterior fossa and squeeze the brainstem;

Question 26

anterior interosseus nerve entrapment

Answer 26

can't make a pinch with the first finger and thumb

Question 27

weakness in eaton lambert syndrome

Answer 27

improves with exertion

Question 28

plantar flexion

Answer 28

tibial nerve

Question 29

dorsiflexion of the foot

Answer 29

peroneal nerve

Question 30

donepezil

Answer 30

for alzheimers; cholinesterase inhib (so pro-Ach)

Question 31

pyridostigmine

Answer 31

also a cholinesterase inhib, but this is used for MG

Question 32

toxo treatment

Answer 32

pyrimethamine/sulfadizine

Question 33

nucleus basalis of meynert

Answer 33

lesion here assoc with Alzheimers

Question 34

parkinsons

Answer 34

globus pallidus tremor

Question 35

hemiballisms localizes where

Answer 35

subthalamic nucleus; lacunar stroke can give you lesion here

Question 36

Parinaud's or dorsal midbrain syndrome

Answer 36

lesion in the brainstem with paralysis of upgaze, argyll-robertson (pseudo) pupils, and nystagmus

Question 37

surgery where for PD?

Answer 37

subthalamic nuc

Question 38

pronate the forearm

Answer 38

radial nerve

Question 39

Saturday night palsy

Answer 39

radial nerve

Question 40

causes of wallenberg syndrome

Answer 40

posterior inferior cerebellar artery or vertebral artery occlusion

Question 41

right beating nystagmus

Answer 41

lesion in the left brainstem

Question 42

pregnant woman develops HA, lethargy, and generalized seixzure

Answer 42

think venous sinus thrombosis; treat with heparin/warfarin;

Question 43

indic for warfarin

Answer 43

a-fib, decr ejection fraction, mural thrombus, atrial clot, mechanical valves, DVT. Heparin for dissection

Question 44

treatment of cataplexy

Answer 44

modafinil (wakefulness promoting agent)

Question 45

REM sleep disorder can sometimes be a harbinger of what?

Answer 45

parkinsons

Question 46

neuroleptic malig syndrome

Answer 46

adverse reaction to anti-psych drugs

Question 47

how to treat neuroleptic malignant syndrome

Answer 47

dantrolene, a direct skeletal muscle relaxant, or benzos

Question 48

what are the HAM side effects and what drugs have them?

Answer 48

anti-Histamine, anti-adrenergic, anti-muscarinic; found in TCAs an dlow potency antipsychotics

Question 49

anti-histamine

Answer 49

sedation, weight gain

Question 50

anti-adrenergic

Answer 50

hypotension

Question 51

anti-muscarinic

Answer 51

dry mouth, blurred vision, urinary retention

Question 52

serotonin syndrome

Answer 52

confusion, flshing diaphoresis, tremor, myoclonic jerks, hyperthermia, hypertonicity, rhabdomyolysis, renal failure, and death

Question 53

what causes serotonin syndrome

Answer 53

SSRIS and MAOIs are combined

Question 54

what causes hypertensive crisis

Answer 54

build up of stored catecholamines; MAOIs plus foods with tyramine or plus sympathomimetics

Question 55

extrapyradimal side effects

Answer 55

symptoms are parkinsonism, akathisia, and dystonia

Question 56

what causes the extrapyramidal side effects

Answer 56

traditional anti-psychotics

Question 57

what drugs cause hyperprolactinemia?

Answer 57

traditional anti-psychotics and risperidone

Question 58

tardive dyskinesia

Answer 58

occurs after years of anti-psychotic use

Question 59

lead pipe rigidity

Answer 59

neuroleptic malignant syndrome (medical emergency; high mortality)

Question 60

how does carbamazepine affect CYP450?

Answer 60

induces