Neurology

Question 1

Cortical spreading depression

Answer 1

Assoc: trauma, migraines, hemorrhage (Rx magnesium, topiramate)

Question 2

Sotagliflozin (sglt1 and SGLT2 inhibitor)

Answer 2

May reduce stroke risk

Question 3

Cognitive motor dissociation

Answer 3

Functional MRI
EEG

Question 4

Albuminocytologic dissociation

Answer 4

Guillain-Barre
Elevated CSF protein
Normal white blood cell count

Question 5

New stroke and New afib

Answer 5

1. Minor to moderate-after 48 hrs DOAC
2. Major stroke 6-7 days start DOAC Fischer U et al NEJM 2023

Question 6

NIHSS <3, stroke OR
ABCD2 of 4 or more, 21 days of dual antiplatelet

Answer 6

Ticagrelor (if plavix unresponsive) and aspirin

Question 7

Carotid stenosis 70-99% , fix it.

Question 8

Intracranial stenosis 90 days dual antiplatelet treatment

Question 9

Guillén Barre

Answer 9

Paresthesias and weakness
FVC/MIF (MIF negative value) NORMAL >20cc/kg
EMG/NCS

Question 10

Upper motor exam

Answer 10

1. Pronator drift
2. Fine finger movements (toe tap
3. Finger extensors, big toe extensors

Question 11

Falls in elderly

Answer 11

1. Parkinson
2. Neuropathy
3. Cervical myelopathy (Lhermitte sign

Question 12

Afib burden

Question 13

G

Question 14

G

Question 15

High ICP TREATMENT

Answer 15

Goal is to get blood out of brain
Head of bed > 30 degrees
Mannitol reduce
Cerebral perfusion pressure = MAP-ICP

Question 16

Meningitis

Answer 16

1. Vancomycin q6 hrs
2. CTX 2g q12
3. Amp 2g q4 (bactrim)
4. DEXA 10 q 6 hrs

Question 17

Aphasia testing

Answer 17

1. Fluency naming , conversation
2. Comprehension: follows difficult tasks
3. Repetition: today is a sunny day

Question 18

Attention span:

Answer 18

Five digits
24637

Question 19

New brain mass

Answer 19

Tumefactive multiple sclerosis

Question 20

Attention span

Answer 20

Digits forward 5724631

Question 21

Aphasia testing

Answer 21

Fluency
Comprehension (follows difficult commands)
Repetition “today is a sunny day)

Question 22

Aphasia: repetition, fluency, comprehension

Answer 22

Broca lesion: fluency bad, repetition bad
Wernicke: repetition bad, comprehension bad
Conduction, repetition bad (fluency and comprehension good)

Question 23

Speech
Fluency: naming, conversation
Comprehension: complex commands
Repetition “today is a sunny day

Question 24

Aphasia

Answer 24

Broca= poor fluency
Conduction = poor repetition
Wernicke = poor comprehension

Question 25

Cranial nerves II pupils, acuity, visual fields 3,4,6 extra ocular movements 5 sensation

Answer 25

7 facial strength 8 hearing 9, 20 palatal elevation XI SCM, trapezius XII TONGUE

Question 26

Do not add aspirin to pts on AC and stroke

Answer 26

European stroke journal 2023 Volume 8(3)722-730

Question 27

Headache

Answer 27

Vascular, infection, inflammation, neoplastic,

Question 28

Levels of consciousness

Answer 28

Alert, lethargy, obtunded, stupor, coma

Question 29

Light headed

Answer 29

Decrease perfusion to CNS Increased vagal tone VTE Dysrhythmia Blood loss

Question 30

Vertigo, disequilibrium

Answer 30

Disorders affecting the posterior circulation (TIA, ischemic, hemorrhagic, Cerebral venous sinus thrombosis Space occupying lesion Infection Inflammation Posterior reversible encephalopathy syndrome Reversible cerebral vasoconstriction

Question 31

MRI

Answer 31

Diffusion weighted images- look for restricted diffusion: thrombosis Susceptibility weighted images look for microhemorrhage associated with fat embolism

Question 32

PRES POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME

Answer 32

Vision changes, nausea, vomiting, headache, seizure