Neurology

Question 1

What do COMT inhibitors do?

Answer 1

Prolong Levodopa effect

Question 2

Why use L-dopa, not dopamine in treating Parkinsons?

Answer 2

Dopamine can’t cross blood-brain barrier

Question 3

Best treatment for essential tremor?

Answer 3

Propranolol or Primidone

Question 4

Classic feature of Guillain-Barré Syndrome

Answer 4

Ascending weakness

Question 5

Myasthenia gravis main cause?

Answer 5

Anti-AChR antibodies

Question 6

GBS CSF findings?

Answer 6

High protein, normal WBC (albuminocytogenic dissociation)

Question 7

Memory loss + urinary incontinence + gait problems?

Answer 7

Normal pressure hydrocephalus

Question 8

GAD required symptom duration?

Answer 8

≥6 months

Question 9

Schizophrenia duration criteria?

Answer 9

≥6 months

Question 10

SAH definitive diagnostic test?

Answer 10

Lumbar puncture (xanthochromia)

Question 11

Triad of normal pressure hydrocephalus?

Answer 11

Wet (incontinence), wobbly (gait), weird (dementia)

Question 12

CSF findings in bacterial meningitis?

Answer 12

↑ WBC, ↓ glucose, ↑ protein

Question 13

Cryptococcal meningitis treatment?

Answer 13

Amphotericin B + Flucytosine

Question 14

What is the best initial test for syncope suspected from structural heart disease?

Answer 14

Echocardiography

Question 15

What test should be done if syncope is unexplained with no heart disease?

Answer 15

Tilt-table test

Question 16

Key differences: Syncope vs. Seizure?

Answer 16

Syncope: brief LOC, fast recovery; Seizure: >5 min LOC, postictal state

Question 17

Childhood epilepsy with multiple seizure types, cognitive impairment, abnormal EEG

Answer 17

Lennox-Gastaut Syndrome (LGS)?

Question 18

First-line treatment for Lennox-Gastaut Syndrome?

Answer 18

Valproate

Question 19

Adjunctive treatment for Lennox-Gastaut Syndrome?

Answer 19

Lamotrigine

Question 20

Stroke mimickers to rule out

Answer 20

Seizure, tumor, migraine, encephalopathy, hypoglycemia

Question 21

What does BEFAST stand for in stroke recognition?

Answer 21

Balance, Eyes, Face, Arms, Speech, Time

Question 22

How long do TIA symptoms last?

Answer 22

Less than 24 hours, resolve completely

Question 23

What stroke type is associated with sudden onset and maximal deficit at onset?

Answer 23

Embolic ischemic stroke

Question 24

What stroke type typically shows evolution of deficits over hours?

Answer 24

Thrombotic ischemic stroke

Question 25

What is a classic clue for thrombotic stroke?

Answer 25

Symptoms appear upon awakening from sleep

Question 26

What is the most common location for hypertensive hemorrhage?

Answer 26

Basal ganglia (especially putamen, internal capsule)

Question 27

When should carotid endarterectomy be done?

Answer 27

For >70% stenosis, not 100%

Question 28

What tests to order in stroke patients <50 years old?

Answer 28

ESR, VDRL/RPR, ANA, dsDNA, Protein C/S, Factor V Leiden, APAS

Question 29

Symptoms of Vertebrobasilar Artery stroke?

Answer 29

Vertigo, nausea, vomiting, dysarthria, ataxia, gait imbalance

Question 30

Symptoms of Anterior Cerebral Artery stroke?

Answer 30

Profound weakness in lower extremity > upper extremity

Question 31

Symptoms of Middle Cerebral Artery stroke?

Answer 31

Profound upper extremity weakness, aphasia

Question 32

Symptoms of Ophthalmic Artery stroke?

Answer 32

Amaurosis fugax (temporary vision loss)

Question 33

Symptoms of Posterior Cerebral Artery stroke?

Answer 33

Ipsilateral face and contralateral body symptoms, vertigo, Horner’s syndrome

Question 34

Time window for thrombolytics in ischemic stroke?

Answer 34

Within 3 hours of symptom onset

Question 35

5 Hs of neuroprotection

Answer 35

Avoid Hypotension, Hypoxemia, Hypo/Hyperglycemia, Hyperthermia

Question 36

SAH treatment

Answer 36

Surgery (clipping or coiling), nimodipine for vasospasm prevention, manage ICP and seizures

Question 37

Common bacterial meningitis pathogens in neonates

Answer 37

Group B Streptococci, E. coli, Listeria monocytogenes

Question 38

Common bacterial meningitis pathogens in children >3 months?

Answer 38

Neisseria meningitidis, S. pneumoniae, H. influenzae

Question 39

Common bacterial meningitis pathogens in adults 18-50?

Answer 39

S. pneumoniae, N. meningitidis, H. influenzae

Question 40

Common bacterial meningitis pathogens in elderly >50?

Answer 40

S. pneumoniae, N. meningitidis, Listeria monocytogenes

Question 41

Common bacterial meningitis pathogens in immunocompromised?

Answer 41

Listeria monocytogenes, gram-negative bacilli, S. pneumoniae

Question 42

Brain abscess typical pathogens in immunocompetent?

Answer 42

Streptococcus spp., Enterobacteriaceae, E. coli, Klebsiella, anaerobes, Staphylococci

Question 43

Brain abscess typical pathogens in immunocompromised?

Answer 43

Nocardia, Toxoplasma gondii, Aspergillus, Candida, Cryptococcus neoformans

Question 44

Classic brain abscess triad?

Answer 44

Headache, fever, focal neurologic deficit

Question 45

Best imaging for brain abscess?

Answer 45

MRI better than CT, especially early and posterior fossa

Question 46

Alzheimer’s disease features?

Answer 46

No focal deficits, exclusive in >65 years, diffuse symmetric brain atrophy on CT

Question 47

Lewy body dementia features?

Answer 47

Parkinsonian symptoms + dementia

Question 48

Dementia vs delirium key difference?

Answer 48

Dementia gradual, persistent; delirium sudden, reversible, waxing/waning

Question 49

Mild Parkinson’s treatment?

Answer 49

Anticholinergics (Benztropine, Hydroxyzine), amantadine (>60 years)

Question 50

Severe Parkinson’s treatment?

Answer 50

Levodopa/Carbidopa (first line)

Question 51

Treatment if levodopa causes psychosis?

Answer 51

Add Quetiapine