Neurology

Question 1

3 grades of concussion

Answer 1

I - Confusion
II - Amnesia
III - Loss of consciousness a lasts seconds b lasts minutes

Question 2

Epidural Hematoma

Answer 2

Head trauma, fine at first with AMS later

Question 3

Presentation of SAH

Answer 3

Worst headach of life with abrupt onset
Nifedipine

Question 4

Bells Palsy

Answer 4

Facial nerve
Herpes or Zoster
Mouth, Eyes and Forehead - (stroke spares forehead)
Steroids early may be helpful

Question 5

Abortive migraine management

Answer 5

Ergotamine
Sumatriptan
Both vasoconstrictors - worry about CAD, pregnancy
DONT use opioids

Question 6

Proph migraine treatment

Answer 6

ASA
Propranolol
Amitryptiline
Clonidine
Verapimil

Question 7

Pseudotumor cerebri

Answer 7

Everything is normal except for elevated opening pressure
Treat cause

Question 8

Encephalitis

Answer 8

Meningitis with signs of upper motor neuron lesions
Increased lymphocytes and protein in the CSF
Acyclovir
Gancyclovir for CMV

Question 9

Meningitis

Answer 9

Meningeal signs
Petechial rash - neisseria
Lacy rash - Viral

Question 10

Neonatal meningitis causes

Answer 10

Gram neg
Strep
Listeria

Question 11

Under 15 meningitis causes

Answer 11

Neisseria
S pneumo
H flu

Question 12

> 15 meningitis

Answer 12

S pneumo
Neisseria
Gram neg
Listeria over 60

Question 13

Normal CSF glucose

Answer 13

60% of serum glucose
Low in fungal and bacterial menigitis

Question 14

EMperic treatment for meningitis

Answer 14

Neonates - Ampicillin and cefotaxime
Children - Vanc and Cefotaxime
Adults - Vanc and cefotaxime w/ meropenem alt
Elderly add Bactrim
Everyone gets steroids

Question 15

Epidural abscess

Answer 15

Staph, Strep or cutibacterium
Often from sinuses
Low back pain, localized tenderness, radicular pain
Dx with MRI
Rocephin and Van or Nafcillin for MRSA

Question 16

Essentail tremor

Answer 16

Head bobbers and worsens with purposeful movements
Treat with propranolol or primidone
Alcohol helps

Question 17

Etiology of huntingtons

Answer 17

Caudate nucleus atrophy

Question 18

Parkinsons etiology

Answer 18

Dopamine depletion in basal ganglia and substantia nigra

Question 19

Classic triad and management of parkinsons

Answer 19

Pill rolling tremor
Rigidity
Bradykinesia

May have micrographia and masked fascies
Levadopa, Bromocriptine, Benztropine
Comon to have hypotension

Question 20

Tourette DIsorder

Answer 20

Inherited autosomal dominant
Onset 3-8 years
FOcusing decreases ticks
Therapy and fluphenazine, pimozole

Question 21

Restless Leg Syndrome

Answer 21

Can be caused by TCA, diphenydramine, SSRIs, Caffeine
DOpamine agonists and Gabapentin to treat

Question 22

Meningioma

Answer 22

Beign tumor - maypresent with visual changes, headaches, etc.

Question 23

Acoustic neuromas

Answer 23

Cranial nerve eight problem looks like menierres
Vertigo, ringing and hearing loss

Question 24

Alzheimer dementia

Answer 24

Tau tangles and plaques
No disturbance in consciousness
Memory loss then personality changes later
Struggle with judgement questions/abstract reasoning

Question 25

Pick's disease

Answer 25

Frontotemporal dementia - personality changes come first

Question 26

Differentiating factor for delerium

Answer 26

Early change of consciousness

Question 27

Management of MS

Answer 27

Blurry vision, weakness, electric shocks MRI with hyperdense areas Steroids and interferon May use glatiramir, natalizumab, mitaxontrone

Question 28

Surgery for myasthenia gravis

Answer 28

Thymectomy

Question 29

Other causes of carpal tunnel

Answer 29

Diabetes, pregnancy, rheumatoid arthritis

Question 30

Management for GBS

Answer 30

IVIG and plasma exchange

Question 31

General seizure management

Answer 31

When in doubt phenytoin or carbemazepime Ethosuximide for absence (may also use lamotrigine) Phenobarbital for febrile

Question 32

Management of status epi

Answer 32

Thiamine and GLucose Benzo THEN phenytoin

Question 33

HTN med for cerebral aneurysm

Answer 33

Nifedipine

Question 34

1st test for order for stroke

Answer 34

Non contrast CT scan

Question 35

ANterior stroke symptoms

Answer 35

From carotids Weakness and sensory Numbness Incontinence

Question 36

Posterior Stroke symptoms

Answer 36

Vertebrobasilar Visual, balance and cranial nerve issues Decrease in memory and reading

Question 37

LAcunar disease

Answer 37

Doesnt fit a stroke pattern All over the brain

Question 38

BP contraindication for thrombolytics in stroke

Answer 38

185/90 or higher Also recent surgery or hemorrhage

Question 39

Management of TIA

Answer 39

ASA or plavix Normal MRI