Neurology

Question 1

Risk factors for stroke (5)

Answer 1

HTN & age most important
smoking
CAD
Afib

Question 2

Risk of stroke after TIA

Answer 2

30% in 5 years

Question 3

Complications from stroke

Answer 3

cerebral edema w/in 1-2 days

tx with mannitol and hyperventilation

Question 4

Tx for ischemic stroke

Answer 4

tPA within 3 hrs if possible
if not, ASA within 24hrs
keep BP<220/120

Question 5

Causes of hemorrhagic stroke

Answer 5

HTN
ischemic stroke conversion
AVM
tumor

Question 6

Locations for hemorrhagic strokes

Answer 6

basal ganglia most common
pons
cerebellum

Question 7

Tx for hemorrhagic stroke

Answer 7

control BP<180/105 with nitroprusside
mannitol + diuretics
surgery

Question 8

Sx of subarachnoid hemorrhage (4)

Answer 8

severe HA
transient LOC
retinal hemorrhages
vomiting

Question 9

Dx of subarachnoid hemorrhage

Answer 9

CT w/o contrast shows star sign

LP if CT negative, xanthochromia shows it was not a traumatic tap

Question 10

Complications of subarachnoid hemorrhage (5)

Answer 10

vasospam (tx with CCBs)
rerupture
hydrocephalus
seizure due to blood
SIADH

Question 11

Tx for subarachnoid hemorrhage

Answer 11

neurosurgery
IV NS
control HTN
CCB for vasospasm

Question 12

Sx of Parkinson’s (4)

Answer 12

tremor (goes away with intention)
bradykinesia/rigidity
expresionless face
change in personality

Question 13

Dx for Parkinson’s

Answer 13

clinical

onset usually over 50yrs

Question 14

Tx for Parkinson’s

Answer 14

levodopa/carbidopa

trihexyphenidyl/benztropine for tremor

Question 15

Sx of Huntington’s (5)

Answer 15

chorea
changed personality
progressive dementia
bradykinesia/rigidity
incontinence

Question 16

Dx of Huntington’s

Answer 16

atrophy of caudate

Question 17

Tx for Huntingont’s

Answer 17

DA antagonsists

Question 18

Causes of ataxia (7)

Answer 18

EtOH
Vit B12 deficiency
cerebellar infarct/tumor
MS
AIDS
syphilis
Friedrich's ataxia/ataxia telangiectasia

Question 19

Tx for Tourette’s

Answer 19

clonidine

haloperidol

Question 20

Causes of dementia (10)

Answer 20

Alzheimer's
vascular dementia
tumor
normal pressure hydrocephalus
Lewy body
Pick's disease
Wilson's/Parkinsons/Huntingtons
HIV/syphilis
Creutzfeld Jacob
hypothyroidism

Question 21

Sx of Alzheimer’s disease (5)

Answer 21

changed personality
visuospatial disturbances
paranoia
hallucinations
incontinence

Question 22

Dx of Alzheimer’s

Answer 22

diffuse cortical atrophy and enlarged ventricles on CT

Question 23

Sx of Lewy body dementia

Answer 23

visual hallucinations
more rapid deterioration than Alzheimer’s
extrapyramidal sx

Question 24

Tx for Multiple Sclerosis

Answer 24

IV corticosteroids

interferon beta-1a

Question 25

Assc with Guillain-Barre (5)

Answer 25

``` mycoplasma campylobacter hepatitis HIV CMV ```

Question 26

Dx of Guillain-Barre

Answer 26

CSF with elevated protein and normal cell count

Question 27

Tx for myasthenia gravis

Answer 27

pyridostigmine | thymectomy*

Question 28

Findings with NF type 1 (6)

Answer 28

``` cafe au lait spots neurofibromas glioma/meningioma Lisch nodules pheochromocytoma optic nerve glioma ```

Question 29

Findings with NF type 2 (4)

Answer 29

acoustic neuromas meningiomas cataracts cafe au lait spots

Question 30

Findings with tuberous sclerosis (4)

Answer 30

renal angiomyolipoma cardiac rhabdomyoma angiofibromas retinal hamartomas

Question 31

Findings with Sturge-Weber (2)

Answer 31

port-wine stain | capillary angiomatoses of pia mater

Question 32

Findings with von Hippel Lindau (3)

Answer 32

renal cell carcinoma cavernous hemangiomas pheochromocytoma

Question 33

Sx of poliomyelitis

Answer 33

flaccid paralysis | intact sensation

Question 34

Tx for peripheral vertigo

Answer 34

meclizine

Question 35

Tx for Meniere's disease

Answer 35

thiazides | Na+ restriction

Question 36

Types of seizures

Answer 36

Simple partial-no LOC Complex partial-altered consciousness Generalized/complete- true LOC

Question 37

Mgt for status epilepticus

Answer 37

IV diazepam +phenytoin +dextrose | IV phenobarbital if resistant

Question 38

Causes of Bell's palsy (5)

Answer 38

``` Guillain-Barre HSV Lyme disease cholesteatoma trauma ```