NEUROLOGY AND PSYCHIATRY

Question 1

What is the most common cause of syncope?

Answer 1

Neurally mediated (vasovagal)

Question 2

Orthostatic hypotension definition

Answer 2

(reduction in SBP of at least 20 mmHg or DBP of at least 10 mmHg within 3 min of standing or head-up tilt on a tilt table.

Question 3

What is the most important step in the management of syncope?

Answer 3

Rule out life threatening conditions.

Question 4

hallmarks of a generalized seizures

Answer 4

Tonic-clonic movements

Question 5

What is the most common type of seizure?

Answer 5

Generalized tonic-clinic

Question 6

What is the most important diagnostic step in seizures?

Answer 6

EEG

Question 7

presents exactly as stroke but symptoms last <24 hours and resolve completely.

Answer 7

Transient ischemic attack (TIA)

Question 8

standard imaging modality to detect the presence or absence of intracranial hemorrhage

Answer 8

Computed tomography (CT) imaging of the brain

Question 9

most common location site of hypertensive bleed.

Answer 9

Basic ganglia (putamen, internal capsule)

Question 10

tearing of superior cerebral veins = gradual mental status change = crescent shaped

Answer 10

Subdural hemorrhage

Question 11

anterior div of middle MA = lucid interval = Biconcave disk- shaped

Answer 11

Epidural hemorrhage

Question 12

Profound weakness lower extremity > upper extremity

Answer 12

Anterior cerebral artery

Question 13

• Profound upper extremity weakness
• Aphasia

Answer 13

Middle cerebral artery

Question 14

• Vertigo, nausea and vomiting
• Dysarthria, ataxia
• Gait imbalance

Answer 14

Vertebrobasilar artery

Question 15

Amaurosis fugax

Answer 15

Ophthalmic artery

Question 16

• Ipsilateral face, contralateral body
• Vertigo, Horner’s syndrome

Answer 16

Posterior cerebellar

Question 17

the most commonly affected artery in hemorrhagic stroke

Answer 17

MCA

Question 18

Thrombolytics should be administered within ___ hours of the onset of symptoms.

Answer 18

3

Question 19

What is the definitive test to detect site of bleeding in hemorrhagic stroke?

Answer 19

Cerebral angiogram

Question 20

What is the most common non-traumatic cause of SAH?

Answer 20

Ruptured aneurysm

Question 21

What is the gold standard for diagnosis of SAH?

Answer 21

Lumbar puncture

Question 22

hallmark of aneurysmal rupture is blood in the CSF.

Answer 22

Xanthochromia is the gold standard for diagnosis of SAH

Question 23

What is the most common form of suppurative CNS infection?

Answer 23

Bacterial meningitis

Question 24

What is the best initial test for meningitis?

Answer 24

CT scan of the head then CSF analysis

Question 25

What is the most accurate test?

Answer 25

CSF culture

Question 26

What is the best initial therapy for meningococcal Meningitis?

Answer 26

Amphotericin B and 5flucytosine

Question 27

The single strongest risk factor for dementia

Answer 27

increasing age.

Question 28

most effective medication for parkinson

Answer 28

Levodopa/carbidopa

Question 29

extend the duration of levodopa/carbidopa by blocking metabolism of dopamine. Used in those treated with levodopa/carbidopa

Answer 29

COMT inhibitor (tolcapone, entacapone)

Question 30

Commonly associated infections of GBS

Answer 30

Campylobacter jejuni and Herpesvirus

Question 31

ascending paresthesia, cranial nerve deficit (dysphagia, dysarthria, facial weakness, papilledema), autonomic dysfunction and respiratory muscle paralysis (extreme cases)

Answer 31

GBS

Question 32

What is the most specific diagnostic test for GBS?

Answer 32

Nerve conduction study / electromyography

Question 33

antibodies against acetylcholine receptors

Answer 33

MYASTHENIA GRAVIS (MG)

Question 34

Presents with diplopia, **drooping** of eye lids, weakness of the muscles of mastication and dysarthria. Associated with **thymomas**

Answer 34

MYASTHENIA GRAVIS (MG)

Question 35

What is the best initial test for GBS?

Answer 35

Anti-acetylcholine receptor antibodies (ACHR) immunoassay

Question 36

Bipolar I vs II

Answer 36

Question 37

Characterized as, for the same 2 weeks, the person experiences 5 or more of the following symptoms, with at least 1 of the symptoms being either a depressed mood or characterized by a loss of pleasure or interest: * Depressed mood * Markedly diminished pleasure or interest in nearly all activities * Significant weight loss or gain or significant loss or increase in appetite * Hypersomnia or insomnia * Psychomotor retardation or agitation * Loss of energy or fatigue * Feelings of worthlessness or excessive guilt * Decreased concentration ability or marked indecisiveness * Preoccupation with death or suicide; patient has a plan or has attempted suicide

Answer 37

MAJOR DEPRESSIVE EPISODES