PANCE_neurology 7% Flashcards
(82 cards)
(CME)
“Which of the following is the most common organism to cause neonatal meningitis?
a) Escherichia coli
b) Streptococcus pneumoniae
c) Group B Streptococcus
d) Neisseria meningitidis
e) Mycoplasma pneumoniae”
“C) GROUP B STREPTOCOCCUS”
(CME)
“The day after Christmas a 68 y/o widow is brought by ambulance to the ER being delirious. On exam, pt appears malnourished, has nystagmus, a 6th CN palsy and ataxia. What is your initial diagnosis?”
THIAMINE DEFICIENCY
(CME)
“Which of the following is the LEAST likely trigger for a migraine headache?
a) chocolate
b) caffeine
c) beer
d) nitrates
e) ASA”
E) ASA
(CME)
“Which artery feeds the basilar artery?
f) ant cerebral artery
g) middle cerebral artery
h) internal carotids
i) vertebral arteries
j) ant communicating artery”
I) VERTEBRAL ARTERIES
(CME)
“Which medication is FDA approved for absence (petit mal) seizures?
a) carbamazepine
b) phenytoin
c) valproic acid
d) pregabalin
e) topiramate”
C) VALPROIC ACID
(CME)
“A 21 y/o girl c/o increasing weakness, difficulty swallowing and some slight double vision. CT scan shows a large thymoma. All of the following may be treatments EXCEPT
f) daily pyridostigmine
g) corticosteroids
h) plasmapheresis
i) thyroidectomy
j) IV immunoglobulin”
I) THYROIDECTOMY
(RR)
define epidural hematoma
blood b/w dura and inner table of skull
(RR)
MC source of bleeding of epidural hematoma
“tear of the middle meningeal artery”
(RR)
CT scan presentation of epidural hematoma
hyperdense BICONVEX LENS-SHAPED collection of blood, margins do not cross suture lines
(RR)
presentation of a pt with epidural hematoma is often:
“hx of a head injury with a LOC followed by a lucid interval”
(RR)
presentation of cauda equina syndrome
acute onset of lower back pain with
pain, weakness, numbness affecting multiple levels and both legs
URINARY RETENTION = most consistent exam finding
other findings = saddle anesthesia, decreased rectal tone, fecal incontinence
(RR)
MC cause of cauda equina syndrome
herniated disc
(RR)
first steps in evaluation of suspected spinal epidural abscess
MRI of spine w/ contrast
(RR)
classic clinical triad of spinal epidural abscess
fever
back pain
neurologic deficits
(RR)
RF for spinal epidural abscess
IV DRUG USE
also,
recent bac infection
recent spinal procedure
presence of chronic indwelling catheter
immunocompromised
hx of DM
(RR)
what pathogen most frequently causes a spinal epidural abscess?
S. aureus
(RR)
what do labs tend to show on spinal epidural abscess?
elevated ESR
(RR)
you suspect a pt has Guillain-Barre syndrome….what CSF analysis findings are highly specific?
ELEVATED PROTEIN with only a MILD PLEOCYTOSIS
(termed ALBUMINOCYTOLOGIC DISSOCIATION)
(RR)
next steps after confirming diagnosis of Guillain-Barre syndrome?
neurology consult
IVIG therapy or plasma exchange
(RR)
what is the treatment for acute dystonic reaction secondary to metoclopramide?
ADMIN OF ANTICHOLINERGIC AGENTS such as DIPHENHYDRAMINE or BENZTROPINE
(RR)
dystonic reaction - usually caused by what two classes of drugs?
antipsychotics
antidopaminergics
(RR)
three main causes of intention tremor
cerebellar or brain stem disease (such as MS w/ cerebellar plaques)
Wilson’s disease
drug toxicity
(these are associated with cerebellar signs)
(RR)
who does NOT get triptan medications for their migraines?
pts with CV or cerebrovascular disease, angina, severe HTN, peripheral vascular disease
(triptans have adrenergic-agonistic properties)
(RR)
what should never be combined with triptan meds?
ergot-derivatives
