Shelf Review Questions Flashcards

1
Q

eye finding in cavernous sinus thrombosis

A

extra ocular movement abnormalities

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2
Q

pizza fundus

A

central retinal vein occlusion- can present with TIA like episodes

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3
Q

risk of stroke in pts who have migraine with aura

A

OR 2.0-3.0

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4
Q

prevalence of PFO in general population

A

25% (this is higher ~ 35-50% in pts with unexplained stroke)

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5
Q

most common arteries affected in lateral medullary syndrome

A

vertebral > PICA

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6
Q

how to tx lateral medullary syndrome

A

heparin to prevent clot propagation

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7
Q

basilar occlusion causes what?

A

locked in syndrome

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8
Q

a mass in the cerebellopontine angle causes what?

A

issues with CN V, VII, VIII

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9
Q

an acute treatment for spinal injury is _______

A

IV mannitol

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10
Q

far lateral disk herniation at L4-5 could cause issues with which root

A

L4

  • loss of patellar reflex
  • weakness of foot dorsiflexion
  • weakness of knee extension
  • sensory loss in the calf
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11
Q

which nerve root is in charge of extensor hallicus longus (EHL)

A

L5

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12
Q

central disk herniation at L4-5 could cause issues with which root

A

L5 (EHL weakness)

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13
Q

2 causes of dorsal root ganglion disease

A

cisplatinum

anti-Hu paraneoplastic disease

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14
Q

what differentiates inclusion body myositis from polymyositis and dermatomyositis

A

inclusion body affects both proximal and distal muscles

-poly and dermato affect proximal muscles more

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15
Q

4 manifestations of diabetic neuropathy

A

distal small fiber
proximal amyotrophy
mononeuropathies single and multiplex
pupil sparing 3rd nerve

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16
Q

tx for GBS vs CIDP

A

GBS- plasmapheresis and IVIG

CIDP- steroids

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17
Q

copper deficiency causes neuropathy that mimics ________

A

B12 deficiency

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18
Q

familial neuropathy… think _______

A

Charcot Marie Tooth

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19
Q

anti-Hu paraneoplastic syndrome

A

paraneoplastic subacute sensory neuropathy and/or limbic encephalitis
-assoc with small cell lung cancer

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20
Q

weakness of biceps
absent biceps reflex
sensory loss to lateral aspect of velar forearm from wrist to forearm

A

lesion of musculocutaneous nerve

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21
Q

axillary nerve innervates which major muscle

A

deltoid

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22
Q
  1. radial nerve palsy but triceps strength is intact… where is the lesion
  2. radial nerve-sensory loss in the hand
  3. radial nerve- triceps are weak and they have crutches
A
  1. below the spiral groove
  2. at the wrist… most likely due to hand cuffs
  3. axilla
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23
Q

unexplained pain in extremity after remote injury

A

complex regional pain syndrome

  • this is due to abnormal sympathetic response
  • possible txs: sympathetic ganglion nerve block, sympatholytics (propranolol, prazocin, AEDs, TCAs)
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24
Q

transtentorial herniation with 3rd nerve palsy/lateral tenurial herniation is also known as _______

A

uncal herniation

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25
Q

comatose, vague dizziness, slurred speech –> unresponsive, ocular bobbing, pinpoint reactive pupils, absent VORs, quadriplegic… what is the insult?

A

basilar artery thrombosis

-in locked in, they would still be responsive

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26
Q

what might still be present in brain death?

A

DTRs

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27
Q

6 months of worsening bioccipital HA precipitated by running, sneezing, coughing, etc. in an older woman

A

chiari malformation and syrinx

“cough HA” –> needs decompression of the posterior fossa

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28
Q

treatment order for bacterial and tuberculous meningitis

A

dexamethasone –> abx –> CT –> LP

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29
Q

differential for hypoglycorrhacia (low glucose in CSF)

A

bacterial, cancer, TB!!!, neurosarcoidosis

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30
Q

meningococcal ppx

A

rifampin and cipro

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31
Q

bacterial meningitis 1 month-15 years

A

H flu –> meningococcus –> strep pneumo

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32
Q

bacterial meningitis 15-50 years

A

strep pneumo –> meningococcus –> staph

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33
Q

bacterial meningitis > 50 years

A

strep pneumo –> listeria –> gram negative rods

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34
Q

empiric tx for bacterial abx

A

ceftriaxone + ampicillin for listeria + vancomycin for staph

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35
Q

India ink identifies which organism

A

cryptococcus

36
Q

nerve gas, organophosphate causes what

A

cholingergic toxicity

37
Q

TCAs, urologic agents, benztropine causes what

A

anticholinergic

38
Q

metaclopramide, other anti-emetics, antipsychotics, valproic acid causes what

A

extrapyramidal sxs

39
Q

how to tx neuroleptic induced dystonia

A

anticholinergic

  • benztropine
  • diphenhydramine (benadryl)
  • tetrabenazine
  • trihexyphenidyl
40
Q

chemo drug that causes leuko-encephalopathy

A

methotrexate

41
Q

seizure about 1 week into admission is usually due to _____ withdrawal

A

benzo (except lorazepam)

-alcohol seizures usually occur in first 24 hours

42
Q

hyperthermia, rigidity, rhabdo after antipsychotic (typical and atypical)

A

neuroleptic malignant hyperthermia caused by DA antagonism

43
Q

med that commonly causes action tremor

44
Q

familial ET treatment

A

propranolol or topiramate

45
Q

cytarabine can cause _______ toxicity

A

cerebellar

46
Q

which drug that treats neuropathic pain can cause urinary retention

47
Q

risk of seizure recurrence in a low risk patient

48
Q

AED + OCPs… what happens?

  • lamictal
  • gabapentin
  • oxcarbazepine, carbamazepine
  • topiramate
A
  • lamictal: OCP drops lamictal levels
  • gabapentin: no interaction
  • oxcarbazepine, carbamazepine: these drop OCP levels
  • topiramate: in large enough doses (>200mg), it can drop OCP levels as well
49
Q

broad spectrum AEDs (3)

A

depakote/valproate- only this can be loaded quickly
topiramate
lamictal

50
Q

which AEDs make generalized seizures worse?

A

carbamazepine, oxcarbazepine, phenytoin- these may precipitate childhood absence status epileptics

51
Q

tx for absence seizures

A

ethosuximide

52
Q

tx for REM behavior disorder

A

clonazepam

53
Q

how to tx RLS

A

r/o iron deficiency

pramipexole or other direct DA agonist

54
Q

associated with cerebral aneurysm and SAH

55
Q

what must you give in a child s/p craniopharyngioma resection

A

hormone replacement therapy

56
Q

alpha synuclein

A

Parkinson’s

57
Q

tau proteins, amyloid beta

A

Alzheimer’s

58
Q

superoxide dismutase

59
Q

areas of abnormalities in Wernicke’s encephalopathy

A

mammillary bodies and periaqueductal grey matter

60
Q

cause of incontinence in NPH

A

failure to inhibit voiding reflex

61
Q

Cushing’s reflex

A

high blood pressure, decreased pulse… this suggests raised ICP. Tx with mannitol infusion and emergent operation

62
Q

soft tissue sarcoma, white matter lesions, skin findings

63
Q

what to give for delirium

A

haldol. .. possibly quetiapine in smaller populations
- reserve benzos for pts going through benzo/alcohol withdrawal, those with PD, and those with neuroleptic malignant syndrome

64
Q

success rate with 3rd AED

A

5%

start considering surgery

65
Q

low back pain with pretty much normal exam… what to do?

A

pain control and activity as tolerated

66
Q

episodes of hypersomnia, hyperphagia, dissociative states lasting several days with normal inter-event behavior

A

Kleine-Levin syndrome

67
Q

patients who respond well to AEDs with completely controlled seizures are good candidates for therapy discontinuation trial (T/F)

68
Q

epileptics have a higher rate of suicide (T/F)

69
Q

there is no difference in mortality between epileptics and normal ppl (T/F)

70
Q

women with epilepsy have a reduced fertility rate (T/F)

71
Q

what med treats prolactin producing adenomas

A

bromocriptine

72
Q

diabetic pupil-sparing 3rd nerve palsy… what’s the prognosis

A

good… will likely recover R eye movement

73
Q

stopping which med might cause irritability, anxiety, labile affect and loose associations with vivid dreams

A

SSRI withdrawal

74
Q

why don’t you stop baclofen abruptly?

A

it can cause withdrawal seizures since it has GABA activity

75
Q

one cause of pseudo tumor cerebra is _______

A

cerebral venous thrombosis… get an MRV

76
Q

zaleplon (sonata), eszoplicon (lunesta)

A

non benzo sedatives

77
Q

pramipexole

A

direct dopamine agonist for PD and for RLS

78
Q

what do you give for dystonia?

A

diphenhydramine

79
Q

tx bladder dysfunction

A

tolterodine, oxybutynin, solefenacin

80
Q

how to tx vasospasm

A

nimodipine

81
Q

tx dementia

A

rivastigmine, galantamine, memantine, donepezil

82
Q

interferons, glatiramer, natalizumab, dalfampridine, fingolimod

83
Q

tx alcohol withdrawal

A

chlordiazepoxide

84
Q

Lamictal side effect (major one)

A

Stevens Johnson

85
Q

Treatment for juvenile myoclonic epilepsy

A

Valproic acid (depakote)