USMLEasy 4

Question 0

Symptoms of lateral medullary syndrome? Typical cause?

Answer 0

#Vertigo/ataxia
#Sensory loss
#Dysphasia/cups

Vertebral artery occlusion

Question 1

Symptoms of ergot toxicity?

Usual cause?

Answer 1

Posterior column/dorsal root degeneration

Rye fungus (Claviceps purpurea)

Question 2

Non-pituitary Tumor associated with precocious puberty?

Answer 2

Pineal tumor

Question 3

How is botulism similar to Lambert Eaton?

Answer 3

Posttetanic potentiation of compound muscle action potential in both

Question 4

Initial sign of seizure is smell hallucination – localization?

Answer 4

Hippocampus (temporal lobe)

Question 5

Tumors in the posterior fossa generally do not produce what symptom?

Answer 5

Seizure

Question 6

Ependymoma can cause death via?

Answer 6

Transforaminal or transtentorial herniation

Question 7

Patient gets severe spinal trauma – when does patient evolve into hyperreflexia and spasticity?

Answer 7

3 days to 3 weeks

Question 8

Signs of Von Hippel- Lindau syndrome?

Answer 8

# erythrocytosis
#Hepato- splenomegaly
#Microscopic hematuria
#Ataxia
#Telangiectasias in the fundi on retinal exam

Question 9

Lhermitte sign? Indicates?

Answer 9

Electrical sensation radiating down spine with neck flexion

Spinal cord disease
NO toxicity

Question 10

Signs of Frederich ataxia?

Compared to normal individuals, patients with Frederich disease are more likely to develop?

Age of presentation?

Answer 10

#Kyphoscoliosis
#Pes cavus
#Gait/cerebellar problems

#Diabetes
#Cardiac conduction defects

Childhood

Question 11

Effective alcohol on fetal brain?

Answer 11

#Impaired neuronal migration
#Microcephaly
#Hyperactivity learning disabilities

Question 12

Classic migraine versus common migraine?

Answer 12

Aura versus no aura

Question 13

VZV ophthalmicus – which ocular motor nerve is most likely to be affected?

Answer 13

CN 4 because it shares it’s nerve sheath with Trigeminal nerve

Question 14

Mumps measles and varicella are aquired how?

Polio?

Rabies?

Answer 14

Inhalation

G.I. tract

Retrograde axonoplasmic flow

Question 15

CN most likely to be injured in sarcoidosis?

Answer 15

CN 7

Question 16

Tumors caused by Von Hippel-Lindau?

Answer 16

#Hemangioblastoma's
#renal carcinomas

Question 17

Uhthoff’s phenomenon?

Answer 17

Patients with demyelinating diseases become worse with heat

Question 18

Drug to give an MS patient with bedwetting?

If patient has urinary retention?

Answer 18

Oxybutynin – anti-cholinergic

Methacholine - cholinergic

Question 19

Glioblastoma multiforme – best treatment?

Answer 19

Radiation (chemotherapy has no benefits)

Question 20

Baclofen used for? Other option for this problem?

Answer 20

Spasticity

Tizanidine (a2-blocker)

Question 21

Most common oculomotor paresis?

Answer 21

CN6 (not CN3)

Question 22

Patients posttransplant may develop a syndrome similar to? Due to what?

Answer 22

Hypertensive encephalopathy

Cyclosporine or tacrolimus

Question 23

Young woman with poorly responsive pupils - suspected diagnosis? Associated findings?

Answer 23

Aide tonic pupil (benign tonic pupillary dilation)

absent Achilles ankle jerks

Question 24

Meige syndrome? Tx?

Answer 24

Idiopathic Focal dystonia (lip retraction, jaw opening, blinking etc) Botox

Question 25

General paresis?

Answer 25

Manifestation of neurosyphilis - delusions, dementia, tremor, myoclonus, spasticity

Question 26

Congenital hydrocephalus linked to?

Answer 26

Maternal mumps/rubella infection

Question 27

Seizures from tuberous sclerosis - tx?

Answer 27

ACTH

Question 28

Spinal cord infarction - most likley CSF change?

Answer 28

Elevated protein

Question 29

Hyperacusis indicates lesion of?

Answer 29

VII

Question 30

Pelizaeus-Merzbacher

Answer 30

Sudanophillic leukodystrophy Young child with demyelinating disease

Question 31

Post SAH, patients should be treated with?

Answer 31

Ca channel blocker to prevent vasospasm

Question 32

Down beating nystagmus suggests a lesion where? Typical diagnosis?

Answer 32

Cervicomedullary junction; meningioma

Question 33

Ocular bobbing? Suggests lesion where?

Answer 33

Conjugate deviations of the eyes Damage to the pons

Question 34

Polyspike and wave discharges in a child? Treatment?

Answer 34

West syndrome ACTH

Question 35

Role of radiotherapy in meningioma? In astrocytoma?

Answer 35

No role versus used postoperatively

Question 36

Neuromyelitis optica?

Answer 36

Demyelination of optic nerve and spinal cord

Question 37

Marchiafava-Bignami?

Answer 37

Corpus callosum demyelination and necrosis Coma/stupor and motor

Question 38

One of the most common cerebral diseases of infancy?

Answer 38

Canavan

Question 39

Delayed relaxation of reflexes - suspect?

Answer 39

Hypothyroid

Question 40

Clumsy-hand and dysarthria - where is infarct?

Answer 40

Lacunar