Uworld questions

Question 1

What are side effects of steroids

Answer 1

Hyperglycemia, bone loss, glucocorticoid induced myopathy ( months to weeks after starting therapy, leg muscles go before arm, no increase CK or ESR)

Question 2

What will be seen on imaging of patients with dementia

Answer 2

diffuse atrophy which is more prominent in the temporal and parietal lobes

Question 3

Muscle strength and loss of vib and joint position on the right and loss of pain and temp on the left is what condition?

Answer 3

Brown-sequard

loss of pain and temp is felt on other side because it damages the lateral spinothalamic tract which has those tracts cross two below the level of the lesion.

Question 4

What is the most likely cause of a single brain abscess

Answer 4

a direct extension from the adjacent tissue( otitis media, sinusitis)
- most common isolated organisms are viridans strep or staphylococcus aureus.

Question 5

What is important to evaluate in a adult with a first time seizure?

Answer 5

exclude metabolic ( hypoglycemia, electrolyte disturbances)
and toxic causes.

Question 6

Thalamic pain syndrome (Dejerine-Roussy syndrome)

Answer 6

severe paroxysmal burning pain over the affected area and is classically exacerbated by light touch (allodynia)

Question 7

What is diagnosis of pt with fluctuating cognitive impairment, bizarre visual hallucinations and parkinsonism?

Answer 7

Dementia with lewy body

Question 8

How do you diagnose pt with Wilson’s disease

Answer 8

Low serum ceruloplasmin (less than 20) , inc urinary copper excretion, Kayser-fleischer rings.

Question 9

What are symptoms of patients with Wilsons disease

Answer 9

• Hepatic failure
• resting tremor
• slowing of movement
• paranoia
• rigitity
• trouble with gait
• slurred speach

Question 10

What is the diagnosis for a patient with headache ( worse at night), nausea/vomiting, possible decreased level of consciousness and maybe focal neurologic symptoms ( vision changes, unsteady gait) and symptoms may worsen with meneuvers such as leaning forward, valsalva, cough

Answer 10

Intracranial hypertension

Question 11

What is Cushing reflex, when is it seen, and what does it signify

Answer 11

Hypertension, bradycardia, respitory depression, seen in Intracranial hypertension, worrisome finding suggestive of brainstem compression.

Question 12

What are risk factors for Idiopathic intracranial hypertension

Answer 12

weight
vit A (isotretinoin)
growth hormone
tetracyclines (antibiotics)

Question 13

What is diagnosis of young girl with headache, possible vision loss, tinitus (whoosing sound), diplopia

Answer 13

idiopathic intracranial hypertension

Question 14

What can cause a precipitation of Myasthenia gravis crisis

Answer 14

• infection
• surgery
• pregnancy
• meds (aminoglycosides, floroquinolones, beta blockers)

Question 15

Pt who has been recently hospitalized for psychosis now out and comes in due to confusion, fever, muscle regidity and diaphoresis has what diagnosis.

• What do you do for pt?

Answer 15

Neuroleptic malignant dyndrome.

Stop medication (dopamine antagonist) and give dantrolene

Question 16

What is diagnosis for pt with visual hallucinations, spontaneous parkinsonism, fluctuating cognition?

Answer 16

Lewy body dementia

Question 17

What is diagnosis of pt with early personality changes, apathy, disinhibitions and compulsive behavior

Answer 17

frontaltemporal dementia

Question 18

True or false: Optic neuritis is usually associated with nausea and vomiting.

Answer 18

False

Question 19

What are the causes of acute angle closure glaucoma

Answer 19

commonly occurs as a response to pupillary dilation from medications (anticholinergics, sympathomimetics or other stimuli such as dim light)

more common in woman greater than 40 and asian

Question 20

What are symptoms of pt with acute closure glaucoma

Answer 20

• orbitofrontal headache, nausea vomiting, eye pain, conjunctival injections, dilated pupil with poor light response.

Question 21

What are symptoms of pt with tabes dorsalis (tertiary siphilis)

Answer 21

sensory ataxia, lancinating pains, reduced deep tendon reflexes, argyll robertson pupils (constrict with accommodation but not light)

Question 22

What are symptoms of Meniere disease

Answer 22

Recurrent episodes of vertigo, unilateral hearing loss and tinnitus, feeling of fullness in the ear.

Question 23

What are clinical sights of cerebellar hemorrhage

Answer 23

occipital headache, neck stiffness, nausea vomiting, nystagmus, ipsilateral hemiataxia

Question 24

What are common symptoms of Cauda equina syndrome.

Answer 24

gradual onset of back pain with unilateral radiculopathy, saddle area numbness, hyporeflexia, asymmetric lower extremity weakness

Question 25

What are symptoms of Conus medullaris syndrome

Answer 25

sudden onset sever back pain, perianal hypo/anesthesia, symmetric motor weakness, hyperreflexia

Question 26

What will be seen on CT of pt with diffuse axonal injury

Answer 26

minute punctate hemorrhages with blurring of gray-white interface.

Question 27

What is the most common cranial mononeuropathy in DM, how is it caused and what will you see with it?

Answer 27

CNIII is most common and is cause by ischemic injury only affects somatic fibers. so symptoms are ptosis and a down and out gaze

Question 28

What are symptoms of herpes encephalitis.

Answer 28

- acute onset (less than a week) of foacl neurological findings (ataxia, herreflexia, seizures) - fever - behavioral changes - Kluver Bucy syndrome (hyperphagia, hypersexuality)

Question 29

What is tx of pt with herpes encephalitis

Answer 29

IV acyclovir

Question 30

What is gold standard for diagnosis of herpes encephalitis

Answer 30

PCR analysis of HSV DNA in CSF

Question 31

What is seen with pt who has Herpes encephalitis in CSF

Answer 31

- lymphocytic pleocytosis - high protein - high red blood cells - No dec glucose