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Uworld6 Flashcards

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1
Q

Difference between peripheral and central bell’s palsy

A

peripheral: inability to raise eyebrow or close eye
central: preserved eyebrow and eye movement

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2
Q

Next step for central bell’s palsy

A

brain imaging

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3
Q

treatment for solitary brain metastasis in patients with good performance status and stable extracranial disease

A

surgical resection

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4
Q

whole brain mets treatment

A

radiation therapy is typically used

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5
Q

when do you refer carotid endarterectomy

A

TIA, stroke past 6 months

70-99% stenosis

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6
Q

Cauda equina syndrome

A

radicular pain
asymmetric motor weakness
hyporeflexia/areflexia

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7
Q

Conus medullaris syndrome

A

symmetric motor weakness

hyperreflexia

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8
Q

What can cause central cord syndrome

A

hyperextension injuries

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9
Q

What type of headache awakens you from sleep

A

cluster headache

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10
Q

ptosis
“down-and-out” gaze
Diplopia
normal pupillary response

A

Ischemic oculomotor palsy
poorly controlled diabetes
Damage to inner somatic nerve fibers
Spare peripheral parasympathetic fibers

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11
Q

Lambert Eaton is associated with what malignancy

A

small cell lung cancer

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12
Q

Clinical feature of Eaton Lambert syndrome

A

symmetric proximal muscle weakness with depressed deep tendon reflexes

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13
Q

lab value for epidural abscess

A

ESR always elevated

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14
Q

equine antitoxin treats

A

botulism

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15
Q

What type of tremor is essential tremor

A

action tremor

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16
Q

Treatment for exertional heat stroke

A

ice water immersion

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17
Q

Atrophy of what part of the brain is Huntington’s disease

A

caudate nucleus

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18
Q

CSF for HSV encephalitis

A

lymphocytic pleocytosis
increased erythrocytes
elevated protein
normal glucose

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19
Q

Difference between Sensorineural and conductive hearing loss

A

Sensorineural: disorder involving inner ear, cochlea, or auditory nerve
Conductive: any cause that limits sound from gaining access to the inner ear

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20
Q

what type of hemorrhagic stroke has rapidly worsening global neurologic symptoms (vomiting, stupor, bradycardia)

A

Intercerebral

Not lacunar strokes

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21
Q

Clinical picture of putaminal hemorrhage

A

contralateral hemiparesis

contralateral sensory loss

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22
Q

What is the cushing reflex and what does it mean

A

hypertension
bradycardia
respiratory depression

Brainstem compression

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23
Q

First line treatment for idiopathic intracranial hypertension

A

acetazolamide +/- furosemide

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24
Q

location of broca

A

dominant frontal lobe

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25
location of wernicke
temporal lobe
26
location of wallenberg syndrome
lateral medullary infarct
27
Patient outstretched the arms with palms up and eyes closed. Affected arm drifts downward and palm turn (pronates) toward the floor
Pronator drift | sign of upper motor neuron or pyramidal tract disease
28
Stand with feet together, arms to the side and eye closed. May loose balance
romberg test
29
what drug is effective in reducing the risk of early recurrence of ischemic stroke?
aspirin, give within 24 hours
30
what drug would you give for recurrent stroke on aspirin therapy
aspirin plus dipyridamole OR clopidogrel
31
Contralateral and motor deficit (face, arm, leg) Homonymous hemianopia conjugate eye deviation toward side of infarct type of stroke?
middle cerebral artery occlusion
32
Contralateral somatosensory and motor deficit urinary incontinence type of stroke?
Anterior cerebral artery occlusion
33
Hemi-neglect syndrome occurs where in the brain
right (non-dominant) Parietal lob
34
what is the biggestest risk factor for stroke
hypertension
35
nerve for facial movement
VII 7
36
nerve for facial sensation
V 5
37
side effect of cisplatin
Nephrotoxicity ototoxicity neurotoxocity
38
psuedodementia
elderly patient with depression present with cognitive impairment
39
oligoclonal IgG bands
multiple sclerosis
40
Uhthoff phenomenon? what is it associated with
symptoms worsen during exposure to high temperatures | such as moving to Arizona in June
41
If MS patient does not respond to steroids, next drug?
plasma exchange
42
name 2 causes of oculomotor nerve palsy
``` nerve compression (posterior communicating aneurysm) diabetes mellitus - microvascular nerve ischemia ```
43
Triad of oculomotor nerve palsy
mydriasis ptosis "down and out" deviation
44
when multiple sclerosis is suspected but clinical examination or MRI is not classic, next step
lumbar puncture
45
Riley-Day syndrome
autonomic nervous system dysfunction with severe orthostatic hypotension
46
For myasthenia gravis, if acetylcholine receptor antibody is present, what is the next step
CT of chest to rule out thymoma
47
problem in motor neuron cell body
ALS
48
Damage to white matter tracts
multiple sclerosis
49
Decreased acetylcholine release from motor neurons
botulism
50
Degeneration of myenteric plexus neurons
achalaisa
51
Fibrous tissue replacement of smooth muscles
systemic sclerosis
52
Worsens with repetitive motions of the same muscle groups and improves with rest
myasthenia gravis
53
Treatment for myasthenia gravis crisis
plasmapheresis (or IVIG) and steroids
54
What causes neuroleptic malignant syndrome
drug reaction to dopamine antagonist
55
3 cardinal signs of parkinson disease
resting tremor rigidity bradykinesia 2/3 for clinical diagnosis
56
What parkinson drug induce acute closure glaucoma
trihexyphenidyl/benztropine | anything anti-cholinergic
57
14-3-3 proteins in cerebrospinal fluid sample
Creutzfeldt-Jakob disease
58
what muscle is responsible for initiating the 1st degress of abduction
supraspinatus
59
What the hallmark of prolonged seizures and can lead to persistent neurologic deficits and recurrent seizures
cortical laminar necrosis
60
What is a complication 3 days after subarachnoid hemorrahge? treatment
vasospasm CT angiogram Nimodipine
61
Upper extremity ischemia (pain, fatigue, paresthesias) Vertebrobasilar insufficiency (dizziness, ataxia, dysequilirbrium) Worsened by upper extremity exercise
subclavian steal syndrome
62
rupture of bridging veins
subdural
63
Syringomyelia is associated with?
Arnold Chiari malformation type 1
64
Toxin-medited neurotranmission blockage
tetanus
65
T-lymphocyte mediated skeletal muscle injury
polymyositits
66
what molecules do tetanus block
glycine and GABA
67
What is the difference between guillan barrie and tick-borne paralysis
GBS: symmetric paralysis over days to weeks tick: asymmetrical paralysis within hours
68
Initial treatment for TIA
aspirin and statin
69
difference between MS episodes and TIA
TIA <24 hours | MS episodes last for days to weeks
70
MOA of sumatriptan
vascular serotonin agonist
71
Location of ulnar nerve entrapment
elbow
72
Methylmalonic acid deviation
B12 deficiency
73
Unfavorable metabolic side effects of thiazide diuretics
hyperglycemia increased LDL cholesterol increaed plasma triglycerides hyperuricemia
74
most comm on form of glomerulopathy with HIV
focal and segmental glomerulosclerosis
75
what causes the pain in PE
pulmonary infarction not pulmonary arterial dilation
76
what type of heart block does digitalis induce
atrial tachycardia with AV block
77
What are respiratory concerns for Granulomatosis with polyangiitis
URI: most common Lower respiratory tract: narrowing with ulceration chest x-ray: multiple lung nodules with cavitation
78
does TB have kidney and upperairway invovlement
no
79
Psychogenic polydipsia ? sodium levels
excessive free water intake by patient | hyponatremic
80
diabetes insipidus sodium level?
hypernatremic
81
pneumothorax on x-ray
radiolucent black region
82
COPD and acute-onset shortness of breath, hypoxia and unulaterally decreased breath sounds
secondary spontaneous pneumothorax | -large alveolar blebs which rupture
83
fluid accumulation in the avleolar spaces
pulmonary edema
84
liver transplant: hyperacute rejection
less than 1 week
85
difference between acute cellular rejection and bacterial infection in liver transplant
bacterial infection: rapid-onset hemodynamic instability significant leukocytosis high fever
86
what type of diarrhea is CMV
bloody
87
when do you give Tdap or Td
tdap --> single dose age 11-18 and pregnancy | td --> every 10 years
88
what vitamin causes thyroid dysfunction, cardiomyopathy,immune dysfunction
selenium
89
what decreases the risk of septic embolic events in patients with native valve infective endocarditis (even if they have right sided weakness)
IV abs | no need for heparin or antiplatelet
90
what will cause severe headache and impaired level of consciousness. focal neurologic findings are uncommon
subarachnoid hemorrhage
91
isoniazid interferes with what vitamin
niacin
92
anti-histone abs
drug-induced lupus
93
cyclic cirtullinated paptide anbs
rheumatoid arthritis
94
which has a greater impact on respiratory acidosis: chloride shift or kidney compensation
kidney compensation
95
what makes tick-borne paralysis different from GBS
absence of fever absence of sensory abnormalities normal CSF examination
96
Treatment for acute hyponatremic encephalopathy
hypertonic (3%) saline with close monitoring of electrolytes
97
Auer rods
AML
98
characterize acute promeylocytic leukemia
life-threatening coagulopathy due to DIC
99
Lupus anticoagulant (anti-phospholipid antibody) changes what lab value
prolongs PTT
100
treatment for autoimmune hemolytic anemia
steroids

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