Week 13 Neurologic Disorders

Question 1

Headache, danger signs, hospital referal

Answer 1

1) Onset of headache after the age of 50
2) asymmetry of pupillary response
3) decreases deep tendon reflexes
4) “worst ever experienced”
5) Personality change
6) onset of new or different headache
7) onset of headache that progressively worsens
8) papilledema
9) painful temporal arteries
10) thunderclamp headache

Question 2

Headache Pharmacologic Management: Preventive

Answer 2

1) anticonvulsants: divalproex, gabapentin, topiramate
2) CCB: diltiazem, amlodipine
3) BB: propranolol, atenolol
4) sleep: amitriptyline
5) SSRI: sertraline

Question 3

Headache Pharmacologic Management: Abortive

Answer 3

1) Tylenol or Aspirin
2) NSAIDs
3) Corticosteroids
4) triptans

Question 4

Common pathogens in bacterial meningitis in adults include:

Answer 4

1) Streptococcus pneumoniae (gram-positive diplococci)
2) Neisseria meningitidis (gram-negative diplococci)
3) Staphylococcus species (gram-positive cocci)
4) Haemophilus influenzae type b (Hib; gram-negative coccobacilli).

Question 5

The clinical presentation of bacterial meningitis

Answer 5

classic triad of fever, headache, and nuchal rigidity, or stiff neck.

Question 6

viruses that cause encephalitis

Answer 6

1) herpes simplex virus, other herpes viruses (e.g., Epstein-Barr virus, varicella-zoster virus)
2) enteroviruses
3) mosquito- and tick-borne viruses
4) the rabies virus
5) childhood viruses (e.g., measles and mumps).

Question 7

Brudzinski and Kernig signs,.

Answer 7

suggestive of nuchal rigidity and meningeal irritation, are often positive in children 2 years or older and adults with meningitis

Question 8

Brudzinski sign

Answer 8

is elicited when passive neck flexion in a supine patient results in flexion of the knees and hips.

Question 9

Kernig sign

Answer 9

elicited with the patient lying supine and the hip flexed at 90 degrees. A positive sign is present when extension of the knee from this position elicits resistance or pain in the lower back or posterior thigh.

Question 10

Encephalitis treatment

Answer 10

Acyclovir 10mg/kg IV q 8 hr

And supportive care

Question 11

Essential Tumor treatment

Answer 11

1) propranolol
2) primidone
3) Benzodiazepines

Question 12

Typical MS onset age

Sex of patient most affected

Answer 12

20 to 50

3 times as many women to men

Question 13

PD medication management

Answer 13

1) Selegiline - delay destruction
2) Levodopa - 5 years develop dyskinesia
3) Dopamine Agonists - stimulate dopamine receptors
4) Catecol O-Methltransferase Inibitor
5) Anticolinergics
6) Amantadine

Question 14

Trigeminal Neuralgia first line treatment

Answer 14

Anticonvulsants

Carbazepine
Oxcarbazepine

Question 15

Serotonin syndrom

Answer 15

mental status changes, autonomic instability, neuromuscular changes