Amer's notes

Question 1

Dementia + Abn gait + urinary incont, Dx?

Answer 1

Normal pressure hydrocephalus

Question 2

Muscle rigidity + Dementia + old age + Behaviroal changes + hallucinations, Dx?

Answer 2

Lewy body dementia

Question 3

Muscle rigiditiy + Tremor only

Answer 3

Parkinsons

Question 4

Young male + Weakness in lower extremity + weakness in face + upper extremity nomral + Hx of diarrhea 1 wk ago, dx?

Answer 4

GBS “post upper RTI or Diarrhea”

Question 5

Mx of GBS & Mysthenia in acute attack

Answer 5

IVIG or Plasmaphersis “ICU”

Question 6

Fasiculations in the dominant hand + Sensory normal + Pulmonary failure

Answer 6

ALS

Question 7

Weakness eye & diplopia after exercise + proximal muscle weakness in progressive manner + Repetition causes more weaknes Dx?

Answer 7

Myasthenia gravis

Question 8

Patient w/small lung cancer + proximal muscle weakness + improves with repetition, dx?

Answer 8

Lambert syndrome

Question 9

MS in acute attack (Gait impairement, blurry vision, fatigue) + MRI showed new leison

Answer 9

High dose Steroid

Question 10

GBS pathophysiology

Answer 10

Demylinating disorder.

Question 11

Inv in GBS VS Mysthenia

Answer 11

Both LP

• GBS: NCS “it’s peripheral nerve disease”
• Mysthenia: MRI + EMG

Question 12

Mx of mysthenia gravis in chronic

Answer 12

pyridostigmine

Question 13

Inv for MS:

Answer 13

MRI will show periventricular plaque

Question 14

No 1, RF for stroke

Answer 14

HTN

Question 15

No. RF for CKD

Answer 15

DM

Question 16

No1. RF fpr acute coronary syndrome

Answer 16

dyslipidemia

Question 17

60y + Hemiparesis + 10 days post stroke, nxt?

Answer 17

Asprin. too late to do any acute mx

Question 18

80 yrs + DM + HTN + Vision loss for 20min in left eye + resolved before reaching ER, Dx

Answer 18

TIA

“Criteria: <1hr, normal CT”

Question 19

40 year + Demential + personality changes + No tremor or rigidity, Dx

Answer 19

Frontrotemproal

Question 20

Alzehimers dementia diagnosed 1yr, Best inv:

Answer 20

MRI

initial is the mini-mental

Question 21

Chromosome in Alzehimer disease

Answer 21

Chromosome 21

“tau, B-amyloid”

Question 22

Elderly + Dementia + Gait changed & slow for 2m. Dx?

Answer 22

Normal pressure hydrocephalus..

Urinary incont is only in 20-30% of patients

Question 23

tx of parkinson tremor:

Answer 23

Carbidopa/levidopa “it cause reduction in BP so only give in severe”

Question 24

85 + DM & HTN + tremor + Gait abn + Shuffling gat + Mask face

Answer 24

Parkinsons

Question 25

Intention tremor VS Resting tremor

Answer 25

Intention is cerebllar | Resting is parkinsons

Question 26

Parkinson + low BP, dx?

Answer 26

shydragr

Question 27

28 yr + 2d fever & lethargy + developed Seizure, Mx

Answer 27

this is Complicated Meningitis | Vancomycin + Ceftriaxone + steroid "reduce the edema in meningitis"

Question 28

old + change level of conciousness + Fever + LP gram +Ve Bacilli +ve catalyse test, Mx?

Answer 28

only give ampicillin because it's confirmed to be listeria monocytogenis "No need to give vancomycin & ceftriaxone"

Question 29

59yr + LP lymphocyte 90% + No gram stain findings, tx - If there's Photophobia, neck rigidity - If there's Change in mental status

Answer 29

- this is meningitis, so viral meningitis => Supportive | - This is encephalitis, So viral encephalitiy ==> Acyclovir "HSV is MC"

Question 30

Indian + chronic headache + LP showed lymohcytosis, dx?

Answer 30

TB meningitis

Question 31

51 Yr, MC organism for bacterial meningitis

Answer 31

Strep pneumonia

Question 32

30 Female + Fever + headache + Neck rigidity, what do you expect to see in CSF

Answer 32

"Bacterial is the MC" | SO: High protein, Low glucose, & PMN

Question 33

Prevention measure in meningitis & when to stop isolation

Answer 33

Droplet | after 24 hrs

Question 34

Prevention measure in Covid:

Answer 34

PPE

Question 35

Prevention measure in TB & when to stop isolation

Answer 35

airboren | 2wk or 72 hours

Question 36

Came from alhaj + Rash + convulsion + fever, organism?

Answer 36

nisseria meningitidis

Question 37

Contact prophylaxis in meningitis with gram -ve dipplococci:

Answer 37

Ciproflaxocin

Question 38

Pt after neurological intervention+ Fever + LP showed MRSA, Tx?

Answer 38

Vancomycin only. | we have the organism no need to add the other agents

Question 39

Generlized seizure + 20mg diazipam (full dose) + still seizing, nxt?

Answer 39

- IV phenytoin Repeat diazipam if he didn't take the full dose. "which he took already"

Question 40

prophylactic for cluster & migraine headache

Answer 40

- Verapmil "CCB --> Cluster --> Chronic" | - Betablocker "BB --> Bigraine" واحد بزكب

Question 41

headache + Nasuea + Can't tolerat noises + Normal vrain, tx?

Answer 41

triptan

Question 42

Headache + red eye + unilateral tearing

Answer 42

O2

Question 43

bilateral band headache - crushing - behind the eye, dx

Answer 43

tension headache

Question 44

man + 2hr stroke w/CT showing ischemia+ hx of ischemic stroke 2m ago, mx?

Answer 44

asprin | avoid thrombolytic because recent stroke <3m

Question 45

TB meningitis CSF findings?

Answer 45

lymphocyte, high protein, low glucose

Question 46

late complications of meningitis

Answer 46

deafness

Question 47

pathophysiology of Mg

Answer 47

Ab against Ach receptors

Question 48

30 Female + L eye pain + Decreased direct pupillary reflex + normal indirect pupillary reflex + Decreased sensation in the same side of face + bilateral LL spasticity + loss sensation + povisitve babinski, best test?

Answer 48

MS "bizzare sx": Brain & spinal MRI

Question 49

45male + unilateral facial nerve weakness 1hr + medically free, Mx?

Answer 49

this is facial palsy give | steroid

Question 50

Clinical features with abducent nerve palsy

Answer 50

Dilopia nystagmus esotropia headache

Question 51

30 yr, throbbing headache + N&V, mx?

Answer 51

triptan