Brain, Nerve Disorders, CNS Infxns

Question 1

Treatment for Bell’s Palsy?

If you are going to give antivirals, treat how?

Answer 1

Prednisone 60mg qd x 10 days

Valacyclovir 1000mg tid x 7 days bc it has better oral absorption than acyclovir

Question 2

What meds are used to treat M.S.?

Answer 2

IFN-B

Glatiramer acetate

Question 3

What is Uhthoff’s phenomenon

Answer 3

Worsening of sx in pts w/M.S. when their body temp is increased a little bit

i.e. exercise, hot bath makes it worse

Question 4

Treatment for acute exacerbation of M.S.?

How to treat the spasticity assoc w/disease?

Answer 4

IV methylprednisolone 250-500mg q12 for 3-7 days

Baclofen 5mg tid and can inc to 20mg

Question 5

Define myelopathy?

Radiculopathy?

Answer 5

Involves spinal cord

Involves nerve root as they LEAVE spinal cord

Question 6

Define neuropathy

Myopathy?

Answer 6

Involves peripheral nerves

Involves muscle

Question 7

How to differentiate between GBS and Tick Paralysis?

Answer 7

Tick paralysis has Fixed and Dilated pupils

Question 8

What are some causes of Non-infectious Meningitis?

Answer 8

Post vaccines
Drugs - NSAID, Bactrim, Allopurinol
Sarcoidosis, Behcet’s, RA, SLE
Leukemia

Question 9

What is normal opening CSF pressure?

Answer 9

5-20 cm H2O

Question 10

What is the Normal amount of leukocytes and granulcytes in CSF?

Answer 10

< 5 leukocytes with at most 1 PMN

Any eosinophil seen is abnormal

Question 11

Ceftriaxone dosing for children?

Cefotaxime dosing for peds < 1 month?

Answer 11

75-100 mg/kg

50 mg/kg

Question 12

When is CSF turbidity seen w/leukocytosis?

How long may CSF xanthochromia persist for?

Answer 12

200 cells

1 month

Question 13

What is the major descending motor tract in the spinal cord?

Answer 13

LCST

Question 14

What carries pain and temperature in the spinal cord?

Answer 14

LSTT

Question 15

What is a marker of spinal shock?

What is this reflex?

Answer 15

Loss of Bulbocavernous reflex

Involuntary reflex ctx of Anal sphincter in response to squeeze of glans penis or tug on Foley

Question 16

How to differentiate bw conus medullaris lesion vs cauda equina?

Answer 16

Conus is b/l

Conus has UMN findings, cauda does not

Question 17

Describe syringomyelia

Answer 17

Neck pain and HA, UE anesthesia w/loss of pain and temp, post column fx intact

WORSE w/cough or Valsalva

Question 18

What has a 90% assoc w/Arnold Chiari malformation type I?

Answer 18

syringomyelia

Question 19

What is Miller Fisher Syndrome?

Answer 19

Type of GBS with triad of ophthalmoplegia, ataxia, areflexia

Question 20

GBS with what FVC means you need intubation?

What NIV?

Answer 20

Less than 20 mL/kg

Less than 30 cm H2O

Question 21

What are the 2 MC mononeuropathies associated with HIV?

Answer 21

Meralgia parenthetica and Facial Nerve neuropathy

Question 22

In a pt with GBS, what muscle strength has been shown to correlate with ventilatory muscle strength?

Answer 22

Extensor neck