Day 2 - Neuro3 Quiz

Question 1

Lung CA w/ muscle weakness

Answer 1

Lambert-Eaton syndrome; Improves w/ contraction or use; Assoc. SCLC

Question 2

66 yo forgetfulness & decreased b/l parietal lobe activity on PET scan

Answer 2

Alzheimer disease

Question 3

Most sensitive test for MS

Answer 3

MRI head and spinal cord; Shows demyelination

Question 4

Med decreases frequency of relapses in patients w/ MS

Answer 4

Interferon-beta; Also glatiramer

Question 5

35 yo W p/w ptosis, diplopia worsens throughout day

Answer 5

Myasthenia gravis (antibodies against ACh receptors at NMJ)

Question 6

Mechanism of first-line tx of restless legs syndrome

Answer 6

Dopamine agonists

Question 7

Common cause of syncope & test(s) to dx

Answer 7

Vasovagal syncope: Tilt table test or orthostatic bp

Question 8

EEG waveform w/ different stages of sleep

Answer 8

(1) Stage N1 - THETA waves - alpha waves relaxed, beta waves awake (2) Stage N2 - Sleep spindles and K complexes (3) Stage N3 & N4 - low frequency, high amplitude delta waves (4) REM sleep - beta wave (high frequency, low amplitude)

Question 9

Next step once brain tumor identified on head MRI or CT

Answer 9

Full body CT - chest, abdomen, pelvis to determine metastasis from brain or to brain from elsewhere; Bone scan - prior bone tumor or metastasis to other bony location

Question 10

2 most common brain tumors in adults

Answer 10

Metastasis, Glioblastoma; Think: MGM Studies (Meningioma, Schwannoma)

Question 11

3 most common brain tumors in kids

Answer 11

Astrocytoma, Medulloblastoma, Ependymoma

Question 12

First-line tx for essential tremor

Answer 12

Beta blockers; Also consider benzos, primidone, surgery; Patients self-medicate w/ alcohol

Question 13

Presentations of major types of dementia

Answer 13

(1) Alzheimer’s - clinical diagnosis of exclusion, not like any presentation below (2) Pick’s Disease - behavioral/personality changes prior to dementia, progressive aphasia (3) Lewy Body Dementia - triad of dementia, parkinsonian symptoms, visual hallucinations ; unexpected falls or syncopal episodes

Question 14

1st line tx restless leg syndrome

Answer 14

Dopamine agonists (like Parkinson’s drugs) - Carbidopa/Levidopa, Pramipexole, Ronipole

Question 15

ALS p/w

Answer 15

Most commonly, Asymmetrical limb weakness; Dysarthria/Dysphagia; UMN & LMN; Executive function; 3-5 years neuromuscular syndrome

Question 16

Tx GBS

Answer 16

Plasmapharesis or IVIg, early better; Supportive care

Question 17

Meds for Alzheimer’s disease

Answer 17

Cholinesterase inhibitors (e.g., Donepezil, rivastigmine, galantamine); Memantine in addition or by itself; Vitamin E losing favor but still used (increased mortality at high doses)