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(PA school) CAM I > Exam 4 (neuro exam) studying > Flashcards

Exam 4 (neuro exam) studying Flashcards

1
Q

The primary purpose of electromyography (EMG) is to
evaluate ____________ and _____________

A

nerve conduction and muscle response

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2
Q

Which of the following is NOT a common association with subdural hematoma?
A. Deceleration injuries
B. Young age
C. Alcoholism
D. Falls in elderly patients

A

B. Young age

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3
Q

List the SNNOOPPPP mnemonic for headache red flags

A

Systemic symptoms – fever, rash, myalgia, weight loss, HTN
Neoplasm – history of cancer,
Brain primary or mets
Neurologic deficit or dysfunction – focal exam, Sz, AMS/cognitive changes
Onset abrupt (thunderclap HA)
Older patient (> 50 y/o)
Pattern change or new type of HA
Papilledema
Painful eye
Pregnancy

*(Thunderclap HA, fever with neck stiffness, papilledema with focal neuro signs or impaired MS, and acute glaucoma warrant emergent evaluation)

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4
Q

What is the primary pharmacologic treatment for essential tremor?
A. Levodopa
B. Propranolol or primidone
C. Donepezil
D. Carbidopa

A

B. Propranolol or primidone

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5
Q

What is the first-line treatment for Bell’s Palsy?
A. High-dose NSAIDs
B. Acyclovir alone
C. Prednisone with possible antivirals
D. Surgical decompression

A

C. Prednisone with possible antivirals
*Acyclovir or Valacyclovir = if presence of herpetic vesicles in EACs

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6
Q

Which of the following is NOT a Sx of Bulbar Palsy?
A. Difficulty swallowing
B. Inability to articulate words
C. Lack of gag reflex
D. Dry mouth

A

D. Dry mouth

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7
Q

Which of the following are treatments for cluster headaches? Select all that apply
A) High flow O2 via non-rebreather mask
B) Injectable sumatriptan
C) Opioids
D) High doses of verapamil

A

A, B, D

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8
Q

Which of the following is the most specific characteristic of a concussion?
A. Loss of consciousness
B. Cognitive deficits
C. Temporal relationship of symptoms to event
D. Physical deficits
C. Temporal relationship of symptoms to event

A

C. Temporal relationship of symptoms to event

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9
Q

True or false: You should not be super concerned if a pt has a GCS score of 15, and you can d/c home with supervision.

A

True

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10
Q

Which of the following conditions is most commonly associated with damage to Broca’s or Wernicke’s area?
A. Apraxia
B. Agnosia
C. Aphasia
D. Amnesia

A

C. Aphasia

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11
Q

What imaging finding is characteristic of subdural hematoma?
A. Crescent-shaped bright bands on CT [that do not cross the midline]
B. Lens-shaped bright bands on CT [that cross the midline]
C. Hyperdense areas in the brainstem
D. Diffuse atrophy with enlarged ventricles

A

A. Crescent-shaped bands [that don’t cross midline]

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12
Q

Triptans are contraindicated in which of the two conditions listed below?
a) Coronary artery disease (CAD) and HTN
b) Coronary artery disease (CAD) and cerebrovascular disease
c) Cerebrovascular disease and HTN
d) HTN and hypercholesterolemia

A

b) Coronary artery disease (CAD) and cerebrovascular disease

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13
Q

Which of the following are associated with typical migraine headaches? Select all that apply
a) Unilateral moderate-severe pulsating pain
b) Nausea/ vomiting
c) Photo or phonophobia
d) Bilateral mild-moderate non-pulsating pain

A

A, B, C

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14
Q

What 3 things can be given via IV to a coma pt before lab results get back?
A) Thiamine, naloxone, and/ or dextromethorphan
B) Dextrose, amantadine, and/ or naloxone
C) Thiamine, dextrose, and/ or naloxone
D) Thiamine, verapamil, and/ or amantadine

A

C. Thiamine, dextrose, and/ or naloxone

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15
Q

What is a treatment mentioned for Tourette’s syndrome?
A. Levodopa
B. Haloperidol or clonidine
C. Propranolol
D. Acetylcholinesterase inhibitors

A

B. Haloperidol or clonidine

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16
Q

Which of the following findings is most specific for a peripheral cause of vertigo?
A. Gradual onset and constant symptoms
B. Vertical nystagmus
C. Sudden onset, episodic symptoms, and horizontal nystagmus
D. No hearing symptoms

A

C. Sudden onset, episodic symptoms, and horizontal nystagmus

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17
Q

“Neuropeptide release leads to neurogenic inflammation of meningeal vessels and trigeminal sensory fibers; hyperexcitable neuro cortex” describes the etiology of what?
A) Cluster headaches
B) Tension headaches
C) Thunderclap headaches
D) Migraine headaches

A

D. Migraine headaches

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18
Q

What are the primary neurotransmitter imbalances in Huntington’s disease?
A. Increased serotonin
B. Increased dopamine, decreased GABA + ACh
C. Decreased dopamine, increased GABA
D. Increased acetylcholine (ACh), decreased norepinephrine

A

B. Increased dopamine, decreased GABA + ACh

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19
Q

Which of the following is NOT a core feature of Parkinson’s disease?
A. Bradykinesia
B. Cogwheel rigidity
C. Chorea
D. Resting tremor

A

C. Chorea

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20
Q

Which medication is commonly used for Alzheimer’s disease? (hint: has less side effects)
A. Memantine
B. Haloperidol
C. Levodopa
D. Sumatriptan

A

A. Memantine

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21
Q

Which of the following is associated with thiamine deficiency?
a) Alcohol-nutritional neuropathy
b) Optic neuritis
c) B12 deficiency
d) DM peripheral neuropathy

A

a) Alcohol-nutritional neuropathy

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22
Q

Which medication was mentioned to commonly treat Restless Leg Syndrome?
A. Ropinirole
B. Propranolol
C. Haloperidol
D. Sumatriptan

A

A. Ropinirole
(& dopamine agonists in general)

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23
Q

Tardive dyskinesia is caused by long-term use of which type of medications?
A. Dopamine receptor-blocking agents (antipsychotics, metoclopramide)
B. Beta blockers
C. Acetylcholinesterase inhibitors
D. Triptans

A

A. Dopamine receptor-blocking agents (antipsychotics, metoclopramide)

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24
Q

Meningitis caused by Neisseria meningitidis is associated with which of the following?
A. Diffuse muscle weakness
B. Petechial rash and fever
C. Intention tremor
D. Bilateral vision loss

A

B. Petechial rash and fever

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25
Q

What is the most common primary malignant brain tumor in adults?
A. Schwannoma
B. Glioblastoma
C. Meningioma
D. Ependymoma

A

B. Glioblastoma

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26
Q

Which clinical signs are commonly used to assess for meningitis?
A. Babinski and Romberg tests
B. Kernig’s and Brudzinski’s signs
C. Hoffman’s and Chvostek’s signs
D. Finger-to-nose and heel-to-shin tests

A

B. Kernig’s and Brudzinski’s signs

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27
Q

What is the treatment of choice for bacterial meningitis caused by Neisseria meningitidis?
A. Acyclovir 5-7d
B. Penicillin G 5-7d
C. Sumatriptan
D. Penicillin G 7-14d

A

B. Penicillin G 5-7d

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28
Q

Which of the following is a first-line treatment for Parkinson’s disease?
A. Propranolol
B. Levodopa-Carbidopa
C. Clonazepam
D. Memantine

A

B. Levodopa-Carbidopa

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29
Q

Which vitamin deficiency is commonly associated with alcohol-related neuropathy?
A. Vitamin B6
B. Vitamin B12
C. Thiamine (B1)
D. Vitamin D

A

C. Thiamine (B1)

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30
Q

Which imaging modality is preferred for diagnosing brain tumors?
A. CT without contrast
B. MRI with gadolinium
C. PET scan
D. X-ray

A

B. MRI with gadolinium

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31
Q

Which of the following is one of the most common sources of metastatic brain tumors?
A. Kidney
B. Lung
C. Prostate
D. Ovarian

A

B. Lung

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32
Q

Levodopa-Carbidopa and Benztropine Mesylate have what in common?
A. Both first line Txs for Multiple Sclerosis (MS)
B. Both first line Txs for Parkinson’s
C. Both are anticholinergics
D. Both are dopamine antagonists

A

B. Both first line Txs for Parkinson’s

33
Q

Which of the following is the primary treatment for alcohol-nutritional neuropathy?
A. Dopamine agonists and alcohol cessation
B. Thiamine supplementation and alcohol cessation
C. Corticosteroids
D. Beta-blockers

A

B. Thiamine supplementation and alcohol cessation

34
Q

What is the most appropriate initial treatment for optic neuritis?
A. Oral prednisone
B. IV methylprednisolone
C. Beta-blockers
D. Acetylcholinesterase inhibitors

A

B. IV methylprednisolone

35
Q

What condition can absent ankle tendon reflexes be seen in?
A) DM peripheral neuropathy
B) Alcohol-nutritional neuropathy
C) Meningitis
D) Subarachnoid hemorrhage

A

B) Alcohol-nutritional neuropathy

36
Q

Which of the following describes the pathophysiology of myasthenia gravis?
A. Autoimmune destruction of myelin in the CNS
B. Autoimmune attack on acetylcholine receptors at the neuromuscular junction
C. Deficiency of dopamine in the basal ganglia
D. Excessive glutamate leading to excitotoxicity

A

B. Autoimmune attack on acetylcholine receptors at the neuromuscular junction

37
Q

Which pathogen is most commonly associated with Guillain-Barré Syndrome?
A. Staphylococcus aureus
B. Campylobacter jejuni
C. Epstein-Barr virus
D. Cytomegalovirus

A

B. Campylobacter jejuni

38
Q

Which is a key feature of myasthenia gravis?

A

Progressive weakness that worsens with use

39
Q

Which of the following is a common trigger for Complex Regional Pain Syndrome?
A. Viral infection
B. Trauma or surgery
C. Vitamin deficiency
D. Autoimmune disease

A

B. Trauma or surgery

40
Q

Which of the following is NOT a typical feature of Guillain-Barré Syndrome?
A. Ascending paralysis
B. Loss of reflexes
C. Sensory loss with bladder dysfunction
D. Recent GI or respiratory infection

A

C. Sensory loss with bladder dysfunction

41
Q

True or false: CRPS is localized to one limb

42
Q

Which is a treatment for Complex Regional Pain Syndrome?
A. Opioids
B. NSAIDs (e.g., Naproxen)
C. Acetylcholinesterase inhibitors
D. Beta-blockers

A

B. NSAIDs (e.g., Naproxen)

(prednisone is also an option)

43
Q

Which treatment is NOT recommended for Guillain-Barré Syndrome?
A. IV immunoglobulin (IVIG)
B. Corticosteroids
C. Plasmapheresis
D. Supportive care

A

B. Corticosteroids (have not shown benefits)

44
Q

Which of the following suggests a pt doesn’t have Guillain-Barré Syndrome?
a) Asymmetric weakness and well-defined sensory loss with early bowel/bladder incontinence.
b) Rapidly ascending progressive paralysis targeting bilateral peripheral nerves.
c) Paresthesias and numbness in hands and feet, paralysis peaks at 4 wks
d) Autonomic involvement (arrhythmias, BP change, GI dysmotility, sweating, etc)

A

a) Asymmetric weakness and well-defined sensory loss with early bowel/bladder incontinence.

45
Q

Which organ is involved in the pathophysiology of myasthenia gravis?
A) Hypothalamus
B) Thalamus
C) Thymus
D) Thyroid

46
Q

Which of the following is a risk factor for cerebral palsy?
A. TORCH infections
B. Huntington’s disease
C. Myasthenia gravis
D. Guillain-Barré syndrome

A

A. TORCH infections

47
Q

Which means muscle contractions and writhing: dyskinesia or dystonia?

A

Dyskinesia

48
Q

What are two aspects of spasticity?

A

Hypertonia + hyperreflexia

49
Q

Which of the following are treatments for cerebral palsy?
A. Levodopa, baclofen, and valium
B. Botulinum toxin (Botox), baclofen, and valium
C. Beta-blockers, levodopa, and valium
D. Acetylcholinesterase inhibitors and valium

A

B. Botulinum toxin (Botox), baclofen, and valium

50
Q

Which of the following is the most common type of diabetic neuropathy?
A. Mononeuropathy
B. Polyneuropathy
C. Autonomic neuropathy
D. Radiculopathy

A

B. Polyneuropathy

51
Q

What is the primary treatment strategy for diabetic neuropathy?
A. Blood sugar control and corticosteroids
B. Blood sugar control and gabapentin/pregabalin
C. IVIG therapy
D. Plasmapheresis

A

B. Blood sugar control and gabapentin/pregabalin
[SNRI/Duloxetine as well]

52
Q

Which lab test is most important in evaluating a patient with suspected diabetic neuropathy?
A. Vitamin B12 level
B. HbA1c
C. CSF analysis
D. Autoantibody panel

53
Q

Which of the following is a red flag symptom requiring urgent evaluation in neuropathy?
A. Chronic progressive sensory loss
B. Acute, asymmetric motor weakness
C. Tingling in the feet
D. Mild gait abnormalities

A

B. Acute, asymmetric motor weakness

54
Q

EMG/NCS (electromyography/nerve conduction study)
should be used in the evaluation of what?

A

Peripheral neuropathies

55
Q

What is the most common cause of seizures across all age groups?
A. Stroke
B. Brain tumor
C. Idiopathic
D. Head trauma

A

C. Idiopathic

56
Q

Which diagnostic test is essential for diagnosing and classifying seizures?
A. MRI
B. EEG
C. CT scan
D. Lumbar puncture

57
Q

The most common type of focal seizure is _____________ and involves being unresponsive and bland for a period of time.
A) Frontal
B) Temporal
C) Occipital
D) Parietal

A

B) Temporal

58
Q

Which of the following is NOT one of the potential aspects of the pathophys of focal seizures?
A) Hyperexcitability in a neuronal population
B) Increase in voltage
C) Decrease in inhibitory NTs
D) Increase in inhibitory NTs

A

D) Increase in inhibitory NTs

59
Q

Which of the following is a typical characteristic of temporal lobe seizures?
A. Flashing lights and visual hallucinations
B. Lip-smacking, chewing, and fear sensations
C. Sudden loss of muscle tone
D. Loss of coordination and balance

A

B. Lip-smacking, chewing, and fear sensations

60
Q

Which medications are preferred for absence seizures? (nonmotor)
A. Phenytoin and Ethosuximide
B. Ethosuximide and Valproic acid (Depakote)
C. Carbamazepine and Valproic acid (Depakote)
D. Phenobarbital and Carbamazepine

A

B. Ethosuximide and Valproic acid (Depakote)

61
Q

Which of the following best describes a tonic-clonic seizure?
A. Brief staring spells with no postictal confusion
B. Sudden, brief muscle jerks without loss of consciousness
C. Sudden rigidity followed by convulsions and loss of consciousness
D. Loss of muscle tone leading to sudden collapse

A

C. Sudden rigidity followed by convulsions and loss of consciousness

(grand mal seizure)

62
Q

Two or more seizures without regaining consciousness in between can be classified as what?

A

Status epilepticus

63
Q

What is the first-line treatment for status epilepticus?
A. Valproic acid
B. Lorazepam
C. Phenytoin
D. Ethosuximide

A

B. Lorazepam

64
Q

Which imaging modality is best for differentiating ischemic from hemorrhagic stroke?
A. MRI with contrast
B. Non-contrast CT
C. EEG
D. PET scan

A

B. Non-contrast CT

65
Q

Which of the following are risk factors for both ischemic and hemorrhagic strokes?
a) HTN and high alcohol intake
b) HIV and HSV
c) Cocaine and meth use
d) Encephalitis and tumors

A

a) HTN and high alcohol intake

66
Q

What “improves outcomes and decreases vasospasms” in cerebral aneurysm rupture?:
a) Methotrexate
b) Nimodipine
c) Gabapentin
d) Epinephrine

A

b) Nimodipine

67
Q

Which of the following is NOT a treatment option for cerebral aneurysm rupture?
a) Clip
b) Coil
c) Stent
d) Shunt

68
Q

Rupture of intracerebral (berry) aneurysm or AVM may cause a(n) ______________ hemorrhage
a) intracranial
b) cerebral
c) subarachnoid
d) subdural

A

intracranial

69
Q

A berry aneurysm in the anterior circle of willis makes a(n) ______________ hemorrhage more likely.
a) intracranial
b) cerebral
c) subarachnoid
d) subdural

A

c) subarachnoid

70
Q

Which is a risk factor of cerebral aneurysm rupture?
a) Male
b) Polycystic kidney disease
c) Anemia
d) Older age

A

b) Polycystic kidney disease

71
Q

The time window for administering IV _________________ in an acute ischemic stroke is within 3-4.5 hours

A

thrombolytics (tPA)

72
Q

Which of the following is recommended for secondary stroke prevention?
A. Beta-blockers + Aspirin
B. Aspirin + Clopidogrel (short-term use)
C. Acetaminophen
D. Antibiotics + Clopidogrel (short-term use)

A

B. Aspirin + Clopidogrel (short-term use)

73
Q

Intraparenchymal and subarachnoid hemorrhages are related to ________________ hemorrhages
a) intracranial
b) cerebral
c) extracranial
d) subdural

A

a) intracranial

74
Q

What is the pathophys of syncope?

A

Excessive vagal tone or impaired control of peripheral circulation

75
Q

Which medication is commonly used to reduce vasospasms following a cerebral aneurysm?
A. Phenytoin
B. Nimodipine
C. Lorazepam
D. Aspirin

A

B. Nimodipine

76
Q

The pathophys of syncope involves ___________vagal tone or impaired control of ____________ circulation
a) excessive; central
b) excessive; peripheral
c) insufficient; central
d) insufficient; peripheral

A

b) excessive; peripheral

77
Q

Which of the following diagnostic tools is most useful for identifying large artery disease in TIA?
A. EEG
B. Neurovascular imaging
C. Lumbar puncture
D. EMG

A

B. Neurovascular imaging
(like carotid doppler ultrasound)

78
Q

What is the primary pathophysiological mechanism behind syncope?
A. Autoimmune destruction of the myelin sheath
B. Excessive vagal tone or impaired peripheral circulation
C. Hyperactivity of the brainstem
D. Increased cerebrospinal fluid pressure

A

B. Excessive vagal tone or impaired peripheral circulation

79
Q

True or falls: subdural hematomas are typically NOT associated with skull Fx

(PA school) CAM I (51 decks)

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