Lange Diff Dx and Mgmt

Question 1

Wernicke encephalopathy presentation?

Answer 1

Bilateral abducens nerve palsy (6th nerve) horizontal nystagmus, ataxia, and global confusion accompanied by apathy

Question 2

Folic acid deficiency presents with?

Answer 2

Cheilitis, glossitis, and diarrhea. Neurological abnormalities usually not seen.

Question 3

Events in alcohol withdrawal along with timeline

Answer 3

6-8 hours: tremors 8-12 hours: hallucinosis 12-72 hours: seizures. DT at any time in the first week of abstinence.

Question 4

Pharm mgmt of opiate withdrawal?

Answer 4

Clonidine (alpha 2 agonist) and methadone (synthetic long acting opiate)

Question 5

Borderline intellectual functioning IQ range

Answer 5

71 to 84?

Question 6

What is the most common side effect of clonidine

Answer 6

Sedation. It should go away in a few weeks but if it doesn’t, consider reducing dose.

Question 7

Complex partial seizures: prior to seizure, patients may notice? During the event, patient may have/look? Also what kind of lobe epilepsy is it a/w?

Answer 7

May notice bad smell, unusual taste, GI sx. During the event, patient may look dazed/confused/have automatisms such as lip smacking, eye blinking, fumbling clothes, impariemnt of consciousness. Usually a/w temporal lobe epilepsy.

Question 8

Neurologic presentation of hyperthryoidism

Answer 8

8-12HZ tremor, lid lag, brisk deep tendon reflexes, proximal myopathy with muscle wasting and myalgias

Question 9

Pick disease is characterized by changes in personality late or early in disease?

Answer 9

Early in disease

Question 10

Hungtington disease imaging, what does it show?

Answer 10

Box car ventricles

Question 11

Beck’s cognitive triad?

Answer 11

Negative thoughts regarding self, the world and the future

Question 12

what % of alcoholics become severel depressed within the first week of abstaining from alcohol? What % become depressed if they are able to abstin for 4 weeks?

Answer 12

40%; 5%

Question 13

Why is it improtant to administer thiamine before giving glucose?

Answer 13

Because glucose oxidation rquires a lot of thiamine, and if you give glucose, you’ll deplete the thiamine reserve int eh body. Rapid drop of thiamine => encephalopathy

Question 14

What is Korsakoff syndrome

Answer 14

anterograde amnestic disroder caused by chronic thiamine deficiency. Classically presents with confabuloation.

Question 15

Monozygotic twin with bipolar disorder increases risk of having BPAD to?

Answer 15

80 to 90%

Question 16

Narcolepsy

Answer 16

Hypersomnolence that is temporarily relieved by brief naps. Cataplexy, sleep paralysis (sudden loss of voluntary muscle tone at beginning or end of sleepy), hypnagogic or hypopompic hallucinations.

Question 17

Advanced sleep-phase syndrome and delayed sleep phase syndrome.

Answer 17

advanced sleep-phase: social/occupational functioning disturbed by drowsiness during evening. Delayed sleep-phase syndrome: social/occupational functioning distrubed by morning drowsiness.