Mix

Question 1

A. What are the causes of Wernick encephalopathy = Thiamine deficiency?

Answer 1

Most common cause is chronic Alcoholism/ hemodialysis/ hyperemesis/ starvation / gastric plication / cancer /AIDS

Question 2

A. What are the S&S of Wernick encephalopathy?

Answer 2

Confusion/ Nystagmus/ partial ophthalmoplesia/ Ataxia /

Question 3

Q. How can you determine if the brain is dead in comatose ptn?

Answer 3

If the EEG has no electrical waves and loss of all brain stem reflexes . Just exclude barbiturate overdose or hypothermia
Because they also cause the EEG to be flat

Question 4

A. What’s delirium tremens?

Answer 4

Is a very serious symptoms may result if chronic alcoholic stopped suddenly. Symptoms will shows after ( >2-10days ) . Affects breathing, circulation and temperature. Symptoms as: ⬆️BP, dehydration, ⬇️ blood flow to the brain, confusion, hyperthermia & sweating, tremor tachypnea and sleep disturbance.

Question 5

A. What are the S&S for delirium tremens?

Answer 5

Initially anxious, later Confusion/ sleeplessness & nightmares / sweating/ depression / high pulse rate / fever / hallucinations / as delirium progresses, the hands develops persistent tremor that might extend to head and other body and become uncoordinated. If left untreated it can be fatal

Question 6

Q. What determines the Glasgow coma scale ?

Answer 6

1- eyes : open spontaneously = 4 / to speech= 3 / to pain =2 / none=1.

2- verbal response: oriented =5/ confused =4 / inappropriate words =3 / incomprehensible sound = 2 / none = 1.

3.motor response: obey commands =6 / localized Pain =5 / withdraws to pain =4 / flexion to pain =3 / extension to pain =2 / none =1.

Question 7

Q. Ptn presented with ptosis + diplopia + dilated pupil that not responding to direct light. What’s the nerve injured?

Answer 7

Oculomotor nerve

Question 8

Q. Ptn who is taking a medicine for depression is now complaining of impotence. Which antidepressant drug is most likely responsible?

Answer 8

Sertaline

Question 9

Q. With overly vigorous sodium correction which part will you expect to damage?

Answer 9

Pons [ central pontine myelinolysis = demyelination of the central pons ]

Question 10

Q.name the neurological conditions ass. with rheumatoid arthritis?

Answer 10

Carpal tunnel syndrome (common) /peripheral neuropathy & mononuritis multiplex ( rare )

Question 11

Q.name the drug that is used to treat pulmonary diseases but can causes temporary behavioral changes?

Answer 11

Theyophylline ( another side effec of it is increased urination)

Question 12

Q. Name a viral infection that is most likely to cause CNS involvement and focal neurological findings?

Answer 12

Rabies

Question 13

Q. Diabetic ptn had one side wild upper limb movement that disappeared while sleeping. What’s your explanation?

Answer 13

This is called hemiballismus which in diabetic ptn is caused by vascular event in contralateral sub-thalamic nucleus

Question 14

Q. What are the S&S of vasovagal syncope and how to diagnose?

Answer 14

S&S : ptn will feel nausea+ blurred vision + hot before syncope then jerking of all limbs during the syncope

Tilt table test will help in diagnosis

Question 15

A. An HIV / homosexual ptn who has multiple ring lesions at both cerebral hemispheres on CT and MRI with symptoms as confusion, personality changes , seizure. what’s your diagnosis and what’s the best medication to give? And what test is contraindicated?

Answer 15

Toxoplasmosis/ 💊 antibiotics/ LP is contraindicated because this is a mass lesion disease and doing LP will elevate the ICP.

Question 16

A. What’s the % for ptn with optic neuritis to develop multiple sclerosis if he/she has normal MRI? And what’s the % if there was > 3 lesions on MRI?

Answer 16

With no MRI lesion is 16% / with 3 lesions is 50%

Question 17

Q. Ptn presented with acetaminophen overdose. What’s the antidote drug given?

Answer 17

If presented within 4 hours of ingestion, then activated charcoal is given.

If after 4h but less than 8h, the best treatment would be N-acetylecystine ( IV or oral)

Of course with other management measures as intubation, IV fluids ect.

Question 18

Q. Ptn with aphasia. Where is the lesion location?

Answer 18

Frontal lobe ( maybe left? )

Question 19

Q. Ptn with history of parathyroidectomy because of Hyperparathyroidism is now complaining of morning headache and loss of peripheral vision. What’s do you think is the disease?

Answer 19

MEN 1 ( Hyperparathyroidism + pituitary tumor + pancreatic tumor )

Question 20

Q. You can’t make a diagnosis of brain death in case of presence of………?

Answer 20

Hypothermia ( because it gives a false signs of brain death on EEG )