MKSAP Neuro I

Question 1

_________ is absolutely contraindicated in dementia with Lew bodies (in a nonviolent patient).

Answer 1

Haldol (use donepezil as an alternative for delirium)

Question 2

When is DBS appropriate for Parkinson’s disease?

Answer 2

Pts who continue to have benefit from carbidopa-levodopa but experience medication-related SFX

Question 3

What is droxidopa used for?

Answer 3

Neurogenic orthostatic hypotension in Parkinson

Question 4

What is Rotigotine?

Answer 4

Dopamine agonist

Question 5

What is apomorphine?

Answer 5

Fast-acting subQ dopamine agonist that is indicated in rapid relief of symptoms caused by sudden, unpredictable wearing off of Parkinson medication

Question 6

In patients with severe head injury, fever must be controlled aggressively with an agent such as ____.

Answer 6

APAP

Question 7

Bilateral periorbital bruising (“raccoon eyes”), mastoid bruising (“Battle sign”), and hemotympanum suggest the presence of _____.

Answer 7

Basilar skull fracture

Question 8

How do you treat MS-related fatigue?

Answer 8

With stimulants such as modafinil

Question 9

Diagnostic criteria of epilepsy

Answer 9

At least two unprovoked seizures more than 24 hours apart or one unprovoked seizure with a high risk of recurrence on the basis of abnormalities found on testing

Question 10

Because there are currently no disease-modifying treatments for behavioral-variant frontotemporal dementia, treatment is symptom based and should target _____.

Answer 10

The disease’s most troublesome manifestations.

I.e. SSRI for OCD, methylphenidate for apathy, etc

Question 11

What is the diagnostic procedure of choice for reversible cerebral vasoconstriction syndrome (second most frequent source of thunderclap HA)?

Answer 11

MRI or CTH angio

Question 12

Which vitamin deficiency is associated with worse MS and accumulation of new lesions on MRI?

Answer 12

vitamin D

Question 13

What is a dystonic tremor?

Answer 13

Occurs both at rest and with action and is characterized by associated dystonic posturing and the presence of a null point at which a change in position resolves that tremor

Question 14

What is a Rubral tremor?

Answer 14

Caused by focal injury to the cerebellar outflow pathway and is characterized by a coarse tremor at rest but worse with action. Has a prominent proximal component. MRI would be positive for a lesion.

Question 15

Convulsive status epilepticus for patients 1st and 2nd line treatment options

Answer 15

1st: benzos (IV ativan, IV diazepam, IM midazolam all the same)
2nd: fosphenytoin or valproic acid if allergic to phenytoin

Question 16

What cancer is most associated with anti-NMDAR encephalitis?

Answer 16

ovarian teratoma (associated with choreoathetosis, psychiatric symptoms, seizures, and autonomic instability)