MKSAP Neuro IV

Question 1

Best prevention of cluster headaches

Answer 1

Verapamil

Question 2

Treatment of trigeminal neuralgia

Answer 2

Carbamazepine

Question 3

____ is characterized by predominantly sensory and motor peripheral neuropathy and/or autonomic neuropathy; it is diagnosed by detecting a mutation of the transthyretin gene.

Answer 3

Familial amyloidosis

This disorder is diagnosed by detection of a transthyretin gene (TTR) mutation. Affected patients often have multiorgan involvement (diseases of the eye [glaucoma] and the neurologic, gastrointestinal, cardiac, and urinary systems).

Question 4

_______ should be suspected in patients with critical illness who develop altered mental status; the diagnosis is confirmed with continuous (24-hour) electroencephalography.

Answer 4

Nonconvulsive status epilepticus

Question 5

Subacute combined degeneration is a myelopathy manifesting as dysfunction of the corticospinal tracts and dorsal columns that is caused by _____ and _____ deficiencies.

Answer 5

B12 and copper

Question 6

Vitamin B6 deficiency is not common but may be associated with drugs that interfere with its metabolism, including … (3)

Answer 6

isoniazid, hydralazine, carbidopa/levodopa.

The most common manifestations are stomatitis, glossitis, cheilosis, confusion, and depression.

Question 7

In patients with multiple sclerosis and impaired mobility, _____ is the most appropriate medication.

Answer 7

dalfampridine (a voltage-gated potassium channel antagonist)

Question 8

Acute or subacute pain and paresthesia in a dermatomal pattern in the thoracic or abdominal region in a patient with diabetes mellitus and no evidence of herpes zoster is most likely due to ________.

Answer 8

diabetic mononeuropathy

Question 9

In a patient with suspected compression of the lower spinal cord, what emergent imaging is the next best step?

Answer 9

MRI

Question 10

Diagnosis and treatment of idiopathic intracranial hypertension

Answer 10

Lumbar puncture; acetazolamide

Question 11

______ is indicated for asymptomatic carotid stenosis of 60% to 80%.

Answer 11

Statin

no indication for surgery

Question 12

GBS is a _____ disease with weakness reaching its nadir in less than ___ weeks.

Answer 12

monophasic; 4 weeks (meaning that you don’t need to repeat IVIG/plasmapheresis unless symptoms worsen)

Question 13

(Name 3 AEDS) are all inducers of the cytochrome p450 system; these drugs increase breakdown of vitamin D, which results in increased parathyroid hormone levels, and thus cause bone loss and osteoporosis.

(Name 1 AED) can also cause bone loss though the mechanism is unclear.

Answer 13

Carbamazepine, phenytoin, and phenobarbital

Valproic acid

Question 14

_____ is indicated for all nonhypotensive patients with subarachnoid hemorrhage and is associated with improved neurologic outcomes and survival because it decreases risk of vasospasm (greatest 5- 10 days after SAH onset).

Answer 14

Nimodipine

Question 15

_____ is characterized by transient localized stabs of head pain that occur spontaneously in the absence of organic disease and typically last seconds; this headache is common among those with a history of migraine

Answer 15

Primary stabbing headache

Question 16

______ is the most appropriate treatment for epilepsy with focal seizure in older patients because of strong evidence of its safety and effectiveness.

Answer 16

Lamotrigine

Question 17

Broad-spectrum agents that can be used to treat both generalized and partial epilepsy syndromes (5)

Answer 17

lamotrigine, levetiracetam, topiramate, valproic acid, and zonisamide

Question 18

Narrow-spectrum AEDS (6) have the potential to exacerbate seizures in patients with generalized epilepsy.

Answer 18

1. carbamazepine
2. gabapentin
3. oxcarbazepine
4. phenobarbital
5. phenytoin
6. pregabalin