NBME

Question 1

What is tonometry?

Answer 1

test used to measure pressure in the eye; used to screen for glaucoma

Question 2

Simple Partial Seizures

Answer 2

begin in focal area of the brain and do not impair awareness; generally associated with positive phenomena (tingling, hallucinations)

Question 3

Complex Partial Seizures

Answer 3

focal onset and involve impairment in awareness; commonly arise in temporal lobe but can involve frontal lobe as well; may include automatisms +/- speech arrest

Question 4

Steps to lower ICP

Answer 4

1. Elevate head of bed
2. Hyperventilate
3. Mannitol

Question 5

Stroke Precautions: embolic

Answer 5

1. Permissive HTn
2. Head of bed flat
3. IV normal saline
4. Maintain normoglycemia, normothermia

Question 6

Stroke Precautions: hemorrhagic

Answer 6

1. Lower Bp
2. Head of bed to 30 degrees
3. Correct fevers, glucose abnormalities
4. Reverse anticoagulation

Question 7

Pathophys: organophosphate poisoning

Answer 7

inhibition of AChE, leading to accumulation of ACh in synaptic cleft

Question 8

Organophosphate poisoning: signs and sx

Answer 8

SLUDGEM (Salivation, Lacrimation, Urination, Defecation, Gastrointestinal motility, Emesis, miosis)

Question 9

Pathophysiology of heat stroke

Answer 9

thermoregulatory center fails to dissipate heat at rate necessary to maintain euthermic state

Question 10

MS: CSF analysis

Answer 10

Oligoclonal bands in the presence of normal protein concentration

Question 11

predominant immunoglobulin type in MS CSF?

Answer 11

IgG (although IgM, IgA also increased)

Question 12

Vessels responsible for lacunar strokes

Answer 12

In order of decreasing frequency:
Basal ganglia (esp putamen)
Thalamus
Pons
Cerebellum
Cortex

Question 13

Med used for young pt with Parkinson’s who present with tremor…

Answer 13

trihexylphenidyl (anticholinergic)

Question 14

Pathology of hyponatremia in subarachnoid hemorrhage

Answer 14

1. Inappropriate vasopressin secretion (water retention)

2. Increased ANP/BNP secretion (salt wasting)