NBME Neuro 20 Qs

Question 1

Chronic Fatigue syndrome

Answer 1

Persistent fatigue not substantially relieved by rest, unrelated to exertion> 6mon. NOT associated with daytime sleepiness (Hypersomnia).

Question 2

Restless Legs syndrome

Answer 2

Irresistible urge to move legs. that is worse at night, associated with dysthesias 9 (abnormal sensation) which are relieved by movement.

Question 3

Obstructive Sleep apnea.

Answer 3

Daytime sleepiness p/w: morning HA, snoring, faitgue, erectile dysfunction. Even with sleep does NOT feel well rested. Pt can present with large tonsils/adenoids that contribute to OSA requiring removal surgery.

Question 4

Thoracic outlet syndrome.

Answer 4

Compression of structures above 1st rib and behind clavicle including: brachial plexus (C8+T1 most common p/w pain/paresthesia in medial arm and digits 4/5), subclavian vein, subclavian artery (p/w: pain, paresthesia, paralysis, pulselessness, pallor)

Question 5

Circadian rhythm sleep disorder.

Answer 5

Unable to sleep/wake at times required by society BUT SLEEP QUALITY IS NORMAL

Question 6

Benign fasciculations.

Answer 6

Common in eyelids, arms, legs.

Question 7

Stiff person syndrome.

Answer 7

Resembles tetanus, waxing & waning muscle rigidity, often autoimmune in origin 2/2 anti glutamic acid decarboxylase seen in DM type 1, Celiac disease. Tx: baclofen since GABA decreases with decrease in GAD.