Nervous System

Question 1

prolonged seizures/ STATUS EPILEPTICUS are at highest risk of:

Answer 1

CORTICAL NECROSIS.

Question 2

hemineglect is caused by…

Answer 2

right parietal lobe lesion

Question 3

cephalohematoma v capput seccundum. which crosses suture lines?

Answer 3

seccundum

Question 4

oligoclonal bands on CSF = dx?

Answer 4

MS

Question 5

ddx: for marfanoid body habitus:
- downward lens dislocation and thrombosis and intellectual disabilit and fair skin].

-upward lens dislocation and aortic root dilation

Answer 5

• DOWNWARD = homocystinuria

- UPWARD = marfans

Question 6

calcification and round, homogenously enhancing DURAL BASED mass. B9

Answer 6

meningioma

Question 7

acute MS exacerbation v. maintenance tx

Answer 7

acute - CS

maintenance = interferone beta

Question 8

-If facial droop with SPARING of forehead muscle movement =?
VERSUS
- If forehead muscles are AFFECTED (cannot close eyelid/forehead mvmt loss) = ?

Answer 8

-If facial droop with SPARING of forehead muscle movement - intracranial lesion.
VERSUS
- If forehead muscles are AFFECTED (cannot close eyelid/forehead mvmt loss)- think peripheral neuropathy (bells = below pons)

Question 9

2 ddx for lesions at gray-white junction

Answer 9

mets v. toxo

Question 10

CT of brain with v without contrast

Answer 10

with = structural or masses

without = seizures or bleeds

Question 11

SE of Dopamine antagonism in:

Mesolimbic v nigrostriatal v tubuloinfundibular

Answer 11

mesolimbic = antipsychotic

nigrostriatal = EPS

tubuloinfundibular = glactorrhea, amenorrhea

Question 12

resting tremor of 4-6Hz = ?

Answer 12

parkinson tremor

Question 13

treat daytime somnolence in narcoplepsy.

Answer 13

modafanil

Question 14

Infective Brain lesions in Immunocompromised. (1)Well defined SINGLE enhancing focal lesion =

Answer 14

EBV causing primary CNS lymphoma.

Question 15

Infective Brain lesions in Immunocompromised. (2)Multiple NONenhancing brain lesions with no mass effect =

Answer 15

JC virus activation causing PML.

Question 16

Infective Brain lesions in Immunocompromised.

MULTIPLE ring enhancing lesions =

Answer 16

toxo

ppx: TMP-SMX
- tx: pyrimethamine and sulfadiazine, plus folinic acid.

Question 17

Infective Brain lesions in Immunocompromised.

Ring enhancing brain abscess <100 CD4 =

Answer 17

nocardia

Question 18

Infective brain lesions in NONimmunocompromised (5)SINGLE brain abscess post sinus/ENT infection =

Answer 18

Viridans strep or staph aureus.

Question 19

Infective brain lesions in NONimmunocompromised. (6)Non ring enhancing Necrotic and destructive in DM or Immunocompr =

Answer 19

Rhizopus/Mucor

Question 20

mcc of orbital cellulitis

Answer 20

bacteria sinusitis

Question 21

what drug is CI in acute glaucoma?

Answer 21

atropine because it causes DILATION

Question 22

TCA OD sx and tx

Answer 22

sx: CNS, Cardio, anticholinerg
tx: sodium bicarbonate

Question 23

cyanide toxicity after combustion or nitro OD - what drug for tx?

Answer 23

sodium thiosulfate or hydroxycobalamin

Question 24

Old person with DJD gets into hyerextension injury (MvA) - subsequent weakness in UE. Dx?

Answer 24

A: Central cord syndrome - LSTT.

Question 25

Q: what is bl spastic motor paresis distal to lesion?

Answer 25

A: anterior cord syndrome

Question 26

define parkinson tremor

Answer 26

resting

Question 27

type of tremor: hands, relived with alcohol and beta blocker.

Answer 27

essential

Question 28

cortical and subcortical atrophy, esp in TEMPRAL and P ARIETAL lobes - dx?.

Answer 28

alz

Question 29

Herpes encephalitis has RBC in CSF bc....?

Answer 29

A: incr erythrocytes due to hemorrhagic destruct | of temporal lobes.

Question 30

dx: pain and temp and motor go away, dorsal column intact(light touch, virbatio position).

Answer 30

syringomyelia

Question 31

what class is CI in acute closure galucoma nad usin gin parkinosn

Answer 31

anti-chol trihexyphenidyl. tx of Parkinson = entacapone-->levodopa

Question 32

ECG broad flat T waves, U waves, ST depression = ? electrolyte abn?

Answer 32

hypokalemia (i.e. hctz wasting)

Question 33

tx for NMS

Answer 33

Neruoleptic malignant syndrome = dantrolene or bromocripting, stop dop-antag meds, supporting (cooling)

Question 34

location of [PEDIATRIC tumor = ICP, seizures.

Answer 34

Supratentiorial

Question 35

location of [PEDIATRIC tumor = ICP, ataxia, clumsiness.

Answer 35

Posterior fossa

Question 36

location of tumor = ataxia, clumsiness, CN palsies.

Answer 36

Brainstem

Question 37

locaiton of tumor | - Back pain, weakness, abn gait.

Answer 37

Spinal Cord

Question 38

mcc of brain tumor in kids is __? presnts with ICP and seizures.

Answer 38

pilocytic astrocytoma = supratentorial = parietal = ICP, seizurs.

Question 39

acute closure glaucoma v uveitis - diff in pupils and light response.

Answer 39

ACG = dilated and nonreactive Uveitis = constricted, poor light response

Question 40

tx antichonilergic OD with...

Answer 40

physostigmine

Question 41

ASA OD

Answer 41

resp alk --> met acid