Neuro 1

Question 1

community acquired bacterial meningitis is most commonly due to
2

Answer 1

s. pneumoniae
n. meningitidis

Question 2

acute bacterial meningitis s/sx
7

Answer 2

acute onset of high fever
severe HA
stiff neck (nuchal rigidity)
AMS
classic purple petechial rashes
NV
photophobia

Question 3

polymylagia rheumatic PMR is associated with ___

Answer 3

giant cell arteritis

Question 4

MS - electric shock like sensation runs down the back

Answer 4

Lhermitte sign

Question 5

visual loss, diplopia, numbness on one side of face, urinary incontinence

Answer 5

MS

Question 6

stereogonosis

Answer 6

ability to recognize familiar object through sense of touch only

Question 7

graphesthesia

Answer 7

ability to identify figures “written” on skin

Question 8

Babinski’s sign is positive in adults if

Answer 8

toes spread like a fan

Question 9

achilles reflex with peripheral neuropathy

Answer 9

weak to no response

Question 10

CN - reminds you of shoulder shrugging together

Answer 10

CN XI

Question 11

shingles of the CN V can result in

Answer 11

corneal blindness

Question 12

rash at the tip of nose and the temple area

Answer 12

r/o shingles infection of the trigeminal nerve

Question 13

testing for pronator drift

Answer 13

pt stands with eyes closed and arms straight forward with palms up; arms drifting sideward or upward after a brisk tap indicate a positive test

Question 14

flex pt’s hip one at a time, then attempt to straighten the leg while keeping the hip flex at 90 degrees - positive if there is resistance bc of painful hamstrings

Answer 14

kernig’s sign

Question 15

passively flex/bend the pt’s neck toward chest - positive if pt flex the hips and knee to relieve pressure and pain

Answer 15

brudzinski’s sign

Question 16

three test to assess for meningeal irritation

Answer 16

kernig’s sign
brudzinski’s sign
nuchal rigidity

Question 17

acute onset of fever, severe HA, stiff neck

Answer 17

acute bacterial meningitis

Question 18

acute bacterial meningitis - perform what before LP

Answer 18

CT scan of the head

Question 19

acute bacterial meningitis - positive LP would show

Answer 19

CSF with large amount of WBCs and is cloudy; definitive dx made from bacteria isolated from the CSF with the presence of elevated protein and low glucose levels in the CSF

Question 20

acute bacterial meningitis - CSF from LP protein and glucose

Answer 20

elevated protein
low glucose

Question 21

acute bacterial meningitis - medication tx

Answer 21

IV 3rd gen cephalosporins + vanco + ampicillin; dexamethasone is also recommended

Question 22

acute bacterial meningitis - supportive care includes
3

Answer 22

fluid management
reduction of ICP
prevention of neuro complications

Question 23

bell’s palsy is abrupt onset of

Answer 23

unilateral facial paralysis due to dysfunction of the motor branch of the facial nerve CN VII

Question 24

bell’s palsy skin sensation

Answer 24

remains intact

Question 25

bell’s palsy - what is suspected to be the most likely cause in many cases

Answer 25

herpes simplex virus activation

Question 26

bell’s palsy early tx

Answer 26

high dose oral glucocorticoids e.g. prednisone 60-80 mg/day for 1 week

Question 27

bell’s palsy tx for severe palsy

Answer 27

oral glucocorticoid and antiviral therapy e.g. valacyclovir or acyclovir x 7 days