Neuro

Question 1

What HA needs an immediate referral?

Answer 1

Anything that sounds like a bleed or a stroke, brain tumor (dull/persistent, same spot, N/V, vision problems, change in personality), “worst HA of my life”
Needs CT

Question 2

A. fib increases risk of what type of stroke?

Answer 2

Ischemic

Question 3

HTN increases risk for what type of stroke?

Answer 3

Hemorrhagic

Question 4

TIA symptoms typically resolve within?

Answer 4

1 hour

Question 5

This is a one-sided HA, with tearing/runny nose, and occurs at the same time every day?

Answer 5

Cluster HA

Question 6

Treatment for cluster HA?

Answer 6

100% O2 and possibly CCB

Question 7

One-sided HA with possible vision impairment, temple pain/pulsing, increase ESR.

Answer 7

Temporal arteritis- giant cell arteritis

**High safety alert due to risk of vision loss

Question 8

Temporal arteritis is seen in patients with?

Answer 8

Polymyatica Rheumatica

Question 9

How is temporal arteritis diagnosed?

Answer 9

temporal artery biopsy

Question 10

How do we treat temporal arteritis?

Answer 10

Long-term steroids

Question 11

Occipital HA typically seen upon awakening?

Answer 11

HTN HA- treat HTN

Question 12

Difficulty with light/sound, throbbing/pulsating HA, possible N/V.

Answer 12

Migraines

Question 13

Migraine prophylaxis?

Answer 13

Avoid triggers, BB

Question 14

Migraine abortive treatment?

Answer 14

Triptans (cannot use in uncontrolled HTN and those on SSRIs)

Question 15

This affects CN V and is painful.

Answer 15

Trigeminal neuralgia

Question 16

Treatment of trigeminal neuralgia?

Answer 16

Tegretol (carbamazepine)

TCA (anticholinergic- no elderly, no BPH)

Question 17

Treatment of Bell’s palsy?

Answer 17

Steroids, antiviral, eye patch

Question 18

3 main symptoms of Parkinson’s disease?

Answer 18

1. Bradykinesia (slowness of movements)
2. Tremor (tx with BB)
3. Rigidity

Question 19

Treatment of Parkinsons disease?

Answer 19

Levadopa/carbadopa mix
Dopamine agonists (Ropinirole, Pramipexole)

Question 20

Signs related to Meningitis?

Answer 20

1. Brudzinskis

2. Kernigs

Question 21

This sign think back of the head, when flex back of head it causes patients hips and knees to flex with it d/t meningeal irritation.

Answer 21

Brudzinskis sign

Question 22

This sign, think knee, will not be able to flex knee past a 90 degree angle without pain.

Answer 22

Kernigs sign

Question 23

3 As of Alzheimer’s disease:

Answer 23

Aphraxia- difficulty with movement
Agnosia- inability to interpret sensation
Aphasia- loss of ability to understand/express speech

Question 24

What is CN VIII?

Answer 24

Acoustic

Question 25

CN VIII tests?

Answer 25

Rinne and Weber

Question 26

With the weber the sound will lateralize to the unaffected or good ear with what type of hearing loss?

Answer 26

Sensorineural hearing loss

Question 27

With the weber the sound will lateralize to the affected of bad ear with what type of hearing loss?

Answer 27

Conductive hearing loss

Question 28

With this disease the patient will typically present with vertigo, tinnitus, ear pressure, and nystagmus. Biggest concern is potential permanent hearing loss.

Answer 28

Meniere’s Disease

Question 29

This is normal sensioneural hearing loss associated with aging?

Answer 29

Presbycusis