Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Internal Medicine > Neuro > Flashcards

Neuro Flashcards

1
Q

Sudden onset of severe headache the begins suddenly and peaks in intensity within seconds. Dx? Test?

A

A thunderclap HA that is associated with Subarachnoid hemorrhage. CT without contrast followed by LP (Check for xanthochromia. Can be assocated with hyponatremia (ADH-> water retention -> BNP -> Diuresis and loss of Na)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Old patient with incontinence, dementia and ataxic gait. Dx? What do you see on CT? Rx?

A

Normal pressure hydrocephalus. Ct shows enlarged ventricles. Diuretics. Steroids. Venticulo shunt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which disease is associated with hypokinetic gait? waddling gait? Wide base gait?

A
  1. Parkinsons 2. Muscular Dystrophy 3. Cerebellar disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In a patient affected with GBS what is the most important in monitoring respiratory function? Rx? What not to give?

A

This occurs s/p Respiratory or GI illness. Vital Capacity. Do not give steroids like in Myasthenia this can worsen the condition. IVIG OR plasmapheresis. Not both there is no additive affect.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Tachycardia + Bleeding from the nose + fever+ working outside all day hot sun moving packages + confusion and disorientation. Dx? Rx? Explain the coagulopathy. What is Heat exhaustion.

A

Exertional Heat Stroke as oppose to a nonexertional heat stroke due to loss of fluids and inability to dissipate heat from the humidity. the cause of the epitaxis is a complication due to coaulopathy associated with heat stroke. Also see rhabdo and ARDS. Heat exhausation is same symptoms with out Confusion and Disorientation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Involuntary Non-repetitive Movements of the trunk, face and Extremities, Depression, Dementia, Family hx, Age 40s. Dx? Test? Rx?

A

Huntingtons Chorea. Clincal and genetic testing for CAG repeat. Haloperidol and Tetrabenazine (dyskinesias)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Scanning speech, urinary incontinence (hypo-reflexic, flaccid bladder), hypereflexia, weakness and sensory loss. Optic neuritis. INO, Lhermitte’s sign. Pt has worsening symptoms in heat. Dx? Test? Rx? Acute and relapsing/remitting

A

MS. MRI best initial and most accurate test. Acute treatment is IV solumedrol. Relapsing/remitting: Interferon B (Besetron), Interferon A (Avonex) and glatiramer, mitaxantrone (chemotherapy agent. Immunosuppressents for refractory cases- azithrosiaprine, cyclosporine, cyclophosmphamide. Spasticity - Baclofen or diazepam Bladder dysfunction - Oxybutinin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Scanning speech, urinary incontinence (hypo-reflexic, flaccid bladder), hypereflexia, weakness and sensory loss. Optic neuritis. INO, Lhermitte’s sign. Pt has worsening symptoms in heat. Dx? Test? Rx for Acute? Rx for relapsing/remitting (4)? Rx for Refractory Cases (3)? Rx for Spasticity? Rx for Incontinence?

A

MS. MRI best initial and most accurate test. Acute treatment is IV solumedrol. Relapsing/remitting: Interferon B (Besetron), Interferon A (Avonex) and Glatiramer, Mitaxantrone (chemotherapy agent.) Immunosuppressents for refractory cases- Azithrosiaprine (Liver), Cyclosporine (gum hypertrophy, tremors), Cyclophosmphamide (Bladder Cancer). Spasticity - Baclofen or Diazepam Bladder dysfunction - Oxybutinin (Anti-Cholinergic).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Loss of forehead and brow movements, loss of nasolabial fold, loss of taste in anterior 2/3 of tongue. Hyperacusis. In ability to close eye and drooping of the eyelid. Dx? Test? Rx?

A

Idiopathic Bells Palsy CN 7. Strokes are morse associated with peripheral nerve palsy- lower sided of facial drop sparing forehead. In Bell’s palsy the upper and lower parts are affected (central palsy.) electromyography. Most resolved without treatment can give prednisone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the indications for carotid endartectomy?

A

> 70-99 with symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Tight like band like bilateral HA associated with tightness of posterior neck. Last days without fluctuation (constant) not exacerbated by movement. No floaters or flashers no photophobia. Dx? Rx ?

A

Tension HA. Meditate and NSAIDS.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Rx for Subarachnoid Hemorrahge? Electrolyte complication?

A

Calcium channel blocker - nimodipine Hyponatremia 2/2 ADH release -> water retention -> BNP rise -> Diuresis and Na loss.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Chronic hearing loss with ringing in ears. Symptoms wax and wane with endolymph pressures. Dx? Test? Rx?

A

Meniere’s disease. Clinical Diagnosis. Rx low salt diet, Diuretics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pulsatile, throbbing, unilateral pain head pain associated with photophobia and phonophobia. The pain peaks 4- 72 hrs. Can be brought on with emotion and food. Dx? Rx acute? Chronic? What are the contraindications of acute treatment.

A

Migraine. Acute/abortive treatment: sumatriptan or erogotamine. Chronic: beta blockers ( propranolol) valporic acid and topiramate, Tricyclics, SSRI, CCBs. Ergotamine not used in pregnancy, HTN or coronary dz.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pt complains of sharp pain of the mouth that radiates to ear. Pt has light touch to the brain and feels sharp pain and screams. Dx? Rx?

A

Trigeminal neuralgia (Tic Dolourex). Compression of the 5th cranial nerve. All imaging, nerve and sensory studies are normal. Rx: Carbamazepine ( anti epileptic.) Ablation and surgical decompression for refractory cases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Treatment of Restless Leg Syndrome? What is it associated with?

A

Dopamine agonist (pramipexole and ropinerole) or levodopa. Like Parkinson’s. Associated with Iron deficiency anemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Contral lateral weakness and sensory loss upper extremity and face more affected, lower extremity can be affected, vision affected (Homonymous hemianopia) aphasia dx stroke?

A

Stroke of MCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Vertigo that is exacerbated by head movement or change in head position. Episodes occur in clusters. Recurrent. and persist for day. Last 10 to 60 seconds. Dx? Test? Rx?

A

Benign Paroxysmal Positional Vertigo. Dip Haxlike Maneuver. Treated with positional attempts to move otolith out the ears (Epley Maneuver.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the conditions of seizures you should treat? (3)

A
  1. Abnormal EEG. 2. Status Epilepticus. 3. More than one Seizure.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Best initial test for Myasthenia Gravis. Most accurate test? and Chronic Rx? Rx for Myasthenia Crisis?

A

Best initial test is Ach-Antibodies. (Attack of the NMJ/Reflexes Present) Most accurate is EMG. Rx: Physotigmine, Neostigmine. 2. Thymectomy if under age 60. 3. Prednisone/Azithiorpine (pancreatitis)/Cyclosporine. Crisis: IVIG or Plasmapharesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Sudden onset of severe vertigo that lasts for several days with hearing loss and tinnitus. Frequently occurs after a viral infection. Dx? What is diagnosis if there are no auditory symptoms? Test? Rx?

A

Labyrinthitis treated symptomatically with Meclizine and Diazepam with severe cases. Vestibular neuritis. Diagnosis of exclusion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Involuntary loss of urine associated with over-distention of the bladder, reflecting lower motor neuron problem. There is constant dribbling or urge or stress incontinent symptoms. Dx? Test? Rx?

A

Overflow incontinence (hypo-reflexic flaccid blader). (LMN: drugs, diabetic neuropathy lower spinal cord inury, pelvic surgery that disrupts innervation to destrusor muscle, outlet obstruction (BPH, prostate cancer.) UA to rule out infection or hematuria. PVR 100ml!!!! Urine cultures, BUN/Cr. When cause is not identified - Cytometry, Cystourethrogra) Valsava, Intermittent self cath, Bethanechol.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Stinging and burning pain of the face following a varicella (zoster) infection. Dx? Rx?

A

Postherpetic Neuralgia. Early treatment of shingles with acyclovir may prevent the development of postherpatic neuralgia. When it is developed give TCAs and gabapentin for symptomatic treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Test and Treatment of choice of Narcolepsy and Cataplexy.

A

MSLT (Mutiple Sleep Latency Test) CSF has decrease hypocretin as well. Narcolepsy - Modafinil Cataplexy- clomipramine and sodium oxabate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Rx of Parkinson’s disease ?

A

Mild Disease: Anticholinergic (benzotropine and trihexyphenidyl) - dont use in older folks) and Amantidine
Severe Disease: Dopamine agonist (Pramipexole and Ropinirole, Bromocriptine and Carbergoline)
Dopamine precursors : Levodopa/Carbidopa(watch for off signs ie bradykinesia)
COMT inhibitors: Tolcapone and Entacapone - they prevent degradation in periphery
MAO inhibitors - rasagiline, segeline (watch out for tyramine rxn)! They can slow progression of disease.
Deep brain stimulation - good for rigidity and tremors
Extremely severe attack: Clonzapine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Caused by JC virus and affects those immunocompromised. Affects the oliogodendrocytes. Dx?

A

Progressive Multifocal Leukoencephalopathy. PML. No rx. fatal course.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Caused by JC virus and affects those immunocompromised, HIV CD4 < 50. Affects the Oliogodendrocytes. CT scan show Mutiple Non-Enhancing Ring lesions. Dx?

A

Progressive Multifocal Leukoencephalopathy. PML. No rx. fatal course.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

27 yo patient complains of hearing loss. On Rhines test the she hears vibration louder on the mastoid then when placed infront of the ear. Dx?

A

Conductive hearing loss due Otosclerosis is autoimmune abnormal remodling of the otic capsule.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Alcoholics presents with Opthalmoplegia, Truncal ataxia and Confusion. Dx? What is the form of the disease that has isolated MEMORY deficits that persist after everything else resolves?

A

Wernicke’s Encephalopathy. Korsakoff’s Syndrome. Give Thiamine (B1) and Glucose to alcoholics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Describe management of Ischemic stroke/Non hemorraghic.

  1. < 3 hrs?
  2. > 3 hrs?
  3. Taking Aspirin Already?
A
  1. After bleeding stroke has been ruled out on CT and its < 3 hrs Since Onset of Stroke -> Give Tpa (Streptokinase)
  2. > 3 hrs Since Onset-> Give Aspirin
  3. If already taking Aspirin add Dipyridamole or switch to Clopidegrol (Plavix) alone.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

AR inheritance. Associated with floppy baby and tongue fasiculations. Death usually occurs by 2 years of age. Dx? What part of the spinal cord is affected? Test? How is this different from Botulism?

A

Spinal Muscular Atrophy (Werdnig Hoffman syndrome) Degeneration of the anterior horn of the spinal cord. Presents of SMN gene in blood (Most accurate). Muscle biopsy shows perinueral denervation. This disease does not have pupil involvement like botulism and the weakness is more severe in legs then arms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Name that Syndrome: Unilateral Severe Radicular Pain, Saddle Anesthesia, Asymmetric Motor Weakness, Hyporeflexia, Late Onset loss of bowel and bladder control.

A

Cauda Equina Syndrome (Peripheral Compression.) - Unilateral Asymmetric.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the difference btw BMD and DMD ? Best initial test? Most accurate test?

A

Both X-linked recessive but BMD is a milder form of DMD. CPK and Aldolase levels Elevated. Confirm with Genetic Testing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Pt presents with Fever, AMS, Seizures, LOC for < 1 week. CSF shows RBC and WBCs. EEG shows epileptiform discharges over one or both temporal regions. Dx? Test? Rx?

A

Herpses simplex. Can do PCR. IV Acylovir.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Presents in adolescence with symmetric slowly progressive distal muscular atrophy of the legs and feet. Decreased deep tendon reflexes. Tremor.s Legs look like inverted Champagne bottles. Hammer toes, Pes vas (high arch.) Dx?

A

Hereditary Motor and Sensory Neuropathy: Charcot- Marie- Tooth disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Most common brain tumor of children presents with rosenthal fibers. It is benign. Dx?

A

Pilocystic Astrocytoma

36
Q

Weakness and stiffness of the distal muscles present in YOUNG ADULTS. Systemic findings such as CATARACTs, ptosis, Arrhythmia, FRONTAL BALDING, TESTICULAR ATROPHY can be present was well has changes in affect. Dx? Best initial Test? Most accurate Test? Rx?

A

Muscular Dystrophy. CPK is normal or elevated. EMG shows Myotonia. DNA testing for CTG expansion Most accurate. Prevent Arrthymias. Phenytoin to reduce myotonia.

37
Q

Common tumor in adult females? Pathology?

A

Meningioma has estrogen receptors. Has whorled pattern of cells with pssamobodies

38
Q

Ascending pararlysis occuring over days to weeks. Autnomic dysregulation. Absent reflexes. Acquired after an GI or Respiratory illness. Dx? What is the best initial test? What is the most accurate diagnostic test?

A

GBS. Best initial test is : CSF will show elevated protein and normal everything else. Most accurate test is EMG. IVIG or plasmapheresis.

39
Q

2 main causes of stroke in young person?

A

Vasculitis and hypercoaguablility.

40
Q

Brain tumor that grows within the ventricles. Present in adults and children.

A

Ependymoma.

41
Q

Benign tumor with a prominent capillary network. Between the capillaries there are neoplastic cells. The cerebellar hemispheres are the most common locations. Associated with Von-Hippel-Lindau Syndrome. Dx?

A

Hemangioblastoma.

42
Q

Rapidly growing brain neuroectodermal in origin tumor that grows from the cerebellar vermis and compresses the 4th ventricle leading to hydrocephalus. Can push down and spread into the spinal cord causing drop metastases. 2nd most common brain tumor of children. Dx?

A

Medulloblastoma.

43
Q

Where is the lesion: Contralateral spastic hemiparesis, contralateral loss of tactile/position/vibration sense, MEDIAL STRABISMUS.

A

Medial Pontine Syndrome: Corticospinal tract, Medial leminiscus, Fibers of CN 6.

44
Q

Most common malignant tumor in adults

A

Glioblastoma multiforme that crosses the corpus collusm. Ring enhancing with central necrosis. (Psuedopallsading) Butterfly pattern.

45
Q

Where is the lesion: Contralateral spastic hemiparesis, contralateral loss of tactile/position/vibration sense, MEDIAL STRABISMUS - pupil deviates medially.

A

Medial Pontine Syndrome: Corticospinal tract, Medial leminiscus, Fibers of CN 6.

46
Q

Where is the lesion: Ipsilateral ataxia, Vertigo, N/V, nystagmus, Ipsilateral FACIAL paralysis, Ipsilateral loss of taste (anterior 2/3 of tongue), Loss of Lacrimation, Loss of Salivation, Loss of Corneal reflex, hyperacusis, Ipsilateral Pain/Temp loss of Face, Contralateral pain/temp loss of body, Ipsilateral hearing loss, Ipsilateral Horner’s Syndrome.

A

Lateral Pontine Syndrome (AICA): Middle cerebellar peduncle, Vestibular nuclei, CN 7 nucleus and fibers, Spinal trigeminal nucleus/tract, Spinothalamic tract, Cochlear nucleus/ CN 8 fibers, Descending hypothalamic tract

47
Q

Where is the lesion: Paralysis of UPWARD GAZE, various pupillary abnormalitie, non communicating hydrocephalus.

A

Dorsal Midbrain (Parinaud Syndrome): Superior colliculus/pretectal area from pineal tumor, cerebra aqueduct compression from tumor can lead to noncomunicating (Blockage) hydrocephalus.

48
Q

Where is the lesion: Contralateral spastic paresis, Contralateral loss of tactile, vibration and position sense, Ipsilateral flaccid paralysis of tongue with tongue deviation toward affected side.

A

Medial Medullary Syndrome: Pyramid (Corticospinal tracts), Medial lemisnucs, CN 12 nucleus.

49
Q

Obesity and pregnancy and sitting with legs crossed compressed what nerve? What is the manifestation?

A

Lateral cutaneous nerve of the thigh. Pain/numbness in ankle and sole of foot.

50
Q

High boots and pressure to back of knee disturbs what nerve? What is he manifestation?

A

Compression of the peroneal nerve. Weakness with decreased dorsiflexion and eversion of foot. “Foot Drop”

51
Q

Where is the lesion: Ipsilateral OCULOMOTOR palsy (lateral strabismus- pupil deviates laterally, dilated pupil, ptosis) contralateral Spastic hemiparesis, Contralateral hemiparesis of the lower face

A

Medial Mibdrain Syndrome: Fibers of CN 3, Corticospinal tract, Corticobulbar tract

52
Q

Steps to Treatment for status epilepticus?

A
  1. Benzo 2. Phenotoyin or Fosphenytoin 3. Phenobarbital 4. Succinylcholine for intubation for general anesthesia.
53
Q

Where is the lesion: Ipsilateral limb ataxia, Vertigo, N/V, nystagmus (away from lesion), ipsilateral paralysis of larynx, pharynx, palate, dysarthia, dysphagia, loss of gag reflex, Ipsilatral pain/temp loss of face, Contralateral pain/tem loss of body, ipsilateral Horner’s Syndrome.

A

Lateral Medullary Syndrome (PICA): Inferior cerebellar peduncle, vestibular nuclei, Nucleaus ambigus CN 9 and 10 nucleus, Spinal trigeminal tract of 5, Spinal thalamic tract, Descending hypothalamic tract.

54
Q

Name that stroke: Atherosclerotic Risk Factors (HTN, DM, +/- TIA hx). Occurs Locally, in-situ obstruction of an artery. Symptoms fluctuate from stuttering in speech to periods of improvement. Dx?

A

Ischemic Thrombotic Stroke

55
Q

Name that stroke: Hx of uncontrolled HTN, Coagulopathy, Ilicit drug use (Cocaine, Amphetamines) Symptoms progress over minutes to hours. Pts have focal defecits then develop global deficits. Dx?

A

Intracerebral Hemorrahge Stroke

56
Q

Name that stroke: Brought on by Afib, Endocarditis, Carotid Atherosclerosis (Bruit.) Onset of Symptoms are abrupt and maximal at start of stroke. Can have multiple infarcts within different vascular territories. Dx?

A

Ischemic Embolic Stroke

57
Q

Name that stroke: Rupture of Arterial Saccular (Berry) Aneurysm or from an AVM. Severe HA at onset of neurological symptoms. Meningeal irritation (neck stiffness) Global deficits.

A

Spontaneous Subarachnoid Hemorrhage

58
Q

A form of PAN ( Hep C and Hep B patients) which can present with fevers, malaise, athralgias, weight loss, palpable purpura, Foot drop, Wrist can deviate, Stroke in a young person. Dx? Most accurate test? Rx?

A

Mononeuritis multiplex. Can happen in the personal nerve and Ulnar Nerve. Most accurate test is Biopsy. Rx: Prednisone.

59
Q

Name that EPS: 1. 14 days after treatment, Sudden in Onset, Sustained contraction of the neck, mouth, tongue, eye muscles, Rx?

  1. Restlessness, inability to sit still., Rx?
  2. Involuntary abnormal lip smacking, tongue protusion, writhing movements of limbs and trunk, Rx?
  3. Years after treatment, Gradual in onset, tremor rigidity, bradykinesia, masked fascies Rx?
A
  1. Acute Dystonia, Rx with Benztropine, Trihexyphenidyl, Benadryl (Diphenhydramine)
  2. Akthasia, Rx with Beta blocker
  3. Tardive Dyskinesia, withdraw neuroleptics.
  4. Parkinsonism, Rx with Amantadine.
60
Q

Name that Syndrome: Sudden onset severe back pain, perianal anesthesia, Symmetric motor weakness, Hyperreflexia, Early onset bowel and bladder dysfunction.

A

Cona Medularis Syndrome ( Spinal Cord Compression, its more diffuse signs then localized like Cauda Equina)

61
Q

Sudden loss of consciousness followed by disorientation then slow gain of consciousness and hemipelgia.

A

Todds paralysis. Posticital paralysis after seizure.

62
Q

Pt has spots on back and spots in eyes. Dx? What is patient prone to developing?

A

Neurofibromastosis. Cafe au lait spots and lisch nodules. Prone to developing tumors.

63
Q

Average duration of this seizure 10-20 seconds. Consciousness is not altered. Movements characterized by asynchronous clonic or tonic movements. Pts complain of preictal aura. Have 2 of these can be what? Dx?

A

Partial (Focal Seziure). Having more than one can be complex partial seizure.

64
Q

LOC + automatism. What kind of seizure?

A

Complex partial seizure

65
Q

No LOC + aura

A

Simple partial seizure

66
Q

This seizure is associated with sudden cessation of motor activity and speech, common in girls, does not occur before age 5, no post ictal state, pts can experience this daily. Dx? Rx? How can you tell the difference btw complex partial seizure and this?

A

Absence Seizures. Valproate or Ethuxsuomide. Complex partial seizure has a normal EEH patteran while Abscence seizures have spike and wave abnormalities.

67
Q

Patients suddenly lose consciousness, their eyes roll back and their entire musculature undergoes tonic contractions, arresting breathing. There is hyperextension gives way to a series of rapid jerks. There is a period of flaccid relaxation. Prodromal symptoms occur and not auras. Dx?

A

Generalized Tonic Clonic Seizures.

68
Q

Most common seizure in childhood. It is a brieft tonic-clonic seizure associated with fever. No longterm sequelae. Dx?

A

Simple Febrile Seizure.

69
Q

These begin age 4 and 8 months and present as short lived symmetric contractions of neck, trunk and extremities. Dx? Rx?

A

Infantile spasms. Rx with ACTH.

70
Q

Facial nevus, seizure, hemiparesis, intracrainal calcifications. Dx?

A

Struge-Weber Syndrome.

71
Q

In children less than 3 years what is the most likely etiology of status epilepticus?

A

Fever/Febrile Seizures.

72
Q

Infantile Spasm, Ashe leaf macule, shagreen patch, sebaceous adenoma, generalized seizures. Dx? Complications (3)

A

Tuberous sclerosis. Rhabdomyoma of the heart, retinal lesion, Polycystic or Harmatomas of the kidneys.

73
Q

Cherry red macular which inborn error of metabolism?

A

Tay-Sachs diseaes.

74
Q

Rx for Transverse myelitis Related to autoimmune cause or infectious cause.

A

Steroids and IVIG. Emergency.

75
Q

Test and Rx for Brain Aneursyms?

A

Angiography. Clipp and Coil

76
Q

Accelerated enlargement of the head. > 2 SD above the mean. Dx? 2 types and etiology? Test? Rx?

A

Hydrocephaus. Noncommunicating - hematoma or turmor- complete obstruction. Communicating (meningitis or intravascular hemorrahge. -exudate block the cisterns) CT/MRI. Acetazolamide Shunt, Drain if chronic condition.

77
Q

Lack of involuntary urinary continence. What is the age limit for diurnal? What is the age limit for nocturnal? Rx?

A

Enuresis. Beyond age 4 is diurnal. Beyond age 6 of nocturnal. Psychotherapy. Positive reinformcent. No liquids after dinner. Desmopressin first line then imipramine

78
Q

Repeated passage of feces into inpparopriate places (clothing and floor) Dx? Rx?

A

Encopresis. Due to anxiety or loss of sphincter tone (physiologic condition) Constipation. Psychotherapy. Positive Reinforcement. Choose time to poop everyday. Stool Softners.

79
Q

A kid who is immunocompromised with gradual headache development, fever and hyperactive reflexes. Dx? Name 2 main risk factors.

A

Brain abscess. Congenital heart disease and sinusitis.

80
Q

Seizure with diffuse muscle aches, elevated CPK or loss of bowel or bladder control. Dx?

A

Partial seizure with secondary generalization

81
Q

Difference btw PM, DM and IBM? Best initial Test? Most accurate test? What else is DM associated with? Rx?

A

PM and DM present with Symmetric Proximal Muscle WEAKNESS!!! while IBM is Distal and Asymmetric Muscle Weakness. IBM is diagnosed when Pt fails Steroids for Rx of polymyositis. DM- Shawl sign (erythema neck, face, chest and upper back,) Grotton papules (PIP and MCP) and Heliotrope rash. Best initial test is CPK and Aldolase (ESR, crp, rf all elevated). Most accurate is Muscle Biopsy not genetic testing like in DMD. Anti-Jo is present when there is lung fibrosis. DM is associated with Lung Cancer. 1. Steroids 2. Methotrexate (Macrocytic Anemia, Bone marrow Suppression), Azithrioprine (Pancreatitis), IVIG, Mycophenolate, Hydroxychloroquine (Retinal deposits) for skin stuff.

82
Q

A mass causing downward herniation of the diencephalon throught the tentorial notch. There is a decreased level of alertness associated with this. Then Small Reactive Pupils (pin point) due to compression of the hypothalamus (sympathetic pathways) Decorticate posturing then progresses to midbrain with Fixed Pupils and Decerebrate posturing.

A

Central herniation

83
Q

Frontal lobe mass can produce herniation of the cingulate gyrus beneath the falx cerebri compresison of what artery can lead to what symptom? Dx?

A

Subfalcine herniation. Compression of the Anterior cerebral artery can lead to leg weakness.

84
Q

HA that has autonomic symptoms but last 10 to 30 mins and pts can have up to 40 attacks in a day. Dx? Rx?

A

Paroxysmal hemicrania. (Trigeminal autnomomic cephalgia like cluster HA they cause ipsilateral autonomic symptoms) this responds to indomethacin/NSAID unlike cluster HA.

85
Q

Rx for tetnus.

A

Rapid administration of Human tetnus immune globulin

86
Q

Peroneal muscle atrophy and peroneal tibial nerves. Pts present with clumpsiness, fall easy, foot drop and claw hand and are slowly progressive. Pes cavas, Champagne looking legs. Dx? Test? RX?

A

Hereditary Motor Sensory Neuropathy: Marie Charcot-Tooth disease. Progressive disease of the periphral nerve. Decreased nerve conduction studies. Stablize ankle.

87
Q

Presents with dysathria, dysphagia, EPS, ataxia and suprenuclear ocular palsy. Dx?

A

Progressive Supranuclear Palsy. (Defined by atrophy of the dorsal midbrain, globus pallidus, subthalamic nucleus.) NFTs, neuronal loss and gliosis in many subcortical structures are present.

88
Q

Orthostatic hypotension, diarrhea, constipation, early satiety, tachycardia, palpitations, blurred vision, urinary retention, and erectile dysfunction. Dx? Which diseases is this seen in? Test? Rx?

A

Autonomic Neuropathy seen in DM, GBS, MSA (Multiple System Atrophy) Lambert-eaton syndrome, Drugs, Toxins. Check HR with Valsava, Tilt table testing. Rx the cause and avoid the exposure. Symptomatic therapy - Compression Stockings, Fludrocortisone, Phenylephrine (alpha agonisr) or Midodrine for vasoconstriction.

Internal Medicine (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions