NEURO

Question 1

Unilateral severe periorbital HA with tearing and conjunctival erythema

Answer 1

Cluster HA

Question 2

Prophylactic tx for migraine HA

Answer 2

antihypertensives, antidepressants, anticonvulsants, dietary changes (also sumatriptan to abort headache!)

Question 3

Most common primary tumor. Treatment?

Answer 3

Prolactinoma. Dopamine agonists (i.e. bromocriptine)

Question 4

55 yo patient presents with “acute broken speech”. What type of aphasia? What lobe and vascular distribution

Answer 4

Broca’s.
Frontal lobe
left MCA

Question 5

Most common cause of SAH

Answer 5

Trauma!!

Second most common is berry aneurysm

Question 6

Crescent shaped hyperdensity on CT that doesn’t cross the midline

Answer 6

Subural hematoma due to torn bridging veins

Question 7

Hx of significant AMS with a lucid interval. Diagnosis?
Most likely source?
Treatement?

Answer 7

Epidural hematoma
middle meningeal artery
Neurosurgical evacuation

Question 8

CSF findings in SAH

Answer 8

xanthochromia, elevated ICP, RBCs

Question 9

“albuminocytologic dissociation”

Answer 9

Guillane Barre syndrome (due to increased protein in CSF without a significant increase in cell count)

Question 10

Cold water flushed into ear, and fast phase of nystagmus is torward the opposite side. Normal or pathologic?

Answer 10

Normal

Question 11

Most common source of mets to the brain

Answer 11

Lung> Breast> Skin(melanoma)>kidney>GI tract

Question 12

May be seen in children who are accused of inattention in class and confused w ADHD.
Tx?

Answer 12

Absence SZ

Ethosuximide

Question 13

Most frequent presentation of intracranial neoplasm

Answer 13

HA. primary neoplasms are much less common than brain mets

Question 14

MCC of SZ in children

Answer 14

Infxn, febrile SZ, trauma, idiopathic

Question 15

MCC of SZ in young adults

Answer 15

trauma, alcohol, brain tumor

Question 16

First line medication for status epilepticus

Answer 16

IV Benzos

Question 17

Confusion, confabulation, opthalmoplegia, ataxia

Answer 17

Wernicke encephalopathy due to thiamine deficiency

Question 18

What % lesion is an indication for carotid endarterectomy?

Answer 18

70% IF the patient is symptomatic

Question 19

MCC of dementia

Answer 19

Alzheimer’s and multi-infarct

Question 20

Combined upper and lower motor neuron dz

Answer 20

ALS

Question 21

Rigidity and stiffness w unilateral resting tremor and masked facies

Answer 21

Parkinson’s dz

Question 22

Parkinson’s tx

Answer 22

Levodopa/Carbidopa

Question 23

Tx for Guillan Barre

Answer 23

IVIG or plasmapheresis, DO NOT GIVE STEROIDS

Question 24

Rigidity and stiffness that progresses to choreiform movements w/ moodiness and odd behavior

Answer 24

Hungtinton’s

Question 25

6 year old girl w port wine stain in the V1 distribution with mental retardation, seizures and ispilateral leptomeningial angioma

Answer 25

Sturge-Weber. Tx = symptomatic. Possibly do focal cerebral resection of the affected lobe.

Question 26

Multiple cafe au lait spots on skin

Answer 26

NF1

Question 27

Hyperphagia, hypersexuality, hyperoality, hyperdocility

Answer 27

Kluver-Bucy syndrome (which affects the amygdala)

Question 28

Administer this drug to diagnose myasthenia gravis

Answer 28

edrophonium