Neuro

Question 0

MC CNS mass lesion in brain in AIDS

Answer 0

Toxoplasmosis

CT contrast ring enhancing lesion

Question 1

Cluster ha

Answer 1

Conjunctival injection
Lacrimal ion
Rhinorrhea
Miosis
Ptosis

O2
Intranasal lidocaine

Question 2

Brudzindki sign

Answer 2

Flex hip caused by flex of neck

Question 3

Kernig sign

Answer 3

Pain in hamstring cause inability to straighten leg when hip flex 90degrees

Question 4

SAH med

Answer 4

Nimidipine PO/NG

Question 5

Bacterial meningitis

Answer 5

High PRO >150
low GLU
>500 WBC

S pneumo
N meningitidis

Cef vanco dexamethasone

Question 6

Gillian Barre

Answer 6

Demyelination
Ascending paralysis
LOSS IF DTRs
IV immunoglobulin

Question 7

MS

Answer 7

Pathognomonic bilateral INO - can't look at nose
Optic neuritis
-central vision loss
-pain on eye movement 
-papillitis - papiledema one eye

Question 8

Pure muscle weakness

Answer 8

Hypokalemia periodic paralysis
Myasthenia
Lambert-Eaton
Tick
Botulism 
ALS
Polio
West Nile
Certain toxins

Question 9

MG

Answer 9

Autoantibodies against Ach receptor
Thymoma 25%
Diplopia
Ptosis
Muscle weakness and fatiguabity proximal>distal
Tensilon - blocks breakdown Ach by cholinesterase
-can cause AVB, give atropine first

Rx physostigmine neostigmine

Question 10

Lambert-eaton

Answer 10

Autoimmune DS affects ca channels 
Decreased DTR
Prox muscle weakness 
Thighs and hips
Weakness improves with use 
50% caused by cancer esp SCLung ca

Question 11

Botulism

Answer 11

Bulbar sxs 
Diplopia
Ptosis
Dysphagia
Dysphonia
Dysarthria

Descending flaccid paralysis
Anticholinergic sxs
Dry mouth 
Dilated pupils
Urinary retention
Ileum
Decreased tears
Sensory nml

Infant - floppy baby constipated

Question 12

Tick paralysis

Answer 12

Rapidly ascending paralysis

Remove tick

Question 13

Wernicke’s

Answer 13

B1 deficiency 
AMS
Nystagmus
Opthalmoplegia
Ataxia 
Admit b1 mg

Question 14

Korsakoff’s

Answer 14

Amnesia

Confabulation

Question 15

West Nile

Answer 15

Dead crows
August and September
Flaccid paralysis 
anterior horn cells 
sensation intact
CSF
-high PRO WBC
Send CSF and serum for IgM

Question 16

MCC sz in a febrile kids

Answer 16

Hyponatremia

GE-rota and shigella

Question 17

UMN

Answer 17

Hyperreflexia clonus normal muscle mass spasticity increased tone increased reflexes Babinski sign

Question 18

LMN

Answer 18

Weakness atrophy fasciculations decreased DTR

Question 19

ALS

Answer 19

UMN and LMN

Question 20

Syringomyelia

Answer 20

Intraosseous muscle wasting
Loss of pain and temperature sensation in hands
Associated with cerebellar Chiari defects
Expanding central cavity in spinal cord usually cervical cord

Question 21

Hemorrhagic stroke

Answer 21

Basil ganglia thalamus
Decrease MAP to 160/90
Labetalol
Nicardipine
Nitroprusside

Question 22

Cerebral CVA

Answer 22

Contralateral motor and sensory deficits

contralateral cranial nerve palsies

Question 23

Brainstem infarct

Answer 23

Ipsilateral facial weakness and contralateral extremity weakness

Question 24

Pontine

Answer 24

Coma
Miosis
Ataxic breathing

Question 25

Cerebellar

Answer 25

Nystagmus 
dizziness nausea
 vomiting
 ataxia
DROP ATTACK

Question 26

ACA CVA

Answer 26

Contra lateral paresis legs
Sensory deficit
Gait disturbance

Question 27

MCA CVA

Answer 27

Most common
Contralateral paralysis arms and face
Sensory deficit in same distribution
Aphasia dominant hemisphere
Hemineglect if non-dominant
Homonymous hemianopsia
Eyes look toward side of stroke

Question 28

PCA CVA

Answer 28

Homonymous hemianopsia
Visual agnosia
Cortical blindness after CPR

Question 29

Vertebrobasilar

Answer 29

Locked in syndrome

Wallenberg

Question 30

Lacunar syndromes

Answer 30

Pure motor: pons internal capsule
Pure sensory: thalamus
Dysarthria-hemiparesis: pons, internal capsule
Ataxia-hemiparesis: pons internal capsule
Mixed sensorimotor: hemiparesis with ipsilateral sensory