Neuro 3

Question 1

one-sided HA that has recurrent severe and stabbing pain behind one eye that is accompanied by lacrimation, nasal congestion, rhinitis, and conjunctival injection/red eyes

Answer 1

cluster HA

Question 2

cluster HA acute tx

Answer 2

high dose oxygen
triptans Sq or intranasal

Question 3

cluster HA prophylaxis - frequent and infrequent attacks

Answer 3

frequent - CCB verapamil is drug of choice; avoid grapefruit juice
infrequent - glucocorticoids

Question 3

HA that gradual comes on, throbbing, over one eye, photophobia, phonophobia, NV, lasts 3-72 hours

Answer 3

migraine HA

Question 4

migraine HA pharm mild to mod attacks
3

Answer 4

NSAIDs
tylenol
antiemetic

Question 5

migraine HA pharm mod to severe attacks

Answer 5

oral triptans or combination sumatriptan-NSAID/naproxen

Question 6

HA - symptoms resemble a stroke, tinnitus, diplopia, bilateral visual field symptoms, bilateral paresthesia, vertigo, dysarthria

Answer 6

migraine w/ brainstem aura

Question 7

HA - bilateral, non throbbing HA of mild to mod intensity, band like sensation, typically w/o features

Answer 7

tension type HA

Question 8

tension HA med

Answer 8

NSAIDs first, then tylenol

Question 9

HAs - acute tx classes
3

Answer 9

NSAIDs
triptans
analgesics

Question 10

HAs - prophylactic classes

Answer 10

tricyclic antidepressants
BBs
SNRIs
SSRIs
anti seizure meds

Question 11

CN VIII is responsible for both what function

Answer 11

hearing and vestibular (i.e. Romberg test)

Question 12

Achilles reflex is what nerve root

Answer 12

S1

Question 13

which other conditions is closely linked with developing GCA

Answer 13

polymylagia rheumatica

Question 14

risks factors for recurrent ischemic stroke after a TIA include
7

Answer 14

1. age 60 +
2. hx of TIA or ischemic stroke w/in 30 days of index event
3. DM
4. BP 140+ or DBP 90+
5. unilateral weakness
6. isolated speech disturbance
7. TIA >10 mins

Question 15

triptan drug class should be avoided in patients with
6

Answer 15

hemiplegic or basilar migraines
ischemic stroke
ischemic heart disease
prinzmetal’s agina
uncontrolled HTN
pregnancy

Question 16

all triptans should be limited to less than ___ days of use per month to avoid overuse HA

Answer 16

<10 days

Question 17

CN for tongue movement

Answer 17

CN XII

Question 18

CN II tests what

Answer 18

distant and near vision test, testing for visual fields by confrontation and extinction

Question 19

CN - raise eyebrows, squeeze eyes shut, puff cheeks

Answer 19

CN VII

Question 20

two acute initial therapies for cluster HAs

Answer 20

oxygen
triptans

Question 21

drop seizures aka

Answer 21

atonic seizures - sudden loss of control of the muscles, usually the legs, which causes the patient to fall to the ground

Question 22

muscle stiffness along w/ impaired consciousness

Answer 22

tonic szs

Question 23

med indicated for acute tx of a mod to severe migraine attack

Answer 23

sumatriptan

Question 24

characterized by non-fluency with sparse output and incorrect grammar

Answer 24

Broca’s aphasia

Question 25

fluent aphasia with impaired comprehension

Answer 25

Wernicke’s aphasia

Question 26

triple abx therapy for bacterial meningitis

Answer 26

vanco + ceftriaxone + ampicillin