NEURO

Question 1

Subclavian steal syndrome:
presentation?
dx?
tx?

Answer 1

asx at rest, but arm claudication and CNS sx with exercise due to stenotic subclavian artery (can present like a TIA)

Dx arteriogram

Tx bypass surgery

Question 2

Presentation of:
Carotid TIA?
Vertebrobasilar TIA?

Answer 2

Carotid TIA: abrupt contralateral sx

Vertebrobasilar TIA: ipsilateral CN palsy, contralateral hemiplegia

Question 3

Transient global amnesia:
location?
presentation?

Answer 3

TIA in temporal lobes or thalamus → rapid retrograde memory loss + confusion but preservation of self-identity

Question 4

Presentation of ACA syndrome:

Answer 4

contralateral leg hemiparesis, incontinence

Question 5

Presentation of MCA syndrome:

Answer 5

contralateral face/arm hemiparesis

Question 6

Presentation of PCA syndrome:

Answer 6

homonymous hemianopia

Question 7

Presentation of Cerebellar infarction:

Answer 7

headache, nausea, vomiting, vertigo, nystagmus

Question 8

Presentation of Lacunar syndromes:

tx?

Answer 8

pure motor or sensory stroke, clumsy hand-dysarthria syndrome

control htn

Question 9

 Basal skull fx presentation?

Answer 9

raccoon eyes, hemotympanum, otorrhea, rhinorrhea, ecchymosis behind the ear (Battle sign)

Question 10

Shy-Drager syndrome:

Answer 10

PD + autonomic insufficiency

Question 11

Progressive supranuclear palsy (PSP):

Answer 11

PD w/o ophthalmoplegia or tremors

Question 12

Creutzfeldt-Jakob disease:
presentation?
dx?

Answer 12

rapidly progressive dementia, myoclonus (muscle spasms), personality changes

EEG (generalized sharp waves) + postmortem

Question 13

Vital signs a/w incr ICP?

Answer 13

↑BP, ↓HR, irregular RR

Question 14

Bilateral vs Unilateral fixed/dilated pupil:

Answer 14

Bilateral fixed/dilated pupils: severe anoxia

Unilateral fixed/dilated pupil: herniation w/ CN III compression

Question 15

Pinpoint pupils =

Answer 15

ICH in pons vs narcotics

Question 16

“Locked in” syndrome is caused by damage to…

Answer 16

ventral pons

Question 17

Result of brain herniation with compression of:
CNIII?
PCA?
crus cerebri?
brainstem causes?

Answer 17

CN III: ipsilateral “blown pupil”

PCA: contralateral homonymous hemianopia

Crus cerebri: ipsilateral paresis

Brainstem: Duret hemorrhages, death

Question 18

ddx for Ring-enhancing lesions:

Answer 18

metastases, abcesses, lymphoma, toxo

Question 19

MC brain cancers:

Answer 19

metastases (overall), astrocytoma (adults), infratentorial tumors (kids)

Question 20

“fried egg” cells, chicken-wire capillary pattern

Answer 20

Oligodendroglioma

Question 21

S-100+

Answer 21

Acoustic schwannoma

Question 22

Rosenthal fibers

Answer 22

Astrocytoma

Question 23

GFAP+

Answer 23

GBM + Astrocytoma

Question 24

Psamomma bodies

Answer 24

Meningioma

Question 25

pseudo- palisading necrosis

Answer 25

GBM

Question 26

Meningeal carcinomatosis:
presentation?
tx?

Answer 26

focal neuro sx, meningitis, hydrocephalus

intrathecal chemotherapy

**metastasizes to meninges via bloodstream

Question 27

Myasthenia gravis:
dx?
tx for myasthenic crisis?

Answer 27

↑anti-nAChR (best), edrophonium test, EMG (decreased response w/ repetitive stimulation), chest CT to look for thymoma

emergent ventilation

Question 28

Lambert-Eaton myasthenic syndrome (LEMS):
presentation?
dx?

Answer 28

gradually progressive muscle weakness that get better w/ repetitive muscle use

Dx ↑anti-VGCC (voltage gated Ca channel)

Question 29

Neurofibromatosis type I (von Recklinghausen disease):

presentation?

Answer 29

café-au-lait spots, Lisch nodules (iris hamartomas), CNS tumors, pheo

Question 30

Neurofibromatosis type II:

presentation?

Answer 30

bilateral acoustic neuromas, juvenile cataracts

Question 31

Tuberous sclerosis:

presentation?

Answer 31

• CNS/retinal hamartomas
• sebaceous adenomas
• hypopigmented “ash leaf spots”
• Shagreen patches
• renal angiomyolipoma
• cardiac rhabdomyoma

Question 32

Sturge-Weber syndrome:

presentation?

Answer 32

facial “port-wine stain” w/ ipsilateral brain AVM

Question 33

Von Hippel-Lindau disease:

presentation?

Answer 33

hemangioblastomas, bilateral RCC, pheochromocytomas