NEURO

Question 1

Patient had a skull fracture with a fixed/dilated pupil – what do you think of?

Answer 1

Epidural hematoma

Question 2

What type of hematoma does NOT cross the suture lines?

Answer 2

Epidural hematoma

Question 3

What type of injury causes a subdural hematoma? What does the CT show?

Answer 3

Elderly/alcoholics or Acceleration/deceleration injury

Crescent shaped CT along the edge

Question 4

Worst HA of their life – you think of? Dx?

Answer 4

Subarachnoid hemorrhage

Dx with CT (if negative do CSF)

Question 5

How do we treat status epilepticus?

Answer 5

Lorazepam + ABC’s

Question 6

How do we treat migraines?

Answer 6

NSAIDS, triptains, or ergots

Question 7

Prophylactic treatment for migraines vs. cluster HA’s?

Answer 7

Migraines = BB or CCCB or TCA (amplodipine)

Cluster = CCB (verapamil)

Question 8

If a patient has focal deficits in a vascular territory – what do we do first?

Answer 8

GET A CT (to look for a bleed)

Question 9

If you believe it’s a stroke and CT is clear – what do you do?

Answer 9

TPA

Question 10

What are the requirements for giving TPA?

Answer 10

185/110, or hypoglycemia

Question 11

If stroke sxs completely resolve within 24 hours – what dx? Tx?

Answer 11

TIA

Aspirin or clopidogrel, stop smoking! BP control

Question 12

Causes of meningitis in under 1 month old? Tx?

Answer 12

GBS, e coli, and listeria

tx with Ampicillin + Gentamycin

Question 13

Causes of meningitis in 1-50 year olds? Tx?

Answer 13

Strep pneumo

Tx with Cefotaxime

Question 14

If a patient is over 50 with meningitis what should we add to Tx? Why?

Answer 14

Add Ampicillin to cover for listeria

Question 15

Special tests for meningitis? How do you Dx?

Answer 15

Brudzinski & Kernig

CSF with high protein, low to normal glucose, CBC with lymphocytosis

Question 16

When would a child get a febrile seizure?

Answer 16

Viral illness – make sure to r/o meningitis!

Question 17

How do you treat absence seizures?

Answer 17

Ethosuximide

Question 18

If you see a bulging anterior fontenella in a child – Dx? Tx?

Answer 18

Hydrocephalus

Tx with a shunt

Question 19

If someone has facial trauma, what should I look for?

Answer 19

Septal hematoma!

Question 20

best solutions to store an avulsed tooth?

Answer 20

Hank solution > milk > saliva > tap water

Question 21

What bacterial infection do we worry about in someone who wears contacts and has a corneal abrasion?

Answer 21

Pseudomonas

Question 22

If a patient has a flat anterior chamber of the eye with no extra-ocular movements – dx? Tx?

Answer 22

Ruptured Globe

DO NOT MEASURE IOP – optho emergency (start IV cephalosporins)

Question 23

You do a fluorescein dye of your patient’s painful eye and you see herpes – Tx?

Answer 23

Acyclovir – NO STEROIDS THEY WILL GO BLIND

Question 24

If a patient has pain with eye movements, acute vision loss, including color vision – what do you think of?

Answer 24

Optic neuritis – get an MRI

Question 25

If your patient suddenly loses vision in one eye and they have NO pain, on PE you note paleness and a cherry red spot – dx? Tx?

Answer 25

Central retinal artery occlusion

Breath into a bag, reduce IOP, vision loss is permanent

Question 26

What’s the most common cause of sensorineural hearing loss?

Answer 26

Presbycusis