neuro

Question 1

meningioma on imaging

Answer 1

• well circumscribed, hyperdense,
• extra-axial –> “rim enhacning” suggests CSF surrounding it
• dural tail
• parafalcine

Question 2

hearing loss assoc with mineiere’s

Answer 2

low freq

Question 3

what should you think about before treating cluster head aches with sumitriptan or ergots?

Answer 3

are they smokers or have other reasons to have CVD? Sumitriptan and ergots cuse vasoconstriction

Question 4

AchE inhibitors that DO NOT cross BBB

Answer 4

pyridostigmine

neostigmine

Question 5

when are steroids indicated in meningitis?

Answer 5

when strep pneumo is known or confirmed?

Question 6

bull’s eye maculopathy

Answer 6

seen in chloroquine toxicity (malaria, rhematoid/ lupus flair)

Question 7

most common meningitis bug in adults?

Answer 7

strep pneumo

Question 8

treatment for acute spinal cord injury?

Answer 8

IV methylpred!!!!!!

not dexamethasone

Question 9

evidence of spinal shock after traua and absence of bulbocavernous reflex… next step?

Answer 9

foley, or else they will develop acute urinary retention

Question 10

treatment options for strabisums

Answer 10

occlusion tx= patching the good eye

penalizatoin (cyclopentolate drops)= blur vision, use them in the good eye to force use of bad eye

Question 11

morton’s neuroma (intermetatarsal neuroma)

Answer 11

usu entrapment of median plantar nerve, caused by narrow heels

Question 12

sensorineural hearing loss, rinne test

Answer 12

lateralizes to GOOD ear

Question 13

conduction hearing loss, rinne test

Answer 13

lateralizes to BAD ear because there’s fluid or something that can conduct sound better

Question 14

cerebellopontine syndrome

Answer 14

most commonly from vestibular schwannoma

• unilateral sensorineural hearing loss
• tinitus
• vertigo

Question 15

you suspect SAH, but CT is clear and pt has no signs of inc ICP. What do you do?

Answer 15

LP –> RBCs, xanthochromia, maybe elevated opening pressure

Question 16

how can you distinguish traumatic LP from SAH?

Answer 16

successive tube collections –> number of RBC will stay the same in SAH

Question 17

mycotic aneurysm

Answer 17

due to septic emboli, most likely from infectious endocarditis

Question 18

most common cause of non traumatic SAH?

Answer 18

saccular aneuryms rupture= 80%

avm~ 10%

Question 19

what would an AVM rupture look like on CT?

Answer 19

foci of calcification and hyperattenuating vessels

Question 20

kernohan’s phenomenon

Answer 20

“false localizing sign”

-uncal herniation of one side causes IPSILATERAL paralysis due to compression of the contralateral cerebellar peduncle

Question 21

but why exactly does HTN lend highest risk to atraumatic ICH?

Answer 21

htn –> lipohyalinosis of arterioles –> creates microaneurysms –> more weak spots

Question 22

posterior fossa mass assoc with obstructive hydrocephalus in children

Answer 22

ependymomma

Question 23

periorbital edema, chemosis, abducens (or other) palsy post sinus like infection?

Answer 23

cavernous sinus thrombosis –> give heparin immediately

Question 24

central retinal artery occlusion. How is this diff from presentation of optic neuritis? How should you manage it?

Answer 24

sudden loss of vision, APD, macular changes (retinal pallor indicating ischemia, cherry red spots)

• optic neuritis would present as above with NO macular changes
• CRAO= eye ball massage, inhalation of 95% O2, sublingual nitroglycerin

Question 25

demographic at risk for malignant otitis externa

Answer 25

diabetics –> tx with high dose IV FQ