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COMLEX 3 > Neuro > Flashcards

Neuro Flashcards

1
Q

Meniere’s disease –> triad of ssx?

A
  • vertigo
  • hearing loss/fullness/tinnitus
  • unrelated to movement
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2
Q

Meniere’s disease –> vertigo episodes –> duration?

A

~30min

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3
Q

BPPV –> vertigo episodes –> duration?

A

<1min

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4
Q

labyrinthitis/vestibular neuritis –> why is it a diagnosis of exclusion?

A
  • pontine strokes/tumors also feature chronic vertigo

- recent URI often goes unnoticed

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5
Q

labyrinthitis/vestibular neuritis –> how long to resolve?

A

months

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6
Q

Meniere’s disease –> tx?

A
  • thiazide diuretics
  • low salt diet
  • meclizine
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7
Q

central vertigo from posterior fossa lesion –> etiology ddx (6)?

A
  • MS
  • CVA
  • tumor
  • abscess
  • migraine
  • sz
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8
Q

pseudotumor cerebri –> occurs in who?

A

young obese F taking isotretinoin & OCPs

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9
Q

drug overdose –> hyperNa, met acidosis, hypoCa, elevated ammonia, mild elevated AST/ALT –> what drug?

A

valproic acid

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10
Q

what allele increases risk for Alzheimer’s?

A

apolipoprotein E4

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11
Q

Alzheimer’s –> volumetric MRI finding

A
  • hippocampal asymmetry

- medial temporal lobe asymmetry

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12
Q

pseudotumor cerebri –> tx

A
  • carbonic anhydrase inh (acetazolamide)

- systemic steroid

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13
Q

pseudotumor cerebri –> trt w acetazolamide –> goal of treatment

A

prevent blindness

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14
Q

L temporal AVM ruptures –> what condition?

A

subarachnoid hemorrhage

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15
Q

B12 deficiency –> presentation

A
  • peripheral sensory neuropathy (stocking-glove)
  • decreased DTR
  • fatigue
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16
Q

B12 deficiency –> causes (3)

A
  • pernicious anemia
  • surgical resection of terminal ileum
  • achlorhydria
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17
Q

34F –> hearing loss for 6mo –> Rinne test shows bone conduction is longer than air conduction –> mother also has hearing loss

what condition?

A

otosclerosis

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18
Q

Rinne test –> bone conduction is longer than air conduction –> what type of hearing loss?

A

conductive hearing loss

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19
Q

otosclerosis –> what reflex is abnormal?

A

loss of stapedial reflex

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20
Q

MCC of headache in children

A

migraine

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21
Q

cluster HA –> tx

A

O2

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22
Q

cluster HA –> 2nd line tx

A

triptan

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23
Q

cluster HA –> prophylaxis

24
Q

cluster HA –> workup

25
Q

pseudotumor cerebri (idiopathic intracranial HTN) –> dx

A

LP –> opening pressure >25

26
Q

pseudotumor cerebri (idiopathic intracranial HTN) –> finding on imaging

27
Q

mercury poisoning –> tx

A

chelating agent:

  • succimer
  • penicillamine
  • dimercaprol
28
Q

exam shows fluid behind L ear –> Weber test shows louder vibration on left

dx?

A

L conductive hearing loss

29
Q

conductive hearing loss –> Weber test result

A

affected ear –> detect sound longer

30
Q

sensorineural hearing loss –> Weber test result

A

affected ear –> detect sound shorter

31
Q

Rinne test –> tuning fork at mastoid –> switch to air –> patient does not hear

dx?

A

conductive hearing loss

32
Q

status epilepticus –> mult doses of lorazepam –> but sz continues –> next step

33
Q

status epilepticus –> mult doses of lorazepam –> phenytoin –> but sz continues –> next step

A

midazolam + propofol

34
Q

generalized sz –> tx

A
  • valproate (cheapest –> probably correct answer on exam)
  • lamotrigine
  • levetiracetam (less AE)
35
Q

generalized sz vs myoclonic sz

A

generalized:

  • whole body shaking
  • LOC

myoclonic:
- no LOC
- increased muscle tone

36
Q

myoclonic sz –> tx

37
Q

atonic sz –> tx

38
Q

pseudosz –> dx

A

24hr EEG w video monitoring –> induce sz w stimuli and sleep deprivation

39
Q

status epilepticus –> dx

A
  • sz >5min

- post-ictal state >20min

40
Q

50M homeless –> h/o esophageal varices –> ER –> lethargy, absent lateral gaze, ataxia

condition?

A

Wernicke’s encephalopathy

41
Q

Wernicke’s encephalopathy –> presentation (triad)

A
  • confusion
  • ophthalmoplegia
  • ataxia
42
Q

Wernicke’s encephalopathy –> cause

A

thiamine (B1) def

43
Q

lumbar stenosis –> sit or lean forward –> pain worse or better?

A

pain is better

44
Q

red flag ssx of cord compression –> next step

A

dexamethasone

give steroid BEFORE get imaging!

45
Q
  • painless progressive vision loss
  • color desaturation

what condition?

A

vitB12 def

46
Q

Guillain-Barre synd –> tx

A
  • plasmapheresis

- IVIG

47
Q

vertical nystagmus, myoclonus, 3+ reflexes bilaterally

what vit/electrolyte deficiency?

48
Q

Mg def –> presentation

A

muscular & neurologic hyperactivity

49
Q

differentiate: cauda equina synd vs conus medullaris synd

A

cauda equina:

  • unilat
  • LMN signs only

conus medullaris:

  • bilat
  • UMN & LMN signs
50
Q

cauda equina synd –> surgical decompression must be performed within how many hours of symptom onset?

51
Q

CN III palsy –> persentation

A
  • ptosis

- eye down & out

52
Q

CN III palsy –> can be caused by aneurysm of what?

A

posterior communicating artery aneurysm

53
Q

post-dural puncture HA (spinal HA) –> worsening despite conservative measures (bed rest, tylenol, caffeine, fluids) –> tx?

A

epidural blood patch –> inject venous blood into epidural space –> immediate relief

54
Q

Guillain-Barre synd -> how dx?

A
  • nerve conduction study

- LP

55
Q

Guillain-Barre synd -> CSF results

A
  • increased protein

- normal WBC

COMLEX 3 (17 decks)

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