Neuro

Question 1

Brain center responsible for fear or anxiety response (e.g., specific phobia).

Answer 1

Amygdala and Insula: Hyperactivated in negative emotional responses and stimulate the SANS.

Question 2

Bentropine (Congentin)

1) Indications
2) Class

Answer 2

1) PD, drug-induced EPS

2) Anti-cholinergic

Question 3

Li-induced Tremor: Best Med?

Answer 3

Propranolol (like Essential tremor)

Question 4

Features of normal pressure hydrocephalus

Answer 4

Gait disturbance, urinary incontinence (unique), and cognitive impairment.

Cf. Lewy body dementia: has psychotic Sx in addition gait and cognitive AbN.

Question 5

GCA

1) SSx
2) Dx test

Answer 5

1) h/a, pain while brushing hair, shoulder stiffness and aching (can last several months)
2) Temporal artery biopsy
(Cf. ESR and CRP are not specific or diagnostic.)

Question 6

B12 (cobalamin) deficiency: SSx

Answer 6

• CNS: weak, light-headed, positive Babinski and Romberg, cognitive impairment
• PNS: paresthesia, impaired dorsal column (proprioception and vibration)
• Sore, beefy-red tongue
• Macrocytic anemia

Question 7

Oculogyric crisis/reaction

1) SSx
2) Cause

Answer 7

1) A type of dystonia characterized by prolonged, invluntary upward deviation of the eye.
2) Drugs (neuroleptics, Li, domperidone, etc) & Neuro conditions (Tourette’s, MS, neurosyphilis, etc)

Question 8

Acute dystonia (e.g., Oculogyric crisis): Tx

Answer 8

Benztropine or Diphenhydramine IM (Anticholinergics)

Cf. PO if milder dystonia.