Neuro

Question 1

Vascular dementia

Answer 1

cortical=large vessels
subcortical=small vessels, focal deficits, urinary sx, gait, psych, cognitive LACUNAR=HTN, step-wise progression get imaging

Question 2

MS

Answer 2

RF low vit D, trigeminal neuralgia, ACUTE glucocorticoids, chronic interferon-B

Question 3

Essential tremor

Answer 3

intention tremor (NOT RESTING)

Question 4

Cervical spondylosis

Answer 4

MC cause of radiculopathy in older pts w/o acute trauma, facet joint osteophytes gait, arms=LMN signs, legs=UMN signs, **syringomyelia similar sx uncommon

Question 5

Heat stroke

Answer 5

exertional T>40 + neuro sx, ICE BATH

Question 6

Broca

Answer 6

frontal lobe

Question 7

Wernicke’s area (speech)

Answer 7

temporal lobe

Question 8

Botulism

Answer 8

vision probs, descending weakness, canned food cured fish, give equine antitoxin

Question 9

Intracranial hypertension

Answer 9

HA n/v blurry vision worse PM + position changes (leaning forward)

Question 10

PD

Answer 10

motor sx > 1y prior to cognitive (vs DLB), artane=trihexyphenidyl anticholinergic sx

Question 11

Juvenile myoclonic epilepsy

Answer 11

Absence 10, myoclonic 15, GTC 16

Question 12

ALS

Answer 12

UMN + LMN but ONLY MOTOR, atrophy

Question 13

Temporal lobe epilepsy

Answer 13

MC, focal sz w/ AMS (absence no post-ictal, TIA focal w/o AMS)

Question 14

Vertigo

Answer 14

Turning over in bed, dizziness

Question 15

Achilles hyporeflexia

Answer 15

NL IN OLD PPL

Question 16

Cerebellar hemorrhage

Answer 16

C/l hemiataxia, SURGERY >3cm AMS obstructive hydrocephalus

Question 17

AD vs FTD

Answer 17

FTD PERSONALITY CHANGES LOSS OF INHIBITION, AD can have neuropsych fts at end STILL AD

Question 18

Putamen hemorrhage

Answer 18

C/l hemiparesis/sensory loss, eye deviation TOWARD lesion

Question 19

Wernicke’s encephalopathy vs alcoholic cerebellar degeneration

Answer 19

W: encephalopathy, nystagmus, thalamus DONT FORGET ABOUT ANNOREXIA
ACD: truncal coordination, nl FTN, nl mental status, cerebellar vermis

Question 20

Ischemic stroke locations

Answer 20

Thalamus=sensory only ALLODYNIA
Internal capsule=motor (+/- sensory)
Midbrain=Oculomotor
Lateral medulla=bulbar, pain/temp, vertigo/nystagmus, Horner
Cortex=sensory + motor + speech

Question 21

Lower ICP

Answer 21

Hyperventilation low CO2 vasoconstriction

Question 22

Thoracic spinal cord ischemia

Answer 22

AAA esp T10-12

Question 23

Berry aneurysm

Answer 23

PKD CT bleed HA cerebellar stuff ataxia nystagmus etc

Question 24

Status epilepticus

Answer 24

2+ sz wo full recovery >5 min (pt is Very FLoPy give Valproate, fospheny/pheny or levetiracetam

Question 25

Phenytoin toxicity (not preg)

Answer 25

Ataxia, nystagmus, bactrim

Question 26

Lobar hemorrhage

Answer 26

Parietal common, amyloid, a/w AD

Question 27

Carpal tunnel

Answer 27

Driving, typing, hypothyroid/DM MUCINOUS DEPOSITS

Question 28

Epilepsy clinical sign highest specificity

Answer 28

Tongue biting

Question 29

Friedrich ataxia

Answer 29

Arrhythmias cardiomyopathy (ataxia telangiectasia is the one w/ cancer)

Question 30

Neurogenic shock

Answer 30

acute trauma=MASSIVE release of NE then crash (vasodilation=hypotension hypothermia, bradycardia), 1-5w

Question 31

Herniated disc

Answer 31

NSAIDs

Question 32

Spinal cord syndromes

Answer 32

Anterior=flexion, disc herniation, infarction a spinal artery (clamping aorta surg), pain temp motor PARALYSIS

Central=extension, syringomyelia, chiari, spondylosis, gait, WEAKNESS arms>legs, sensory variable, old ppl, bladder

Question 33

Median nerve @ the wrist compression

Answer 33

Thenar atrophy, driving/typing/carpal tunnel RFs, sensation to light touch distal thumb, index, middle finger

Question 34

GBS dx

Answer 34

EMG nerve conduction studies