Neuro

Question 1

Thunderclap headache

Answer 1

subarachnoid bleed, especially post partum

Question 2

Headache associated with pregnancy

Answer 2

Pre-eclampsia. Protein in urine can verify this

Question 3

Headache associated with HTN, sweats, and heart palpitations

Answer 3

Pheochromocytoma

Question 4

Headaches associated with cough diagnoses is made when?

Answer 4

headache is brought on and occurs only in association with coughing, straining or a Valsalva manoeuvre and in the absence of any abnormalities on neuro-imaging.

Question 5

symptomatic cough headache diagnoses is made when?

Answer 5

underlying pathology is identified

Question 6

Cluster headaches are more common in which people?

Answer 6

men

Question 7

Cluster headache symptoms, when do they occur, for how long

Answer 7

Wakes patient up at night. Lasts between 15 minutes and 3 hours. Patients usually agitated, No family history of migraines. Will resolve spontaneously, then reoccur. Several episodes per year.

Question 8

migraines are associated with which symptoms

Answer 8

photophobia, phonophobia, blurring of vision, cognitive impairment, nausea, vomiting

Question 9

migraine treatment

Answer 9

NSAIDs, Ibuprofen, ASA, triptans, ergotamine/Caffeine (Cafergot)

Question 10

cluster headache treatment

Answer 10

Prednisone 60 mg for 5 days.Ergotamine and Imitrex not usually effective

Question 11

Triptans should be avoided in which kinds of patients?

Answer 11

pregnancy, Ischemic disease, diabetes mellitus, coronary artery disease or vascular disease.

Question 12

Zomigdose

Answer 12

5 mgm at onset, may repeat in 2 hours.

Question 13

ergotamine/Caffeine (Cafergot) dose

Answer 13

1 mg with 100 mg caffeine

Question 14

Headache due to Intracranial Mass Lesions symptoms

Answer 14

New onset headache in middle age or later in life, Night sweats, Weight loss, Visual defecits: esotropia, exotropia, Neurological deficits, Papillar edema, Seizure like tremoring or grand mall

Question 15

medication overuse (withdrawal headache) treatment

Answer 15

Cafergot

Question 16

most common causes of head injuries in young people are

Answer 16

falls

Question 17

primary interventions for concussion

Answer 17

Cognitive and physical rest

Question 18

Zofran is given to help with nausea in concussion patients, what are the side effects of zofran

Answer 18

headaches, drowsiness, and dizziness that may exacerbate other symptoms of concussion. Thus, caregivers should be instructed to stop ondansetron if it makes their child feel worse

Question 19

concussion patients may have sleep disturbances, what do we do for them?

Answer 19

educate on good sleep habits, can give melatonin

Question 20

which patients are at risk for prolonged recovery of concussions?

Answer 20

history of prior concussions, female sex, history of migraines, history of learning disabilities, recurrent concussion soon after recovery, or degree of symptoms after a concussion

Question 21

Second impact syndrome

Answer 21

death or devastating neurological injury attributable to massive swelling of the brain in athletes who sustain a second head injury prior to full recovery from a concussion

Question 22

Concussion danger symptoms in adults that could signify a blood clot in brain that formed after concussion

Answer 22

Headache that gets worse and does not go away, Weakness, numbness or decreased coordination, Repeated vomiting or nausea, Slurred speech.

Question 23

Which patients with mild TBI should have a noncontrast head CT scan in the ED?

Answer 23

Level A: Loss of consciousness or posttraumatic amnesia and one or more of the following:
• Headache
• Vomiting
• Age > 60 years old
• Drug or alcohol intoxication
• Deficits in short-term memory
• Physical evidence of trauma above the clavicle
• Posttraumatic seizure
• GCS score < 15
• Focal neurologic deficit
• Coagulopathy

Question 24

First line therapy for sleep disturbance

other than melatonin

Answer 24

Trazadone 25-50mg

Question 25

Treatment for Post Concussion Syndrome

Answer 25

Amitryptilline 10-25mg, increase to 50 mgm weekly as necessary. Must have baseline EKG in adults due to possibility of conductive disturbances.

Question 26

glasco scoring for TBI range and what does it look at?

Answer 26

3-15, eye movement, motor response, verbal response, the lower the score the worse off they are

Question 27

if patient has a glasco score of 8 after 6 hours what is the likelihood of them dying?

Answer 27

50%

Question 28

Do older individuals with vasovagal syncope experience a prodrome?

Answer 28

no

Question 29

carotid sinus syncope is caused by

Answer 29

neck movements

Question 30

A vagal "surge" immediately upon swallowing can cause

Answer 30

bradycardia and hypotension in predisposed patients

Question 31

Exertional syncope can be caused by?

Answer 31

ventricular tachycardia and obstruction from aortic stenosis, hypertrophic cardiomyopathy, hypotension from vagally-mediated vasodepression in patients with hypertrophic cardiomyopathy.

Question 32

If exertional syncope has occurred and there is no other reason for it, what is the diagnoses?

Answer 32

neurocardiogenic syncope

Question 33

why is it important to do an EKG with syncope patients?

Answer 33

restore of consciousness is usually quick but even an arrhythmia can still be present with neurocardiogenic syncope

Question 34

syncope without a prodrome is more common in which patients?

Answer 34

cardiac syncope

Question 35

Hyperventilation can be seen with

Answer 35

pulmonary embolism or psychiatric causes of syncope

Question 36

In-hospital monitoring is recommended in syncope patients with

Answer 36

structural heart disease

Question 37

Iatrogenic syncope

Answer 37

syncope caused by medications

Question 38

preferred treatment for syncope due to Supraventricular arrhythmias 

Answer 38

radiofrequency ablation

Question 39

Documented, suspected, or induced ventricular tachycardia syncope should be treatment with what?

Answer 39

an ICD

Question 40

typical vertigo symptoms

Answer 40

n/v

Question 41

is vertigo a diagnoses?

Answer 41

no its a symptom

Question 42

Tilt illusion 

Answer 42

patients feel that they and their environment are tilted with respect to gravity, feels like they are upside down

Question 43

patients experiencing Tilt illusion have damage to what?

Answer 43

otolithic organs

Question 44

Drop attacks 

Answer 44

feeling like you're being pushed or pulled to ground

Question 45

drop attacks are seen with which disorder?

Answer 45

Meniere disease.

Question 46

Spatial disorientation 

Answer 46

A fleeting spatial disorientation with rapid head turns

Question 47

Oscillopsia

Answer 47

a visual illusion of to-and-fro environmental motion

Question 48

Impaired balance without vertigo is a sign of what

Answer 48

acute simultaneous bilateral vestibular loss

Question 49

Aminoglycoside toxicity is the most common identified etiology of

Answer 49

bilateral vestibulopathy

Question 50

bilateral vestibulopathy is a key feature in which problems?

Answer 50

CANVAS (cerebellar ataxia, neuropathy and vestibular areflexia syndrome