Neuro and gen med

Question 1

What is the most common presentation of neurosarcoid?

Answer 1

cranial neuropathy due to chronic basal meningitis

Question 2

A patient presents with a rash on the umbilicus around to the back. Weeks later, pain persists and she is unable to touch the area. This is..

Answer 2

post herpetic pain

Question 3

Is the peripheral neuropathy of diabetes reversible?

Answer 3

No

Question 4

Besides peripheral neuropathy, what are common neuropathies associated with diabetes?

Answer 4

Cranial neuropathy (III, IV, VI), focal compression neuropathy, radiculopathy

Question 5

What EEG pattern correlates with metabolic disease?

Answer 5

triphasic waves

Question 6

How do you monitor AED levels in renal failure?

Answer 6

need to follow free levels

Question 7

What old disease used to afflict patients on dialysis and looked a lot like CJD (dysarthria, aphasia, ataxia, dementia)?

Answer 7

dialysis dementia from aluminum

Question 8

A dialysis patient receives a renal transplant and is on tacrolimus. On post op day #3, he is mildly confused and becomes rapidly agitated. What is this? How do you treat?

Answer 8

Posterior Reversible Encephalopathy Syndrome - treat with IV lorazepam, phenytoin

Question 9

What are the causes of PRES?

Answer 9

eclampsia, hypertensive encephalopathy, uremic encephalopathy, endothelial dysfunction due to drugs

Question 10

A patient on long term dialysis presents with thickened dura, headache, papilledema, and lymphocytic CSF. What is this?

Answer 10

nephrogenic systemic fibrosis

Question 11

A patient takes isoniazid and starts experiencing what neurological symptoms? What is lacking?

Answer 11

polyneuropathy - lacking pyridoxine

Question 12

What patients are at risk for Wernicke’s ?

Answer 12

bariatric patients, cancer patients, alcoholics

Question 13

What patients used to experience copper deficiencies?

Answer 13

older patients that had dentures - Zn used to bind Cu

Question 14

A young patient trying to get rid of her acne presents with pseudotumor cerebri. What is this, probably?

Answer 14

vitamin A overdose

Question 15

A patient who hangs out indoors all the time has osteomalacia. What neurologic symptoms may be present?

Answer 15

proximal myopathy

Question 16

A patient presents with hydrocephalus and is found on imaging to have subependymal nodules. You should suspect.. (and how do you treat?)

Answer 16

tuberous sclerosis - treat with rapamycin

Question 17

A patient presents with cafe au lait marks, freckling under the armpits, and soft bumps under the skin. This is..

Answer 17

NF1

Question 18

A patient presents with bilateral hearing difficulties, ringing in the ears. He was adopted but told that his birth parents had some disease. Think..

Answer 18

NF2

Question 19

A young mother who just delivered comes in with a headache and right focal seizure as well as right hemiparesis. This is most likely…

Answer 19

venous sinus thrombosis

Question 20

What are the other mechanisms of stroke during pregnancy?

Answer 20

PFO embolic, hypercoagulable, antiphospholipid antibody, aneurysm, pre-eclampsia

Question 21

What are the peripheral neuropathies that occur during pregnancy?

Answer 21

facial palsy, carpal tunnel, meralgia paresthetica (lateral femoral cutaneous nerve), obturator nerve, femoral neuropathy, GBS

Question 22

How big are the risks of epilepsy during pregnancy?

Answer 22

25% increased seizures at second trimester - due to lack of compliance, increased metabolism, hormone changes, etc. ; 2 fold increased risk of fetal malformation, but not nearly as great a risk as falling

Question 23

What AED should you try to avoid during pregnacy?

Answer 23

valproic acid, carbamazepine

Question 24

What is the most common manifestation of lupus peripherally? Centrally?

Answer 24

peripheral - distal symmetric polyneuropathy

central - stroke due to hypercoagulable state

Question 25

A patient who had hyponatremia was treated and now presents with confusion, dysarthria, dysphagia and quadraperesis. This is..

Answer 25

central pontine myelinolysis

Question 26

A 45 year old man who has been taking isoniazid presents with numbness and tingling, diminished propioception and vibration to the mid calf. This is..

Answer 26

pyroxidine deficiency

Question 27

A farm worker develops nausea, vomiting, diophoresis, weakness and pinpoint pupils. This is..

Answer 27

organophosphate intoxication

Question 28

A 40 year old man with a history of alcoholism comes in with nystagmus in all directions. This is..

Answer 28

thiamine deficiency

Question 29

A 70 year old man who had a total colectomy has a broad based gait and positive Romberg. He has absent ankle reflexes and diminished propioception. This is..

Answer 29

vitamin E deficiency (spinal and cerebellar signs)

Question 30

A ceramics designer comes in with abdominal pain, constipation and weakness of her limbs, especially extensors. This is..

Answer 30

lead poisoning

Question 31

A woman who has been receiving TEN complains of cogwheeling and stiffness. This is..

Answer 31

Manganese intoxication

Question 32

A man has a total body rash, nausea, vomiting and tinnitus. He has oval patches on his neck and increased pigmentation around the axilla with neuro exam showing decreased sensation to pinprick over the feet. This is..

Answer 32

arsenic poisoning