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Step 2 CS > Neuro Cases > Flashcards

Neuro Cases Flashcards

1
Q

headache qs

A

acute vs chronic, location / lateralization, duration, timing, photophobia/auras, neck stiffness, n&v, jaw claudication, trauma / Sx, sinusitis, exacerbating/ alleviating facctors

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2
Q

workup headache

A

cbc, ct, mri, lp, crp / dopper us/biopsy for temporal arteritis

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3
Q

sudden, severe headache

A

subarachnoid hem, use NCC to image, pt/ptt/inr

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4
Q

sinusitis imaging

A

xr sinus, ct, lp (csf anaysis)

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5
Q

pseudotumor cerebri

A

urine hCG, cbc, head ct, opening pressure

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6
Q

trigeminal neuralgia

A

cbc, esr, mri brain

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7
Q

memory loss qs

A

course of deficits, collateral info (from family etc), delirium screen (waxing/waning?), falls, med changes/polypharmacy, associated Sx (incontinence, fevers, chills, weight loss, ataxia, hypothyroid, depression), Hx stroke or vascular dz, etoH, b12 deficiency, FHx of Alzheimer’s etc

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8
Q

memory loss workup

A

cbc, b12, tsh, MRI/ct, vdrl/rpr, LP

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9
Q

alz dz imaging

A

MRI preferred

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10
Q

cjd workup (myoclonus, ataxia, startle)

A

elecrolytes/ Ca, EEG, LP, brain Bx

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11
Q

hypoglycemia w/u

A

glucose, cbc, electrolytes, cpk-mb, troponin, echo, ecg, mri brain, doppler u/s carotid

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12
Q

vision loss qs

A

acute vs chronic, time course, pain, discharge, itching tearingn, redness, photophobia, weakness/uimbness. Hx cardiac, rheum, thrombotic, autoimmune, neuro. jaw claudication, meds, trauma

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13
Q

retinal artery occlusion (a fib, vision loss in one eye) wu

A

fluorescein angio, echo, dopper carotids, intraocular tonometry, esr, temporal artery bx, cbc

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14
Q

retinal artery occlusion differential

A

vein occlusion, acute angle closure, retinal detachment, temporal arteritis

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15
Q

depression qs

A

sig e caps (sleep, interest/anhedonia, guilt, concentration, psychomotor agitation/retardation…), previous episodes, drugs/etoh/meds, social

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16
Q

depression exam and wu

A

MSE, appearance, behavior, speech, mood, affect, thoughts. tsh, cbc, u tox, Beck depression inventory

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17
Q

psychosis qs

A

+ (hallucinations, delusions, thought disorganization), - (blunted affect, social withdrawl, decreased motivation/speech/thought)

18
Q

substance induced psychosis

A

u tox, tsh, cbc, MSE, electrolytes, bun/cr, ast/alt

19
Q

dizziness qs

A

vertigo vs lightheaded (is the room spinning or? ), duration, positioing or post head trauma, visual disturbance, URI, nausea, neck pain, meds, atherosclerotic vascular dz

20
Q

dizziness ex

A

vitals, neuro ex (+romberg, nystagmus, dix halpike, weber/rinne), ent, cardio.

21
Q

diziness wu

A

/cbc, electrolytes, mri brain. vdrl / rpr (for Meniere’s dz), orthostatic bp change/flurosemide or hydrochlorothiazide etc use/ stool or diarrhea hx for dehydration, dix/mri brain/audiogram from bph. mri/mra for labryinth and vestibular neuronitis

22
Q

dizziness ddx

A

Meniere’s, vestibular neuronitis, labryinthitis, bpv, acoustic neuroma if sensorineural, vertebrobasilar insufficiency, brainstem or cerebellar tumor, cervical spine dz/injury vertigo

23
Q

vestibular neuronitis vs labryinthtis

A

both morning, n& v, URI a few days ago, but vestibular has no hearing loss while labryinth does

24
Q

LOC hx

A

nausea, diaphoresis, palpitations, pallor, lightheaded, exertional/postural/calustrophobic/dehydration/trauma/stress. tongue biting, incontinence, tonic cllonic, prolonged confusion, dypsnea or PE risk, arrythmia, htn, diabetes, etoh and alcohol use.

25
Q

LOC ex

A

vitals (bp standing vs sitting), neuro, carotid and cardiac, lung, lower limbs

26
Q

LOC w/u

A

cbc, electrolytes, glu, u tox. eeg, mri/ct (seizures). echo, ecg, holter (syncome via orthostatic hypotension or arrythmia). v/q, cta, d-dimers for PE

27
Q

numbness/weakness Hx, ex

A

distribution (prox, distal…unilateral or not), progression, pain, diabetes, athero, etoh. ex neuro, msk, vitals, vascular

28
Q

numbness w/u

A

ct head/mri, cpc, electolytes, glu, lipid panel, ecg, echo, dopper u/s. nerve conduction/ edrophonium for myastheia ruleout for gbs, retinal evoked potentials for MS

29
Q

fatigue hx, ex

A

sleep hygeine, stress etc, thyroid, anemia, meds/etoh/caffeine/drugs. vitals, ent (conjnctival pallor, tonsils, lymph nodes, thyroid), heart, lung, abdo quickly. pallor, coolness at distal extremeties

30
Q

fatigue wu

A

cbc, tsh, u tox, electrolytes, bun/cr, Ca, fasting glucose, hba1c, UA, std tests. polysomnography and noctural pulse ox for sleep apnea (evaluate if cpap useful),

31
Q

glove and stocking numbness and tingling

A

diabetic or alcoholic peripheral neuropathy, hypocalcemia, hyperproteinemia/myeloma, hyperventilation(?)

32
Q

tingling/numb median nerve distrib, progressive, fatigue, weight gain

A

carpal tunnel 2ndary to hypothyroidism. overuse injury median nerve, medial epicondylitis

33
Q

fatigue, weight loss, constipation. FHx of this dz

A

colon ca. hypothyroidism, renal failure (hypercalcemia-constipation, stones, abdo moans, psych groans), depression.

34
Q

fatigue, thirst, polyuria, increased appetite

A

DM (type 1), primary polydipsia, DI, atypial depression

35
Q

insomnia Hx, Ex

A

duration, earning morn vs multiple awakenings vs trouble sleeping, daytime sleepiness. arthritis, diabetes. snoring, nightmares, depression. substances (caffeine, etoh, meds, illegal), shift work, jet lag, sleep hygiene, stress, psychiatric

ex: vitals, mse, thyroid

36
Q

insomnia wu

A

cpc, tsh, mse, polysomnography, ecg

37
Q

insomnia ddx

A

circadian rhythm sleep disorder, depression, primary hypersomnia, osa, caffeine or stress induced

38
Q

neck mass hx

A

socrates, mobility, mvmt with swallowing (thyroglossal duct cyst or not), obstructive(sob, dysphagia), associated sx (heme, constitutional-likelier ca, GI, endo, pulm), sick contacts, other masses like lymph nodes

39
Q

neck mass ex

A

heent, lymph nodes, spleen, tonsils. heart, lung, abdo

40
Q

neck mass wu

A

cbc (& differential ie wbc), euc, esr/crp, lymph node bx, ppd, cxr, tsh, thyroid us, upper endoscopy

41
Q

neck mass ddx

A

hodgkin’s/nhl, tb, thyroid nodule

Step 2 CS (8 decks)

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