neuro- pretest

Question 1

multi infarct and hemosiderin

Answer 1

amyloid angiopathy

Question 2

wallenberg stroke syndrome (lateral medullary)

Answer 2

ipsi: ataxia, horners, loss f facial pain and temp, impaired corneal reflex (effects CNV)
contra: pain and temp of limbs and trunk

dysphagia and dysphonia

Question 3

nucleus ambiguus

Answer 3

contains motor of CN IX, X –> dysphagia

Question 4

lamictal vs keppra in inpatient setting?

Answer 4

keppra! Lamictal takes a looooong time to become therapuetic

Question 5

sturge weber (encephalofacial angiomatosis)

Answer 5

port wine stain over upper dist of V1 and leptomeningeal angioma

Question 6

alcohol withdrawal timelines:

• sz
• DTs

Answer 6

sz- 24 hours

DTs- 2-4 days

Question 7

Lennox-Gestaut syndrome

Answer 7

epilepsy: 1-2Hz spikes
- mental dysfunction
- multiple seizure types
- hx of infantile spasms

Question 8

olfactory hallucinations auras come from…..

Answer 8

mesial temporal lobe

Question 9

most common complication of temporal lobectomy

Answer 9

right superior quadrantanopsia

Question 10

most common cause of intractable complex partial seizures in adults

Answer 10

mesial temporal sclerosis

-80% sz freedom with temporalectomy

Question 11

treatment for West syndrome (recurrent infantile febrile sz)

Answer 11

ACTH?

Question 12

why would you choose valproate in absence sz?

Answer 12

ethosuximide causes GI distress

also if they also have generalized tonic clonic sz

Question 13

jacksonian march: general or focal?

Answer 13

begins focal, usually becomes general

Question 14

benign juvenile myoclonic epilepsy

Answer 14

often see myoclonic sz

myoclonus occurs when pt is awake!!

Question 15

no taste after head trauma?

Answer 15

(aguesia)

avulsion of olfactory rootlets –> anosmia is common after brain injury

Question 16

managment of spinal cord trauma patient coming into ED

Answer 16

high dose IV methylpred

Question 17

you see a ring enhancing lesion on CT in a patient with known HIV. What do you do next?

Answer 17

LP CSF for EBV PCR –> specific for CNS lymphomoa

Question 18

JC virus leads to….

Answer 18

PML (progressive multifocal leukoencephalopathy

Question 19

how does rabies access CNS?

Answer 19

retrograde axoplasmic flow

Question 20

upward herniation

Answer 20

transtentorial –> crosses tentorium cerebelli

Question 21

downward herniation

Answer 21

transforaminal –> crosses foramen magnum

Question 22

cerebellr ataxia signs in someone with breast lump, ovarian, or lung cancer found?

Answer 22

paraneoplastic cerebellar degeneration –> deg of purkinje fibers, assoc with anti-yo antibodies

Question 23

enzymatic abnormabilty of tay sachs?

Answer 23

hexosaminidase A

cherry red spots

Question 24

visual field cut in B12 deficiency?

Answer 24

centrocecal scotoma

Question 25

language disturbance in alzheimers

Answer 25

transcoritcal sensory loss - repition intact - lack understanding of complex language

Question 26

caudate shapes what ventricle?

Answer 26

lateral

Question 27

tremor in parkinsons is......

Answer 27

asymmetric

Question 28

Lewy bodies are intracyctoplasmic or intranuclear inclusions?

Answer 28

CYTOPLASM

Question 29

speech defect in parkinsons

Answer 29

hypophonia --> progressively inaudible. think of as similar to handwriting

Question 30

hepatolentricular dz

Answer 30

WILSONS atrophy of putamen and globus pallidus

Question 31

bladder issue in MS?

Answer 31

spastic bladder (UMN) good contractility, but poor distensibility--> leads to spasticity usu have urge incont

Question 32

uthoff phenomenon

Answer 32

demylinating sx that get worse in the heat

Question 33

leber optic atrophy

Answer 33

mitochondrial DNA mutations looks like optic neuritis but blind spot extends into central field of vision

Question 34

fragile X phenotype in men vs women Repeat?

Answer 34

women- about half have mild retardation but generally normal men- hyperextensible joints, prominent thumbs CGG (chin, giant gonads)

Question 35

friedrichs ataxia repeats? phenoytpe?

Answer 35

GAA (ataxic GAAit) cerebellar signs hypertrophic cardiomyopathy!! (cause of death)

Question 36

myotonic dystrophy repeats

Answer 36

CTG (cataracts, toupe, gone gonads) arrythmias

Question 37

neimann pick

Answer 37

Sphingomyelinase cherry red spots on macula progressive neuro degeneration (no man picks his nose with his sphinger)

Question 38

antibiotic proph for n. meningitis

Answer 38

rifampin

Question 39

transient global amnesia

Answer 39

1-24h only!! general anterograde amenesia resolves spontanesously

Question 40

a risk of acute angle closure glauc? tx?

Answer 40

mydriasis (drug induced, dark room) - pilocarpine to inc angle, acetazolamide to dec aq humor production - beta blocker drops NO ATROPINE OR EPI NO BP LOWERING

Question 41

characteristics of cavernous sinus thrombosis

Answer 41

- palsy of 3,4,5i ii, 6 - proptosis - most common from spread of infection

Question 42

presentation of polymyositis

Answer 42

proximal muscle weakness --> difficulty climbing stiars, brushing hair dysphagia

Question 43

(cervical) spondylytic myelopathy

Answer 43

inter or extramedullary compression of mass that causes LMN signs at level of lesion and UMN signs below level of lesion (wide based gait, absent babinski) - impaired sensatin - impaired bowel/bladder

Question 44

sx of uncal hernation

Answer 44

ipsilateral CNIII palsy with contralat

Question 45

INO

Answer 45

weak adduction of the AFFECTED EYE