Neuro/psych

Question 1

PTSD tx

Answer 1

SSRI, SNRI first line

If sleep disturbance, augment with prazosin (other alpha blockers do not have evidence) and consider eval for OSA

Question 2

Most effective drug for motion sickness

Answer 2

Scopalomine. Patches > oral.

Question 3

Contraindications to donepazil

Answer 3

Bradycardia/Syncope – can cause bradycardia (cholinesterase inhibitor)

Question 4

pathologic tinnitus

Answer 4

unilateral
pulsatile
associated with asymmetric hearing loss

Question 5

1st line tx conversion do/somatic sx disorder

Answer 5

SSRI

Question 6

T/f: can use maxalt and sumitriptan w/in same 24 hours

Answer 6

FALSE

Question 7

in office option for refractory migraine

Answer 7

IM antiemetic like promethazine, prochlorperazine

IV reglan is best

Question 8

1st line tx PTSD

Answer 8

SSRI or venlafaxine + therapy

Question 9

‘gv when do try Z drug

Answer 9

after CBT, doxepin, extended release melatonin

Question 10

cluster headache dx/tx

Answer 10

unilateral, orbital pain, vasomotor phenomenon (block nasal passage, rhinorrhea conjunctival injection)

Tx: 100% O2, verapamil, indomethacin

Question 11

most common causes of peripheral neuropathy

Answer 11

DM
hypothyroidism
nutrition
liver disease
renal
meds: amioo, dig, macrobid, statins

MGUS

Question 12

anti-psychotic use in behavioral disturbance in dementia

Answer 12

off label. Abilify is the only one that has shown small reductions

Question 13

first line depression in adolescents AFTER psychotherapy

Answer 13

prozac

than sertraline, citalopram

Question 14

Frequency of stroke subtypes

Answer 14

ITE HIS

Ischemic: thrombotic > embolic

Hemmorhagic: intercerebral > subarach

Question 15

CHA2DVASC

Answer 15

CHF, HTN, Age >75, DM, Vasc, Age 65-74, Stroke hx

2+= DOAC, warf
1+ = ASA or DOAC
0= ASA

Question 16

indications for TPA

Answer 16

Neg CT, no hx ICH, no seizure, BP <185/110

Age > 80 = <3 hrs, no AC
Age <80 = 4.5hr, INR < 1.7

Question 17

When to decrease BP in acute ischemic stroke

Answer 17

> 220/120

Labetolol (10mg) or Nicardipine (5mg/hr) –> goal dec by 15%

Question 18

BP control for hemorraghic or subarach?

Answer 18

hemmoragic CVA <140

SAH < 160

Question 19

diff between TIA and stroke

Answer 19

Neurologic dysfunction/impairment w/:

+MRI= stroke
-MRI= TIA

Question 20

Secondary management after stroke/TIA

Answer 20

DAPT foor 21 days

Question 21

max MME for opiods, and threshold for prescribing naloxone

Answer 21

Max= 90
Naloxone= 50

Question 22

Contraindications to triptans

Answer 22

CAD
hx of stroke
PVD
chronically uncontrolled HTN

Question 23

meds that slow progression of parkinsons?

Answer 23

None.

Carbidopa/levadopa is 1st line for motor symptoms

Question 24

1st ddx in acute AMS of eldrely without undrlying explanationo

Answer 24

delerium if ACUTE. Aka do not just diagnose dementia

Question 25

Vascular dementia usually happens after......

Answer 25

CVA. Also will have "uncontrolled" HTN

Question 26

New concussion management

Answer 26

- 24-48hr rest > return to learning > step wise return to sports once base to academic baseline

Question 27

central vision loss with peripheral sparing

Answer 27

macular degeneration

Question 28

halos and decreased night visin

Answer 28

cataracts

Question 29

patchy peripheral vision loss

Answer 29

glaucoma

Question 30

sudden scattered floaters

Answer 30

retinal detachment