Neuro Review

Question 1

Older woman, worsening bilateral low back pain, right leg pain radiating to buttock/back of leg

pain worse w walking/standing, improves w sitting

no reflex at right ankle, dec sensation over lateral right foot, weakness

cause of low back pain

Answer 1

narrowing of the spinal cord

Question 2

Suprahyoid stab from one side of neck to other

tongue deviates to right, no lost sensory modality

damage has occured to

Answer 2

right hypoglossal nerve

Question 3

older male, slow tremor at rest, improves w movement

problems walking, slow shuffling steps

dx is ___
damage hs occurred to ___

Answer 3

parkinsons dz

substantia nigra pars compacta

Question 4

loss of pain/temp on R side of face and L neck

Exam w partial paralysis of soft palata/larynx/pharynx/ataxia on r

thrombosis has occurred to ___

Answer 4

right posterior inferior cerebellar artery

Question 5

older woman, 1 yr of strange/inappropraite behavior

lost memory of people important to her

dx is ___
deficit in ___

Answer 5

alzheimers

ach

Question 6

young boy, not paying attention in class

stops and blinks and makes chewing movements, stares into space

EEG shows general spike/wave @ 3 Hz

type of seizure ___

Answer 6

absence

Question 7

fever, poorly localized HA, stiff neck

preceded by nasal congestion/muscle aches/chills

nuchal rigidity, photophobia
no papilledema

dx is

Answer 7

acute meningitis

Question 8

Younger woman, chronic hepatic dz, behavioral/personality change
difficulty walking, clumsy, slurred speech

dystonia/dysarthria, intention tremor/rigidity/ataxia

slit slamp w brown corneal ring

dx is __
decreased ____

Answer 8

wilsons dz

ceruloplasmin

Question 9

drug blocks demyelination in CNS

which cell does it target

Answer 9

oligodendrocytes

Question 10

woman w history of double vision, difficulty keeping eyes open, diffuse weakness

muscles tirre easy, limited horizontal/vertical movements in eyes

poor speech, ptosis

dx is ___
damage to the ___

Answer 10

myasthenia gravis

NM junction

Question 11

older woman, visual problems, hx of HA/scalp tenderness

visual acuity is different bilaterally

elevated ESR

dx is ___

Answer 11

temporal arteritis

Question 12

electric shock feeling in hands bilateral

worked as a computer man

atrophy of thenar eminence

positive tinels sign

dx is ___

compressed ___

Answer 12

carpal tunnel syndrome

median nerve

Question 13

older man, on haloperidol

problems walking/hand tremor, slow steps, rigidty of arms

dx is ____

due to ___ effects

Answer 13

parkinsonism

antidopaminergic

Question 14

too rapid correction of hypoNa

pt w flaccid paresis of upper/lower extremities

dx is ____

Answer 14

cerebral pontine myelinosis

Question 15

Bacterial meningitis

Opening pressure __
high ___
__ protein
___ glucose

Answer 15

high
PMN
high
dec

Question 16

fungal/Tb meningitis

opening pressure ___
inc ___
__ protein
___ glucose

Answer 16

inc
lymphocytes
inc
dec

Question 17

viral Tb

opening pressure __/__
inc ___
Protein is __/__
glucose is ___

Answer 17

n/inc
lymphs
n/inc
n

Question 18

older woman, left arm/leg weakness

hx of hTN/DM
HBP, inc HR
diminshed sensation to pinprick of left arm/leg

most appropriate pharm therapy ___

Answer 18

aspirin

Question 19

older man, foaming at the mouth/eyes tearing

V/D, grows corn
bradycardia/hypoTN

diffuse wheezes

toxicity due to ___

Answer 19

organophosphate

Question 20

sudden loss of vision, conjunctiva normal

blurred vision last year, went way

normal pupillary responses, responsive to swinging flashlight test

retina has normal vasculature

dx is ____

Answer 20

optic neuritis

Question 21

older man, gradually worsening hearing, esp w crowds

worsening ringing in ears

audiogram drops off around 2K

dx is ___

Answer 21

presbycusis