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USMLE Step Two > Neurologic/Psychiatric Disorders > Flashcards

Neurologic/Psychiatric Disorders Flashcards

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USMLE® Step 1 flashcards
1
Q

CSF findings in bacterial meningitis

A

neutrophils
high protein
low glucose
positive culture/positive gram stain

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2
Q

CSF findings in viral meningitis

A

lymphocytes
high protein
normal glucose
viral PCR may be positive

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3
Q

CSF findings in viral encephalitis

A

lymphocytes
high protein
normal glucose
viral PCR may be positive

may also see frontotemporal hemorrhage and RBCs in HSV encephalitis

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4
Q

CSF findings in tuberculosis meningitis

A

lymphocytes
high protein
very low glucose
positive for acid-fast bacilli

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5
Q

CSF findings in guillain-barre syndrome

A

no cells
high protein
normal glucose

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6
Q

CSF findings in multiple sclerosis

A

few lymhocytes
slightly high protein
normal glucose
oligoclonal bands

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7
Q

CSF findings in acute disseminated encephalomyelitis

A

lymphocytes
high protein
normal glucose
oligoclonal bands

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8
Q

CSF findings in subarachnoid hemorrhage

A

lymphocytes and many RBCs
high protein
normal glucose
xanthochromia

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9
Q

CSF: RBCs and no xanthochromia

A

traumatic tap

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10
Q

CSF: positive EBV PCR

A

highly suggestive of CNS lymphoma

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11
Q

CSF: oligoclonal bands

A

multiple sclerosis, CNS infections, or non-infectious inflammatory processes (SLE)

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12
Q

CSF: low glucose

A

bacterial or mycobacterial infections

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13
Q

CSF: lymphocytes

A

viral, fungal, or mycobacterial infection, demyelination, CNS lymphoma

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14
Q

normal CSF pressure

A

70-180 mmH2O

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15
Q

where olfactory nerve exits

A

cribiform plate

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16
Q

where optic nerve exits

A

optic canal

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17
Q

where oculomotor nerve exits

A

superior orbital fissure

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18
Q

where trochlear nerve exits

A

superior orbital fissure

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19
Q

where trigeminal V1 exits

A

superior orbital fissure

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20
Q

where trigeminal V2 exits

A

foramen rotundum

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21
Q

where trigeminal V3 exits

A

foramen ovale

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22
Q

where abducens nerve exits

A

superior orbital fissure

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23
Q

where facial nerve exits

A

internal auditory meatus

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24
Q

where vestibulocochlear nerve exits

A

internal auditory meatus

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25
Q

where glossopharyngeal nerve exits

A

jugular foramen

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26
Q

where vagus nerve exits

A

jugular foramen

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27
Q

where accessory nerve exits

A

jugular foramen

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28
Q

where hypoglossal nerve exits

A

hypoglossal foramen

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29
Q

pupillary reflex

A

CNII (afferent fibers) and CNIII (efferent fibers)

shine line in each pupil and observe reaction and accomodation

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30
Q

oculocephalic (doll’s eyes) reflex

A

CNVIII (afferent) and CN III, IV, and VI (efferent) forcibly turn head horizontally and vertically and observe for conjugate eye movement in opposite direction

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31
Q

gag reflex

A

CNIX (afferent) and CN X, XI (efferent)

stimulate posterior pharynx with cotton tip and observe for gag

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32
Q

biceps reflex

A

C5

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33
Q

brachioradialis reflex

A

C6

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34
Q

triceps reflex

A

C7

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35
Q

finger flexor reflex

A

C8/T1

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36
Q

patellar reflex

A

L4

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37
Q

hip adductor reflex

A

L3

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38
Q

ankle jerk reflex

A

S1

39
Q

PCA stroke

A

occipital cortex, visual cortex

contralateral hemianopsia with macular sparing

40
Q

amygdala lesion

A

kluver-bucy syndrome: hyperorality, hypersexuality, disinhibited behavior

41
Q

friedreich ataxia

A

progressive ataxia that affects ares more than legs, onset usually in childhood, impaired vibration and position sense

42
Q

slapping gait

A

dorsal column neuropathy

vitamin B12 deficiecny, tabes dorsalis

43
Q

waddling gait

A

hip-girdle weakness

muscular atrophy, proximal myopathy, muscular dystrophy

44
Q

simple v. complex seizures

A

complex seizures have a loss of consciousness, simple seizures do not

45
Q

best predictor of prognosis in astrocytomas

A

degree of anaplasia

46
Q

first line therapy for delirium in the elderly

A

haloperidol

47
Q

prion disease that may cause myoclonus

A

creutzfeldt-jakob disease

48
Q

children under 7 who have a wide array of seizure types accompanied by mental retardation

A

lennox-gastaut syndrome

49
Q

progression from absence seizures beginning age 10 to myoclonic seizures around age 15 to tonic-clonic seizures around age 16, may be worsened by sleep deprivation

A

juvenile myoclonic epilepsy

50
Q

cushing’s triad for intracranial pressure

A

bradycardia, bradypnea, hypertension

51
Q

subarachnoid hemorrhage suspected, CT is equivocal, next step

A

lumbar puncture

52
Q

most common etiologies of bacterial meningitis in adults < 60

A

streptococcus pneumoniae
neisseria menigitidis
haemophilus influenzae

53
Q

treatment for various side effects of typical antipsychotics

A

acute dystonia: benztropine
akathisia: benzodiazapine
neuroleptic malignant syndrome: bromocriptine
tardive dyskinesia: irreversible, stop offending agent

54
Q

ipsilateral motor and proprioception loss and contralateral pain loss below the level of the lesion

A

hemsection of cord

55
Q

burning pain and paralysis in upper extremities, secondary to forced hyperextension type of injury to the neck

A

central cord syndrome

56
Q

burst fracture of vertebra characterized by total loss of motor function below the level of the lesion, loss of pain and temperature bilaterally

A

anterior cord syndrome

57
Q

innervation of anterior thigh muscles

A

femoral nerve

58
Q

nerve that provides sensation to the medial leg (calf)

A

saphenous branch of femoral nerve

59
Q

innervation of medial thigh muscles

A

obturator nerve (adduction)

60
Q

innervation of posterior compartment of leg (calf), plantar muscles of foot

A

tibial nerve (flexion)

61
Q

innervation to anterolateral leg, dorsum of foot

A

fibular nerve (extension)

62
Q

vascular supply of midbrain

A

basilar artery

63
Q

vascular supply of pons

A

basilar artery and AICA

64
Q

vascular supply of medulla

A

PICA

65
Q

dorsal column function

A

vibration and proprioception

66
Q

spinothalamic tract function

A

pain and temperature

67
Q

corticospinal tract function

A

voluntary movement

68
Q

loss of spinal cord function except dorsal columns are intact

A

anterior spinal artery syndrome

69
Q

ventral horn and ventral white commissure affected, flaccid paralysis at level of lesion, loss of pain and temperature one level below the lesion

A

syringomyelia

70
Q

bilateral loss of vibration and discrimination and bilateral spastic paresis affecting legs before arms

A

vitamin B12 deficiency

71
Q

contralateral lower extremity and trunk weakness

A

anterior cerebral artery stroke

72
Q

contralateral face and upper extremity weakness and decreased sensation, bilateral visual abnormalities, aphasia or neglect

A

middle cerebral artery stroke

73
Q

contralateral visual abnormalities

A

posterior cerebral abnormalities

74
Q

focal motor or sensory deficits, loss of coordination, difficulty speaking

A

lacunar arteries

75
Q

cranial nerve abnormalities, contralateral full body weakness and decreased sensation, vertigo, loss of coordination, difficulty speaking, visual abnormalities, coma

A

basilar artery

76
Q

measures on the glascow coma scale

A

eye opening (4), verbal response (5), motor response (6)

77
Q

long-term treatment for mania

A

lithium, lamotrigine, olanzapine, or quetiapine

second line: valproate, aripiprazole

78
Q

treatment for bedwetting

A

first line: desmopressin

second line: imipramine (more side effects)

79
Q

treatment for adjustment disorder

A

psychodynamic psychotherapy

80
Q

acute treatment for panic attack

A

short-term benzo: alprazolam

81
Q

long-term treatment for panic attack

A

SSRI

second line: long-acting benzo (clonazepam, diazepam)

82
Q

treatment for ADHD

A

methylphenidate, atomoxetine

second line: bupropion, alpha-agonists, TCAs

83
Q

treatment for tourette’s syndrome

A

fluphenazine, pimozide, tetrabenazine

second line: haloperidol

84
Q

autism-like symptoms that develop after age 3

A

childhood disintegrative disorder

85
Q

want to hit your wife but you hit a chair instead

A

displacement

86
Q

unfaithful husband accuses his own wife of being unfaithful

A

projection

87
Q

IV drug use gets hepatitis C through needles and blames the community for not having adequate control over hepatitis C

A

distortion

88
Q

patient rescued from a burning building and denies any memory of the event

A

dissociation

89
Q

feelings of shyness, inferiority

desire to make friends overcome by fear of rejection

A

avoidant personality disorder

90
Q

excessive need to be cared for, submissive with loved ones

A

dependent perosnality disorder

91
Q

magical thinking

A

schizotypal

92
Q

side effects of lithium in utero

A

ebstein’s anomaly in first trimester

goiter and neuromuscular dysfunction in later trimesters

93
Q

injectable anti-psychotics

A 
haloperidol decanoate (1-2 times a month)
fluphenazine decanoate (twice a month)
risperidone depot (twice a month)
palpieridone depot (once a month)

USMLE Step Two (17 decks)

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