Neurological

Question 1

Red flags for headaches - SAH

Answer 1

Sudden onset in seconds or minutes

Question 2

Red flag for headache - Hemorrhage or infection

Answer 2

“first or worst headache”

Question 3

Red flag for headache - Mass, AVM

Answer 3

Focal neuro symptoms

Question 4

Red flag for headache - Infection

Answer 4

Fever

Question 5

Red flag for headache - Other

Answer 5

change in personality, mental status, LOC

Question 6

Papilledema

Answer 6

Swelling of the optic disc due ot increased ICP. Almost always bilat

Question 7

When to image with a HA

Answer 7

• Red Flags
• Change in pattern, frequency, or severity of HA
• Worsening of HA despite therapy
• Abnormal exam
• Onset of HA with exertion, cough, sex
• New onset > 40 yo

Question 8

Duration of migraine

Answer 8

4-72 hours

Question 9

Trigeminal Neuralgia

Answer 9

sudden, brief, unilateral facial pain
Distribution over one or more branches of CN V
Common in elderly

Question 10

Tx Trigeminal Neuralgia

Answer 10

carbamazepine (Tegritol)

Question 11

Tx of bells palsy

Answer 11

Steroids and acyclovir

Question 12

Vertigo - Peripheral Etiology

Answer 12

benign positional vertigo
Meniere’s disease
acoustic neuroma
otitis media

Question 13

Vertigo - Central Etiology

Answer 13

migrainous vertigo, brainstem ischemia, MS, chiara malformation

Question 14

Sx of Parkinson’s disease

Answer 14

rest tremor, rigidity, bradykinesia, and gait disturbance

Question 15

Dx of Parkinson’s

Answer 15

Dopaminergic therapy

Question 16

What helps physiologic tremors?

Answer 16

propanolol

Question 17

What labs should you draw with suspected dementia?

Answer 17

B12, TSH, CBC, CMP, folate

Question 18

CN I

Answer 18

Sensory - Olfactory

Question 19

CN II

Answer 19

Optic - Test with snellen chart, finger count

Question 20

CN III

Answer 20

Oculomotor - Test pupillary constriction, accommodation

Question 21

CN IV

Answer 21

Trochlear - Responsible for for movement of the superior oblique muscle. LS6 SO4

Question 22

CN V

Answer 22

Trigeminal - Sensation to face, nasal and buccal mucosa, and the teeth. Moter responsible for mastication

Question 23

CN VI

Answer 23

Abducans - Responsible for movement of the lateral rectus muscle
LR4 SO4

Question 24

CN VII

Answer 24

Innervates the facial muscles and supplies taste to the anterior 2/3 of tongue

Question 25

CN VIII

Answer 25

Vestibuloocular - Hearing, balance, and awareness of position

Question 26

CN IX

Answer 26

Glossopharangeal - Supplies sensation to the pharynx, posterior 1/3 of the tongue, and tympanic membrane

Question 27

CN X

Answer 27

Vagus - Supplies parasympethetic fibers to the viscera of the chest, abdomen, motor fibers of the pharynx, larynx

Question 28

CN XI

Answer 28

Spinal accessory - Motor nerve supplying the sternocleidomastoid and trapezius muscles

Question 29

CN XII

Answer 29

Hypoglossal - Supplies motor fibers to the muscles of the tongue. Observe for fasciculations of the tongue