Neurologie Flashcards

1
Q

Management of respiratory problem in Myasthenia gravis(3)

A

Stop acetyl cholinesterase inhibitor
Monitor CV and tidal volume
antibiotics

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2
Q

What to monitor in ptient with myastenia gravis and respiratory problem

A

vital capacity

or Tidal volume

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3
Q

trigeminal neuralgia management

A

carbamazepine

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4
Q

Next step if medical rx fails in trigeminal neuralgia(2)

A

gangliolysis

or decompression of trigeminal nerve

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5
Q

Method of decompressing trigeminal nerve

A

suboccipital craniectomy

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6
Q

clue of trigeminal neuralgia

A

shock like wave sensation

knife like sensation

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7
Q

Dx of pseudotumor cerebri

A

Lumbar ponction

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8
Q

Feature of pseudotumor

A

High intracranial pressure

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9
Q

finding for pseudotumor in LP

A

opening pressure >250mm de HG

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10
Q

Anatomic abnormality in subdural hematoma

A

rupture of bridging veins

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11
Q

anatomic abnormality in epidural hematoma

A

artere meningee moyenne

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12
Q

risk factor for pseudo tumor(2)

A

obesity

med rich in vit A

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13
Q

risk factor for subdural hematoma(2)

A

alcohol

increase age during trauma

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14
Q

CT finding of subdural hematoma

A

semilunar hemorrage

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15
Q

Rx of parkinson disease

A

trihexyphenidyl

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16
Q

side effect of antichlinergic drug(6)

A
red-flushing
dry-mucous membrane
hot-
mad-agitation
blind-precipitation of glaucoma
full-constipation, retention urinaire
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17
Q

opthtalmologic problem with anticholinergic

A

precipitation of glaucoma

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18
Q

Urinary problem with anticholinergic

A

void impossibility

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19
Q

digestive problem with anticholinergic

A

constipation

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20
Q

Monitoring of respiratory difficulty in Guillain barre

A

Vital capacity

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21
Q

redflag VC in Guillain barre

A

<15

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22
Q

first symptom of lewy body demencia

A

visio-spatial impairment

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23
Q

late finding in lewy body dementia(2)

A

memory impairment

hallucination

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24
Q

specfic findings for lewy body

A

parkinsonism

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25
Q

Rx of lewy body(2)

A

rivastigmine

or atypical psychotic

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26
Q

indication of surgery in carotid stenosis (2)

A

> 60% stenosis asymptomatic

symptomatic

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27
Q

Quid of Todd’s Palsy

A

paralysis transient after seizure

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28
Q

work up for weight loss

A

hiv test

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29
Q

Endocarditis plus hemiplegia

A

embolic stroke

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30
Q

Rx of stroke caused by endocarditis

A

Antibiotics

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31
Q

cause of cord compression(3)

A

injury
malignancy
infection

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32
Q

cord compression clue

A

Pain worse in reccubent position

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33
Q

Initial work up in intracerabral hemorrage

A

Ct scan of the head

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34
Q

clue for thalamic stroke(2)

A

no motor problem

sensesory problem

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35
Q

sensory problem in thalamic stroke(2)

A

anesthesia

dysesthesia

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36
Q

Quid of dyesthesia

A

stimulus to pain is exagerated

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37
Q

Most important feature of dementia

A

functionnal impairement

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38
Q

Differentiate aging from dementia

A

functionnal impairement=dementia

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39
Q

type of aphasia(3)

A

Broca
wernicke
conduction

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40
Q

features of broca aphasia (3)

A

difficulty speaking
hemiparesis
no comprehension problem

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41
Q

features of wernike(2)

A

no problem speaking but lack of meaning

comprehension problem

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42
Q

part of the brain involved in a right handed man with speech problem and right hemipresis

A

dominant frontal lobe

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43
Q

Quid of motor problem in wernike aphasia

A

controlateral visual field defect

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44
Q

Quid of motor problem in broca aphasia

A

contolateral hemiparesis

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45
Q

complication of increased intracranial pressure

A

blindness

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46
Q

Physical eye exam findings in patient with increased intracranial pressure

A

papilledema

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47
Q

Rx of multiple sclerosis acutely

A

corticosteroids

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48
Q

Management of MS rebellious to corticosteroids

A

plasma exchange

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49
Q

Physical eye exam in glaucoma

A

Mydriasis

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50
Q

Physical eye exam in cluster headache

A

Myosis

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51
Q

Dx of glaucoma

A

tonometry

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52
Q

quid of action tremor

A

essential tremor

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53
Q

Quid ot parkison tremor

A

resting tremor

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54
Q

rx for essential tremor

A

propranolol

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55
Q

alternative rx for essential tremor(2)

A

primidone

topiramate

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56
Q

what is the mx most commonly involved in Myasthenia gravis

A

extra occular muscle

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57
Q

Manifestation occular of Myasthenia gravis

A

diplopia

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58
Q

4 stages of pressure ulcers

A

redness
ulcer
ulcer plus subcutaneous fat
bone is seen tendon and muscle

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59
Q

Physiopatho of cerebral infarct after sub arachnoid hematoma

A

3 days after SAH ,vasospasm —>cause infarction

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60
Q

chronologic risk for patient with SAH

A

after 3 days risk of infarction

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61
Q

Physiopatho of difficulty walking in patient with cerebellar hemmorrage

A

balance problem

no mx weakness problem

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62
Q

Physiopatho af Myasthenia gravis

A

auto antibody against acetylcholine receptor

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63
Q

site of action of auto antibody in myasthenia gravis

A

Post receptor

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64
Q

organs run by upper motor neuron(2)

A

Moelle

cerveau

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65
Q

upper motor neuron findings in physical exam(3)

A

Hyperreflexia
Babinski +
Pronator drift

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66
Q

Cause of vertigo(5)

A
Benign paroxysmal positional vertigo
Migraine
vestibular neuritis
Meniere disease
brainstem /cerebellar stroke
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67
Q

Quid of Meniere disease(2)

A

Vertigo

auditory problem

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68
Q

Type of facial nerve palsy(2)

A

Peripherique

Central

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69
Q

quid facial paralysis below the pons

A

peripheric facial paralysis

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70
Q

Findings in facial paralysis below the pons(3)

A

problem in
eyebrows
palpebral ptosis
labial deviation

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71
Q

Findings in centrally located facial paralysis

A

Sensory problem in 2/3 inferior of hemi face

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72
Q

clue for cluster headache

A

horner syndrome=Myosis

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73
Q

Rx of cluster headache

A

100% oxygen

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74
Q

Clue for cavernous sinus thrombosis(2)

A

orbital cellulitis
vomiting
headache

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75
Q

Physiopatho of vomiting in cavernous sinus thrombosis

A

High intracranial pressure

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76
Q

Veins forming cavernous sinus(6)

A

Ethmoidale 2 ant et post
nasofrontale
lacrymale
ophtalmique 2 superieur et inferieur

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77
Q

Nerves that could be reached in case of cavernous sinus thrombosis(4)

A

3,4,5,6

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78
Q

Disease associated with acoustic neuroma

A

Neurofibromatosis

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79
Q

Dx of acoustic neuroma

A

MRI with gadolinium

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80
Q

Drug induced vestibulo cochleaire toxicity(2)

A

gentamycin(aminoglycoside)

furosemide

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81
Q

Clue for angle closure glaucoma(2)

A

Pain in eye

dilated pupil

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82
Q

Neurologic finding in dead person

A

Deep tendon reflexes still present

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83
Q

why deep tendon reflexes are still present in dead people

A

because spinal cord is still functionnal

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84
Q

cause of heat stroke(2)

A

Inadequate of thermoregulation

failure of thermoregulation

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85
Q

Cause of cerebellar dysfunction

A

alcohol

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86
Q

cerebellar signs(4)

A

gait problem
ataxia
nystagmus
tremor

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87
Q

Best initial rx in Myastheni gravis

A

Pyridostigmine

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88
Q

gold standard test to Dx herpes encephalitis

A

PCR

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89
Q

Management of cerebral hemorrage in patient on warfarin(2)

A

stop warfarin

give fresh frozen plasma

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90
Q

period of acting for vitk in case of warfarin side effect

A

8-12 h

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91
Q

CT finding in patient with anaerobic cerebral abcess

A

ring enhancing lesion

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92
Q

clue to make you think of anaerobic cerebral abcess

A

History of sinusitis

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93
Q

Manif of Hypokliemie(2)

A

Mx weakness

Hyporeflexia

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94
Q

EKG findings in hypokaliemia

A

flat and broad t waves

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95
Q

Dx for painless loss of vision

A

amaurosis fugax

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96
Q

Next step after dx amaurosis fugax

A

duplex of the neck

97
Q

Quid of duplex of the neck

A

to see plaques in carotid artery

98
Q

Med causing increase intracranial hypertension(2)

A

tetracyclines

vit A

99
Q

Drug of choice of Parkinson(2)

A

carbilevodopa

trihexyphenidyl

100
Q

Side effect of levo carbi dopa

A

hallucination

101
Q

site of motor problem in cerebellar hemorrage

A

only in face

102
Q

eye exam findings in cerebellar hemorrage

A

deviation of the eye towards the normal size

103
Q

Cause of SAH

A

rupture of berry aneurysm

104
Q

First site of hypertensive stroke

A

Putamen

105
Q

Clinical dx of Multiple sclerosis(3)

A

Optalmoplegia
other neurological findings
Patchy neurologic problem

106
Q

Best test to Dx Multiple sclerosis

A

MRI

107
Q

Finding in steppage gait(2)

A

foot drop

Hip flexion

108
Q

Cause of steppage gait(2)

A

Peroneal nerve problem or

L5 radiculopathy

109
Q

Patient with spatial organisation problem after stroke,Dx

A

hemineglect syndrome

110
Q

What part of the brain is affected in hemineglect

syndrome

A

parietal lobe ,the non dominant part

111
Q

what test will help you to dx hemi neglect syndrome

A

the clock test

112
Q

What ‘s the clock test from a patient with parietal lobe stroke

A

the pateint draws a clock and put number only in the right

113
Q

symptoms of lewy body dementia(4)

A

visiospatial impairment
Hallucination
loss of memory
parkinsonism

114
Q

Rx of restless leg syndrome

A

dopamine agonist

115
Q

give me one dopamine agonist

A

pramipexole

116
Q

cause of focal dystonia(2)

A

Trauma

medication

117
Q

Long term treatment of Multiple sclerosis

A

interferon B

118
Q

What’s cushing reflexe

A

bradycardia in a context of high intracranial pressure

119
Q

When to consider ICH

A

when the intracranial pressure > 20

120
Q

clinical findings of craniopharyngioma(2)

A

Bitemporal loss of vision

Hypopituitarism

121
Q

symptom of hypopituitarism in adult

A

sexual dysfunction

122
Q

symptom of hypopituitarism in children

A

retarded growth

123
Q

Dx of Cranyopharyngioma(2)

A

MRI or

ct scan of head

124
Q

Rx of craniopharyngioma(2)

A

surgery/and or

radiotherapy

125
Q

syncope while standing

A

neurocardiogenic syncope=vasovagal syncope

126
Q

trigger of vasovagal syncope(3)

A

Pain
emotionnal stress
prolonged standing

127
Q

Syncope with positional changes

A

orthostatic hypotension

128
Q

syncope with exercice (4)

A

aortic stenosis
HOC
VTAC
anomalous coronary arteries

129
Q

syncope associated with hypokaliemie and hypomagnesemie

A

torsades de pointes

130
Q

syncope with bradycardia(3)

A

sick sinus syndrome
brady arrythmia
AV block

131
Q

Syncope during sleep or with exercice or sudden noise

A

congenital long Qt syndrome

132
Q

Measure of opening pressure in idiopathic intracranial pressure(pseudotumor cerebri)

A

> 250

133
Q

Rx of IIH(2)

A

acetazolamide

furosemide

134
Q

frequet cause of increased intracranial pressure in

USMLE

A

IIH

135
Q

Quid of shy drager syndrome

A

multiple system atrophy

136
Q

triad of shy drager syndrome(3)

A

autonomic dysfunction
parkisonism
neurologic findings

137
Q

quid automonic dysfunction(5)

A
importence
hyoptension orthostatic
gastroparesis
disturbance of bladder and bowel control
extreme salivation and lacrymation and sweating
138
Q

what kill patient with shy drager(2)

A

Bulbar dysfunction

laryngeal stridor

139
Q

Difference between syncope and seizure

A

tongue bite and/or

confusion after the spell

140
Q

lower motor neuron dysfunction

A

fasciculations

areflexia

141
Q

Patient diabetic IV drug user with paresis but no fever hyperreflexia,Dx

A

Epidural abcess

142
Q

Confirmatory dx of epidural abcess

A

MRI

143
Q

Symptom in statin induced myositis(2)

A

weakness

no eye involvement

144
Q

Vessel involved in pure motor hemiparesis

A

lacunar infarct=internal capsule infarct

145
Q

sympton of lacunar infarct(2)

A

only motor involvement

hemiaaresis invoving hemiface

146
Q

Laps ot time to begin alteplase after ischemis stroke

A

within 3 a 4,5 H

147
Q

Quid of wernicke encephalopathy

A

B1 deficiency

148
Q

what part of the brain is involved in wernicke encephalopathy?

A

cerebellum

149
Q

risk factor for wernicke

A

alcohol

150
Q

what ‘s the cranial nerve most commonly involved in diabetic mononeuropathy

A

3

151
Q

Manif of cranial nerve 3 diabetic mononeuropathy(3)

A

ptosis
eye go down and out
pupil reactive

152
Q

why pupil is reactive in cranial nerve 3 neuropathy

A

because parasympathis fibers are intact

you have involvement of somatic fibers

153
Q

Is there speaking problem in lacunar infarct

A

Never

154
Q

Triad for creutzfeld Jacob

A

Dementia
Myoclonus
EEG changes

155
Q

EEG changes in Creuztfeld Jacob

A

sharp,synchronic, triphasic discharge

156
Q

Cause of creutz feld Jacob

A

Prion

157
Q

other name for creutzfeld Jacob

A

spongiform encephalopathy

158
Q

cancer causing eaton lambert syndrome

A

small cell carcinoma of lung

159
Q

manif of eaton lambert syndrome

A

mx weakness

160
Q

Physiopatho of eaton lambert syndrome

A

antibody against voltage gate channel calcium

161
Q

site of neuromxar blockage in eaton lambert

A

presynaptique

162
Q

Quid of pseudo dementia

A

Major depression in aging people

remember SIGECAP

163
Q

the single test to differentiate Pseudodementia and dementia

A

dexamethasone suppression test

164
Q

Disease involving upper and lower motor neuron at the same time

A

Amyotrophic lateral sclerosis

165
Q

drug of choice for amyotrophisc lateral sclerosis

A

riluzole

166
Q

what’s riluzole

A

glutamate inhibitor

167
Q

Quid of korsakoff syndrome

A

irreversible amnesia

168
Q

cause of korsakoff syndrome

A

alcohol

169
Q

What vessel is invoved in stroke anr aphasia

A

MCA

170
Q

confirmatory dx for Eaton lambert syndrome

A

electrophysiological studies

171
Q

Rx for eaton lambert syndrome(2)

A

Plasmapheresis

immunosuppresion drug therapy

172
Q

Dx for ring enhancing lesion and EBV DNA positive

A

Primary CNS lymphoma

173
Q

Best test in case of emergency patient wit seizure

A

CT scan of the head

174
Q

Dx in elective situation for seizure

A

MRI

175
Q

Dx in focal neurologic findings in HIV patient

A

progressive multifocal leukoencephalopathy

176
Q

Dx of PML

A

MRI

177
Q

cause of PML

A

JC virus

178
Q

finding n MRI in cas of PML

A

Multiple ring enhancing lesions

179
Q

prognosis in case of PML in HIV patients

A

6 months to live

180
Q

risk factor for epidural abcess(3)

A

HIV
diabetes
IV drug user

181
Q

Rx of epidural abcess

A

surgical decompression

182
Q

Bugs involved in epidural abcess

A

staph aureus

183
Q

Management acute of confusionnal state(4)

A

Dextrose
oxygen
Naloxone
Thiamine

184
Q

Disease causing cord cavitation

A

syringomyelie

185
Q

Manif of syringomyelia(4)

A

weakness of upper extremities
hyperreflexia of “ “ “ “
pain and temperature absent
Position and vibration conservees

186
Q

Manif of carpal tunnel syndrome(2)

A

Paresthesia of first 3 digits and half 4e

atrophy eminence thenar

187
Q

Triad of huntington

A

Mood disturbances
choreiform mvt
dementia

188
Q

Quid of choreiform mvts(5)

A
facial grimacing
dystonia
writhing mvts of extremities
ataxia
tongue protrusion
189
Q

Transmission of Huntington

A

autosomal dominant

190
Q

cerebellar tumor manifestation(3)

A

Nystagmus
Coordination problem
Ataxia

191
Q

Dx differentiel of progressive ascending paralysis(2)

A

GBS

Lyme disease

192
Q

Differnce entre GBS and Lyme(2)

A

No autonomic dysfunction in Lyme

CSF is normal

193
Q

Physio patho of tick borne paralysis

A

relargage de Neurotoxine

194
Q

First step in Lme disease

A

Meticulous search of tick

195
Q

Role of spino thalamic tract

A

Temperature
Pain
Motricite

196
Q

Patient with loss of pain and temperature depuis T12 and hemiparesis a droit .What ‘s the problem and what’s the level(2)

A

Spinothalamic tract gauche

Level is at T10

197
Q

Quid for alzheimer dementia(2)

A

memory problem first

visuo spatial later

198
Q

When will see changes on CT after ischemic stroke

A

after 24 H

199
Q

Benefit riluzole

A

prolong survival in Amyotrophic lateral sclerosis

200
Q

Eye exam in opiod intoxication

A

Mioisis

201
Q

Quid of brown sequard syndrome

A

Lateral spinothalamic tract damage

202
Q

quid of apraxia

A

difficulty of using comb

203
Q

Minimental score confirming dementia

A

< 24

204
Q

CT findings scan in alzheimer(2)

A

Temporal atrophy

parietal atrophy

205
Q

clue for fronto temporal dementia

A

deshinibition

206
Q

Chorea of Huntington on CT

A

atrophy of caudate nucleus

207
Q

1 Bug causing Guillain barre syndrome

A

Campylobacter jejuni

208
Q

Triad of parkisonism

A

RBR
Rest tremor
Bradykinesia
rigidity

209
Q

histopatho in alzheimer

A

neurofibrillary tangles

210
Q

severe Pain management in drug addict

A

give morphine anyway

211
Q

site of compression of ulnar nerve

A

elbow

212
Q

Manif of Ulnar nerve compression

A

Paresthesia of 4e and 5e Finger

213
Q

Cause of tremor in parkisonism

A

Basal ganglia problem

214
Q

cause of tremor in alcoholics(2)

A

cerebellum atrophy

role de thiamine

215
Q

Cause of physiologik tremor(3)

A

hyperthyroidie
caffeine intake
anxiety

216
Q

Clue for essential tremor

A

it’s relieved bay alcohol

217
Q

what’s Dejerine roussy syndrome

A

thalamic stroke

218
Q

cause of ophtalmoplegia in MS

A

MLF dysfunction

Medial longitudinal fasciculus

219
Q

Pseudo dementia rx

A

SSRI

220
Q

Wallenberg syndrome manif (4)

A

vestibular cerebellar symptom
sensory problem
BulbarMx weakness
autonomic dysfunction

221
Q

Quid of Wallenberg syndrome

A

Lateral medulla stroke

222
Q

Vestibullar cerebellar symptom in Wallenberg syndrome(3)

A

vertigo
Nystagmus
limb ataxia (ipsilateral)

223
Q

Sensory problem in Wallenberg syndrome(2)

A

facial pain

Loss of pain and T ipsilateral face and controlateral limbs and trunk

224
Q

Bulbar MX weakness in Wallenberg syndrome Manif

A

Hoarseness

225
Q

Autonomic dysfunction in Wallenberg

A

Horner syndrome ipsi lateral

226
Q

Artery involved in lateral medulla syndrome

A

intracranial vertebral artery

227
Q

horner’s syndrome (3)

A

Miosis
Ptosis
anhidrosis

228
Q

Painful loss of vision and neurologic problem

A

MS

229
Q

Acute rx of migraine(3)

A

(iv)chlorpromazine + Nsaids
metochlopramide
Prochlorperazine

230
Q

Patient with MS and absent sensation from the nipple downwards, paraplegia,rectal and urine incontinence localisation de la plaque

A

Upper thoracic localisation

231
Q

Patient with MS and absent sensation from the umbilicus downwards paraplegia rectal and urine incontinence,quid de la localisation de la plaque

A

Lower thoracic

232
Q

CSF findings in GBS(3)

A

dissociation albumino cytologic
high protein
Normal WBC

233
Q

Rx of GBS (2)

A

Immunoglobuline IV and

Plasmapheresis

234
Q

Rx of metochlopramide induced extrapyramidal syndrome

A

benztropine or

diphenidramine

235
Q

differentiale parkison from lewy body(3)

A

Motor problem first
dementia later for parkinson
inverse pour Lewy body

236
Q

non intrinsic neurologic cause of seizures(3)

A

flashlights in club
alcohol
sleep deprivation

237
Q

first symtom in alzheimer

A

memory loss(dementia)

238
Q

Late findings in alzheimer(3)

A

visio spatial
Hallucination
Difference with lewy body