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Project - USMLE Step 3 > Neurology > Flashcards

Neurology Flashcards

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USMLE® Step 1 flashcards
1
Q
  • sudden onset weakness on ONE side of body
  • weakness of half of face
  • aphasia
  • +/- partial/total loss of vision
A

stroke, or TIA (transient ischemic attack)

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2
Q

stroke SPARES what part of face?

A

UPPER THIRD OF FACE

from the eyes up

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3
Q

80% of strokes are

A

ischemic (d/t thrombosis, or embolism)

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4
Q

20% of strokes are

A

hemorrhagic

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5
Q

symptoms last

A

TIA (transient ischemic attack)

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6
Q

transient loss of vision in one eye

A

amaurosis fugax

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7
Q

TIAs are ALWAYS caused by what? and are NEVER caused by?

A
  • emboli, or thrombosis

- never hemorrhage

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8
Q

best INITIAL test for stroke or TIA

A

head CT WITHOUT contrast

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9
Q

how many days are needed to achieve > 95% sensitivity in detection of nonhemorrhagic stroke?

A

3-5 days

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10
Q

achieves 99% sensitivity for nonhemorrhagic stroke w/i 24 hours

A

MRI

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11
Q

can be positive for nonhemorrhagic stroke w/i 1 hour

A

MRA

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12
Q

treatment for stroke w/i 3 HOURS of onset of symptoms

A

thrombolytics

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13
Q

ABSOLUTE CI to thrombolytic therapy in a stroke pt (8)

A
  • h/o hemorrhagic stroke
  • intracranial mass
  • active bleeding/surgery w/i 6 weeks
  • bleeding d/o
  • CPR w/i 3 weeks
  • suspicion of aortic dissection
  • stroke w/i 1 year
  • cerebral trauma/brain surgery w/i 6 months
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14
Q

best INITIAL treatment for pts coming too late for thrombolytics, and AFTER use of thrombolytics

A

aspirin

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15
Q

treatment if pt develops stroke while already on aspirin

A
  • switch to clopidogrel, or

- add dipyridamole to aspirin

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16
Q

should be added to ALL nonhemorrhagic strokes

A

statin

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17
Q

arterial lesions and symptoms:

  • C/L PROFOUND LOWER extremity weakness
  • mild upper extremity weakness
  • personality changes, or psychiatric disturbance
  • urinary incontinence
A

anterior cerebral artery

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18
Q

arterial lesions and symptoms:

  • C/L PROFOUND UPPER extremity weakness
  • APHASIA (can’t speak)
  • apraxia/neglect (inability to carry out purposeful movements)
  • eyes deviate TOWARDS the lesion
  • C/L homonymous hemianopsia
A

middle cerebral artery

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19
Q

arterial lesions and symptoms:

  • prosopagnosia (inability to recognize faces)
A

posterior cerebral artery

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20
Q

arterial lesions and symptoms:

  • vertigo
  • N/V
  • “drop attack,” LOC
  • VERTICAL nystagmus
  • dysarthria (difficulty pronouncing words), and dystonia
  • sensory changes in face and scalp
  • ATAXIA
  • B/L FINDINGS
A

vertebrobasilar artery

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21
Q

arterial lesions and symptoms:

  • I/L FACE
  • C/L body
  • VERTIGO
  • Horner’s syndrome (doesn’t have to be all 4 signs: miosis, ptosis, anhydrosis, and enophthalmos)
A

posterior inferior CEREBELLAR artery

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22
Q

arterial lesions and symptoms:

  • MUST BE AN ABSENCE OF CORTICAL DEFICITS
  • ataxia
  • Parkinsonian signs
  • sensory deficits
  • hemiparesis (most notable in face)
  • possible bulbar signs (impairment of CNs 9, 10, 11, 12)
A

lacunar infarct

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23
Q

arterial lesions and symptoms:

  • amaurosis fugax
A

ophthalmic artery

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24
Q

after initial treatment of stroke/TIA, most important issue is to?

A

determine origin of stroke

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25
Q

the following are indicated in ALL pts with stroke/TIA

A
  • echocardiogram
  • carotid dopplers/duplex
  • EKG/Holter monitor
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26
Q

the following are indicated in young pts (

A
  • ESR
  • VDRL, or RPR
  • ANA
  • ds-DNA Ab
  • protein C
  • protein S
  • factor V Leiden mutation
  • antiphospholipid syndrome
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27
Q

the younger the pt, the more likely the cause of stroke is from

A

vasculitis, or hypercoagulable state

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28
Q

treatment for status epilepticus

A

benzodiazepine

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29
Q

treatment for status epilepticus if seizure PERSISTS after use of benzodiazepine

A

add fosphenytoin

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30
Q

treatment for status epilepticus if seizure PERSISTS after use of benzodiazepine, and fosphenytoin

A

add phenobarbital

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31
Q

treatment for status epilepticus if seizure PERSISTS after use of benzodiazepine, fosphenytoin, and phenobarbital

A

general anesthesia (pentobarbital, thiopental, midazolam, propofol)

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32
Q

the following tests should be ordered on a pt having a seizure

A
  • sodium, calcium, magnesium, glucose, O2
  • stat head CT (MRI if CT is negative)
  • urine toxicology screening
  • liver and renal function
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33
Q

if INITIAL tests do not reveal etiology of seizure, next step in mangement

A

EEG (electroencephalogram)

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34
Q

generally, should you treat with chronic antiepileptic drug therapy after a SINGLE seizure?

A

NO

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35
Q

treat seizures chronically under the following circumstances:

A
  • strong family history
  • abnormal EEG
  • status epilepticus requiring a benzodiazepine
  • non-correctable precipitating cause (brain tumor)
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36
Q

first-line treatments for long-term management of seizures

A
  • valproic acid
  • carbamazepine
  • phenytoin
  • levetiracetam
  • lamotrigine

(all equal in efficacy)

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37
Q

adverse effect of lamotrigine

A
  • Stevens-Johnson syndrome
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38
Q

second-line treatments for long-term management of seizures

A
  • gabapentin

- phenobarbital

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39
Q

best treatment for absence seizures (petit mal)

A

ethosuximide

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40
Q
  • tremulous pt w/ slow, abnormal “festinating” gait
  • predominantly a gait d/o
  • orthostasis
A

Parkinson’s disease

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41
Q

PE findings of Parkinson’s disease

A
  • cogwheel rigidity
  • resting tremor
  • hypomimia (masklike/underreactive face)
  • micrographia
  • orthostasis
  • INTACT cognition and memory
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42
Q

diagnostic test for Parkinson’s disease

A

NONE, clinical diagnosis

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43
Q

treatment for Parkinson’s disease:

  • mild symptoms
  • under age 60
A

anticholinergic agent (benztropine, hydroxyzine)

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44
Q

treatment for Parkinson’s disease:

  • mild symptoms
  • over age 60
A

amantadine

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45
Q

treatment for Parkinson’s disease:

  • severe symptoms
A
  • levodopa/carbidopa
  • COMT inhibitors (tolCAPONE, entaCAPONE)
  • MAO inhibitors (seleGILINE, rasaGILINE)
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46
Q

definition of severe symptoms in Parkinson’s disease

A

inability to perform ADL

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47
Q

resting tremor

  • diagnosis
  • treatment
A
  • Parkinson’s disease

- amantadine

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48
Q

intention tremor

  • diagnosis
  • treatment
A
  • cerebellar d/o

- treat etiology

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49
Q

resting AND intention tremor

  • diagnosis
  • treatment
A
  • essential tremor

- propranolol

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50
Q
  • abnormalities of ANY part of CNS
  • optic neuritis
  • MOTOR and SENSORY problems
  • bladder defect
  • fatigue
  • hyperreflexia
  • spasticity
  • depression
A

multiple sclerosis

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51
Q

MC abnormality of multiple sclerosis

A

optic neuritis

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52
Q

best INITIAL test for multiple sclerosis

A

MRI

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53
Q

MOST ACCURATE test for multiple sclerosis

A

MRI

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54
Q

when is CSF tap indicated in multiple sclerosis?

A

if MRI is nondiagnostic

check for presence of oligoclonal bands

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55
Q

best INITIAL treatment for acute exacerbation of multiple sclerosis

A

steroids

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56
Q

disease-modifying treatment for multiple sclerosis

A
  • beta interferon
  • glatiramer
  • mitoxantrone
  • natalizumab
  • fingolimod
  • dalfampridine
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57
Q

adverse effect of natalizumab

A

PML

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58
Q

treatment for fatigue in multiple sclerosis

A

amantadine

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59
Q

treatment for spasticity in multiple sclerosis

A
  • baclofen

- tizanidine

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60
Q
  • slowly progressive loss of memory EXCLUSIVELY in older pts (> 65 yoa)
  • NO focal deficits
  • diagnosis of exclusion
A

Alzheimer’s disease

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61
Q

for ALL pts w/ memory loss, you must order the following:

A
  • head CT
  • B12 level
  • TSH/T4
  • VDRL, or RPR
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62
Q

only abnormal test in Alzheimer’s disease will be

A

head CT showing DIFFUSE, SYMMETRICAL ATROPHY

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63
Q

standard of care treatment for Alzheimer’s disease

A

anticholinesterase inhibitors

  • donepezil
  • rivastigmine
  • galantamine
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64
Q
  • PERSONALITY and BEHAVIOR become abnormal FIRST

- memory loss afterwards

A

frontotemporal dementia (Pick’s disease)

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65
Q

head CT, or MRI shows what in frontotemporal dementia (Pick’s disease)?

A

FOCAL atrophy of FRONTAL and TEMPORAL lobes

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66
Q

treatment for frontotemporal dementia (Pick’s disease)

A

same as Alzheimer’s disease:

anticholinesterase inhibitors

  • donepezil
  • rivastigmine
  • galantamine
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67
Q
  • caused by prions
  • RAPIDLY progressive dementia
  • MYOCLONUS
A

Creutzfeldt-Jakob disease (CJD)

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68
Q

MOST ACCURATE test for Creutzfeldt-Jakob disease (CJD)

A

brain biopsy

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69
Q

CSF shows what in Creutzfeldt-Jakob disease (CJD)?

A

14-3-3 protein

if found, spares pt from needing brain biopsy

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70
Q
  • Parkinson’s disease PLUS dementia

- very vivid, detailed hallucinations

A

lewy body dementia

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71
Q
  • wet: urinary incontinence
  • weird: dementia
  • wobbly: wide-based gait/ataxia
A

normal pressure hydrocephalus (NPH)

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72
Q

diagnostic tests for normal pressure hydrocephalus (NPH)

A
  • head CT

- lumbar puncture showing NORMAL pressure

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73
Q

treatment for normal pressure hydrocephalus (NPH)

A

shunt placement

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74
Q
  • young pt (30’s)
  • family history
  • dementia
  • psychiatric disturbance w/ personality changes
  • chorea/movement d/o
A

huntington’s disease/chorea

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75
Q

diagnosis for huntington’s disease/chorea

A

genetic testing

autosomal dominant

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76
Q

treatment for movement d/o in huntington’s disease/chorea

A

tetrabenazine

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77
Q

symptomatic control of huntington’s disease/chorea

A

antipsychotics

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78
Q

what percentage of migraine headaches are unilateral vs bilateral?

A
  • 60% U/L

- 40% B/L

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79
Q

triggers for migraines

A
  • cheese
  • caffeine
  • menstruation
  • OCPs
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80
Q

symptoms that may proceed migraine headache

A
  • aura of bright flashing lights
  • scotomata
  • abnormal smells
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81
Q

when should head CT or MRI be done for migraines?

A
  • sudden and/or severe
  • onset of headaches AFTER age 40
  • FNDs
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82
Q

best INITIAL (abortive) treatment for migraines

A

sumatriptan, or ergotamine

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83
Q

prophylactic treatment for migraines (requires several weeks to take effect)

A
  • BB
  • CCB
  • TCA
  • SSRI
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84
Q

when should a pt be placed on prophylactic treatment for migraines?

A

4 or more headaches per month

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85
Q
  • 10x more frequent in men than women
  • EXCLUSIVELY unilateral
  • redness/tearing of eye
  • rhinorrhea
A

cluster headache

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86
Q

best INITIAL (abortive) treatment for cluster headache

A

triptans, or 100% oxygen

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87
Q

best INITIAL prophylactic treatment for cluster headache

A

CCB

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88
Q
  • tenderness of temporal area

- jaw claudication

A

temporal arteritis

89
Q

diagnostic test for temporal arteritis

A

ESR

90
Q

MOST ACCURATE test for temporal arteritis

A

temporal artery biopsy

91
Q

most important treatment for temporal arteritis

A

STEROIDS

a delay may result in permanent vision loss

92
Q
  • obese, young woman w/ headache and double vision
  • papilledema
  • normal CT/MRI
  • +/- vitamin A use
  • 6th CN palsy
  • pulsatile tinnitus
A

pseudotumor cerebri

93
Q

MOST ACCURATE test for pseudotumor cerebri

A

LP w/ OPENING PRESSURE MEASUREMENT (markedly elevated)

94
Q

treatment for pseudotumor cerebri

A
  • weight loss
  • acetazolamide
  • surgery if those fail
95
Q
  • room spinning
  • N/V
  • HORIZONTAL nystagmus
A

vertigo

96
Q

ALL pts w/ vertigo should have what?

A

MRI of internal auditory canal

97
Q

causes of vertigo:

  • changes w/ position
  • NO hearing loss
A

benign positional vertigo (BPPV)

98
Q

causes of vertigo:

  • does NOT change w/ position
  • NO hearing loss
A

vestibular neuritis

99
Q

causes of vertigo:

  • acute
  • hearing loss
A

labyrinthitis

100
Q

causes of vertigo:

  • chronic
  • hearing loss
A

Meniere’s disease

101
Q

causes of vertigo:

  • ATAXIA
  • hearing loss
A

acoustic neuroma

102
Q

causes of vertigo:

  • h/o trauma
  • hearing loss
A

perilymph fistula

103
Q

PE finding in BPPV

A

Dix-Hallpike maneuver

104
Q

treatment for BPPV

A

meclizine

105
Q

treatment for vestibular neuritis

A

meclizine

106
Q

treatment for labyrinthitis

A

meclizine and steroids

107
Q

treatment for Meniere’s disease

A

salt restriction and diuretics

108
Q

diagnosis for acoustic neuroma (8th CN tumor related to neurofibromatosis)

A

MRI of internal auditory canal

109
Q

treatment for acoustic neuroma (8th CN tumor related to neurofibromatosis)

A

surgical resection

110
Q
  • h/o chronic heavy alcohol abuse
  • confusion w/ confabulation
  • ataxia
  • memory loss
  • gaze palsy/ophthalmoplegia
  • nystagmus
A

Wernicke-Korsakoff syndrome

111
Q

diagnostic tests for Wernicke-Korsakoff syndrome

A
  • head CT
  • B12 level
  • TSH/T4
  • VDRL, or RPR
112
Q

treatment for Wernicke-Korsakoff syndrome

A

THIAMINE FIRST, then glucose

113
Q

if a CNS infection is suspected, when should you do a head CT before doing an LP?

A
  • h/o CNS disease
  • FND
  • PAPILLEDEMA
  • seizures
  • altered consciousness
  • significant delay in ability to perform LP
114
Q

if CNS infection is suspected, next steps in management

A
  • LP
  • blood cultures
  • empiric antibiotics
115
Q

does a negative blood culture exclude meningitis?

A

NO, only 50-60% sensitive

116
Q

gram + diplococci

A

Pneumococcus

117
Q

gram - diplococci

A

Neisseria

118
Q

gram - pleomorphic, coccobacillary organisms

A

Haemophilus

119
Q

gram + bacilli

A

Listeria

120
Q

CSF glucose below 60 is consistent w/

A

bacterial meningitis

121
Q

best INITIAL test for meningitis

A

CSF cell count

122
Q

if thousands of neutrophils are present in CSF, next step in management

A

start IV ceftriaxone, vancomycin, and steroids

123
Q

MOST IMPORTANT criterion to determine need to treat pt w/ suspected meningitis

A

CSF cell count

thousands of neutrophils is meningitis until proven otherwise

124
Q
  • HIV-positive pt w/ CD4 count
A

Cryptococcus

125
Q

best INITIAL test for Cryptococcal meningitis

A

India ink

126
Q

MOST ACCURATE test for Cryptococcal meningitis

A

Cryptococcal Ag

127
Q

best INITIAL treatment for Cryptococcal meningitis

A

amphotericin and 5-flucytosine (5FC), followed by fluconazole PO until CD4 count is > 100

128
Q
  • recent camping/hiking trip
  • tick exposure only remembered by 20% of pts
  • joint pain
  • 7th CN palsy
  • rash w/ central clearing (target lesion)
A

lyme disease

129
Q

MOST ACCURATE tests for CNS lyme disease

A

serology and Western blot of CSF

130
Q

treatment for CNS lyme disease

A

IV ceftriaxone, or IV PCN

131
Q
  • camper/hiker
  • rash that STARTS on WRISTS and ANKLES, and moves centripetally toward center
  • fever, headache, and malaise PRECEDE rash
  • only 60% will remember tick bite
A

rocky mountain spotted fever

132
Q
  • extremely difficult diagnosis
  • look for immigrant w/ h/o lung TB
  • presentation is very slow over weeks to months
  • if case describes fever, headache, and neck stiffness over HOURS then it is not TB
A

TB meningitis

133
Q

CSF protein level in TB meningitis

A

very high

134
Q

acid fast stain is positive in what percentage of TB meningitis?

A

10%

135
Q

treatment for TB meningitis

A

rifampin, isoniazid, pyrazinamide, ethambutol, and steroids

136
Q
  • diagnosis of exclusion

- lymphocytic pleocytosis (elevated WBCs)

A

viral meningitis

137
Q

treatment for viral meningitis

A

no specific treatment

138
Q

treatment for Listeria monocytogenes meningitis

A

IV ampicillin

139
Q
  • elderly pt
  • neonatal pt
  • HIV-positive pt
  • asplenic pt
  • immunocompromised w/ leukemia/lymphoma
  • elevated neutrophils in CSF
A

Listeria monocytogenes meningitis

140
Q
  • adolescent pt
  • pt in the military
  • asplenic pt
  • pt w/ TERMINAL COMPLEMENT DEFICIENCY
A

Neisseria meningitidis

141
Q

treatment for Neisseria meningitidis meningitis

A
  • respiratory isolation

- IV ceftriaxone

142
Q

isolation type for Neisseria meningitidis meningitis

A

droplet precautions

143
Q

Neisseria meningitidis meningitis: prophylactic treatment for close contacts

A

rifampin, ciprofloxacin, or ceftriaxone

144
Q

fever + confusion over a few hours =

A

encephalitis

145
Q

best INITIAL test for encephalitis

A

head CT scan

146
Q

MOST ACCURATE test for encephalitis

A

PCR of CSF

147
Q

best INITIAL treatment for encephalitis

A

acyclovir (MCC of encephalitis in USA is HSV)

148
Q

treatment for acyclovir-resistant pts for encephalitis

A

foscarnet

149
Q
  • fever, headache, FND

- “ring,” or contrast-enhancing lesion

A

brain abscess

150
Q

next step in management of brain abscess is based on?

A

HIV status

151
Q

if HIV-negative, next step in management of brain abscess

A

brain biopsy

152
Q

if HIV-positive, next step in management of brain abscess

A

treat for toxoplasmosis w/ pyrimethamine/sulfadiazine x 2 weeks and repeat head CT

153
Q
  • NON-enhancing brain lesions in HIV-positive pt

- no mass effect

A

progressive multifocal leukoencephalopathy (PML)

154
Q

treatment for progressive multifocal leukoencephalopathy (PML)

A

raise CD4 count w/ ART

155
Q
  • Mexican pt w/ seizure

- multiple 1cm CYSTIC lesions (calcify over time)

A

neurocysticercosis

156
Q

diagnosis for neurocysticercosis

A

serology

157
Q

treatment for neurocysticercosis if still active and uncalcified

A

albendazole and steroids

158
Q

treatment for neurocysticercosis if there’s only calcifications

A

antiepileptics only

159
Q

head trauma and intracranial hemorrhage:

focal deficits: never
head CT: normal

A

concussion

160
Q

head trauma and intracranial hemorrhage:

focal deficits: rarely
head CT: ecchymosis

A

contusion

161
Q

head trauma and intracranial hemorrhage:

focal deficits: +/-
head CT: crescent-shaped collection

A

subdural hemorrhage

162
Q

head trauma and intracranial hemorrhage:

focal deficits: +/-
head CT: lens-shaped collection

A

epidural hemorrhage

163
Q

best initial test for head trauma and LOC

A

head CT scan

164
Q

treatment for concussion

A

none

165
Q

treatment for contusion

A

admit for observation

166
Q

treatment for subdural and epidural hemorrhage

A
  • leave small ones alone

- drain large ones

167
Q

treatment for large intracranial hemorrhage w/ mass effect

A
  • intubation/hyperventilation to decrease ICP (decrease pCO2 to 28-32 to constrict cerebral blood vessels)
  • mannitol to decrease ICP
  • surgical evacuation
168
Q

which pts should receive stress ulcer prophylaxis

A
  • head trauma
  • burns
  • endotracheal intubation w/ mechanical ventilation
169
Q
  • sudden, severe headache
  • stiff neck
  • photophobia
  • LOC (in 50% of pts)
  • FND (in 30% of pts)
A

subarachnoid hemorrhage (SAH)

170
Q

best INITIAL test for subarachnoid hemorrhage (SAH)

A

head CT w/o contrast

171
Q

MOST ACCURATE test for subarachnoid hemorrhage (SAH)

A

lumbar puncture

172
Q

normal WBC to RBC ratio in CSF

A

1:500

173
Q

treatment for subarachnoid hemorrhage (SAH)

A
  • angiography to locate site of bleeding

- embolize site of bleeding (superior to surgical clipping)

174
Q

treatment for subarachnoid hemorrhage (SAH) if hydrocephalus develops

A

ventriculoperitoneal shunt (VP shunt)

175
Q

treatment to prevent stroke in subarachnoid hemorrhage (SAH)

A

nimodipine (CCB)

176
Q

50% chance of what if pt rebleeds in SAH?

A

pt will die

177
Q

spine d/o’s:

nontender

A

lumbosacral strain

178
Q

spine d/o’s:

tender

A

cord compression

179
Q

spine d/o’s:

tender and fever

A

epidural abscess

180
Q

spine d/o’s:

pain on walking downhill

A

spinal stenosis

181
Q
  • defective fluid cavity in center of spinal cord caused by trauma, tumor, or congenital defect
  • loss of sensation of pain and temperature in UE’s B/L in cape-like distribution over neck, shoulders, and down both arms
A

syringomyelia

182
Q

diagnosis of syringomyelia

A

MRI

183
Q

treatment for syringomyelia

A

surgery

184
Q

diagnosis of cord compression

A

MRI

185
Q

MOST ACCURATE test for cord compression if diagnosis is unclear from history

A

biopsy

186
Q

MOST URGENT step in cases of cord compression

A

steroids to reduce swelling

187
Q

diagnosis of spinal epidural abscess

A

MRI

188
Q

treatment for spinal epidural abscess

A

treat against Staphylococcus

  • oxacillin
  • nafcillin
189
Q

treatment for spinal epidural abscess w/ large accumulations

A

surgical decompression

190
Q

diagnosis of spinal stenosis

A

MRI

191
Q

treatment for spinal stenosis

A

surgical decompression

192
Q
  • ALL SENSATION is lost except position and vibratory sense
A

anterior spinal artery infarction

193
Q

treatment for anterior spinal artery infarction

A

no specific treatment

194
Q
  • traumatic injury to spine (e.g. knife wound)
  • loss of I/L position and vibratory sense
  • loss of C/L pain and temperature
A

Brown-Sequard syndrome

195
Q

idiopathic d/o of BOTH upper and lower motor neurons

- upper motor neuron signs:
= hyperreflexia
= + Babinski
= spasticity
= weakness
  • lower motor neuron signs:
    = wasting
    = fasciculations
    = weakness
A

amyotrophic lateral sclerosis (ALS)

196
Q

treatment for amyotrophic lateral sclerosis (ALS)

A

riluzole (blocks glutamate accumulation)

197
Q

MCC of peripheral neuropathy

A

DM

198
Q

treatment for peripheral neuropathy

A

gabapentin, or pregabalin

199
Q
  • pain and weakness of 1st 3 digits of hand

- symptoms worsen w/ repetitive use

A

carpal tunnel syndrome

200
Q

treatment for carpal tunnel syndrome

A
  • splint

- steroids

201
Q
  • results from falling asleep w/ pressure on arms underneath body, or
  • outstretched arm, draped over back of chair
  • WRIST DROP
A

radial nerve palsy

202
Q
  • results from high boot pressing on back of knee

- FOOT DROP, and inability to Evert foot

A

peroneal nerve palsy

203
Q
  • hemifacial paralysis of BOTH UPPER and lower halves of face
  • loss of taste on ANTERIOR 2/3 of tongue
  • hyperacusis
  • inability to close eye at night
A

7th cranial nerve palsy (Bell’s palsy)

204
Q

treatment for 7th cranial nerve palsy (Bell’s palsy)

A

steroids

205
Q
  • occurs in pt w/ previous injury to extremity

- light touch results in extreme pain (“burning”)

A

reflex sympathetic dystrophy

206
Q

treatment for reflex sympathetic dystrophy

A
  • NSAIDs
  • gabapentin
  • nerve block
207
Q
  • bed partner c/o pain and bruises in legs
  • pt experiences uncomfortable feeling in legs relieved by movement
  • associated w/ iron deficiency
A

restless leg syndrome (RLS)

208
Q

treatment for restless leg syndrome (RLS)

A

pramipexole, or ropinirole

209
Q
  • ASCENDING weakness
  • LOSS OF DTRs
  • URI 2-4 weeks may precede
  • paresthesia is common, but true sensory deficits are rare
A

Guillain-Barre syndrome

210
Q

MOST URGENT step in Guillain-Barre syndrome

A

peak inspiratory pressure

211
Q

most important factor in determining need for therapy w/ either IVIG, or plasmapheresis

A

peak inspiratory pressure

212
Q
  • weakness in muscles of mastication
  • blurry vision d/t diplopia
  • drooping of eyelids as day progresses
A

myasthenia gravis

213
Q

best INITIAL test for myasthenia gravis

A

anti-acetylcholine receptor Abs (ACHR Abs)

214
Q

MOST ACCURATE test for myasthenia gravis

A

clinical presentation AND ACHR Abs

215
Q

best INITIAL treatment for myasthenia gravis

A

pyridostigmine, or neostigmine

216
Q

treatment for myasthenia gravis in pts

A

thymectomy

217
Q

treatment for myasthenia gravis if thymectomy does NOT work, or no response to pyridostigmine, or neostigmine

A

steroids

218
Q

treatment for myasthenia gravis to keep pts off of long-term steroids

A

azathioprine, or cyclosporine

Project - USMLE Step 3 (82 decks)

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