neurology

Question 1

neisseria meningitis will present how in a gram stain?

Answer 1

Gram-negative diplococci

Question 2

what is the mode of transmission in meningococcus?

Answer 2

droplets

Question 3

What is waterhouse-friderichsen syndrome and what is it associated with?

Answer 3

bilateral adrenal hemorrhage and fulminant meningosepticemia

Question 4

What causes a headache that is worse in the morning and may cause nausea, vomiting, and ataxia?

Answer 4

A brain tumor

Question 5

what is the treatment of Tension headache?

Answer 5

Rest, avoid triggers and stressors, NSAIDS or acetaminophen
NSAIDs: abortive
TCAs: preventive

Question 6

What does the ability to raise the eyebrows suggest in a patients with Bell’s palsy?

Answer 6

Suggests a central process. This is because the forehead receives bilateral upper motor neuron innervation, so a central stroke will spare the forehead and allow the patient to raise the eyebrows.

Question 7

How to grade facial weakness in Bell’s palsy?

Answer 7

House and Brackmann grading 1-6

Question 8

Name the condition with attacks of lancinating pain in the distribution of cranial nerve V.

Answer 8

Trigeminal neuralgia or tic douloureux.

Question 9

Patient waking up with unilateral facial nerve paralysis, hyperacusis, and taste disturbance?

Answer 9

Bell’s palsy

Question 10

Name the condition with attacks of lancinating pain in the distribution of cranial nerve V and its treatment

Answer 10

Trigeminal neuralgia or tic douloureux
Carbamazepine

Question 11

What is the most common underlying condition associated with optic neuritis?

Answer 11

Multiple sclerosis.

Question 12

Putamen hemorrhage PE

Answer 12

Contralateral hemiparesis
contralateral sensory loss
gaze paresis
homonymous hemianopia
abulia (loss of initiative)
aphasia
neglect
apraxia

Question 13

BP goal is hypertensive intracranial hemorrhage?

Answer 13

140-160 mm Hg systolic

Question 14

Which medications cause acute dystonic reactions?

Answer 14

Antipsychotics and antidopaminergic, ex: metoclopramide and haloperidol

Question 15

How to treat acute dystonic reaction?

Answer 15

Anticholinergic agents such as benztropine and diphenhydramine

Question 16

How to treat acute dystonic reaction?

Answer 16

Anticholinergic agents such as benztropine and diphenhydramine

Question 17

Most common cause of epidural abscess?

Answer 17

hematogenous spread

Question 18

What is a SENSITIVE marker in epidural abscess diagnosis?

Answer 18

ESR

Question 19

What is the abx choice in epidural abscess?

Answer 19

3rd generation cephalosporin and vancomycin

Question 20

What are the classic findings in transverse myelitis?

Answer 20

A transverse level of sensory impairment, paraplegia, and sphincter disturbance.

Question 21

Cluster headache abortive medication and prophylaxis?

Answer 21

Abortive: 100% oxygen in non-rebreather for 15 minutes, subQ sumatriptan
Prophylaxis: verapamil

Question 22

What is Miller-Fisher syndrome?

Answer 22

GBS variant associated with:
Ophthalmoplegia
Ataxia
Areflexia

Question 23

Which bacteria should be considered as a cause of meningitis in patients ≥ 50 years?

Answer 23

Listeria monocytogenes.

Question 24

Indications for head CT scan before performing LP?

Answer 24

AMS
Immunocompromised state
Focal neurological deficit
ICP high
CNS lesion
seizure one week
suspected subarachnoid hemorrhage

Question 25

What medication should be administered to help reduce the vasospasm associated with subarachnoid hemorrhage?

Answer 25

Nimodipine.

Question 26

Hunter and hess grading for what and what grades?

Answer 26

Subarachnoid hemorrhage
Grades 1-2: no nerve deficits except CN
Grade 3: confused, somnolent, CN or mild motor deficit (rapid deterioration, 50%)
Grade 4-5: stupor coma, moderate/severe hemiparesis