Neurology

Question 1

How does HYPOVENTILATION affect the ICP?

Answer 1

Vaso-DILATION
HYPER - carbia
worsening ICP

Question 2

How does HYPERVENTILATION affect the ICP?

Answer 2

VasoCONSTRICTION causing cerebral ischemia

Question 3

What is central cord syndrome?

Answer 3

Weakness in the UPPER extremities > LOWER extremities. The lesion encroaches the medial aspect of the spinal cord on the anterior horn gray matter.

Question 4

What drug induces substance-induced mania in asthmatic patients?

Answer 4

steroids

Question 5

Name the diagnostic tool to confirm a definitive diagnosis of osteomyelitis.

Answer 5

MRI because it is more sensitive.

Question 6

What is brown-sequard syndrome?

Answer 6

involves the dorsal column and the spinothalamic tract

unilaterally producing weakness,

IPSILATERAL loss of VIBRATION and PROPRIOCEPTION to the site of injury

CONTRALATERAL loss of PAIN and TEMPERATURE

Question 7

What are the s/sx of an anterior cerebral arterial embolism?

Answer 7

The anterior cerebral artery supplies the medial portions of the frontal and parietal lobes and corpus callosum.

Hemiplegia

Question 8

What are the s/sx of posterior cerebral artery embolism?

Answer 8

Sensory and visual loss.

Question 9

What signs are associated with middle cerebral artery embolism?

Answer 9

Aphasia

Question 10

What are the hallmark s/sx of normal pressure hydrocephalus?

Answer 10

Increase agitation

Increasing urinary incontinence

cognitive decline with disinhibition and apathy

gait disturbances resulting in falls

enlarged ventricular caliber

Question 11

What are the s/sx of idiopathic intracranial HTN?

Answer 11

HA
Visual changes and disturbances

Question 12

What are the risk factors for idiopathic intracranial HTN?

Answer 12

females of childbearing age
obesity
hypothyroidism
recent tx w/ tetracycline, i.e. doxycycline

An MRI will show any tumor or bleeding but will come back w/out any changes or abnormalities for idiopathic intracranial hypertension.

Question 13

What is the best pain medication intervention to tx Herpes Zoster flare up w/out drowsiness?

Answer 13

SNRI - Serotonin and norepinephrine reuptake inhibitors, i.e. Duloxetine 60 mg PO daily.

Question 14

What is the treatment for tricyclic antidepressant overdose?

Answer 14

NaHCO3 - reverses the metabolic acidosis and cardiac complications of the medications.

Question 15

What is the tx for Tylenol OD?

Answer 15

N-acetylcysteine.

Question 16

What is the antidote for beta blocker or calcium channel blocker overdose?

Answer 16

Glucagon and calcium

Question 17

What is the antidote for benzodiazepines?

Answer 17

Flumazenil

Question 18

What are the characteristics of Horner syndrome?

Answer 18

Miosis
Anhidrosis
Ptosis

Question 19

What diagnostic tool is used for Horner syndrome?

Answer 19

MRA of the head & neck to r/o carotid artery dissection.

Other considerations are pulmonary tumors.

Question 20

State the acronym for Mini Mental Status Exam (MMSE)

Answer 20

ORArL 2, 3 RWD

O: Orientation to Place & Time

R: recognition (repeat 3 objects; e.g., orange dog, pencil)

A: attention (serial 7s counting backward from 100)

R: recall (ask to recall 3 objects 5 minutes later)

L: Language

2: Identify names of 2 objects (clock & chair)

3: Follow a 3-step command (take this paper in your right hand, fold it in half and place it on the floor)

R: reading (read this statement to yourself, do exactly what it says but do not say it aloud: “Close your eyes.”)

W: writing (write a sentence)

D: drawing (copy a design)

• Maximum: 30
• No cognition impairment: 24-30 (average: 27)
• Delirium/dementia:
  • 19-23 (mild cognitive impairment)
    -10 - 18 (moderate cognitive impairment)
  • =/< 9 (severe cognitive impairment)

Question 21

What is the diagnostic standard to evaluate intracranial lesion?

Answer 21

MRI w/ gadolinium