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Internal Medicine Board Exam > Neurology > Flashcards

Neurology Flashcards

1
Q

Painful progressive axonal polyneuropathy with multi-organ dysautonomia, anti-Ro and anti-La negative, and electrophoresis is negative?

A

Amyloid Neuropathy, think about doing a biopsy

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2
Q

What is a good treatment for levodopa-cardopa dyskinesia?

A

Amantadine

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3
Q

Anti–muscle-specific kinase antibody is specific to what disease?

A

Myasthenia Gravis

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4
Q

Neuro symptoms plus Serum Gq1b antibody is specific to what?

A

Miller Fisher variant of GBS

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5
Q

Acute Migraine problem treatment with a benign physical exam is what?

A

Subcutaneous Sumatriptan

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6
Q

Postural Hypotension is common when what happens?

Assuming, no disasters, what is the best treatment?

A

Intracranial Hypotension

Epidural Blood Patch

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7
Q

If a patient is about to receive immunocompromising medication, when should vaccines be given?

A

4-6 weeks beforehand

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8
Q

Generalized tonic-clonic seizures are characterized by what?

A

Seizure episodes more than 5 minutes, or two in less than minutes without a return to a return neuro baseline

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9
Q

Myoclonic Seizures are characterized by what events?

A

Jerking, Shaking, less than 1 second, resulting in the patient falling down, no post-ictal lethargy or confusion

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10
Q

After Aortic Anuerysm repair, the patient has poor leg reflexes and paralysis, what happened?

A

Spinal Cord Infarction

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11
Q

Positive Myasthenia Gravis and symptommatic under 65 and 3 years of symptoms, what is the best treatment?

A

Surgery

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12
Q

Unexplained myopathy, what is an endocrine disorder?

A

Hypothyroidism

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13
Q

If a M.S. patient has been non-ambulatory for more than 2 years/no relapsing-readmitting activity what should be done?

A

Stop DMARDs and/or IFN medications

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14
Q

Ocrelizumab is approved for what?

A

Patients with relapsing-remitting M.S. and 1 progressive MS

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15
Q

What medication is good for migraine prophylaxis?

A

Venlafaxine

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16
Q

What aneurysm size can be watched in the brain?

A

Posterior Circulation less than 7mm, Anterior Circulation less than 12mm

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17
Q

If an IV drug user history patient has point tenderness on their L1, what is the next best step?

A

Imaging of the entire spine

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18
Q

If the patient has a right sided weakness and aphasia, elevated ABCD score, what should be done next?

A

Carotid Ultrasound

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19
Q

If a patient has bilateral essential tremor that is refractory to medication, what should be done next?

A

Deep Brain Simulation

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20
Q

What muscle abnormality is slow and sustained muscle contractions?

A

Dystonia

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21
Q

Brief, shock-like, and jerky movements that originate from any part of the nervous system system?

A

Myoclonus

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22
Q

Pharmacological intervention of FTD (Frontal Temporal Dementia) is what?

A

SSRI

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23
Q

A patient with new onset dementia in the past three years should have what?

A

MRI> CT scan

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24
Q

If a patient has drug resistant seizures and epilepsy, what is something that should be done before surgery?

A

Video EEG monitoring

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25
If a patient has an obvious musculoskeletal deficiency, every female family member has it, what should we think about?
Mitochondrial Inheritance Pattern Mitochondrial Myopathy
26
NIH stroke of 3, Minor stroke, elevated BP, what should be done with BP?
Goal BP is decrease amount 15% in the first 24 hours
27
Multiple Sclerosis with declining cognitive function, what should be done?
Cognitive therapy
28
_______________ include pain with eye movement, unilateral visual deficit, and an afferent pupillary defect
Optic Neuritis
29
Aneurysmal Subarachnoid hemorrhage, what is the best BP treatment?
Oral Nimodipine
30
Two signs of vascular cognitive impairment are what?
early gait impairment and personality/mood changes
31
If a patient does not have hippocampal atrophy and presence of confluent white matter hypersensitivities, what is the leading diagnosis?
Vascular Dementia
32
Stroke of an unknown origin, what is the next best outpatient step?
Ambulatory EKG monitor
33
Chronic tension type headaches can be treated with what?
Amitriptyline
34
What medication is recommended that there be no use with respect to headache management?
Butalbital
35
Onabotulinium toxin can be given for what neurology problem?
Chronic Migraine
36
If a patient has new brain lesions, unknown until currently, what should be done?
Brain Biopsy, no radiation
37
What is one bad mental health side effect that Keppra can cause?
Worsening of depression, anxiety, and suicidal ideation
38
Sustained or intermittent muscle contractions that are slow, repetitive, and directional?
Dystonia
39
What BP is needed in an ischemic stroke for alteplase treatment?
185/110
40
A patient has a meningoma, bad headaches, and some numbness/tingling. No seizures. What is the next best treatment?
Serial Brain MRIs
41
New onset seizure, Brain CT scan is wnl, what test should be ordered next?
Brain MRI
42
Neuromyelitis Optica is an inflammatory disorder of the central nervous system, affects the spinal cord and optic nerve. What is the antibody marker?
Aquaporin-4 antibody
43
Restless Leg Syndrome, what else should be evaluated?
Ferritin
44
A1c of 6.9, alcohol abuse and asymmetric sensory neuropathy, what is the most likely cause?
Diabetes
45
Tardive Dyskinesia is treated by what?
Valbenazine
46
What is the stenosis number needed to for intervention?
80%
47
Gait dysfunction in multiple sclerosis with ambulatory dysfunction, what should be given?
Dalfampridine
48
What is the chronic migraine drug of choice?
Erenumab
49
Post-stroke fatigue, what should be evaluated?
Polysomnography
50
Can an elderly patient withdraw from paroxetine?
Yes!
51
Chronic Cluster headaches should be treated how?
Subcutaneous Sumatriptan
52
A patient has a stroke, CT head is negative, no bleeding, on TPA, what is the next step for further evaluation?
CTA of the head, for further evaluation
53
Real time quaking induction assay is the test needed for what disease?
CJD Disease, 14-3-3 protein is not as sensitive or specific
54
When a patient has migraines and uses birth control, when should birth control pills be should they be stopped?
When a patient has an aura
55
If a patient has migraines that have not responded to NSAIDS over three attacks, what is the next recommendation?
Sumatriptan, assuming no CAD
56
Cancer, metastasis back pain, what is the best treatment?
Glucocorticoids and Radiotherapy
57
What are the guidelines for back surgery with cancer metastasis?
Must be less than 65, 6 months or longer of life, and a single area
58
Thunderclap headache, during sexual intercourse, known history of migraines, worse headache of their life, OTC dont make it better, CT brain is ordered, what is something that should be evaluated?
Berry Aneurysm Rupture
59
Donepizil can cause what cardio side effect?
Unintentional Bradycardia
60
Multiple Seziures back to back despite lorazepam, what is the next best drug?
Fosphenytoin
61
GBM surgery, s/p, what is the correct VTE?
SCDs, mechanical prophylaxis
62
Doxycycline treatment for acne with new onset headaches that are concerning for idiopathic intracranial HTN, what should be done?
Stop Doxycycline
63
S/P stroke, with TPA, no bleed, Neuro function is stable, what is another test to confirm neuro status?
Swallow Evaluation
64
TIA that has resolved after two minutes, what is the treatment regimen?
ASA and Plavix Plavix only for 21 days
65
Parkison like symptoms plus visual hallucinations is what? Treatment is what?
Lewy Body Dementia Rivastigmine and Donepizil
66
A patient has a TIA, what is the scoring system to determine if he will have another stroke?
ABCD2 scoring system
67
Orthostatic hypotension with Cabidopa-Levodopa, what should be done?
Increase the dose, higher doses of medication help the side effects
68
Multiple Sclerosis patient, what thing should be done for annual wellness?
Flu vaccine
69
Anti-muscle specific kinase antibody measurement, what is this?
Myasthenia gravis
70
Atypical Bells palsy, involving multiple facial nerves, requires what other testing?
MRI evaluation
71
Frontotemporal Dementia and compulsive behaviors can be best treated how?
SSRI
72
Visual Blurring without diplopia, nocturnal pulsatile tinnitus, and neck stiffness -> including headache, physical exam includes bilateral papilledema, Lumbar puncture has elevated pressure, what disease is this with a young women?
Idiopathic Intracranial Hypertension
73
Mild to moderate Dementia with Alzheimer's disease, what medication is prescribed?
Donepezil, Rivastigmine, and galantamine
74
Moderate to Severe Dementia with Alzheimer's disease, what medication is prescribed?
Memantine is added on, acetylcholinesterase inhibitor, severe dementia is an MMSE < 10
75
A seizure episode where the patient describes a spasm, jerks, or shakes. This episode is usually bilaterally and happens for one second or less. Awareness is maintained during the seizures. What is this?
Myoclonic Seizures
76
What medical term means sustained or intermittent muscle contractions are slow, repetitive, and directional?
Dystonia
77
What medical term is random flowing patterns with regards to movement?
Chorea
78
Pyschogenic nonepileptic events are usually related to what?
PTSD or Conversion Disorder
79
Right sided aphasia, weakness, resolved after 1 minute, what is a common diagnosis to think about?
TIA
80
Patients with non-thrombolytic stroke treatment, what is the blood pressure treatment target and goal?
Treat when BP is above 220/120, only reduce 15% in the first 24 hours
81
After TPA, what is the goal BP?
180/105
82
If a person has a new seizure onset, they only had one seizure, the entire work up is negative, what is the next thing to do?
Brain MRI
83
Parkison + hallucination + Rapid eye movement + sleep disorder is what? What meds can help?
Lewy body dementia Rivastigmine and Donepezil
84
What are rapid, jerky, synchronous, and uniform movements, what is this?
Myoclonous
85
What is dystonia?
slow, sustained muscle contractions
86
Complex, coordinated, and ritualistic movements that are repeated in a prolonged cycle, is what? Usually related with developmental delay and neurometabolic syndromes
Sterotypy
87
If a patient has levo-dopa dyskinesia, i.e. levo-dopa wearing off quickly, what should be given next?
Amantadine
88
Homonogenous dural based lesion that has well-demarcated borders, minimal headaches and minor numbness and tingling, what is the best course of action?
Serial Brain MRIs
89
Hearing Loss Tinnitus Ear Pressure Endolymph Hydrops Horizontal Nystagmus Vertigo symptoms last at least 20 minutes to 12-24 hours (symptoms come and go)
Meniere's Disease
90
Vertigo (Days to weeks) No auditory Symptoms Usually after Sick Contacts or Illness Vestibular Nerve Infection Horizontal Nystagmus
Vestibular Neuronitis or Viral Labyrinthitis
91
What are triggers for Meniere's Disease?
Caffeine, Nicotine, EtOH, high salt intake, MSG, stress, food allergies, and environmental allergies
92
Vertigo No auditory Symptoms Triggered by Head Position Rotary Nystagmus Symptoms Last Seconds
BPPV, Benign Paroxysmal Positional Vertigo
93
What maneuver can help BPPV?
Dix Hall pike maneuver
94
What is Leptomeningeal Carcinomatosis, how is it diagnosised?
Metatastic Melanoma that is in the Meninges, diagnosed via MRI Brain and Spine
95
What three things make up the Cushing Reflex?
1) Hypertension 2) Bradycardia 3) Cheyne-Stokes Breathing
96
What is a hemiplegic migraine?
A severe headache and weakness on half the body
97
What is non-fluent aphasia, effortful speech, agrammatism, and preserved comprehension. Typically, a stroke to the left inferior frontal gyrus?
Broca's aphasia
98
What is fluent by non-sensical speech and poor comprehension?
Wernicke's aphasia (aka word salad)
99
What is a headache, worse with exertion, papilledema, and neurologic symptoms? Hypercoagulable states, pregnancy, and oral contraceptive use increases this risk
Thrombosis of cerebral vein or dural sinus
100
What is the "worst headache of my life" usually?
Subarachnoid hemorrhage
101
What is the difference between subdural and epidural hematomas?
Epidural: has a brief lucency period, then patient declines Subdural: has a slow decline, often days to a week (usually older patient with AC)
102
Subdural Hematoma: what is seen on CT scan? Epidural Hematoma: what is seen on CT scan?
Subdural: A crescent shape bleed, crosses suture lines Epidural: Biconvex lens, does not cross suture lines
103
What pathology can progressive vertigo symptoms, positive romberg, and some associate with neural crest cells?
Acoustic Neuroma

Internal Medicine Board Exam (22 decks)

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