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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
Q

If a patient has an obvious musculoskeletal deficiency, every female family member has it, what should we think about?

A

Mitochondrial Inheritance Pattern

Mitochondrial Myopathy

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26
Q

NIH stroke of 3, Minor stroke, elevated BP, what should be done with BP?

A

Goal BP is decrease amount 15% in the first 24 hours

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27
Q

Multiple Sclerosis with declining cognitive function, what should be done?

A

Cognitive therapy

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28
Q

_______________ include pain with eye movement, unilateral visual deficit, and an afferent pupillary defect

A

Optic Neuritis

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29
Q

Aneurysmal Subarachnoid hemorrhage, what is the best BP treatment?

A

Oral Nimodipine

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30
Q

Two signs of vascular cognitive impairment are what?

A

early gait impairment and personality/mood changes

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31
Q

If a patient does not have hippocampal atrophy and presence of confluent white matter hypersensitivities, what is the leading diagnosis?

A

Vascular Dementia

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32
Q

Stroke of an unknown origin, what is the next best outpatient step?

A

Ambulatory EKG monitor

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33
Q

Chronic tension type headaches can be treated with what?

A

Amitriptyline

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34
Q

What medication is recommended that there be no use with respect to headache management?

A

Butalbital

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35
Q

Onabotulinium toxin can be given for what neurology problem?

A

Chronic Migraine

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36
Q

If a patient has new brain lesions, unknown until currently, what should be done?

A

Brain Biopsy, no radiation

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37
Q

What is one bad mental health side effect that Keppra can cause?

A

Worsening of depression, anxiety, and suicidal ideation

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38
Q

Sustained or intermittent muscle contractions that are slow, repetitive, and directional?

39
Q

What BP is needed in an ischemic stroke for alteplase treatment?

40
Q

A patient has a meningoma, bad headaches, and some numbness/tingling. No seizures. What is the next best treatment?

A

Serial Brain MRIs

41
Q

New onset seizure, Brain CT scan is wnl, what test should be ordered next?

42
Q

Neuromyelitis Optica is an inflammatory disorder of the central nervous system, affects the spinal cord and optic nerve. What is the antibody marker?

A

Aquaporin-4 antibody

43
Q

Restless Leg Syndrome, what else should be evaluated?

44
Q

A1c of 6.9, alcohol abuse and asymmetric sensory neuropathy, what is the most likely cause?

45
Q

Tardive Dyskinesia is treated by what?

A

Valbenazine

46
Q

What is the stenosis number needed to for intervention?

47
Q

Gait dysfunction in multiple sclerosis with ambulatory dysfunction, what should be given?

A

Dalfampridine

48
Q

What is the chronic migraine drug of choice?

49
Q

Post-stroke fatigue, what should be evaluated?

A

Polysomnography

50
Q

Can an elderly patient withdraw from paroxetine?

51
Q

Chronic Cluster headaches should be treated how?

A

Subcutaneous Sumatriptan

52
Q

A patient has a stroke, CT head is negative, no bleeding, on TPA, what is the next step for further evaluation?

A

CTA of the head, for further evaluation

53
Q

Real time quaking induction assay is the test needed for what disease?

A

CJD Disease, 14-3-3 protein is not as sensitive or specific

54
Q

When a patient has migraines and uses birth control, when should birth control pills be should they be stopped?

A

When a patient has an aura

55
Q

If a patient has migraines that have not responded to NSAIDS over three attacks, what is the next recommendation?

A

Sumatriptan, assuming no CAD

56
Q

Cancer, metastasis back pain, what is the best treatment?

A

Glucocorticoids and Radiotherapy

57
Q

What are the guidelines for back surgery with cancer metastasis?

A

Must be less than 65, 6 months or longer of life, and a single area

58
Q

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?

A

Berry Aneurysm Rupture

59
Q

Donepizil can cause what cardio side effect?

A

Unintentional Bradycardia

60
Q

Multiple Seziures back to back despite lorazepam, what is the next best drug?

A

Fosphenytoin

61
Q

GBM surgery, s/p, what is the correct VTE?

A

SCDs, mechanical prophylaxis

62
Q

Doxycycline treatment for acne with new onset headaches that are concerning for idiopathic intracranial HTN, what should be done?

A

Stop Doxycycline

63
Q

S/P stroke, with TPA, no bleed, Neuro function is stable, what is another test to confirm neuro status?

A

Swallow Evaluation

64
Q

TIA that has resolved after two minutes, what is the treatment regimen?

A

ASA and Plavix
Plavix only for 21 days

65
Q

Parkison like symptoms plus visual hallucinations is what?

Treatment is what?

A

Lewy Body Dementia

Rivastigmine and Donepizil

66
Q

A patient has a TIA, what is the scoring system to determine if he will have another stroke?

A

ABCD2 scoring system

67
Q

Orthostatic hypotension with Cabidopa-Levodopa, what should be done?

A

Increase the dose, higher doses of medication help the side effects

68
Q

Multiple Sclerosis patient, what thing should be done for annual wellness?

A

Flu vaccine

69
Q

Anti-muscle specific kinase antibody measurement, what is this?

A

Myasthenia gravis

70
Q

Atypical Bells palsy, involving multiple facial nerves, requires what other testing?

A

MRI evaluation

71
Q

Frontotemporal Dementia and compulsive behaviors can be best treated how?

72
Q

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?

A

Idiopathic Intracranial Hypertension

73
Q

Mild to moderate Dementia with Alzheimer’s disease, what medication is prescribed?

A

Donepezil, Rivastigmine, and galantamine

74
Q

Moderate to Severe Dementia with Alzheimer’s disease, what medication is prescribed?

A

Memantine is added on, acetylcholinesterase inhibitor, severe dementia is an MMSE < 10

75
Q

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?

A

Myoclonic Seizures

76
Q

What medical term means sustained or intermittent muscle contractions are slow, repetitive, and directional?

77
Q

What medical term is random flowing patterns with regards to movement?

78
Q

Pyschogenic nonepileptic events are usually related to what?

A

PTSD or Conversion Disorder

79
Q

Right sided aphasia, weakness, resolved after 1 minute, what is a common diagnosis to think about?

80
Q

Patients with non-thrombolytic stroke treatment, what is the blood pressure treatment target and goal?

A

Treat when BP is above 220/120, only reduce 15% in the first 24 hours

81
Q

After TPA, what is the goal BP?

82
Q

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?

83
Q

Parkison + hallucination + Rapid eye movement + sleep disorder is what?

What meds can help?

A

Lewy body dementia

Rivastigmine and Donepezil

84
Q

What are rapid, jerky, synchronous, and uniform movements, what is this?

A

Myoclonous

85
Q

What is dystonia?

A

slow, sustained muscle contractions

86
Q

Complex, coordinated, and ritualistic movements that are repeated in a prolonged cycle, is what? Usually related with developmental delay and neurometabolic syndromes

87
Q

If a patient has levo-dopa dyskinesia, i.e. levo-dopa wearing off quickly, what should be given next?

A

Amantadine

88
Q

Homonogenous dural based lesion that has well-demarcated borders, minimal headaches and minor numbness and tingling, what is the best course of action?

A

Serial Brain MRIs

89
Q

Hearing Loss
Tinnitus
Ear Pressure
Endolymph Hydrops
Horizontal Nystagmus

Vertigo symptoms last at least 20 minutes to 12-24 hours

A

Meniere’s Disease

90
Q

Vertigo (Days to weeks)
No auditory Symptoms
Usually after Sick Contacts or Illness
Vestibular Nerve Infection
Horizontal Nystagmus

A

Vestibular Neuronitis or Viral Labyrinthitis

91
Q

What are triggers for Meniere’s Disease?

A

Caffeine, Nicotine, EtOH, high salt intake, MSG, stress, food allergies, and environmental allergies

92
Q

Vertigo
No auditory Symptoms
Triggered by Head Position
Rotary Nystagmus
Symptoms Last Seconds

A

BPPV, Benign Paroxysmal Positional Vertigo

93
Q

What maneuver can help BPPV?

A

Dix Hall pike maneuver

Internal Medicine Board Exam (19 decks)

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