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UWORLD Q BANK review > Neurology > Flashcards

Neurology Flashcards

1
Q

At what age does social smile occur

A

2 months

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2
Q

When can ca child use 3 finger pincer

A

9 months

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3
Q

When does a child kick a ball

A

18 months

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4
Q

When is speech 75% and 100% intelligible

A

3 yrs and 4 yrs

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5
Q

First step in speech or language disorder

A

Hearing test

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6
Q

Diagnosis of intraventricular haemorrhage

A

Cranial USG

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7
Q

Sequelae of IVH

A

Cerebral palsy, intellectual disability

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8
Q

Rx of apnea of prematurity

A

Caffeine, NIV, self resolving

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9
Q

MRI Brain findings in CP

A

Periventricular leukomalacia, basal ganglia lesions

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10
Q

First sign of CP

A

Delayed gross motor findings, diagnosis by age 2

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11
Q

Types of tonicity in CP

A

Spastic, dyskinetic, ataxic

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12
Q

Types of breath holding spells

A

Cyanotic, pallid

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13
Q

Causes of hemiplegia in children

A

Ischemia stroke, intracranial haemorrhage, Todd paralysis, hemiplegic migraine

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14
Q

Risk factors of haemorrhaging stroke

A

AVM, Aneurysm, hemoglobinopathies

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15
Q

MCC of paediatric stroke

A

Sickle cell disease

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16
Q

When is autism screening performed

A

18 months and 2 yrs

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17
Q

When is depression screening initially done

A

12 yrs

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18
Q

Cranial moulding helmets are used for which condition

A

Positional plagiocephaly

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19
Q

Syringomyelia is associated with which condition

A

Arnold chiari malformation 1, meningitis, inflammatory disorders, tumours, spinal cord injury

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20
Q

Initial presentation of syringomyelia and Arnold chiari malformation

A

Scoliosis maybe the only sign, Arnold - presents with occipital headache in adolescence

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21
Q

Myelomeningocele associated with ?

A

Arnold chiari malformation 2

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22
Q

Mutation involved in Rett syndrome

A

MECP2

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23
Q

Landau Kleffner syndrome

A

Normal development followed by regressive language milestones

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24
Q

Rx of homocysteinuria

A

B6, folate, B12, anti platelets or anticoagulant

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25
Q

Common causes of ID in children

A

FAS, Downs. Fragile X

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26
Q

Management of essential tremors?

A

Propranolol, primidone, topiramate

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27
Q

Meige syndrome. How is spasm terminated

A

Blepharospasm with spasm of lower face. Rx- sensory trick

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28
Q

Pronator drift is seen in

A

Pyramidal tract lesion

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29
Q

Upward drift is seen in

A

Cerebellar lesion

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30
Q

Lesion in hemineglect syndrome

A

Non dominant parietal lobe

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31
Q

Gerstmann syndrome

A

Dominant parietal lobe

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32
Q

Rx of restless leg syndrome

A

Pramipexole, gabapentin enacarbil

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33
Q

Nest step after diagnosing epidural abscess spinal cord compression

A

IV glucocorticoids

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34
Q

A complication of neuraxial block causing spinal cord compression

A

Spinal epidural hematoma

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35
Q

Confirmatory diagnosis of central canal syndrome

A

Cervical myelogram

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36
Q

Positive spurling test in

A

Radiculopathy causing neck pain

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37
Q

Presentation of spondylitic myelopathy

A

LE weakness, gait, bowel bladder dysfunction, Lhermitte sign

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38
Q

Rx for Freidrich ataxia

A

Only supportive therapies, physical and psychological

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39
Q

Rx of ALS

A

Riluzole, respiratory support, nutritional support- per cutaneous endoscopic gastrostomy tube.

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40
Q

Meds that cause distal symmetric polyneuropathy

A

FQ, metronidazole, dapsone, amiodarone, digoxin, cisplatin, paclitaxel

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41
Q

Triggers of AIP

A

CYP450 inducers, progesterone, fasting, surgery, illness, alcohol, tobacco

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42
Q

Lab findings, rx of AIP

A

Positive for urobilinogen
Elevated serum and urine PBG, ALA, porphyrins
Hyponatremia, elevated transaminases
Mx- glucose and hemin

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43
Q

Next step in hemodynamically stable patient in GBS. Tx?

A

Assess pulmonary function with spirometry.
If FVC <20 ml/kg, warrants endotracheal intubation
Tx- IVIG, Plasmapheresis

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44
Q

Presentation of Miller Fischer syndrome

A

Ophthalmoplegia, ataxia, areflexia

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45
Q

Miller Fischer syndrome associated with which antibody

A

Anti GQ1b

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46
Q

Rx for food borne botulism

A

Equine serum heptavalent botulinum antitoxin

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47
Q

Werdnig Hoffman syndrome

A

Floppy baby syndrome

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48
Q

RF of MS

A

Female, Caucasian, HLA DRB1, USA, Europe, cold climate, low vit d, smoking

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49
Q

Diagnostic imaging in MS, CSF findings?

A

T2 weighted MRI of brain and spinal cord.
Oligoclonal IgG bands

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50
Q

Tx of MS

A

IV methylprednisolone, plasmapheresis, IFN beta, natalizumab, glatiramer acetate
Baclofen for spasticity
Gabapentin for neuropathic pain

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51
Q

DD of UMN cause of NM weakness

A

Leukodystrophies, vasculitis, brain mass, B12 def, ALS

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52
Q

DD of anterior horn cell cause of NM weakness

A

SMA, ALS, Polio, paraneoplastic syndromes

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53
Q

DD of peripheral nerves causes of NM weakness

A

Hereditary primary motor sensory neuropathy, GBS, Diabetic neuropathy, amyloid neuropathy, lead poisoning

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54
Q

NMJ cause of NM weakness

A

Myasthenia gravis, Lambert Eaton, OPC poisoning, Botulism

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55
Q

Muscle fibres causes of NM weakness

A

Muscular dystrophies, polymyositis, dermatomyositis, hypothyroidism, corticosteroids, HIV myopathy

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56
Q

Symptomatic treatment of lambert Eaton syndrome

A

Guanidine or 3,4 - diaminopyridine- increases acetylcholine levels
refractory -IVIG, Immunosuppressants

57
Q

Dd of myopathies

A
  1. Glucocorticoid induced 2. Polymyalgia rheumatica 3. Inflammatory 4. Statin induced 5. Hypothyroid
58
Q

Trinueleolide repeat in DMDK gene seen in

A

Myotonic dystrophy

59
Q

Associated findings in myotonic dystrophy

A

Arrhythmia, cataracts, increased day time sleepiness, testicular atrophy

60
Q

Manifestations of malignant hyperthermia and treatment

A

Masseter muscle rigidity, sinus tachycardia, hypercarbia, rhabdomyolysis, hyperkalemia, hyperthermia
Treatment - dantrolene

61
Q

Most important RF for stroke

A

Hypertension

62
Q

Mx of TIA

A

Smoking cessation, start aspirin and statin, reduce BP

63
Q

Initial imaging for acute stroke

A

NCCT head

64
Q

Lacunae infarct presentation

A

Unilateral motor impairment

65
Q

MCA occlusion ppt

A

C/L somatosensory and motor deficit, conjugate eye deviation towards side of infarct, homonymous hemianopia, aphasia, hemineglect

66
Q

ACA occlusion ppt

A

C/L somatosensory and motor deficit in LL extremity, abulia, dyspraxia, emotional disturbance, urinary incontinence

67
Q

Areas affected in lacunae stroke

A

Basal ganglia, subcortical white matter, pons

68
Q

Dejerine Roussy syndrome

A

Thalamic pain syndrome- paroxysmal burning pain exacerbated by light touch due to stroke involving posterolateral thalamus

69
Q

PCA stroke

A

Homonymous hemianopia, alexia without agraphia, visual hallucinations, sensory symptoms, 3rd nerve palsy with paresis of vertical and horizontal eye movements, C/L Motor deficits

70
Q

Wallenburg syndrome

A

Lateral medullary syndrome- intracranial vertebral artery, vestibulocerebellar, sensory, ipsilateral bulbar, autonomic dysfunction

71
Q

Medial medullary syndrome

A

C/L hemiparesis, C/L vibration loss, ipsilateral tongue paralysis

72
Q

BP meds for haemorrhagic stroke

A

IV nicardipine, labetalol, goal 140-160mm hg

73
Q

Ppt of carotid artery injury, diagnosis

A

Hemiplegia, aphasia, thunder clap headache, neck pain
CT or MR angiography

74
Q

Pathology behind IIH

A

Impaired absorption of CSF by arachnoid villi

75
Q

Tx of IIH

A

Weight reduction, acetazolamide, may use furosemide on acetazolamide, corticosteroids and serial LP while awaiting surgery

76
Q

RF of cerebral vein thrombosis. Diagnosis and Tx?

A

Inherited thrombophilia, pregnancy, post partum, OCP, malignancy, infection
MRI brain with venography
Anticoagulants heparin acutely

77
Q

Subclavian steal syndrome, diagnosis, Tx

A

Upper extremity ischemia, vertebrobasilar insufficiency
Lower brachial SBP, systolic bruit, S4+
Doppler USG or MR angiography
Tx- lifestyle management, stent

78
Q

Uncal herniation findings

A

Ipsilateral fixed and dilated pupil, c/l hemiparesis, c/l homonymous hemianopia

79
Q

Abnormal posturing seen with which type of brain herniation

A

Central, decorticate and decerebrate

80
Q

Routine lab tests for dementia

A

CBC, VIT B12, TSH, CMP
Folate, syphilis, vit d
Atypical- CSF
Imaging- CT or MRI brain, atypical- EEG

81
Q

Neuro imaging finding in Alzheimers

A

Medial temporal lobe atrophy

82
Q

Neuro imaging in vascular dementia

A

Cerebral infarction, deep white matter changes

83
Q

Findings in dementia with Lewy bodies

A

Visual hallucinations, spontaneous parkinsonism, fluctuating cognition, REM sleep behaviour disorder

84
Q

Anti Parkinson’s meds causing psychosis

A

Levodopa, dopamine agonists

85
Q

PD in younger patients, treatment where tremor is the primary symptom

A

Trihexiphenidyl

86
Q

Old patients, mild tremor dominant PD, TX?

A

Amantadine

87
Q

Tx of hallucinations in PD

A

Initial trial adjustment, low dose anti psychotic like quetiapine, Pimavanserin

88
Q

Lewy bodies

A

Eosinophilic intractyoplasmic inclusions

89
Q

Shy drager syndrome, Tx

A

Multiple system atrophy- parkinsonism, autonomic dysfunction, neurological signs
Fludrocortisone, salt supplementation, alpha agonists, constrictive garments to lower body

90
Q

Riley Day syndrome

A

Familial dysautonomia- Askanazi Jew children, feeding problems, hypotonia, decreased lacrimation with severe ortho static hypotension

91
Q

Findings in Huntington

A

CAG repeat expansion, loss of GABAergic neurons, caudate and putamen atrophy

92
Q

Mx of frontotemporal dementia

A

SSRI, trazodone for neuropsychiatric symptoms

93
Q

Findings in CJD

A

EEG shows periodic sharp wave complexes
MRI, Widespread atrophy, cortical enhancement, hockey stick sign
CSF-positive 14-3- 3, positive RT-QulC test

94
Q

Rx of Sturgge Weber syndrome

A

Laser therapy, anti epileptics, intraocular pressure reduction

95
Q

Findings in tuberous sclerosis

A

Ash leaf spots, angiofibromas, shagreen patches, subependymal tumours, infantile spasms, ID, autism, ADHD, rhabdomyoma, angiomyolipoma

96
Q

Screening for tuberous sclerosis

A

Regular skin and eye examination
Serial MRI of brain and kidney
Echo, ECG
EEG, neuropsychiatric screening

97
Q

Features of craniopharyngioma

A

Optic chasm and pituitary stalk compression-Bitemporal hemianopsia, growth failure, pubertal delay, sexual dysfunction, diabetes insipidus

98
Q

Cranial nerve palsy involved in medulloblastoma

A

Abducens

99
Q

Features of pinealoma

A

Parinaud syndrome, obstructive hydrocephalus

100
Q

MRI appearance of glioblastoma

A

Butterfly appearance with central necrosis, heterogeneous serpiginous contrast enhancement shows high grade astrocytoma

101
Q

Which brain tumor has a bimodal presentation

A

Craniopharyngioma

102
Q

Location of metastatic brain disease

A

Grey white matter junction

103
Q

Metastatic brain frequency

A

Lung> breast> unknown primary> melanoma> colon

104
Q

Tx for malignant neurological compromise like spinal cord compressions causing bone pain and neurological deficits

A

Systemic glucocorticoids

105
Q

Psychogenic pseudosyncope

A

Conversion disorder, LOC without impaired cerebral perfusion

106
Q

Neurogenic orthostatic hypotension seen in

A

Parkinsonism

107
Q

Causes of cardiogenic syncope

A

AS, HCM, VT, TDP, AV block, sick sinus

108
Q

How does cluster headache improve

A

Oxygen therapy

109
Q

Prophylactic for cluster headache

A

Verapamil, lithium

110
Q

First line for trigeminal neuralgia

A

Carbamazepine, oxcarbazepine

111
Q

Mx of traumatic brain injury

A

Maintain MAP, reduce ICP, prevent ICH, prevent seizures, control blood glucose, maintain normothermia

112
Q

GCS to who tranexamic acid is to be given with TBI

A

9-12 within 3 hrs of injury

113
Q

Imaging performed in primary survey in ATLS

A

Chest and pelvis x ray, FAST, cervical spine imaging

114
Q

What should be done in anterior cord syndrome to prevent bladder distension.

A

Catheterisation

115
Q

MRI findings in diffuse axonal injury

A

Punctuate haemorrhages in white matter, blurring of grey white matter junction

116
Q

Artery involved in epidural hematoma, CT findings

A

Middle meningeal artery, sphenoid bone trauma
Biconvex lens shaped hyper density, does not cross suture lines

117
Q

Pathogenesis of SDH, CT findings

A

Rupture of bridging veins
Crescent hyperdensity crosses suture lines

118
Q

Tx of SAH

A

Angiographic procedure to stabilise aneurysm by coiling or stenting, nimodipine and hyperdynamic therapy for vasospasm

119
Q

Common sites of hypertensive haemorrhage

A

Basal ganglia> cerebellar nuclei> thalamus> pons> cerebral cortex

120
Q

Sites involved in cerebral amyloid angiopathy, condition associated with it?

A

Occipital and parietal lobes, Alzheimers.

121
Q

Man with aortic dissection, improves with meds but can’t move lower limbs, distended bladder, weakness and decreased reflexes in legs, loss of touch and pain. Cause?

A

Thoracic spinal cord ischemia- T10-12

122
Q

Rx of AIP

A

Glucose and hemin

123
Q

Parkinson disease dementia, psychosis rx

A

Anticholinesterase inhibitors- eg- donepezil. psychosis- low dose antipsych- pimavanserin, quetiapine

124
Q

Decreased sensation in ant thigh, medial leg, knee extension, patellar reflex. nerve inj?

A

Femoral nerve

125
Q

Focal to GTCS, h/o RCC, hypoNa

A

Do MRI brain- for mets

126
Q

Kid- speech delay, decreased attention, diff opening hands after squeezing someone’s fingers

A

Myotonic dystrophy

127
Q

Girl- breathing prob, seizures, unsteady gait, twisting fingers, not speaking words anymore

A

Rett syndrome- look for head growth deceleration

128
Q

right temporal Headache, ICP findings, left DTR increased, HTN, bradycardia

A

AVM

129
Q

TBI- ICP, fever, HTN, tachycard, tachypnea, diaphoresis on sponge bath

A

Paroxysmal sympathetic hyperactivity

130
Q

Acute headache, nausea, htn, right ptosis, mydriasis

A

SAH- PCom aneurysm

131
Q

Aneurysm causing u/l vision loss or bitemp hemianopsia

A

ACom or ICA

132
Q

Confusion, fever, takes TNF alpha for RA, MR+, MRI shows brain abscess. NBS

A

Echo for IE

133
Q

MRI finding in CJD

A

Widespread cortical atrophy, enhancement-ribboning, caudate and putamen enhancement- hockey stick sign

134
Q

In 18hrs- Progressive ascending paralysis, paraesthesias, areflexia, hiking to colorado

A

Search for tick- tick borne paralysis

135
Q

Underwent SAH aneursym repair- POD5 confused, tingling in right hand, weakness, facial droop

A

Cerebral vasospasm- causing cerebral ischemia- prevention- nimodipine, euvolemia

136
Q

Neuroimaging findings in diffuse axonal inj?

A

Punctate hemorrhages in white matter, blurring of gray white interface

137
Q

Post herpetic neuralgia rx

A

gabapentin, pregabalin, TCA

138
Q
A

UWORLD Q BANK review (17 decks)

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