Neurology

Question 1

84yo female brought by her son with c/o forgetfulness along with difficulty performing some of her daily activities. the problem has gradually progressed over the past few years. whats the diagnoses?

Answer 1

Alzheimer’s disease
- progressive cognitive decline; mc older than 65yo

Question 2

what neurodegernative disease presents with beta-amyloid plaques and neurofibrillary tangle formation

Answer 2

alzheimers disease

Question 3

how is the definitive diagnosis of alzheimers disease made

Answer 3

brain biopsy post mortum

Question 4

what are medications used for the treatment of alzheimers

Answer 4

first line = cholinesterase inhibitors (donepezil, and rivastigmine)
Memantine (NMDA-receptor antagonist)

Question 5

what condition presents wtih hemifacial weakness/paralysis of muscles innervated by CN VII due to swelling

Answer 5

Bell’s Palsy

Question 6

what is the treatment for Bell’s Palsy

Answer 6

usually non required
short course of steroid therapy (prednisone) and acyclovir
eyepatch at night to prevent corneal abrasion

Question 7

what are the two types of CVA

Answer 7

ischemic stroke and hemorrhagic stroke

Question 8

what causes ischemic stroke

Answer 8

blockage

Question 9

what causes hemorrhagic stroke

Answer 9

rupture of blood vessel

Question 10

what is amaurosis fugax

Answer 10

monocular blindness

Question 11

how are bells and strokes differentiated

Answer 11

stroke pts are able to wrinkle forehead where Bells palsy cannot

Question 12

what is the treatment of occlusive stroke

Answer 12

IV tPA if within 3-4.5 hours of symptom onset

Question 13

what condition presents as an acute cognitive dysfunction secondary to an underlying medical condition and is usually reversible

Answer 13

delirium

Question 14

what type of headache presents as unilateral, excruciating, sharp, searing, or piercing pain, lacrimation and nasal congestion

Answer 14

Cluster headache

Question 15

what is the treatment of cluster headaches

Answer 15

100% oxygen at 6-12L/min for 15 min

Question 16

what type of headache presents as headache of varying intensity, often unilateral and accompanied by nausea, sensitivity to light and sound

Answer 16

migraines

Question 17

what condition occurs with the loss of dopamine-containing neurons located in the substantia nigra and locus coeruleus

Answer 17

parkinsons disease

Question 18

what is present with parkinsons disease

Answer 18

Lewy Bodies
acetlcholine/dopamine imbalance

Question 19

what are the three cardinal featrues of parkinsons

Answer 19

rest (pill-rolling) tremor
cogwheel rigidity
bradykinesia (slowness of movement)

Question 20

how is parkinsons diagnosed

Answer 20

clinical impression
GS = neuopathologic exam
MRI can be useful

Question 21

what is the treatment of parkinsons disease

Answer 21

dopamine agonists
- < 65 dopamine agnoists: bromocriptine, pramipexole, ropinerole
- >65 sinemet (levedopa/carbidopa)

Question 22

what type of seizures present with retained awareness

Answer 22

focal seizure or simple partial seizure

Question 23

what type of seizures present with loss of awareness

Answer 23

focal seizure with loss of awarenss (complex partial seizure)

Question 24

what is the treatment of focal seizures

Answer 24

phenytoin and carbamazepine

Question 25

what are the different types of generalized seizures

Answer 25

absence seizure
tonic-clonic
atonic seizures
clonic seizures
tonic seizures
myoclonic seizures

Question 26

what is the treatment of status epilepticus

Answer 26

benzos (lorazepam)