Neurology

Question 1

What is the most common site of hypertensive hemorrhage?

Answer 1

putamen

Question 2

Draw blood supply to the midbrain and pons

Answer 2

Question 3

How do you distinguish between lesions of the lateral medulla and the lateral mid pons?

Answer 3

lateral medulla lesions involve CN IX and X, causing dysphagia, hoarseness, diminished gag reflex.

lateral mid pons lesions cause weakness of muscles of mastication, diminished jaw jerk reflex, impaired tactile and position sensation over the face

Question 4

A patient presents with contralateral paralysis of the arm and leg as well as tongue deviation. The lesion is located..

Answer 4

medial medulla

Question 5

A patient presents with contralateral ataxia and hemiparesis of the face, trunk and limbs. This lesion is located..

Answer 5

medial mid pons

Question 6

What is the mechanism of aminoglycoside mediated vestibulotoxicity?

Answer 6

damages motion sensitive hair cells in the inner ear

Question 7

A patient with MS presents with paraplegia, bladder and rectal incontinence and sensation absent from the nipple downwards. The lesion is located in the..

Answer 7

upper thoracic spinal cord

Question 8

How is heat exhaustion separate from heat stroke?

Answer 8

both involve temps >104, however heat stroke involves CNS dysfunction

Question 9

What is the best method for management of heat stroke?

Answer 9

Rapid cooling (preferably ice water immersion)

Question 10

A patient presents with an unprovoked seizure in which he loses consciousness for 2 minutes. What is the first brain imaging study that should be performed?

Answer 10

brain CT without contrast

Question 11

A young patient with no cardiac history presents with nausea and warm feelings before passing out in line at the supermarket. She has a pulse of 40 during the episode. She has never experienced a similar event, takes no meds or drugs. This is..

Answer 11

vasovagal response

Question 12

What is the most significant complication of SAH in untreated patients?

Answer 12

rebleeding

Question 13

A patient presents with hand tingling and a mild facial droop after being treated with coiling for SAH. The patient is likely suffering from (and explain the mechanism and how it can be prevented)

Answer 13

cerebral vasospasm - caused by cerebral artery constriction following blood product breakdown

prevented with nimodipine (CCB)

Question 14

An elderly patient presents with sudden onset delirium (talking to herself). She is afebrile and her glucose is 155. What should be the next step?

Answer 14

serum electrolytes and UA

Question 15

What is the definition of delirium?

Answer 15

cognitive impairment, impaired attention, fluctuating course

Question 16

What is one of the most common causes of hypermanganesemia? How does it present?

Answer 16

TPN - causes parkinsonism

Question 17

Why are elderly patients at particularly great risk for pharma issues?

Answer 17

decrease albumin, decreased renal clearence, decreased hepatic mass