Neurology

Question 1

Unilateral, severe periorbital headache w/ tearing and conjunctival erythema

Answer 1

Cluster headache

Question 2

Prophylactic treatment for migraine

Answer 2

Antihypertensives (BBs), antidepressants, anticonvulsants, dietary changes

Question 3

Most common pituitary tumor and Tx.

Answer 3

Prolactinoma. Dopamine agonists (bromocriptine)

Question 4

55yo M present w/ acute “broken speech.” What type of aphasia? What lobe and vascular distribution?

Answer 4

Broca’s aphasia. Frontal lobe, left MCA distribution.

Question 5

Most common cause of SAH

Answer 5

Trauma; second most common is berry aneurysm

Question 6

Crescent-shaped hyperdensity on CT that does not cross midline

Answer 6

Subdural hematoma - bridging veins torn

Question 7

History significant for initial altered mental status w/ an intervening lucid interval. Dx? Most likely source? Treatment?

Answer 7

Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation.

Question 8

CSF findings w/ SAH

Answer 8

Elevated ICP, RBCs, xanthochromia

Question 9

Albuminocytologic dissociation

Answer 9

Guillain-Barre (increased protein in CSF w/out significant increase in cell count)

Question 10

Cold water flushed into patient’s ear, and the fast phase of the nystagmus is toward the opposite side. Normal or pathologic?

Answer 10

Normal

Question 11

Most common primary source of metastases to the brain

Answer 11

Lung, breast, skin (melanoma), kidney, GI tract

Question 12

May be seen in children who are accused of inattention in class and confused with ADHD

Answer 12

Absence seizures

Question 13

Most frequent presentation of intracranial neoplasm

Answer 13

Headache. Primary neoplasms are much less common than brain mets.

Question 14

Most common cause of seizures in children (2-10)

Answer 14

Infection, febrile seizures, trauma, idiopathic

Question 15

Most common cause of seizures in young adults

Answer 15

Trauma, alcohol withdrawal, brain tumor

Question 16

First-line medication for status epilepticus

Answer 16

IV benzodiazepine

Question 17

Confusion, confabulation, ophthalmoplegia, ataxia

Answer 17

Wernicke’s encephalopathy due to deficiency of thiamine

Question 18

What % lesion is an indication for carotid endarterectomy?

Answer 18

70% if symptomatic

Question 19

Most common causes of dementia

Answer 19

Alzheimer’s and multi-infarct

Question 20

Combined UMN and LMN disorder

Answer 20

ALS

Question 21

Rigidity and stiffness w/ unilateral resting tremor and masked facies

Answer 21

Parkinson’s disease

Question 22

Mainstay of Parkinson’s therapy

Answer 22

Levodopa/carbidopa

Question 23

Treatment for Guillan-Barre

Answer 23

IVIG or plasmapheresis. Avoid steroids.

Question 24

Rigidity and stiffness that progress to choreiform movements, accompanied by moodiness and altered behavior

Answer 24

Huntington’s disease

Question 25

6yo F presents w/ port-wine stain in the V1 distribution as well as w/ mental retardation, seizures, and ipsilateral leptomeningeal angioma

Answer 25

Sturge-Weber syndrome. Treat symptomatically. Possible focal cerebral resection of the affected lobe.

Question 26

Multiple cafe au last spots on skin

Answer 26

Neurofibromatosis type 1

Question 27

Hyperphagia, hypersexuality, hyperorality, and hyperdocility

Answer 27

Kluver-Bucy syndrome (amygdala)

Question 28

May be administered to a symptomatic patient to diagnose myasthenia gravis

Answer 28

Edrophonium