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USMLE Rapid Review > Neurology > Flashcards

Neurology Flashcards

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USMLE® Step 1 flashcards
1
Q

most common pituitary tumor? tx?

A

prolactinoma. dopamine agonists (bromocriptine) or transphenoid resection

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2
Q

55 yo pt presents w/ acute “broken speech.” what type of aphasia? what lobe and vascular distribution?

A

broca’s aphasia and frontal lobe, left MCA distribution

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3
Q

most common cause of SAH

A

trauma, the second most common is berry aneurysms

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4
Q

crescent-shaped hyperdensity on CT that does not cross the midline

A

subdural hematoma - 2/2 torn bridging veins

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5
Q

hx of initial AMS w/ an intervening lucid interval. Dx? most likely source? tx?

A

epidural hematoma. middle meningeal artery. neurosurgical evacuation

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6
Q

CSF findings w/ SAH

A

elevated ICP, RBCs, xanthochromia

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7
Q

albuminocytologic dissociation (increased protein in CSF w/o a significant increase in cell count)

A

guillain-barre syndrome

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8
Q

most common primary source of mets to the brain

A

lung, breasts, skin (melanoma), kidney, and GI

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9
Q

seizures seen in children who are accused of inattention in class; may be confused w/ ADHD

A

absence seizures

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10
Q

most frequent presentation of intracranial neoplasm

A

HA

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11
Q

most common cause of seizures in children (2-10 yo)

A

infection, febrile seizures, trauma, idiopathic

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12
Q

most common cause of seizures in young adults (18-35 yo)

A

trauma, alcohol withdrawal, brain tumors

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13
Q

first line med for status epilepticus

A

IV BZDs

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14
Q

confusion, confabulation, ophthalmoplegia, ataxia

A

wernicke’s encephalopathy due to def of thiamine

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15
Q

what % lesion is an indication for carotid endarterectomy

A

70% if the stenosis is symptomatic

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16
Q

most common causes of dementia

A

alzheimer’s and multi-infarct

17
Q

combined UMN and LMN disorder

A

ALS

18
Q

rigidity and stiffness w/ unilateral resting tremor and masked faces

A

parkinson’s dz

19
Q

mainstay of parkinson’s dz therapy

A

levodopa/carbidopa

20
Q

tx for guillain-barre syndrome

A

IVIG or plasmapheresis. avoid steroids

21
Q

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

A

huntington’s dz

22
Q

multiple cafe-au lait spots on skin

A

NF1

23
Q

hyperphagia, hypersexuality, hyperorality, and hyperdocility

A

kluver-bucy syndrome (amygdala)

24
Q

unilateral, severe, periorbital HA w/ tearing and conjunctival erythema

A

cluster HA

25
Q

signs of UMN damage

A

hyperreflexia, hypertonia, + babinski

26
Q

signs of LMN damage

A

hyporeflexia, hypotonia, atrophy, fasciculations

27
Q

hallmarks of this neuro dz include a mask-like, immobile facial expression, bradykinesia, resting tremor, rigidity, and festinating gait (hypokinetic, shuffling gait - pt appears as if he was chasing his center of gravity). dx? cause? tx?

A

parkinson’s dz - caused by overactivity of cholinergic neurons and underactivity of dopaminergic neurons in the substantia nigra. tx include dopaminergic and/or anti-cholinergic drugs

28
Q

HA triggered by darkness

A

closed-angle glaucoma (due to pupillary dilation)

29
Q

HA triggered by light

A

migraine HA

30
Q

differentiate between open angle and closed angle glaucoma

A

open angle = bilateral, gradual loss of peripheral vision w/ cupping (increased cup-to-disk ratio) of optic nerve head
vs
closed angle = unilateral, extremely painful, blurred vision, HA, N/V w/ hard, red eye, dilated pupil that is non-reactive to light

31
Q

tx for closed angle glaucoma

A

medical emergency - consult + decreased IOP (eye drops - timolol, pilocarpine; systemic meds - oral or IV acetazolamide/mannitol; laser peripheral iridotomy)

32
Q

pt presents w/ loss of visual acuity and difficulty w/ night vision. dx?

A

cataracts

33
Q

pt presents w/ painles loss of central vision (distortion of straight lines is early sign). dx?

A

age-related macular degeneration

34
Q

pt presents w/ sudden, painless, unilateral loss of vision. fundoscopic exam shows optic disk swelling, retinal hemorrhage, dilated veins, and cotton wool spots. dx?

A

central retinal vein occlusion

35
Q

pt presents w/ sudden, painless, unilateral loss of vision. fundoscopic exam shows pallor of the optic disk, cherry red fovea, retinal swelling, boxcar segmentation of blood in retinal veins. dx?

A

central retinal artery occlusion

36
Q

pt w/ throbbing HA (may be unilateral or bilateral) triggered by stress, food, light, etc that is associated w/ N/V, photophobia, +/- aura, and noise sensitive, usually relieved by sleep and darkness. dx? tx?

A

migraine HA. tx includes avoidance of known triggers, abortive therapy includes NSAIDs, triptans (5HT agonist), metoclopramide; prophylactic therapy includes anti-convulsants (topiramate), TCAs (amitriptyline), B-blockers (propranolol), and CCBs

37
Q

pt w/ brief, excruciating, unilateral periorbital HA that may cause ipsilateral lacrimation of the eye, conjunctival injection, horner’s syndrome, and nasal stuffiness. dx? tx?

A

cluster HA. tx includes acute therapy - high flow O2, dihydroergotamine, octreotide, or sumatriptan and prophylactice therapy - CCB, lithium, valproic acid, topiramate

38
Q

pt w/ HA at the end of the day that worsens w/ stress and improves w/ relaxation or massage, may describe as tight, bandlike pain. dx? tx?

A

tension-type HA. tx includes relaxation, avoidance of stressors, NSAIDs and acetaminophen

39
Q 
lewy body dementia vs 
pick's dz
vs
alzheimer's dz
vs
multi-infarct dementia
A

lewy body - fluctuating cognitive impairment, recurrent visual hallucinations, and motor features of parkinsonism
pick’s dz - personality changes, compulsive behaviors, and impaired memory w/ intact visual-spatial functions
alzheimer’s dz - subtle memory loss, language difficulties, apraxia, followed by impaired judgement and personality changes
multi-infarct dementia - step-wise decrease in cognitive function w/ motor and sensory neurological dysfunction

USMLE Rapid Review (16 decks)

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