Neurology

Question 1

MS flare up: ataxia, incoordination and dysarthria

Tx?

Answer 1

Steroids!: Methylprednisolone

Question 2

Intense retro-orbital headache
CT is normal
Next?

Answer 2

Do LP and Look for Xanthochromia

- Sub arachnoid hemorrhage!

Question 3

40 y/o with ALS( amyotrophic lateral sclerosis);

Clinical manifestation?

Answer 3

Pure Motor disorder

Asymmetric leg weakness!

Question 4

Male with personality changes
Making inappropriate comments to female
Withdrawn at social gathering
Normal exam

DX?

Answer 4

Frontotemporal dementia - decline in social and interpersonal conduct

Question 5

22 y/o male with debilitating headache occurring 3-4 times / month
Throbbing, sharp on the right side for 6 hrs
Not responding to Ibuprofen

Tx?

Answer 5

1. Sumatriptan + IV metoclopramide

Fiorocet and IV dilaudid only if failed other tx

Question 6

Female with Pituitary mass

What lab will suggest ACTH secreting adenoma

Answer 6

Elevated 24 hr Urine cortisol