Neurology

Question 1

Epidural hemorrhage is most often associated with skull fracture across what artery?

Answer 1

Middle meningeal

Question 2

Biconvex blood collection between skull and dura;

dx?

Answer 2

Epidural hemorrhage

Question 3

Most likely age group for epidural hematoma

Answer 3

Children < 2;

then elderly

Question 4

Hemotympanum is most associated with what head injury?

Answer 4

Basilar skull fracture

Question 5

Location for LP

Answer 5

L2-S1

Question 6

Pure loss of motor function of arm and leg on same side, where is the bleed?

Answer 6

Lacunar infarct/internal capsule

Question 7

Motor deficits plus aphasia/agnosia

Answer 7

MCA

Question 8

Determining hearing loss is important in the evaluation of what symptom?

Answer 8

Vertigo

Question 9

What kind of ear infection can result in hearing loss?

Answer 9

Labyrinthitis

Question 10

Diplopia is a symptom of what kind of vertigo?

Answer 10

Central vertigo

Question 11

Most common organism implicated in spinal epidural abscess

Answer 11

Staph aureus

Question 12

Pathophysiology of Myasthenia gravis

Answer 12

Antibodies to ACTH receptors at the NMJ

Question 13

Prolonged nitroprusside use may cause what complication in renal failure patients?

Answer 13

Cyanide toxicity

Question 14

What cutoffs define hypertensive urgency?

Answer 14

Systolic 210 or greater

Diastolic 140 or greater

Question 15

In hypertensive emergencies, reduce the BP how fast?

Answer 15

10-25% in the first hour

Question 16

Why should phenytoin be administered as an infusion over 45-60 min as opposed to bolus?

Answer 16

The diluent in phenytoin causes hypotension if given rapidly

Question 17

Ages during which febrile seizures happen

Answer 17

6 months to 5 years

Question 18

GCS score which categorie gets 6

Answer 18

Motor response

Question 19

Explain the HINTS exam

Answer 19

The head impulse exam has the patient fix their vision on an object while the examiner rapidly rotates the patient’s head to one side. If the patient’s eyes deviate from the object followed by a corrective saccade, then this suggests a peripheral etiology, whereas if the patient’s eyes stay focused, this suggests a central etiology. Horizontal nystagmus is the next component of the exam in which a horizontal nystagmus supports a peripheral etiology. If the nystagmus is direction changing, then this could be a central etiology. Finally, the test of skew is when the patient fixes their gaze on an object as the physician rapidly covers and uncovers each eye. If there is no skew deviation of the eye as it is uncovered, then this suggests a peripheral etiology, whereas skew deviation or misalignment suggests a central etiology

Question 20

What are the four exam maneuvers that test cerebellar function?

Answer 20

Finger-to-nose exam, heel-to-shin test, gait, and rapid alternating movements

Question 21

Causes of Horner syndrome

Answer 21

Important causes of Horner syndrome include cavernous sinus syndrome, brainstem ischemia, carotid dissection, and mass effect resulting from pathology of the spinal cord, thoracic outlet, or apex of the lungs

Question 22

What muscles are controlled by the third cranial nerve?

Answer 22

Superior rectus, 
inferior rectus, 
medial rectus, 
inferior oblique,
levator palpebrae superioris

Question 23

Cervical radiculopathy at which nerve roots may mimic carpal tunnel syndrome?

Answer 23

C6-C7

Question 24

Common finding in optic neuritis/MS

Answer 24

Optic neuritis, when unilateral, causes an afferent pupillary defect (APD), also known as Marcus Gunn pupil. When testing for APD, shining a light in one eye and then the other demonstrates a more sluggish response to direct light in the affected eye. In normal patients, both pupils should constrict equally when shining a light into either eye due to the consensual light reflex

Question 25

``` Hypoproteinemia Edema Proteinuria Weight gain Peds patients Increased risk of thrombotic events dx? ```

Answer 25

Nephrotic Syndrome