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Step 2 CK > Neurology > Flashcards

Neurology Flashcards

1
Q

Ischemic strokes < ____ hours old are usually not visible on CT

A

6

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2
Q

Riluzole

A

treatment modestly increases survival in ALS by decreasing presynaptic glutamate release

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3
Q

Facial nerve palsy is seen as a complication in what diseases?

A

AIDS, Lyme, Sarcoid, Tumors, Diabetes

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4
Q

Single greatest risk factor for stroke?

A

HTN

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5
Q

Nerve root: achilles?

A

S1

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6
Q

Nerve root: patella

A

L3,4

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7
Q

Nerve root: biceps

A

C5

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8
Q

Nerve root: triceps

A

C7

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9
Q

Name artery: contralateral paresis, sensory loss in leg, cognitive and personality change

A

ACA

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10
Q

Name artery: homonymous hemianopia, vertigo

A

PCA

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11
Q

Name artery: pure motor, pure sensory, ataxic hemiparesis, dysarthria

A

Lacunar

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12
Q

contralateral paresis, sensory loss in face and arm, gaze to side of lesion, neglect if non-dom hemisphere, aphasia if dom hemisphere

A

MCA

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13
Q

Target INR when someone has a prosthetic valve?

A

2.5-3.5

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14
Q

Etiologies of SAH?

A

ruptured berry aneurysm (saccular aneurysm), AVM, trauma to circle of willis

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15
Q

Rapid onset of “worst HA of my life” with photophobia and neck stiffness?

A

SAH

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16
Q

If CT is negative and you have suspicion of SAH what should you do?

A

LP (RBCs, xanthochromia)

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17
Q

Once SAH has been confirmed, next test?

A

Four vessel angiography

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18
Q

Conditions associated with berry aneurysm that make SAH more likely diagnosis?

A

Marfan, aortic coarc, ADPKD, ehlers danlos, sickle-cell anemia, smoking, atherosclerosis, htn

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19
Q

Treatment for SAH?

A
  • -neurosurg for definitive
  • prevent rebleed (BP <150)
  • revent vasospasm/ischemic stroke (CCBs- nimodipine)
  • decrease ICP
  • treat hydrocephalus with lumbar drain, serial LPs, ventriculoperitoneal shunt
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20
Q

Major cause of delayed morbidity/mortality in SAH?

A

vasospasm- ischemic stroke

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21
Q

Early and late signs and symptoms of intracerebral hemorrhage are?

A

early: focal motor, sensory deficits that worsen as hematoma expands
late: increased ICP (vomit, HA, brady, reduced altertness)

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22
Q

Suspect herniation if patient develops _____

A

Cushing’s triad: hypertension, brady, irregular respiration)

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23
Q

common etiology for septic thrombosis of cavernous sinus?

A

central face skin infection, orbit infection, sinus infection.

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24
Q

blown pupil suggests impending ____

A

ipsilateral brainstem compression

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25
Q

Rupture of bridging veins

A

subdural

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26
Q

more common hematoma in elderly and alcoholics

A

subdural

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27
Q

immediate loss of consciousness, followed by lucid interval and then subsequent loss of consciosness (changes over minutes/hours)

A

epidural

28
Q

most common bug causing cavernous sinus infection

A

staph aureus

29
Q

Abortive therapy for migraines

A

triptans (after NSAIDS)

30
Q

Prophylactic migraine therapy

A

anticonvulsant (gabapentin, topiramate, TCAs, B-block, CCB)

31
Q

First episode of cluster HA require?

A

MRI, carotid artery ultrasound (to exclude brain lesion or disorders associated with horner like CA dissection or cavernous sinus infection)

32
Q

Prophylactic therapy for cluster HA?

A

verapamil

33
Q

in patients > 50 with new HA what should you do?

A

ESR to rule out GSA

34
Q

patient presents with uncontrollable twitching of his thumb and is fully aware of symptoms. what kind of seizure?

A

simple, partial seizure

35
Q

patient presents with lip smacking and impaired level of consciousness followed by confusion? type of seizure?

A

complex partial

36
Q

simple seizure means

A

no impaired LOC

37
Q

EEG normal during concerning seziure think?

A

pseudoseizure

38
Q

first line anticonvulsant in children?

A

phenobarbital

39
Q

2nd line for absence seizure

A

valproic acid

40
Q

what should you give a patient who has been seizing > 5 mins to treat potential etiologies?

A

thiamine, glucose, naloxone

41
Q

Treatment for status epi?

A

IV benzo at 5 mins. Another IV benzo 5-10 mins after if needed. If 20 minutes go by, give fosphenytoin.

42
Q

BPPV

A

otolith leads to disturbance in semicircular canals.

43
Q

patients with transient episodic vertigo lasting < 1 min and nystagmus triggered by changes in head position?

A

BPPV

44
Q

vertigo and vomiting for 1 week after recovering from viral infection?

A

vestibular neuritis

45
Q

epley maneuver can be used to resolve?

A

BPPV

46
Q

What may present with similar symptoms to labrynthitis?

A

anterior inferior cerebellar artery stroke

47
Q

Treatment for optic neuritis?

A

IV steroids

48
Q

how can you distinguish ALS from cervical spondylosis?

A

bulbar involvement suggests pathology above foreman magnum-> ALS

49
Q

periodic sharp wave complexes on EEG?

A

creutzfeld-jakob

50
Q

clumps of alpha synuclein proteins

A

lewy body

51
Q

cerebral atrophy of caudate/putamen, altered behavior, dementia and random movements?

A

huntington (CAG repeats on chrom 4)

52
Q

how can you differentiate gait in NPH from gait in parkinson’s?

A

preservation of arm swing i n NPH

53
Q

Parkinson tetrad

A

resting tremor (decreases with voluntary movement)
rigidity
bradykinesia
stooped posture (instability)

54
Q

etiology of parkinson disease.

A

DA deficiency in substantia nigra, Ach excess

55
Q

etiology of Alz

A

Ach and NE deficient

56
Q

most common primary CNS tumors in adults

A

glioblastoma multiforme

meningioma

57
Q

rhabdo of heart esp in apex of LV affects 50% of patients with?

A

tuberous sclerosis

58
Q

sebaceous adenomas in a butterfly distribution?

A

tuberous sclerosis

59
Q

Infantile spasms may be an early sign of

A

tuberous sclerosis

60
Q

left superior MCA stroke in posterior inferior frontal cortex may cause?

A

broca aphasia

61
Q

left posterior superior lobe. due to inferior MCA stroke?

A

wernicke aphasia

62
Q

encephalopathy, ophthalmoplegia, ataxia

A

wernicke encephalopathy

63
Q

anterograde and retrograde amnesia, horizontal nystagmus, confabulations

A

korsakoffs (irreversible)

64
Q

open angle glaucoma occurs _____ while closed angle glaucoma occurs _____

A

bilaterally.

unilaterally

65
Q

gradual loss of peripheral vision?

A

open angle glaucoma

66
Q

painless loss of central vision with distortion of straight lines?

A

macular degeneration

Step 2 CK (26 decks)

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