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PANCE Exam Review > Neurology > Flashcards

Neurology Flashcards

1
Q

“Extrapyramidal symptom”: repetitive, abnormal, orofacial involuntary movements

A

Dyskinesia

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2
Q

In initial workup for polyneuropathy, what is done?

A

Electrodiagnostic (nerve conduction and EMG) before labs. (use the results of 1st to order labs)

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3
Q

PE test for Myasthenia Gravis

A

Ice test improves Sxs

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4
Q

What causes PD?

What does that produce?

A
  • Degeneration of Lewy Bodies.

- Lewy bodies produce Dompaine.

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5
Q

Tx for Absence (Petit Mal) Seizure

A

EthoSUXimide

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6
Q

What is the MIDBRAIN part of and what is its function?

A
  • Brainstem
  • Controls eye movements
  • Relays visual and auditory info
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7
Q

What is severely diminished with Alzheimer Disease (AD)?

A

Acetylcholine

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8
Q

Dx for Alzheimer Disease (AD) and what does it show?

A
  • CT

- Cerebral Cortex Atrophy

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9
Q

PE finding in Guillain-Barre Syndrome

A

Loss DTR

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10
Q

Dx for Syringomyelia

A

MRI

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11
Q

1st line imaging to Dx Intracranial Hemorrhage

A

Non-contrast CT

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12
Q

What does Cerebellum do?

A
  • Maintains posture and balance

- Coordinates voluntary movement

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13
Q

Brief LOC, blank stare, NO aura. Dx?

A

Absence (Petit Mal)

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14
Q

Cerebral Palsy cause:

A

Brain injury near time of birth.

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15
Q

Tx for Guillain-Barre Syndrome

A
  • Plasmapheresis

- IVIG

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16
Q

Dx for Myasthenia Gravis

A
  1. (+) Ach receptor Antibodies

2. Edrophonium (Tensilon) test

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17
Q

TOC for Huntington Dz. and what does it show?

A
  • CT

- Cerebral and Caudate nucleus atrophy.

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18
Q

Tx for Tourette Syndrome

A

-Dopamine blockers: Pimozide, Halo, Risperidone

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19
Q

Tx Restless Legs Syndrome

A

Dopamine agonist: Pramipexole, Ropinirole

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20
Q

CSF: HIGH protein, normal WBC. Dx?

A

Guillain-Barre Syndrome

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21
Q

Tx for Migraine and MOA

A
  • Triptans or Ergos

- Serotonin 5HT-1 agonist → vasoconstrict

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22
Q

Pt. presents with diplopia and muscle weakness WORSE AT NIGHT and better with rest. Dx?

A

Myasthenia Gravis

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23
Q 
Initial: 
1) Behavioral (personality, intellect, psych) →
2) Chorea* 
3) Dementia
Dx?
A

Huntington Dz.

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24
Q

Tx for Myasthenia Gravis

A
  • Acetylcholin-Esterase Inhibitors: Pyridostigmine or Neostigmine
  • Acute: Plasmapheresis or IVIG (rapid response). Mechanical ventilation.
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25
Q

Confirmatory Dx for Multiple Sclerosis and what does it show?

A
  • MRI T2-weighted (Gadolinium)

- White matter plaques (periventricular hyperdensities)

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26
Q

What does a LP show in Multiple Sclerosis?

A
  • ↑ IgG (oligoclonal bands)

- ↑ WBC (pleocytosis)

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27
Q

Tx for Multiple Sclerosis

A
  • Acute: IV Steroids > Plasmapheresis (if no response to steroids)
  • Progressive: INF-B
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28
Q

Pt. presents with sudden onset of a weak face and inability to lift right eyebrow. Dx?

A

Bell Palsy

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29
Q

Sustained contraction (spasm) leading to twisting of body and abnormal posturing.

A

Dystonia

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30
Q

Tx for Trigeminal Neuralgia

A

1st: Carbamazepine
2nd: Gabapentin

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31
Q

Tx for Cluster HA and Prophy

A

1st: Oxygen
2nd: Triptans
Prophy: Verapamil

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32
Q

HA that presents with congestion, lacrimation, conjunctivitis:

A

Cluster

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33
Q

TOC for suspected concussion:

A

CT

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34
Q

Sudden onset confused state d/t identifiable cause (infxn, med)

A

Delirium

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35
Q

Tx for Alzheimer Disease (AD)

A

1) Ach-Esterase inhibitors: Donepezil

2) NMDA Agonist: Memantine

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36
Q

What is seen on imagining for Glioblastomas?

A

Variable ring of enhancement surrounded by edema.

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37
Q

What is seen on imagining for Meningiomas?

A

Intensely enhancing, well-defined lesion often attached to the dura.

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38
Q

-Motor deficits: Lower ext. > upper*.
-Sensory deficit: pain, temp, light touch
+/- Bladder dyfxn
Dx?

A

Anterior Cord

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39
Q

Initial TOC TIA

A

Head CT

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40
Q

MC hemorrhage in elderly and alcoholics and what does CT show?

A
  • Subdural

- Concave (crescent-shaped)

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41
Q

CM: F/N/V/HA, chills → AMS, seizures.
(+) Kernig’s
(+) Brudzinski’s

A

Bacterial Meningitis

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42
Q

Cranial nerve function of voice, soft palate, gag reflex:

A

X (10) Vagus

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43
Q

1st: LOC → rigidity
2nd: repetitive jerking
3rd: coma/sleep
Dx?

A

Tonic-Clonic (Grand Mal)

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44
Q

Paresthesias of medial ankle down to foot arch involves ____ nerve.

A

Saphenous (L3-L4)

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45
Q

Which lobe of the brain controls hearing?

A

Temporal lobe

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46
Q

Teratogenic Antiepileptic drug:

A

Valproate

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47
Q

What is the next step with (–) CT but high suspicion of Subarachnoid Hemorrhage?
What does it show?

A
  • LP

- Xanthochromia

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48
Q

Sudden onset of uni neck pain or HA around eye or frontal area, can be d/t chiropractor manipulation. Dx?

A

Carotid Artery Dissection

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49
Q

Phenytoin SE of chronic use and what electrolyte d/o does it cause?

A
  • Gingival hyperplasia

- HypoCa+

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50
Q

CSF: HIGH protein, ↑ WBC, low Glucose, (+) PMN. Dx?

A

Bacterial Meningitis

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51
Q

Tx for Bacterial Meningitis >50 yo

A

Ceftriaxone + Vanco + Ampicillin (covers Listeria)

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52
Q

What BB is used to treat Essential (Familial) Tremor?

A

Propanolol ONLY

53
Q

CN responsible for eye movements → LATERAL rectus muscle:

A

CN VI (6) Abducens

54
Q

Sxs: sudden “worst HA ever”, syncope, N/V. Dx?

A

Subarachnoid Hemorrhage

55
Q

1st and 2nd MCC bacterial meningitis

A

1st: Strep pneumoniae
2nd: N. meningitidis

56
Q

When is Subdural Hematoma considered CHRONIC?

A

After at least 3 wks

57
Q

Subarachnoid Hemorrhage Tx

A

Nimodipine (decreases vasospasm)

58
Q

Dystonic Reaction Tx

A
  • Benztropine

- Diphenhydramine

59
Q

With open skull fracture, what Tx is necessary?

60
Q

Caloric Testing: What does COWS stand for?

A
  • Cold (water) Opposite
  • Warm (water) Same
  • Direction of nystagmus to see if patient really IS in a coma.
61
Q

Dx for Subdural Hematoma

A

NON-contrast CT

62
Q

Dx for Subdural Hematoma and Subarachnoid Hemorrhage

A

NON-contrast CT

63
Q

MCC Guillain-Barre Syndrome

A

Campylobacter jejuni

64
Q

MCC stroke <45yo

A

Carotid Artery Dissection

65
Q

What time frame is ACUTE Subdural Hematoma?

A

≤ 3 days

66
Q

CN responsible for head and neck motor functions of trapezius and sternocleidomastoid muscles

A

XI (11) Accessory

67
Q

Migraine prophy

A

Anti-HTN meds → BB, CCB

68
Q

MC HA in men:

69
Q

With Myasthenia Gravis and respiratory issues, what is the next step in mgmt?

A

Breathing study (Neg. inspiratory force)

70
Q

MC complication of Bell’s Palsy

71
Q

This Dx should NOT have post-ictal period or prolonged state of confusion:

72
Q

What is Cushing Reflex/Triad and what did it signify?

A
  • HTN, brady, diminished respiratory

- ↑ ICP

73
Q

Daily neck stretches would most benefit what type of HA?

74
Q

What PE hand gesture tests Median Nerve function?

A

“OK” sign → pincer function with thumb and index finger OR thumb and 5th finger.

75
Q

Common cause of bilateral peripheral facial nerve palsy (can also be Bell Palsy).

A

Lyme disease

76
Q

MC SE of Topiramate

A

Paresthesia

77
Q

MC type of HA

78
Q

Chronic migraine is strongly associated with which disorder?

A

Med overuse (rebound phenomenon)

79
Q

Triptans and DHE are CI in:

A

HTN or CV disease

80
Q

LP finding in Idiopathic Intracranial HTN (Pseudotumor Cerebri)

A

↑ opening pressure

81
Q

Tx for Cluster HA

A

HIGH flow O2

82
Q

MCC of Bell Palsy

83
Q

MC sequelae p LP

84
Q

Tx for Tension HA

A

Daily neck stretches, NSAIDs

85
Q

Chronic migraine is strongly associated with which disorder?

A

Med overuse (rebound phenomenon)

86
Q

MC source of infection-induced delirium in the elderly population

87
Q

Vertigo that present with HL

A

Meniere’s and Labyrinthitis

88
Q

What is Homonymous Hemianopia and MCC?

A
  • Visual field loss on the same side of both eyes.

- Stroke

89
Q

Trigeminal Neuralgia (Tic douloureux) affects what facial distributions?

A

V2 (maxillary) and V3 (mandibular)

90
Q

Tx for Carotid Artery Dissection

A

Heparin before Warfarin

91
Q

What is part of immediate work up in patient with AMS?

A

Fingerstick Glucose

92
Q

Most characteristic sign of idiopathic intracranial HTN

A

Transient vision loss

93
Q

Normal opening pressure in adults

A

5 to 20 cm

94
Q

What fracture compromises radial nerve?

A

Humeral shaft

95
Q

Diplopia worse at the end of the day and muscle weakness. Dx?

A

Myasthenia Gravis

96
Q

Bilateral motor paresis upper extremities more than lower. Damage to:

A

Central cord

97
Q

Reversible extrapyramidal syndrome: sensation of motor RESTLESSNESS

98
Q

For intracranial hemorrhage, Head CT scan is with or without contrast?

A

NO contrast → blood and contrast are both hyperdense

99
Q

Tx for Intracranial Abscess

A

3rd gen Ceph + Metronidazole (if source unknown)

100
Q

Contralateral hemisensory loss seen in:

A

Thalamic hemorrhage

101
Q

Bell Palsy Tx

A

Prednisone, artificial tears, tape eyelid shut

102
Q

With LOC, when is CT needed?

A
  • Age ≥ 65
  • Vomit ≥ 2
  • Fracture
  • GCS <15 p 2 hrs
103
Q

Pt. presents with drooping eyelids, constricted pupils, and lack of sweat formation. What is the likely diagnosis?

A

Horner’s Syndrome

104
Q

Which antiepileptic med requires dose adjustment for patients with hypoalbuminemia?

105
Q

Tx for Intracerebral Hemorrhage

A

CCB → Nicardipine

106
Q
  • Contralateral loss of pain and temp

- Ipsilateral loss of motor, position and vibration

A

Brown-Sequard Syndrome

107
Q

In what setting is dual antiplatelet therapy with aspirin and clopidogrel indicated?

A

After percutaneous coronary intervention and stent placement.

108
Q

Amaurosis Fugax is seen in what 3 Dx?

A
  • Central Retinal ARTERY Occlusion
  • Giant Cell (Temporal) Arteritis
  • Transient Ischemic Attack (TIA)
109
Q

What nerve would be damaged with buttock injury, hip dislocation, ↓ knee flexion, foot drop?

110
Q

When treating CO2 poisoning, what does hyperbaric oxygen reduce the risk of?

A

Developing delayed neurologic sequelae

111
Q

What is the 1st line treatment of multiple sclerosis exacerbations?

A

High-dose methylprednisolone, then prednisone taper.

112
Q

CSF shows ↑ RBCs. MRI shows left temporal lobe edema. Dx?

A

Herpes Encephalitis

113
Q

During cog testing pt. only recalls 1 of 3 words and all numbers are on 1 side on the clock on drawing. She has Hx of stroke, hyperlipidemia, HTN, DM. Daughter reports S/T memory loss. What type of dementia is this?

A

Vascular dementia

114
Q

Constant headaches and bitemporal hemianopsia. Dx?

A

Pituitary Tumor

115
Q

What tests is most likely to determine the source of an arterial thrombus?

A

Carotid ultrasound

116
Q

What finding is consistent with a lower motor neuron deficit?

117
Q

2nd line Tx for Migraine

A

Dopamine blockers: Phe, Meto, Pro (given with Diphenhydramine)

118
Q

Chronic back pain + abnormalities of proprioception and vibration discrimination. What portion of the spinal column is most likely affected?

A

Posterior column

119
Q

A patient with an upper motor neuron lesion would exhibit what finding?

A

Spasticity

120
Q

Myasthenia Gravis vs. Bell Palsy

A

MG: muscle weakness, diplopia/ptosis.
BP: can’t wrinkle forehead or move brow. Post URI*

121
Q

Tx for Akathisia

A

Benztropine

122
Q

MC type of meningitis in a neonate

A

Group B Strep

123
Q

MC type of meningitis in 1 mo to 18 yo

A

Neisseria Meningitis

124
Q

Pt. reports to clinic saying her roommate was diagnosed with meningitis. She asks if she needs to be treated for prevention. What do you do?

A

Tx with Cipro or Rifampin

125
Q

What med should be used in a patient recently diagnosed with Bells Palsy >60 yo?

A
  • Acyclovir + Pneumococcal vac

- D/T Ramsay Hunt Syndrome

126
Q

What is the most important test to order in a patient with Meniere’s Disease?

127
Q

When is CT contrast used in neuro?

A

Intracranial lesions like METS brain CA and abscesses

128
Q

What is the next step after a Horner’s Syndrome Dx?

A

CXR or CT scan

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