Neurology

Question 1

right leg numbess/weakness, motor aphasia, ideomotor apraxia- vascular territory

Answer 1

left ACA

Question 2

left leg numbness and weakness, motor neglect- vascular territory

Answer 2

right ACA

Question 3

right face/arm>leg numbness/weakness, aphasia, left gaze preference-vascular territory

Answer 3

left MCA

Question 4

left face/arm>leg numbness and weakness, left hemispacial neglect, right gaze preference-vascular territory

Answer 4

right MCA

Question 5

4 options for second line treatment of status epilepticus

Answer 5

1. phenytoin (20mg/kg)
2. valproic acid (20mg/kg)
3. phenobarbitol (20mg/kg)
4. keppra (2g-4g)

Question 6

treatment for high altitude cerebral edema

Answer 6

descent, dexamethasone, hyperbarics

Question 7

delta sign on head CT suggests

Answer 7

cerebral venous thrombosis

Question 8

slow headache with AMS, seizures, neurologic deficits, or papilledema

Answer 8

cerebral venous thrombosis

Question 9

CNVII palsy+ vesicles on on cheek or ear

Answer 9

ramsay hunt

Question 10

ice test in MG

Answer 10

symptoms should improve

Question 11

autoimmune distruction of ACH receptors

Answer 11

myasthenia gravis

Question 12

treatment for MG

Answer 12

acethylcholinesterase inhibitor such as pryridostigmine

Question 13

IIH opening pressure

Answer 13

> 20 in non-obese

>25 in obese

Question 14

what distinguishes mononeuropathy caused by aneurysm vs diabetes

Answer 14

diabetes- pupillary response intact (parasympathetic fibers are perfused by other vessels so this stays intact and they are on the outside so they end up getting compressed by tumors)

Question 15

descending flaccid paralysis, dysarthria, dysphagia, diplopia

Answer 15

botulism

Question 16

diplopia in lateral gave

Answer 16

CNVI palsy

Question 17

ataxia, lateralizing dysmetria

Answer 17

cerebellar cause of central vertigo

Question 18

dysarthria, dysphasia, diplopia, Horner syndrome, blindness

Answer 18

brainstem cause of central vertigo

Question 19

oxcarbazepine can cause what electrolyte abnormality

Answer 19

hyponatremia

Question 20

migraine medications that are contraindicated in patients iwth HTN

Answer 20

DHE, triptans

Question 21

major risk of edrophonium test

Answer 21

bradycardia

Question 22

medication to give in SAH

Answer 22

nimodipine

Question 23

what receptor does sumatriptan target

Answer 23

5-HT3

Question 24

role of temperature in myasthenia gravis

Answer 24

symptoms improve with cooling

Question 25

mechanism of MG

Answer 25

antibodies against ACh receptors causing decreased response to ACh

Question 26

treatment for MG

Answer 26

acetylcholinesterase inhibitors- pyridostigmine

Question 27

most common shunt malfunction

Answer 27

shunt obstruction

Question 28

when is the NIHSS scale a contraindication to tpa

Answer 28

when it is >20 in the 3-4.5 hour window due to increased risk for hemorrhagic conversion

Question 29

how to do a weber test

Answer 29

tuning fork midline on the skull

Question 30

weber test- how to interpret findings

Answer 30

normal-> no lateralization Unilateral conductive-> lateralizes to affected side (imagine that the ear is blocked off to all external sounds) Unilateral sensorineural-> lateralizes to normal or better hearing side

Question 31

how to do rinne test

Answer 31

tuning fork on mastoid process and then in air

Question 32

what is a normal rinne test

Answer 32

air> bone conduction

Question 33

how to interpret findings of rinne test

Answer 33

normal/sensorineural- air >bone | conductive hearing loss-> bone >air

Question 34

sudden onset sensorineural hearing loss should have what test

Answer 34

MRI

Question 35

MCC sensorineural hearing loss

Answer 35

viral/inflammatory hearing loss (also drugs, normal agin)

Question 36

3 MCC of conductive hearing loss

Answer 36

cerumen impaction> OM, serous otitis

Question 37

what score is used to predict 2-day risk of stroke after TIA

Answer 37

ABCD2 score

Question 38

grading scale for SAH

Answer 38

hunt and hess- grade 1 is mild severity-> grade 5 is high mortality

Question 39

sensitivity of kerning/brudzisnki sign

Answer 39

both are around 5%

Question 40

mnemonic for brudzinski/kernig

Answer 40

Brudzisnki- Bend the brain, kernig- extend knees

Question 41

EMG finding in guillan barre

Answer 41

acute denervation of the muscle

Question 42

what nerve innervates the lateral rectus muscle

Answer 42

CNVI

Question 43

describe what eye looks like with CNIII palsy

Answer 43

eye that is deviated down and out, ptosis, dilated pupil

Question 44

describe eye movements of CNIV palsy

Answer 44

innervates the superior oblique muscle and causes rotational diplopia that worsens when looking down and towards the nose

Question 45

strabismus on exam should make you concerned for

Answer 45

CNVI (abducens nerve) palsy

Question 46

horner syndrome + facial numbness+ ipsilateral bulbar signs

Answer 46

lateral medullary infarction

Question 47

medication that can cause gingival hyperplasia and hirsutism

Answer 47

phenytoin

Question 48

Compare/contrast ACA vs MCA stroke

Answer 48

ACA- contralateral lower extremity weakness, abulia, slow speech MCA- arm and leg weakness.

Question 49

Horizontal diplopia is caused by what CN dysfunction in IIH

Answer 49

CNVI

Question 50

treatment for GBS

Answer 50

IVIG or plasmapharesis (either way, both are equally effective)

Question 51

uththoff phenomenon

Answer 51

worsening of vision with increased body temperature

Question 52

rapid progression of hemiplegia, nausea, vomiting and headache over 30 minutes, which is quickly followed by ipsilateral deviation of the eyes, stupor, coma and mydriatic pupils- where is the bleed

Answer 52

Putamen

Question 53

infectious cause of multiple subcortical lesions in the basal ganglia

Answer 53

toxoplasmosis

Question 54

CD4 count that puts you at risk for cerebral toxoplasmosis

Answer 54

<100