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USMLE STEP 2 CK RETAKE > Neurology > Flashcards

Neurology Flashcards

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USMLE® Step 1 flashcards
1
Q

ACA embolism

A

Feet and leg deficits

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2
Q

MCA embolism

A

Hands, Arms, Face, Speech deficits

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3
Q

PCA embolism

A

Visual Cortex deficits

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4
Q

Cerebellar embolism

A

Coordination deficits (Ataxia)

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5
Q

Stroke Presentation

A

Focal neurologic deficit localized to the brain

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6
Q

Stroke Diagnostic steps

A
  1. Non-Con CT head
    negative blood-Ischemic Stroke
    Positive blood-Hemorrhagic stroke
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7
Q

Ischemic Stroke Diagnostic Steps

A

give tPA maybe
next day do 2d echo
EKG
Carotid U/S

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8
Q

Hemorrhagic stroke treatment

A

Decrease Blood pressure

neurosurgery

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9
Q

2D echo shows thrombus

A

Warfarin
Noac
Heparin bridge

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10
Q

EKG shows A-fib/flutter stroke

A

Warfarin

Noac

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11
Q

Carotid artery Stenosis Treatment

A

<70% occlusion + Asx
>70% + Sx or >80% occlusion
Surgery within two weeks

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12
Q

Contraindications to tPA

A

Bleeding
Recent surgery within 2 weeks
ICH

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13
Q

When to use tPA

A

<3hr BP-180/105

<4.5 DM BP-180/105

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14
Q

Causes of 1st time seizure

VITAMIN

A 
Vascular
Infection
Trauma 
Autoimmune
Metabolic
Ingestion/wIthdrawl
Neoplasm
pSych
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15
Q

Seizures Presentation

A

Loss of consciousness, Jerking
Bowel/Bladder incontinence
Tongue Biting
Post ictal state

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16
Q

Seizure no epilepsy (1st time)

A 
Currently seizing, (>5m or failure to return to baseline after >20 min)
Benzos
Fosphenytoin
Midozolam + propofol
Phenobarbital
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17
Q

Seizure with h/o of epilepsy

A

Check medication levels
increase drug dose
Add drug
change drug

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18
Q

General Seizure coverage

A

Valproate, Lamotrigine, Levatiracetam

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19
Q

Atonic seizure presentation treatment

A

No LOC, (+) LOT, Suddenly fall

Valproic acid, valproate

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20
Q

Myoclonic Presentation, Treatment

A

No LOC, too much tone

Valproic acid, Valproate

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21
Q

Trigeminal Neuralgia Treatment

A

Carbamazepine

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22
Q

Parkinsons Presentation

A

Bradykinesia
Cogwheel Rigidity
Resting tremor (Pill rolling)
Gait/postural instability-Shuffling steps

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23
Q

Parkinsons treatment <70, good function

A

dopamine agonists

Ropinerol, Promipexole

24
Q

Parkinsons treatment >70 with decline in function

A

levodopa + carbidopa

25
Q

Essential tremor presentation

A

tremor with movement or use, no tremor at rest

Tx: Propanolol

26
Q

Intention tremor Presentation

A

cerebellar dysfunction
alcohol stroke
tremor with movement none at rest
worsens closer to the target

27
Q

Tension headache Presentation, Treatment

A

Most common
Muscular pain, Bilateral
Starts in front and radiates to the neck
Tx: NSAIDs

28
Q

Analgesic Rebound Presentation, treatment

A

Withdrawl
Pt: Takes medication more than 10x/month
HA when they stop their meds
Tx: Let them withdraw

29
Q

Cluster Headache Presentation, treatment

A 
Asx for months
then happens 8-10x/day
unilateral pain with Horner Syndrome
Tx: Acute-O2
Sumitriptan 
ppx-CCB (verapamil)
f/u with MRI
30
Q

Migraine presentation, treatment

A 
unilateral pulsatile, debilitating HA, photphobia, phonophobia, N/V, aura, trigger 
Tx: Acute, Mild-NSAIDs 
Mod/severe-Triptans 
ppx-b-blockers
Valproate
topiramate
31
Q

Migraine Prophylaxis

A

B-blockers
Valproate
Topiramate

32
Q

Cluster Headache Prophylaxis

A

CCB=Verapamil

33
Q

Idiopathic Intracranial Hemorrhage Presentation, treatment

A 
Woman, increased ICP, Papilledema, N/V, FND, negative CT, OCP use
Dx: LP, OP >25 
Tx: Acetazolamide
Serial LP
VP shunt
34
Q

Musculoskeletal pain Presentation, Tx

A 
Vague symptoms 
30-50 y/o 
h/o heavy lifting 
Tx: Exercise and NSAIDs
reassess after 4 weeks
35
Q

Disc Herniation Presentation, Dx, Tx

A 
Sciatica pain 
Positive Straight Leg test 
30-50 
heavy lifting 
Dx: X-ray 
MRI 
Tx: NS > conservative @ 6mo
NS=conservative @ 1 year
36
Q

Compression Fracture presentation, Dx, Tx

A 
>50 F 
Fall on coccyx 
(+) vertebral step off 
(+) pinpoint tenderness 
Dx: X-ray 
best MRI
Tx: Surgery
37
Q

Spinal Stenosis Presentation, Dx, Tx

A 
Narrow Canal 
>50 
Pseudoclaudication 
positional, Hunched over 
Dx: x-ray
MRI 
Tx: Laminectomy
38
Q

Osteophyte (bone spur) Presentation, Dx, Tx

A 
>50 
No heavy lifting 
Sciatica 
positive straight leg raise 
Dx: X-ray 
MRI 
Tx: Surgery
39
Q

Alarm symptoms for lower back pain

A

bowel/Bladder incontinence
Saddle Anesthesia
New FND/rapidly progressing

40
Q

Alzheimers Presentation, Dx, Tx

A 
Associated with downs 
Memory goes first 
Down syndrome 
spares social graces 
Dx: CT=diffuse cortical atrophy 
Tx: Supportive care 
Family education 
Donepezil
41
Q

Creutz-feld Jakob Presentation, Dx, Tx

A

Undercooked meat, Sporadic mutation
young dementia with myoclonus
Dx: MRI
Tx: Supportive

42
Q

Normal Pressure Hydrocephalus Presentation, Dx, Tx

A 
Increased ICP
Pt: Wet, Wobbly, Weird 
Dx: CT- Hydrocephalus 
LP- will provide improvement 
Tx: VP Shunt
43
Q

Neiman Picks disease Presentation, Tx

A

Personality goes 1st, Hypersexual

Tx: Supportive

44
Q

Vascular Dementia presentation, Dx, Tx

A

Stepwise decline with each stroke
Dx: Ct=infarcts
Tx: CVA, supportive

45
Q

Lewey-Body Dementia Presentation, Tx, Dx

A

Parkinsonian Sx and dementia
Visual Hallucinations
Tx: Supportive

46
Q

Vertigo
(-) tinnitus, hearing loss
(+) FND

A

Posterior Fossa insult

MRI

47
Q

Posterior Fossa Insult Presentation, Dx, Tx

A 
MS, Stroke, Tumor, Abscess, Seizure, Migraine 
FND
(-) ear Sx 
Dx: MRI
Tx: Disease Specific
48
Q

BPPV presentation, Dx, Tx

A

Reccurrent and reproducible vertigo
lasts <1 min
Dx: Dix Hallpike (Rotary Nystagmus)
Tx: Epley Maneuver

49
Q

Menier’s Disease Presentation, Dx, Tx

A 
Hearing loss, tinnitus, Vertigo
Lasts >30m <1hr
Tx: Salt restriction 
Thiazide diuretics 
Meclizine
50
Q

Vestibular Neuritis Labrynthitis Presentation, Tx

A 
4 wks after URI 
Vertigo 1-10m 
(+) Hearing loss 
N/V
Tx: Steroids 
Meclozine
51
Q

Multiple Sclerosis Presentation, Dx

A 
AI, Demyelinating 
20-40
Any neuro Sx separated by time and space 
Optic neuritis 
Dx: MRI=periventricular white matter
52
Q

Multiple Sclerosis Tx

A

Acute Flare=Steroids
Chronic= Interferon
Glatramer
Finoglonad

53
Q

Multiple Sclerosis Complications and treatment

A

Urinary retention=bethanachol
Urinary incontinence=Amitryptiline
Spasms=Baclofen
Neuropathic pain=Gabapentin

54
Q

ALS presentation, Dx, Tx

A

UMN and LMN lesions
Dx: EMG
Tx: Supportive

55
Q

Guillain Barre Syndrome Presentation, Dx, Tx

A 
Watery diarrhea or presenting after a flu shot 
Ascending paralysis, Distal to proximal 
Hyporeflexia 
Dx: LP=alot of proteins 
few cells 
Tx: Intubation 
IVIg=plasmapheresis 
NEVER STEROIDS
56
Q

Myasthenia Gravis Presentation, Dx, Tx

A 
>50 
Fatigue of the eyes, throat, fine movements 
Worse in the evening 
Dx: Abs against AChR
EMG
CT scan for thymoma (assoc)
Tx: Cholinesterasei(Stigmine)
Steroids refractory 
IVIg=plasmapheresis Crisis
57
Q

Eaton Lambert Presentation, Dx, Tx

A 
Presynaptic CaR 
Paraneoplastic Syndrome 
>50
Improvement w/use 
Proximal muscles-problems combing hair, rising out of a chair 
Dx: Abs 
EMG 
CT Small cell 
Tx: Treat CA

USMLE STEP 2 CK RETAKE (15 decks)

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