Neurology/BW Flashcards
You believe a patient has a stroke. He presents with aphasia, loss of hearing in one ear and loss of vision in his left eye. Is the blockage likely in the anterior or posterior circulation?
Posterior
Under what conditions would aspirin or clopidogrel be used following a TIA as prophaylaxis?
These are antiplatelet medications. They would be used unless there is a known cardiac etiology for the embolism. Patients with a cardiac cause should use heparin or coumadin
A patient who is asymptomatic should consider having an endartectomy at what percent blockage of the carotid artery? How about in a symptomatic patient?
70% if asymptomatic and 60% if symptomatic
A patient presents complaining of the worst headache of his life. What might you expect his blood pressure to be?
This is the description for a subarachnoid hemorrhage. Blood pressure would be elevated.
Name abortive migraine drugs
triptans ( sumatriptan, zolmitriptan), ergotamine
An EEG showing focal rhythmic discharges at the onset of the seizure should make you think of what diagnosis
SImple partial seizure
What is the single most important thing to be concerned about with a patient in status epilepticus
Airway then managemnt of hyperthermia
Describe Brudzinski’s sign
lift the patients head and bend at the hips
Name medications used to break a seizure
Diazepam, lorazepam, phenytoin or fosphenytoin.
There is an MRI result of multiple foci of demyelination in the white matter. What is the most likely diagnosis?
Multiple Sclerosis
List 3 medications used to treat multiple sclerosis
Steriods, interferon-beta, copolymer
What is the most common cause of dementia?
Alzheimers ( 80%)
What are the 4 chromosomes that have been linked to dementia?
1,14,19,21
Is the ankle jerk reflex or lumbar or sacral origin?
sacral
A study result comes back with intracellular neurofibrillary tangles and extracellular neuritic plaques. What is the most likely diagnosis?
Alzheimers
A patient complains of an aching headache which feels like a band around his head. What is the most likely diagnosis?
Tension Headache
A patient present with a tremor in his right hand. He states that the tremor goes away completely when he has a beer. What is the most likely diagnosis?
benign essential or familial tremor
Two medications to treat an essential tremor?
Beta blocker ( propanolol), Primidone
At what age do the symptoms of Huntington’s appear?
30
A 35 year old patient comes to your office because his wife made him. He has been increasingly irritable and moody. She has also noticed that he is very restless. You order a CT scan which shows cerebral atrophy as well as atrophy of the caudate nucleus. What is the most likely diagnosis?
Huntington’s
Medication of choice for a patient with Tourette’s syndrome?
Haloperidol
slit lamp shows Kayser- Fleischer rings. Most likely diagnosis?
Wilson’s Disease
Wilson’s disease is associated with a build up of what mineral?
Buildup of copper because there is a deficiency of copper binding protein
What are the genetic characteristics of Wilson’s disease?
Autosomal recessive, chromosome 13
What cranial nerve is affected with Bell’s Palsy?
7
A LP for a patient with bacterial meningitis will show an increase or decrease in: WBC, glucose, protein?
elevated WBC and protein. Decreased glucose
What symptom is associated with a classic migraine
Having an aura
Elevated acetylcholine receptor antibodies should make you thin of what dx
myasthenia gravis
Duchenne’s and Becker’s muscular dystrophy have what genetic characteristic?
x linked recessive
Age range for Duchenne’s muscular dystrophy?
3-5 years
An EEG showing generalized spikes and associated slow waves should make you think of what diagnosis?
generalized or absence seizure
Most common cause of subarachnoid hemorrhage aside from trauma?
ruptured cerebral aneurysm
Most common primary cancer sites that metastasize to the brain
Lung, breast, kidney
Resting or pill rolling tremor makes you think of what dx?
Parkinson’s
Weakness and numbness in the left hand might be a blockage in which carotid artery?
right
A patient has an intracranial neoplasm causing auditory illusions, olfactory hallucinations and emotional changes. What lobe is the lesion likely in?
temporal
If you are looking for lesions associated with multiple sclerosis and you order an MRI do you order with gadolinium or without?
With gadolineum
Defining symptom of Alzheimer’s?
progressive memory impairment
Nerve root responsible for knee jerk reflex?
L3-L4
An EEG showing interictal spikes should make you think of what diagnosis?
Complex partial seizure
Which is the most commonly herniated vertebral disc?
L4-L5 followed by L5-S1
Three symptoms of normal pressure hydrocephalus?
Gait disturbance, dementia, urinary incontinence
A patient presents with inability to speak and right sided weakness. He seems to understand speech and follows commands well. What type of aphasia should you be thinking of?
Broca’s aphasia
Alcohol may be a major factor in which encephalopathy?
Wernicke’s
A patient complains of muscle weakness and fatigability that improves with rest. What is the most likely diagnosis?
Myasthenia gravis
Lead pole of cogwheel rigidity should make you think of what diagnosis?
Parkinson’s
