Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

UWORLD ABIM > Neuropsych > Flashcards

Neuropsych Flashcards

1
Q

T/F: ssris are effective for anorexia and bulimia

A

false

bulimia: ssri
anorexia: olanzapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Contraindications to Buproprion

A

Hx of seizures

Active eating disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

T/F: Cervical myelopathy causes UMN signs in the UE and LE

A

False. Causes

  • UE deficits with LMN signs
  • LE weakness with UMN signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

timing for tpa for CVA

A

within 4.5 hours of sx onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

when does mechanical thrombectomy need to be initiated for CVA

A

within 24 hours

doesnt matter if tpa has been given . hold asa in patients who undergo thrombolysis for 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How would a brainstem stroke present?

A

Acute CN deficit + contralateral hemiparesis or hemisensory loss (crossed signs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Lateral medulla stroke (wallenberg syndrome)

A

ipsilateral Horner
loss of facial pain/temp
contralateral loss of body pain/temp
hoarseness, dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

cerebellar stroke

A

nystagmus/falling to the side of the lesion, limb ataxia, n/v, vertigo, inability to ambulate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

midbrain stroke

A

ipsilateral CN 3 palsy +. contralateral lower facial weakness/hemiplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

when might neuroleptic malignant syndrome present in a parkinson pateint

A

after withdrawal, dose reduction, or a switch in dopamine agents

look for lead-pipe rigidity, hyperthermia, autonomic instability (CK will be high, >1000)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

T/F: Buproprion induces fewer sexual side effects and less wt gain when compared with out antidepressants

A

true.

it is also activating (good for low energy, hypersomnia patients)

avoid if hx of seziures or active eating disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

typical LP findings in GBS

A

increased CSF protein with normal wbc count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Scores < *** on MMSE are sensitive/specific for dementia

A

<24/30 (so 26/30 is a good score)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the most common etiology of transverse myelitis?

A

Autoimmune process following a viral infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What will MRI and LP show for transverse myelitis

A

MRI: enhancing cord segments with surrounding edema

CSF: elevated protein, moderate lymphocytosis, normal glucose, no oligoclonal bands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how do cauda equina and transverse myelitis present?

A

Cauda Equina (lumbosacral roots): severe unilateral pain in saddle region. radiates down to legs. assymmetrical LE weakness.

TM: Acute onset weakness and sensory loss below a spinal level + bowel/bladder/sphincter dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

acute monocular vision loss, central scotoma (black spot), loss of color vision, eye pain

A

optic neuritis (screen for MS).

Exam may show afferent pupillary defect, hyperemia. MRI of brain and orbits with gadolinium can show optic nerve inflam and findings of MS (periventricular white matter lesions)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T/F: IDA is commonly associated with RLS

A

true, measure ferritin in all patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Factitious vs malingering

A

Factitious: they want the attending of assuming the sick role

Malingering: working the system for external rewards (i.e. disability pay, meds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

best AED to start in female of reproductive age

A

Lamotrigine or Levetiracetam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

medications for Parkinsons disese

A

Age >65: levodopa/carbidopa

Age <65: Dopamine agonists (bromocriptine, pramipexole, ropinirole) due to fewer motor fluctuations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

T/F: Donepezil is a dopamine agonist used in PD

A

False. It is an AChesterase inhibitor, increases ACh levels in dementia patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Tx of myasthenic crisis

A
  • Measure VC q2 hours
  • Consider intubation (VC <20 or MIF >-30)
  • hold Pyridostigmine aka Acetycholinesterase inhibitors (to reduce secretions)
  • PLEX or IVIg, + high dose steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

T/F: Metoclopramide can cause tardive dyskinesia

A

True, stop it if it develops. Best tx for even antipsychotic-induced TD = drug discontinuation or switching to a second -gen. If you can’t, add valbenazine (NOT benztropine).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
T/F: ASA should be started in the first 24 hours after tpa
False. ASA should be avoided in the first 24 hours until repeat non-con CT shows no bleeding. This applies to early enteral feeding and anticoagulants also
26
features of idiopathic intracranial hypertension
Usually young obese female. HA, visual sxs, diplopia and tinnitius. Can be pulsatile and worse by laying flat. Most important sign = papilledema, can lead rapidly to vison loss. Empty sella syndrome is commonly seen. LP demonstrating opening pressure elevation is dx. Tx = wt loss, acetazolamide.
27
tx of depression when life expectancy <4-6 weeks
Psychostimulants: Methylphenidate, dextroamphetamine, modafinil
28
features of phenytoin toxicity
Dose independent: gingival hyperplasia, folic acid deficiency, peripheral neuropathy, vit d def, drug-induced lupus, anticonvulsant hypersensitivity syndrome (rash, LN, fever, eosinophilia, elevated LFTS/CK) Dose dependent: rash, horizontal nystagmus, ataxia, slurred speech, lethargy IV infusion: hypotension, bradyarrythmias and asystole
29
main meds once MS confirmed
``` Either: -interferon beta (+ vit D) (CI in liver dz or depression) or -glatiramer acetate ``` steroids for acute flares, tx fever and underlying infx if present. normal immunization including annual influenza
30
Optic neuritis features
- Monocular vision loss - eye pain w/movement - Afferent Pupillary Defect (paradoxical dilation of pupil when light rapidly shifted to affected eye) - "washed out" color vision (colors look more dull)
31
what is clinically isolated syndrome (CIS)?
First episode of CNS dysf(x) caused by demyelination but doesn't have all features yet of MS
32
fatigue, diplopia, dysphagia and anterior mediastinal mass
Thymoma + Myasthenia Gravis
33
Anterior mediastinal mass
4 T's: - thymoma (most common) - teratoma - thyroid tumors (goiter) - Terrible lymphoma
34
Lambert Eaton myasthenic syndrome is associated with
small cell lung cancer
35
myelopathy after bariatric surgery or zinc supplementation
Copper deficiency (mimics vit b12 def)
36
vit b12 def sxs
``` paresthesias LE weakness gait instability -anemia can be absent -loss of MVP, sensory ataxia -check MMA and homocysteine for borderline vit b12 levels ```
37
what is the first manifestation of MG in most patients?
Ptosis or Diplopia
38
common precipitants of myasthenic crisis
``` Fluoroquinolones Beta blockers CCB Magnesium Aminoglycosides (gentamicin, tobramycin, amikacin) ```
39
how are Botulism and MG different?
Botulism: sluggish/non-reactive pupils MG: normal pupils ocular sxs also rare in LE
40
Dx of LE
detected of serum anti-voltage-gated calcium channel antibodies EMG: facilitation of motor response to rapid repetitive stimulation (diminished tendon reflexes that improve with repetitive movements of affected mm)
41
T/F: MG is associated with autoimmune thyroid disorders
True, look for elevated serum TSH
42
dementia with sparing of memory and visuospatial function (not getting lost)
Frontotemporal dementia (note: no drug is beneficial for FTD)
43
How do you slow decline of cognitive decline in Alzheimer patients?
Mild to moderate disease: Acetylcholinesterase inhibitors (donepezil, rivastigmine, galantamine...note they can have cholinergic side effects i.e. bardycarida, diarrhea, n/v, heart block, syncope) Moderate to advanced (MMSE 3-14): Memantine can also use ACHesterase inhibitors for Lewy Body Dementia, vascular dementia
44
T/F: Benzos are not recommended for tx of behavioral sxs in dementia patients
true atypical antipsychotics also carry black box warning for increasing mortality, used when patient safety is jeapordized
45
lobar hemorrhage in an older patient (>75)
usually Cerebral amyloid angiopathy (second most common cause of ICH) Tx similar to other ICH: - reverse anticoag - mannitol /hyperventilation/barbiturate coma to reduce ICP - IV nicardipine or labetalol for SBP between 140-160 if warfarin associated ICH, give IV vitamin K and PCC
46
when to use naltrexone and disulfuram in EtOH use disorder?
Naltrexone: FIRST LINE. Decreases cravings and heavy drinking, can be initiated in patients still drinking (CI is opioids and liver dz) Disulfiram: does not reduce cravings. reserved for abstinent patients highly motivated or taking medication in a supervised setting. it is SECOND-line
47
What is next step if you suspect SAH (worst HA of my life) but CT negative?
CSF exam to look for rbc or xanthochromia
48
T/F: Oral nimodipine is used for patients with SAH to prevent vasospasm and improve outcomes
True
49
T/F: Vertebral-basilar stroke can present as older patient with persistent, acute-onset vertigo
True
50
high risk features for TIA patient to be admitted
``` Age>60 Blood pressure >140/90 Weakness Duration >60 min Diabetes ```
51
blood pressure rules ofr tpa for ischemic stroke
CI if SBP >185 or DBP >110 Don't really tx BP in first 48 hours of ischemic stroke unless SBP >220, DBP >120 OR thrombolytic therapy planned and SBP >185 or DBP >110 Use IV Nicardipine or Labetolol
52
T/F: All stroke patients get 325mg asa
False. This is generally true but the exception = if thrombolysis (tpa) is planned
53
after what period is anticoag started post ischemic stroke
after 48 hours (this is also when DVT prophy is started if no cardiac etiology)
54
when is revascularization performed (endarterctomy or stenting) for stroke?
within 2 weeks (not right away)
55
T/F: Do not select heparin for most patients with ischemic stroke
true
56
Mgmt of trigeminal neuralgia (V2, V3 distribution unilateral pains, often by light touch
Obtain MRI to r/o intracranial lesions and MS Carbamazepine for tx
57
when would tx for HA = withdraw pain medications?
Medication overuse HA...chronic HA >10-15 days/mo with a bunch of HA or pain meds (and not migraine)
58
1st line for mild-moderate migraine
ASA or NSAIDS Triptan or dihydroergotamine used for severe acute migraines or poor response to first line tx Nasal/subq triptans for those present on awakening and associated with vomiting Triptans CI when CAD or CVD
59
Prophylactic medications for migraines:
``` Amitriptyline Metoprolol Propranolol Timolol Topiramate Valproic Acid Venlafaxine ``` watch out for things like lung disease (no BB) or pregnancy
60
T/F: Myasthenic Crisis you can use PLEX/IVIG + steroids, in GBS you don't use steroids
true! steroids can slow recovery times in GBS, just use PLEX or IVIG
61
T/F: Romberg and pronator drift tests assess cerebellar function
False. Romberg = proprioception (i.e. peripheral neuropathy) Pronator drift = cerebellar
62
general workup for patients with peripheral neuropathy
``` Blood glucose B12 TSH ANA RPR HbA1c ESR CBC SPEP (don't be fooled, find anemia and hypercalcemia) ```
63
tx for serotonin syndrome
DC agent + Cyproheptadine
64
what distinguishes NMS and SS?
NMS: Lead-pipe rigidity. Key finding is increased CK from muscle necrosis. Leukocytosis usually present. SS: Neuromuscular irritability (hyperreflexia, myoclonus) + GI sxs Both have autonomic instablility and AMS
65
Precipitating factors for NMS
-antipsychotics -antiemetics (metoclopramide, promethazine) -antiparkinson (dopamine agonist) medication withdrawal -infection surgery
66
tx of NMS
stop offending agent, restart dopamine agents if held, supportive care. Low evidence to support dantrolene/bromocriptine (not the first thing)
67
most common glaucoma
open-angle. 90% of cases. gradual painless loss of vision. Increased cup-to-disk ratio. -if papilledema, probably closed-angle
68
T/F: ALS = both UE and LE signs
False, it is both UMN and LMN signs. relative sensory sparing. asymmetric limb weakness (hand weak, foot drop) = most common presenting sx
69
T/F: Majority of people with REM sleep behavior disorder will develop Parkinsons or Lewy body dementia
True. Look for this plus excessive daytime somnolence, mood disturbance, anosmia, constipation as manifestations of Early Parkinson disease (prior to motor sx onset)
70
how do you distinguish MG ptosis from horner syndrome and bells palsy?
MG: spared pupillar response, vs in Horners not spared Involvement of extraocular muscles, palate helps distinguish from Bells (which is only CN 7)
71
if you suspect MG but AchR antibodies negative, whats the next test
Muscle-specific tyrosine kinase antibodies (MuSK) So first AchR, then MuSK. if still negative then EMG. don't choose edrophonium or ice pack test. Check TSH in all patients due to autoimmune thyroid abnormality. CT scan or MRI chest shoudl be performed once MG dx confirmed
72
Time course between acute stress disorder and PTSD
<30 days = acute stress disorder more than a month = PTSD
73
T/F: For RLS< supplement Iron when ferritin <75 and non pharm measures, in addition to dopaminergic agents
TRUE. non pharm measures = leg massage, warm/cold compress, sleep hygiene, regular exercise
74
MOCA and MMSE scoring
MMSE: >24 is normal, less is MCI/dementia | MoCA (montreal) :>25 is normal, and less is MCI/dementia
75
Tx of eating disorders
Anorexia: CBT, nutritional rehab; olanzapine if no response Bulimia: CBT, nutirtional rehab, SSRI (fluoextine) Binge eating: CBT, behavioral weight loss therapy, SSRI, lisdexamfetamine
76
complications of SAH
first 24 hour: rebleeding (prevent with angiogram with coiling/stenting aka endovascular) After 72 hours: vasospasm (nimodipine and hyperdynamic therapy)
77
Presentation of carotid artery dissection
- unilateral head/neck pain - transient vision loss - ipsilateral Horner syndrome (ptosis and miosis but usually no anhidrosis) - focal weakness
78
mgmt of carotid artery dissection
TPA if <4.5 hours, aspirin + anticoag because the blood in the different layers can clot and lead to embolic stroke
79
ICA dissection and Vertebral dissection
- ICA: after head/neck trauma. acute ipsilateral horner syndrome with cerebral ischemia (focal weakness), maybe aphasia - vertbral a dissection: thunderclap headache, wallenberg syndrome (ipsilateral horner, loss of sensation on contralateral face and body), nystagmus, ataxia, dysarthria
80
tx of cluster HA
- 100% oxygen - sumatriptan add on preventative tx: Verapamil (or lithium, topiramate)
81
what do you screen patients for while on second gen antipsychotics (clozapine, olanzapine)
metabolic syndrome i.e. glucose/lipis, BP, waist etc
82
T/F: Intracerebral hemorrhage will have focal neuro sxs early following by features of increased ICP (vomiting, HA, bradycardia, lethargy) vs SAH will have severe HA at onset, meningeal irritation without many focal neuro deficits
true
83
Does peripheral or central vertigo have more gait disturbance?
Central: Severe gait/postural disturbance, usually no hearing loss or tinnitus, other CNS sxs present Peripheral: Hearing loss/tinnitus may be present, walking preserved with minimal gait problems
84
T/F: Clonus and Crproheptadine go with Serotonin Syndrome
true

UWORLD ABIM (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions