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.RoshReview > Sept '21 > Flashcards

Sept '21 Flashcards

1
Q

Which muscles do the motor fibers of the trigeminal nerve innervate?

A

muscles of mastication

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2
Q

What is the most frequent cause of stroke in patients <45 yo?

A

carotid artery dissection

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3
Q

carotid artery dissection symptoms

A

unilateral neck pain, or headache around the eye or frontal area. abrupt in onset.

partial ipsilateral horner syndrome without anhidrosis

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4
Q

vertebral artery dissection symptoms

A

marked occipital or posterior neck pain and may have FND, including facial numbness and CL pain and temp sensory loss

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5
Q

treatment of a pt with a brain abscess and signs of increased ICP?

A

surgical drainage

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6
Q

which type of vertigo is vertical nystagmus always associated with?

A

central vertigo

periph is associated with horizontal or horizontal rotatry nystagmus

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7
Q

afferent pupillary defect and loss of monocular partial or complete vision

A

optic neuritis

concern for MS, infection, autoimmune, methanol poisoning, B12 deficiency, diabetes

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8
Q

bilateral internuclear ophthalmoplegia is pathognomonic for

A

MS

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9
Q

what class of medications used to treat peripheral vertigo?

A

antihistamines

meclizine 25

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10
Q

abx for neonatal sepsis

A

ampicillin plus either gentamicin or cefotaxime

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11
Q

MC congenital heart defect

A

VSD

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12
Q

classic VSD murmur

A

holosystolic and best heard at left lower sternal border

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13
Q

fixed split S2 and a loud S1

A

ASD

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14
Q

when is vasospasm most common after a subarachnoid hemorrhage?

A

2 to 21 days

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15
Q

Marcus Gunn pupil

A

afferent pupillary defect

bilateral pupil constriction when shining light in the unaffected eye but pupil dilation when light shines in the affected eye

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16
Q

How will a pt with MG respond to edrophonium chloride testing if she is having a cholinergic crisis?

A

muscle fasciculations, cholinergic symptoms, and respiratory depression will occur within a few minutes

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17
Q

acute spinal cord disorder characterized by paraplegia, a transverse level of sensory impairment, and sphincter disturbance

A

transverse myelitis

sometimes noted to follow a viral infection, aka post infectious myelitis

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18
Q

Where does syringomyelia most often occur?

A

cervical spine

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19
Q

causes of transverse myelitis

A

viral, autoimmune, idopathic

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20
Q

fluctuating headache with seizure activity should prompt clinician to consider

A

cerebral venous thrombosis

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21
Q

How are migraine headaches affected by pregnancy

A

vastly improve in most women

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22
Q

first line treatment for chemoprophylaxis for exposure to bacterial meningitis?

A

rifampin, with cipro as alternative

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23
Q

what is the name of the toxin associated with tick paralysis?

A

ixobotoxin

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24
Q

What is the Miller fisher variant of GBS?

A

affects eye muscles and presents with triad of ophthalmoplegia, ataxia, and areflexia

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25
Q

which anatomical location does ALS involve?

A

anterior horn cells

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26
Q

MCC of chronic stridor in infants?

A

vocal cord paralysis

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27
Q

torus fracture

A

buckle fx

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28
Q

Triangular metaphyseal fragment in the mataphysis from a salter harris type II fx

A

Thurstan Holland sign

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29
Q

which anatomical regions of the brain does infectious encephalitis have a predilection for?

A

gray matter of the temporal lobes and inferior frontal lobe

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30
Q

how long until the onset of action of penobarbital?

A

onset is 15-30 min

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31
Q

What is the MC aura associated with migraines?

A

visual - scintillating scotomas or flashing lights

32
Q

meningitis suspected, AMS, what is the order of tx?

A

dexamethasone, empiric abx, CT head, LP

33
Q

most reliable physical exam finding in patients with meningitis?

A

jolt accentuation - baseline headache increases when the patient turns the head horizontally two or three rotations per second

34
Q

MC location for pediatric pseudosubluxation?

A

C2 on C3

35
Q

how do you correct for pseudosubluxation during radiography?

A

pt placed in cervical extension

36
Q

How long do you monitor a pt with TCA overdose?

A

until ECG normal for 12-24 hours

37
Q

kid with status asthmaticus, not responding to initial therapies, next line?

A

IV mag sulfate

smooth muscle relaxant, acting on Ca channels to competitively block calcium influx and promote bronchodilation

38
Q

CSF findings suggestive of MS?

A

pleocytosis, elevated gamma globulin, oligoclonal banding

39
Q

How many g/dL of deoxygenated blood is classically required before cyanosis is apparent?

A

5g/dL

40
Q

classic EKG findings in tetralogy of Fallot?

A

RV hypertrophy (dominant R wave in the right precordium) and right axis deviation

41
Q

AMS, cerebral edema, hepatic dysfunction in a kid that has had a viral syndrome

A

Reye Syndrome from aspirin

progressive encephalopathty with hepatic dysfunction

42
Q

What are three substances that contain salicylates?

A

aspirin, bismuth subsalicylate, and oil of wintergreen (methyl salicylate)

43
Q

URI prodrome, then high fever, inspiratory and expiratory stridor in kid

A

bacterial tracheitis

44
Q

test for exogenous v endogenous insulin

A

c- peptide level

low in patients taking exogenous insulin

45
Q

encephalitis v meningitits

A

AMS and FND is more likely encephalitis

46
Q

in kids under 8 what is the most common fx of the elbow?

A

supracondylar fx, usually due to a FOOSH

47
Q

What division of the median nerve is damaged in supracondylar elbow fx and how do you test for it?

A

anterior interosseous

make the OK sign/strength

48
Q

what happens with instillation of cold water into ear of comatose pt?

A

tonic deviation toward the ear with cold water inserted

49
Q

clusters of myoclonic seizures, hypsarrhythmia on EEG, and developmental delay, onset 4-8 months old

A

West syndroma/infantile spasms

50
Q

less than 5 yo and painless rectal bleeding

A

meckels diverticulum

51
Q

abx for brain abscess from sinus or oral source?

A

IV metronidazole + ceftriaxone or cefotaxime, +/- vanc

52
Q

what renal disorder puts patient at higher risk of cerebral aneurysm/SAH?

A

autosomal dominant polycystic kidney disease

53
Q

BP goal for SAH

A

140-160

54
Q

MC tumor of cerebellopontine angle?

A

vestibular schwannoma

55
Q

MC tumor of the CNS

A

meningioma

56
Q

how long should facial sutures in children be left in place?

A

3-5 days

57
Q

MCC of congenital hydrocephalus?

A

aqueductal stenosis

58
Q

pt with fatigue, diplopia, and asymmetric paresthesias and weakness after heat exposure

A

Multiple sclerosis

59
Q

correct formula to calculate systolic hypotension in children?

A

70 + (age x2) is the lower limit of normal BP for children aged 1 to 10 years

60
Q

What CSF opening pressure is diagnostic for idiopathic intracranial HTN?

A

250 mm H2O or 25 cm H2O

61
Q

Most sensitive lab test for spinal epidural abscess?

A

ESR

62
Q

combination of acute HTN and endothelial dysfunction resulting in bilateral symmetric vasogenic edema

A

posterior reversible encephalopathy syndrome (PRES)

63
Q

which antihypertensivese agents are recommended in the treatment of PRES

A

labetalol or nicardipine

64
Q

MC sign of a CNS tumor in infants and young children?

A

macrocephaly

65
Q

type of tracheoesophageal fistula that usually presents after the newborn period

A

an H type tracheoesophageal fistula

66
Q

when should children with umbilical hernia be referred to a pediatric surgeon

A

at 2 yo or sooner if symptomatic

67
Q

at what blood pressure should antihypertensives be given prior to the administration of tPA?

A

185/110 mmHg

68
Q

VP shunt overdraining and associated headaches

A

slit ventricle syndrome

69
Q

symptoms most sensitive for VP shunt failure?

A

nausea, vomiting, and decreased LOC

70
Q

high RDW is common in what type of anemia

A

fe deficiency

71
Q

what diseases should be considered when a patient has thrombocytopenia associated with anemia?

A

HUS and TTP

72
Q

IV lorazepam or diazepam for seizure and why?

A

lorazepam, shorter time to peak effect and significantly longer effective duration of action

73
Q

best benzo for seizure if no IV access?

A

IM midazolam

74
Q

tx of akathisia?

A

antihistamine, like benadryl

75
Q

tx for transverse myelitis?

A

IV glucocorticoids

.RoshReview (11 decks)

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