Tulane Block II (HIGH YIELD)

Question 1

Absence (pettimal) seizure EEG pattern

Answer 1

3 Hertz spikes then a slow wave

Question 2

Atypical absence seizure EEG pattern

Answer 2

Slow spike and wave

Question 3

“Bicycling” with respect to seizures likely indicates what?

Answer 3

Frontal lobe seizure

Question 4

Juvenile Myoclonic Epilepsy classic presentation

Answer 4

Clumsiness, jerks the morning after alcohol intoxication + sleep deprivation

Question 5

Juvenile Myoclonic Epilepsy EEG pattern

Answer 5

4-5 Hertz spike and wave

Question 6

Define Ramsay Hunt Syndrome

Answer 6

Herpes Zoster infection + CN VII palsy; presents as herpes zoster + facial droop + lesions inside ear canal

Question 7

Charcot Marie Tooth disease features

Answer 7

High arches, hammer toes, champagne botttle legs

Question 8

Spinal muscular dystrophy genetics

Answer 8

Defective SMN1 gene

Question 9

What does mitoxantrone treat? Why isn’t it used anymore?

Answer 9

MS; horrible side effects (cardio, leukemia)

Question 10

Brain metastases’ most common primary cancers (adults)

Answer 10

Lungs > melanoma > RCC > breast > colon

Question 11

Brain metastases’ most common primary cancers (children)

Answer 11

Sarcomas > neuroblastoma > germ cell tumor

Question 12

Brain metastasis most likely to hemorrhage (by intrinsic qualities)

Answer 12

Melanoma

Question 13

Brain metastasis most likely to hemorrhage (by incidence)

Answer 13

Lung cancer

Question 14

Treatment options for brain metastases

Answer 14

Whole brain radiotherapy (or hippocampal avoidance), Stereotactic Radiosurgery

Question 15

Pilocytic astrocytoma imaging appearance

Answer 15

Cystic lesion with mural nodule

Question 16

Oligodendroglioma histologic findings

Answer 16

Fried egg, chickenwire appearance

Question 17

Oligodendroglioma mutation

Answer 17

1p/19q codeletion

Question 18

Ependymoma appearance on imaging

Answer 18

Sausage-shaped lesion in conus medullaris

Question 19

Prolactinoma presentation

Answer 19

Amenorrhea, lactation, infertility

Question 20

How to determine if a headache is a symptom secondary to a life-threatening pathology?

Answer 20

SNOOP *4 trouble:
Systemic signs
Neurologic symptoms
Onset
Old age (> 50 risk for temporal arteritis)
Papilledema
Positional/postural (intracranial HTN worsens with valsalva, lying down)
Progression/patterns

Question 21

Headache + focal neck pain + Horner’s

Answer 21

Think arterial dissection

Question 22

For every patient over 50 with headache you must…

Answer 22

Order ESR, CRP (check for temporal arteritis)