USMLE questions Flashcards
Medication that slows progression of relapsing-remitting MS?
IFN-beta
Underlying pathology of lacunar infarcts?
Combination of microatheroma and lipohyalinosis
Are lacunar infarcts often embolic?
NO
Most common site for lacunar infarct?
Posterior limb of the internal capsule, producing purely motor stroke (corticospinal, corticobulbar fibers)
Organism most commonly causing spinal epidural abscess?
Staph aureus
Typical features of cerebellar degeneration?
Progressive gait dysfunction, truncal ataxia, nystagmus, intention tremor or dysmetria, impaired rapid alternating movements (dysdiadochokinesia)
Organisms most commonly responsible for brain abscess 2/2 sinus infection?
Aerobic and anaerobic streptococci (60-70%), Bacteroides (anearobes, 20-40%)
Lambert-Eaton Syndrome: clinical presentation
often seen in SCLC, antibodies to pre-synaptic voltage-gated Ca++ channels, proximal muscle weakness and malaise; tx w/plasmapheresis and immunosuppressive therapy
Trihexylphenidyl….what?
antimuscarinic anti-Parkinsonian agent, classic sx are “red as a beet, dry as a bone, hot as a hare, blind as a bat, mad as a hatter, full as a flask” + HA, confusion, dizziness, tachycardia
Trihexylphenidyl can precipitate what?
Acute angle closure glaucoma
Patients who are anti coagulated and present with severe intracranial bleeding should be given what?
Fresh frozen plasma (FFP), target INR <1.5
Classical presentation of multi-system atrophy (Shy-Drager Syndrome)
- Parkinsonism
- Autonomic dysfunction (postural hypotension, abnormal swelling, bowel/bladder dysfunction, salivation or lacrimation, impotence, gastroparesis)
- Widespread neurological signs (cerebellar, pyramidal, LMN)
EEG pattern in CJD?
Periodic synchronous bi- or triphasic sharp wave complexes
Metoclopramide - what is it, and what is a common side effect?
Dopamine receptor antagonist used to treat nausea, vomiting, and gastroparesis; can cause dystonia
Steppage gait is due to…
L5 radiculopathy
Primidone is?
anticonvulsant that converts into phenylethylmalonamide and phenobarbital, may precipitate AIP (abdominal pain, neurologic and psychiatric abnormalities)
Intracranial HTN - symptoms
Diffuse headaches (worse in morning), n/v early in day, vision changes, papilledema, CN deficits, somnolence, confusion, unsteadiness, Cushing’s reflex (HTN and bradycardia) – requires CT/MRI
Heat stroke: definition
Core temp >40 deg C (>104), AMS
Treatment of restless leg syndrome?
Dopamine agonists (eg pramipexole)
Myasthenia gravis - imaging study to check?
CT of chest to r/o thymoma
Migraine headache - best initial treatment?
Anti-emetic (eg prochlorperazine)
Initial treatment of heat stroke
Rehydration and evaporative cooling
Patients in status epilepticus are at risk for developing what?
Cortical necrosis
Definition of status epilepticus
Any single seizure lasting >5min or a cluster of seizures w/patient not recovering mental status in between
most common site for ulnar nerve compression
elbow
Neurologic sx of hypokalemia
flaccid paralysis, hyporeflexia, tetany, weakness, fatigue, muscle cramps
Bilateral trigeminal neuralgia: dx correlate
MS
Riluzole
glutamate inhibitor approved for use in pt with ALS
