USMLEasy

Question 0

Wallenberg syndrome – AKA? Symptoms?

Answer 0

#Lateral medulla (ipsilateral ataxia)
#Descending tract of CN5 (ipsilateral loss of facial pain and temperature)
#Nucleus ambiguous damage (motor CN 9&10 - dysphasia and dysphonia)
#Ipsilateral Horner's syndrome

Question 1

Toxins that leads to parkinsonian syndrome? Treatment that will not work?

Answer 1

#Manganese
#Phenothiazines
#Metoclopramide (reglan)
#Butyrophenones

L-dopa

Question 2

Drugs that cause toxic labyrinthitis?

Answer 2

#Salicylates
#Alcohol
#Quinine
#Aminoglycosides

Question 3

Weakness of eye abduction bilaterally usually indicates?

Answer 3

Increased ICP (false localizing sign)

Question 4

Effect of tumor on funduscopic exam?

Answer 4

Blurring of the margins of the optic disc

Question 5

Transcortical motor aphasia (versus Broca’s aphasia)?

Answer 5

Preserved repetition

Question 6

Gradenigo syndrome – symptoms? due to? Associated with?

Answer 6

#Unilateral facial pain
#Blurry vision
#Deficit of CN 6

Osteomyelitis of the petrous pyramid

Abducens and trigeminal nerves are affected as they pass close to the tip of the petrous bone

Chronic ear infections

Question 7

Gelastic seizures? Typical cause? Other symptoms?

Answer 7

Uncontrollable laughter prior to seizures; hypothalamic hamartomas

Precocious puberty/acromegaly

Question 8

Eye pathology with preserved visual acuity excludes?

Answer 8

#Optic neuritis 
#Cavernous sinus thrombosis

Question 9

Epilepsia partialis continua?

Answer 9

Essentially, a focal motor status epilepticus (although alert and able to follow commands)

Question 10

Patient can acquire the transmissible form of CJD via?

Answer 10

#Growth hormone preparations
#Eating human brains

Question 11

Neurologic effects of carbon monoxide poisoning? Occurs when?

Answer 11

Extrapyramidal disorder with Parkinsonian gait and bradykinesia

1-3 weeks after exposure

Question 12

Rapid infusion of this antiepileptic may produce a cardiac arrhythmia?

Answer 12

Phenytoin

Question 13

Pathology that can mimic ALS? (Caused by?)

Answer 13

Cervical myelopathy (cervical spondylosis or midline disc extrusion)

Question 14

Long-standing hepatic disease causes what changes in brain tissue?

Answer 14

Increases in Alzheimer type 2 astrocytes

Question 15

Brain lesion Sturge-Weber?

Answer 15

Leptomeningeal angioma

Question 16

When will a CT fail to show a hematoma?

Answer 16

In subacute lesions (after a few days, hematoma contents become less dense, and maybe difficult to distinguish)

Question 17

Nonsurgical management of meningioma?

Answer 17

#Serial CT scans 
#Ventriculoperitoneal shunting if hydrocephalus
#Phenytoin if seizures occur 
(Radiation ineffective)

Question 18

Do not use this anticonvulsant in acute settings?

Answer 18

Lamotrigine – must be slowly titrated over weeks

Question 19

Artery of Adamkiewicz supplies?

Answer 19

Anterior median spinal artery

T10 - L1

Question 20

Child presents with decreased cognitive function and an increase in gamma globulin fraction – suspected diagnosis? CSF will also show?

Answer 20

Subacute sclerosing panencephalitis

Oligoclonal bands

Question 21

Patient with motor loss to face, arm, leg – location of lesion?

Patient with loss of sensation to face, arm, leg – location of lesion?

Answer 21

Internal capsule

Thalamus

Question 22

Symptoms of vestibular schwannoma?

Answer 22

#Unsteadiness
#Tinnitus
#Hearing loss

Question 24

Pathognomonic neurological symptom for Whipples disease?

Answer 24

Oculomasticatory myorhythmia (pendular convergence movements of the eyes in association with contractions of the masticatory muscles)

Question 25

Anti-spasmodic agents used in MS?

Answer 25

# baclofen
#Benzodiazepine

Question 26

Rett syndrome – typically affects? Symptoms?

Answer 26

Two-year-old girls

#Loss of acquired language skills
#Odd hand movements

Question 27

Patient from the tropics presents with subacute developing paraparesis – suspected diagnosis? Pathogenesis?

Answer 27

S. mansoni – fluke deposits eggs at the veins of Baston, which drain the intestines and communicate with the drainage from the lumbosacral spinal cord. Granulomas developed in the spinal area crushing the cord.

Question 28

Paraneoplastic neurologic syndromes?

Answer 28

#Lambert-Eaton
#Dermatomyositis

Question 29

Basilar vs classic migraine?

Answer 29

More severe neurologic deficits ( blindness instead of photophobia; psychosis instead of irritability; quadriplegia instead of mild hemiparesis)

Question 30

Tension headache also associated with?

Answer 30

Neck spasm leading to reduced the range of motion and paracervical tenderness

Question 31

Spongiform encephalopathy – symptoms? MRI findings? EEG findings?

Answer 31

#Dementia
#Tremor
#Ataxia
#Myoclonus

Subtle increase in T2 signal in basal ganglia

Periodic sharp-wave discharges that occur repetitively at one second intervals

Question 35

Treatment for restless leg syndrome?

Answer 35

#Gabapentin
#L-dopa/dopamine agonists
#Clonazepam/Opiates

Question 36

CSF abnormality in GBS?

Answer 36

Elevated protein ( reflects degree of inflammatory activity)