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Neuro Shelf > USMLEWorld > Flashcards

USMLEWorld Flashcards

1
Q

Status epilepticus (>5 mins) –> what type of brain damage?

A

Cortical laminar necrosis

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2
Q

Lambert-Eaton = antibodies against

A

voltage-gated calcium channels in the presynaptic motor nerve terminal

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3
Q

Tx Lambert-Eaton

A

Plasmapheresis and immunosuppressants

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4
Q

Benign suprasella tumor that usually p/w signs of hypopit, headaches, and bitemporal blindness

A

craniopharyngioma

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5
Q

Tx Acute exacerbation of MS

A

Methylprednisolone (high dose IV steroids)

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6
Q

Tx acute MS exacerbation that doesn’t respond to steroids

A

plasma exchange

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7
Q

first seizure workup

A

CBC, electrolytes, EKG, urine toxicology, brain CT without contrast

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8
Q

anticholinergic med sometimes used in the tx of PD, generally in younger pts where tremor is the primary symptom

A

Trihexyphenidyl

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9
Q

bilateral trigeminal neuralgia?

A

MS

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10
Q

Do CEA in pts with carotid artery stenoses of …

A

60-99%, esp men > 80%

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11
Q

tx spinal cord compression

A

emergency MRI, IV glucocoricoids, neurosurg consult

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12
Q

spinal shock

A

absence of reflexes, flaccid paraplegia

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13
Q

acute onset eye pain, photophobia, and mid-dilated pupil =

A

glaucoma

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14
Q

dx acute glacuoma

A

tonometry

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15
Q

pronator drift =

A

UMN dz

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16
Q

DOC trigeminal neuralgia

A

Carbamazepine

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17
Q

first step w/ ? stroke

A

Non-contrast CT head

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18
Q

unilateral motor weakness of face, arm, and leg on same side

A

posterior limb of internal capsule

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19
Q

contralateral hemiplegia + ipsilateral cranial nerve

A

vertebrobasilar system supplying brainstem

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20
Q

areflexic weakness in UE + anesthesia in a cape distribution

A

syringomyelia

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21
Q

Rapidly progressive ascending paralysis (over hours), absence of fever and sensory abnormalities, normal CSF

A

tic-borne paralysis

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22
Q

ascending symmetrical paralysis over days to weeks, with normal to mildly abnormal sensation, plus autonomic dysfunction, plus albuminocytologic dissociation (high protein with few cells in CSF)

A

GBS

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23
Q

Tx GBS

A

IVIG or plasmapheresis

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24
Q

T2-weighted MRI shows multifocal ovoid subcortical white matter lesions

A

MS

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25
Q

hemorrhage are seen as WHAT on CT

A

hyperdense (white) areas

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26
Q

infarcts are seen as WHAT on CT

A

hypodense (black) areas

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27
Q

Prevent vasospasm post SAH with

A

nimodipine

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28
Q

internuclear opthalmoplegia is a lesion in the

A

MLF

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29
Q

Tx cluster headache

A

100% oxygen

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30
Q

Dx MS

A

MRI

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31
Q

Dx GBS

A

LP: nl WBC (<10), elevated protein

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32
Q

Dx HSV encephalitis

A

CSF w/ lymphocytic pleocytosis, inc RBC, elevated protein, HSV PCR +

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33
Q

sites of spontaneous intracranial hemorrhage

A

basal ganglia, thalamus, pons, cerebellum, lobar

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34
Q

cerebral hemorrhage causes what defects?

A

motor defects opposite the site of the lesion but gaze deviation toward the side of the lesion

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35
Q

CJD on EEG?

A

sharp, triphasic, synchronous discharges on EEG

36
Q

Dx acoustic neuroma

A

MRI w/ contrast

37
Q

ipsilateral ataxia, nystagmus, intention tremor, loss of coordination, fall TOWARDs the lesion

A

cerebellar tumor

38
Q

type of damage in diabetic mononeuropathy

A

ischemic

39
Q

type of nerve fibers damaged in diabetic mononeuropathy

A

only somatic, not parasympathetic

40
Q

ptosis and a down and out gaze with normal light and accommodation reflexes

A

diabetic CNIII neuropathy

41
Q

SE sinemet

A

somnolence, confusion, hallucinations, dyskinesia

42
Q

SE trihexyphenidyl or benztropine

A

dry mouth, blurred vision, constipation, nausea, urinary retention

43
Q

SE amantadine

A

ankle edema and lived reticularis

44
Q

SE apomorphine, crompocriptine, pramipexole, ropinirole

A

somnolence, hypotension, confusion, hallucinations

45
Q

SE entacapone, tolcapone

A

dyskinesia, hallucinations, confusion, nausea, orthostatic hypotension

46
Q

SE selegine

A

insomnia, confusino

47
Q

mech sinemet

A

dopamine precursor

48
Q

mech trihexyphenidyl, benztropine

A

anticholinergic

49
Q

mech amantadine

A

unclear

50
Q

mech apomorphine, bromocriptine, pramipexole, ropinirole

A

dopamine agonist

51
Q

mech entacapone, tolcapone

A

COMT inhibitor

52
Q

mech selegiline

A

MAO B inhibitor

53
Q

apraxia is due to a lesion in the

A

dominant supplementary motor cortex

54
Q

most frequent precipitant of GBS

A

campylobacter

55
Q

multiple non-enhancing lesions with no mass effect on CT in HIV+ pt

A

Progressive multifocal leukoencephalopathy

56
Q

multiple, spherical ring enhancing lesions in the basal ganglia in HIV+ pt

A

toxo, not in person on bactrim

57
Q

solitary, weakly ring-enhancing periventricular lesion in HIV+ pt, +EBV DNA in CSF

A

primary CNS lymphoma

58
Q

cortical and subcortical atrophy and secondary ventricular enlargement in HIV+ pt

A

AIDS dementia complex

59
Q

occurs many years after antecedent measles infxn. CT shows scarring and atrophy

A

Subacute sclerosing panencephalitis

60
Q

ataxia, right-sided facial weakness, and eyes to left

A

cerebellar hemorrhage

61
Q

hemisensory loss, homonymous hemianopia, stupor coma, eyes away

A

putamen hemorrhage

62
Q

glutatmate inhibitor for ALS

A

riluzole

63
Q

SE riluzole

A

weight loss, elevates liver enzymes, skeletal weakness

64
Q

ACA stroke

A

weakness in lower leg > weakness in upper leg

65
Q

left hemi-neglect

A

right parietal

66
Q

DOC RLS

A

pramipexole (dopamine agonist)

67
Q

Alpha-2-delta calcium channel ligand

A

gabapentin

68
Q

tx pseudotumor

A

weight reduction and acetazolamide +/- furosemide plus possible shunting of optic nerve sheath fenestration

69
Q

most common site of median nerve entrapment

A

wrist

70
Q

lacunar strokes are due to

A

microatheroma and lipohyalinosis in small penetrating arteries of the brain

71
Q

drugs to decrease frequency of exacerbations in pts with relapsing-remitting or secondary progressive MS

A

beta-interferon or glatiramer acetate

72
Q

lacunar infart in the posterior limb of the internal capsule

A

pure motor hemiparesis

73
Q

stroke in the VPL of the thalamus

A

pure sensory stroke

74
Q

lacunar infarction in the anterior limb of the internal capsule

A

ataxic-hemiparesis

75
Q

lacunar stroke at the basis pontis

A

dysarthria-clumsy hand syndrome

76
Q

what medication decreases the freq of relapse and may slow the long-term progression of relapsing-remitting MS?

A

interferon-beta

77
Q

DOC myasthenia gravis

A

Pyridostigmine (anticholinesterase)

78
Q

steppage gait = foot drop

A

neuropathy, L5 radiculopathy, traumatic damage to the common peroneal

79
Q

loss of pain and temperature over ipsilateral face and contralateral body, ipsilateral bulbar muscle weakness, vestibulocerebellar impairment, and Horner’s sydnrome

A

PICA infarct = Lateral medullary infarct

80
Q

three types of anti emetics that can be used for migraines

A

chlorpromazine, prochlorperazine, metoclopramide

81
Q

hemisensory loss with severe dysesthesia of the affected area

A

thalamic stroke

82
Q

unilateral eye pain, redness, and a dilated pupil with poor light response

A

acute angle closure glaucoma

83
Q

rupture of bridging veins –>

A

subdural

84
Q

rupture of middle meningeal artery

A

epidural

85
Q

alterations in alertness, visual hallucinations, extrapyramidal symptoms

A

Lewy body dementia

86
Q

most common site of ulnar nerve entrapment

A

elbow where ulnar nerve lies at the medial epicondylar groove

87
Q

fasiculations =

A

LMN

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