Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ABIM IM Recert > UWorld Neurology > Flashcards

UWorld Neurology Flashcards

1
Q

Does hypercapnia typically cause nausea and vomiting?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Does a cerebellar hemorrhage typically cause vomiting?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the Cushing reflex?

A
  • Hypertension
  • Bradycardia
  • Chene-Strokes breathing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Does middle cerebral artery occlusion cause extensor posturing?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Do patients with enteroviral meningitis typically have altered mental status?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Patient presents with hypertension and acute to subacute onset of severe headache (thunderclap), hemiparesis, seizures, altered mentation, and visual impairment A brain MRI commonly shows evidence of symmetrical hyperintense T2IFLAIR signal abnormalities predominantly in the subcortical white matter of posterior parieto-occipital lobes suggestive of vasogenic edema.

Diagnosis?

A

Posterior reversible encephalopathy syndrome
(PRES)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Should propranolol be used as a migraine prophylaxis medication in a patient with asthma?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Does topiramate or valproic acid have a better side effect profile as a migraine prophylactic therapy?

A

Topiramate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the name for alternating oculomotor hemiplegia?

A

Weber’s syndrome (brainstem stroke syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Patient has findings of a complete non-pupil-sparing third nerve palsy (fascicle of third cranial nerve) which is the highest cranial nerve involved in this case in addition to
contralateral cogwheel rigidity (substantia nigra pars compacts), lower facial weakness (corticobulbar tracts in the cerebral peduncle), and hemiplegia (corticospinal tracts in the cerebral peduncle). Symptoms include headache, vertigo, diplopia, hiccups, nausea, and vomiting.

Diagnosis?

A

Brainstem stroke at the level of the midbrain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Patient presents with numbness of the ipsilateral face (trigeminal nucleus caudalis), contralateral body (spinal lemniscus), Horner’s syndrome (descending sympathetics), decreased gag and cough reflexes (nucleus ambiguus), nystagmus (vestibular nuclei), and ipsilateral ataxia (inferior cerebellar peduncle) without any motor symptoms.

Diagnosis?

A

Lateral medullary syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Patient presents with ipsilateral tongue deviation, contralateral sensory symptoms, and hemiparesis.

Diagnosis?

A

Medial medullary syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Does a cortical stroke usually lead to cogwheel rigidity or cranial nerve dysfunction (e.g., diplopia, nystagmus, etc)?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Is autosomal dominant polycystic kidney disease associated with intracranial hemorrhage?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Is low-grade fever common with intracranial hemorrhage?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which drug speeds recovery of neurological function in patients with minimal consciousness resulting from traumatic brain injury when applied 4 weeks after initial injury?

A

Amantadine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Does hyperbaric oxygen therapy improve neurologic function?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the best treatment for myasthenia crisis?

A
  • Plasma exchange
  • IV immunoglobulin + high dose glucocorticoids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Young woman presents was a chronic pulsatile and holocranial headache worsened by lying flat and ameliorated by sitting up.

Diagnosis?

A

Idiopathic intracranial hypertension (Le., pseudotumor cerebri)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Patient presents with a progressive dementia over 2- 3 years with prominent dysautonomia, frequent falls and parkinsonism.

Diagnosis?

A

Multiple system atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Patients typically present with complaints of pain, numbness, dysesthesias, or loss of reflexes (sensory and motor symptoms). Some patients may initially present with foot drop (steppage or foot-slapping gait) or wrist drop.

Diagnosis?

A

Mononeuritis multiplex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Do patients with amyotrophic lateral sclerosis have sensory symptoms?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What should be done in case of patients with an initial negative HSV PCR but high clinical suspicion for Herpes simplex encephalitis?

A

Repeat lumbar puncture for an HSV PCR (and continue the acyclovir)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How long do you give IV acyclovir for in herpes simplex encephalitis?

A

14 - 21 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Lambert-Eaton myasthenic syndrome (LEMS) is a paraneoplastic syndrome associated with which condition?

A

Small-cell lung cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What confirms the diagnosis of Lambert-Eaton myasthenic syndrome (LEMS)?

A

Voltage-gated calcium channel antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What serologies diagnose myasthenia gravis?

A

Acetylcholine receptor and muscle-specific tyrosine kinase receptor antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What else should be ordered in all patients with myasthenia gravis?

A
  • TSH
  • CT chest (look for thymoma)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What test do you do first if you think a patient is brain dead?

A

Bedside apnea testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the treatment of hospital acquired bacterial meningitis?

A

Cefepime (or meropenem or ceftazidime) and vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Does piperacillin/tazobactam have CNS penetration?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Toxicity of which medication results in the following physical examination?

A narrow-based, unsteady gait with poor balance. Speech slightly slurred. The patient has horizontal nystagmus and poor coordination with rapid alternating movements and finger-to-nose maneuvers bilaterally. Strength and sensation are intact.

A

Phenytoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Do neurologic symptoms recover with post-cardiac arrest hypothermia?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Permissive hypercapnia is contraindicated in neurologic injury.

True or false?

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What imaging study should patients presenting with a pupil-sparing third nerve palsy and most certainly those with a non—pupil-sparing third nerve palsy get?

A

MR or CT angiography of the head to rule out an aneurismal compression of the third nerve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Are patients with a history of intracranial hemorrhage candidates for intravenous tPA therapy for acute stroke?

A

No

37
Q

What medication should be given to all stroke patients within 24 hours if they are not candidates for tPA?

A

Aspirin

38
Q

Are aphasia and weakness typically seen in vertebral artery dissections?

A

No

39
Q

In HSV encephalitis - should the lumbar puncture to confirm diagnosis be done first or should you just give empiric IV acyclovir?

A

IV acyclovir

40
Q

Patient with a basal ganglia stroke is at highest risk of developing what in the future?

A

More strokes and then vascular dementia

41
Q

Do cortical strokes or subcortical strokes increase the risk of seizures?

A

Cortical strokes

42
Q

What is the risk of developing seizures in case of a cortical stroke?

A

5 - 10%

43
Q

Patient with frequent falls presents with insidious onset of more global deficits than focal neurologic deficits. These include headaches, lightheadedness, cognitive impairment, personality changes, and somnolence. Symptoms are fluctuating.

Diagnosis?

A

Chronic subdural hematoma

44
Q

Encephalitis associated with acute asymmetric flaccid paralysis or extrapyramidal symptoms is highly suggestive of which condition?

A

West Nile virus infection

45
Q

Patient with prior history of paralytic polio presents with progressive weakness, fatigue, and muscle or joint pain. There is no fever, mental status changes, headache, or seizures.

Diagnosis?

A

Post-polio syndrome

46
Q

What type of headache involves the eye and causes severe throbbing or stabbing pain with lacrimation?

A

Cluster headache

47
Q

What is the first line treatment for cluster headache?

A
  • Oxygen (100%)
  • Sumatriptan
48
Q

Is closure of a patent foramen ovale superior to medical therapy alone in preventing stroke?

A

No

49
Q

What imaging study should be done if central vertigo is suspected?

A

MRI brain (to look for acute causes such as stroke)

50
Q

Patient presents with jaw claudication followed by vision loss.

Diagnosis?

A

Giant cell arteritis

51
Q

What is the treatment of giant cell arteritis?

A

Steroids

52
Q

What is the confirmatory test for giant cell arteritis?

A

Temporal artery biopsy

53
Q

Which medication can be added to carbidopa/levodopa for the treatment of parkinsonian tremors?

A

Anticholinergic agent (triheryphenidyl)

54
Q

Which drug is indicated to treat levodopa-induced dyskinesias and rigidity in patients with Parkinson disease?

A

Amantadine

55
Q

What is done for persistent tremor in Parkinson’s disease patients who fail medical therapy?

A

Deep brain stimulation

56
Q

Are hypertensive hemorrhages more commonly in the cortical or subcortical areas of the brain?

A

Subcortical

57
Q

Are cerebral amyloid angiopathy related hemorrhages more commonly in the cortical or subcortical areas of the brain?

A

Cortical

58
Q

What is the treatment of idiopathic intracranial hypertension?

A

Acetazolamide and weight loss

59
Q

Patient presents with foot drop and paresthesias of the dorsum of the foot; along with normal reflexes and foot inversion.

Diagnosis?

A

Peroneal neuropathy (injury at fibular head)

60
Q

What is the treatment for obsessive-compulsive disorder?

A
  • High-dose selective serotonin reuptake inhibitor
  • Cognitive behavioral therapy
61
Q

What is the treatment for borderline personality disorder?

A

Dialectical behavioral therapy

62
Q

Patient presents with cognitive dysfunction, gait difficulty and urinary incontinence.

Diagnosis?

A

Normal-pressure hydrocephalus

63
Q

Which patients have aphasia or apraxia - Alzheimer’s dementia or normal-pressure hydrocephalus?

A

Alzheimer’s dementia

64
Q

Woman presents with throbbing head pain (usually from 10 minutes to 2 hours) that is episodic, unilateral without radiation, and associated with autonomic symptoms (ipsilateral lacrimation, conjunctival injection, and miosis). Improvement of the headache after an indomethacin trial (necessary to confirm diagnosis).

Diagnosis?

A

Paroxysmal hemicrania

65
Q

Man presents with unilateral sharp head pain with associated autonomic symptoms. The pain usually lasts 20 minutes to 3 hours and improves with high-flow oxygen or subcutaneous sumatriptan.

Diagnosis?

A

Cluster headaches

66
Q

What test is done to diagnose Guillain-Barre syndrome?

A

Lumbar puncture

67
Q

What is the treatment of mild carpal tunnel syndrome?

A

Nocturnal wrist splint or steroid injection

68
Q

What is the treatment of severe carpal tunnel syndrome (EMG changes)?

A

Surgical decompression

69
Q

What is the first thing to do to prevent rebleeding in a subarachnoid hemorrhage?

A

Endovascular coiling or stenting of aneurysm

70
Q

When does vasospasm occur in subarachnoid hemorrhage?

A

Day 3

71
Q

What drug reduces vasospasm in subarachnoid hemorrhage?

A

Nimodipine

72
Q

Patient has the following findings: T2-weighted magnetic resonance images show multifocal ovoid subcortical white matter lesions located in periventricular, juxtacortical, infratentorial, or spinal cord areas.

What’s the most likely diagnosis?

A

Multiple sclerosis

73
Q

Patient presents with neurologic symptoms. Cerebrospinal fluid analysis shows normal pressure and fluid studies; and the presence of oligoclonal IgG bands.

Diagnosis?

A

Multiple sclerosis

74
Q

Which condition often presents with upper motor neuron signs in the lower extremities and lower motor neuron signs in the upper extremities?

A

Cervical spondylotic myelopathy

75
Q

Does essential tremor usually get worse or better at the end of goal-directed movements?

A

Worse

76
Q

Which syndrome of severe motor restlessness can occur in patients taking neuroleptics or selective serotonin reuptake inhibitors?

A

Akathisia

77
Q

What’s the treatment of akathisia?

A

Cautiously reducing the dose of antipsychotic; if cannot be reduced then adding benzodiazepines.

78
Q

Does akathisia improve with movement?

A

No

79
Q

Does restless legs syndrome improve with movement?

A

Yes

80
Q

Patient presents with unilateral, severe, and episodic sharp pain involving the facial muscles of the cheek and jaw.

Diagnosis?

A

Trigeminal neuralgia

81
Q

What is the next step in high-risk trigeminal neuralgia patients (e.g., bilateral disease, age < 40, sensory
symptoms)?

A

MRI brain to rule out demyelinating disease or secondary causes

82
Q

What is the treatment of classic (idiopathic) trigeminal neuralgia?

A

Carbamazepine

83
Q

Brachial plexopathy presents with more severe pain at symptom onset, involves the lower plexus, and is associated with Horner’s syndrome - is it cancer-induced or radiation-induced?

A

Cancer-induced

84
Q

Patients typically present with acute, painless, and severe vision loss in one eye. There is generally a complete or relative afferent pupillary defect Funduscopic examination usually shows diffuse ischemic retinal whitening and cherry red spots.

Diagnosis?

A

Central retinal artery occlusion

85
Q

Dopamine agonists can cause orthostatic hypotension.

True or false?

A

True

86
Q

Patient presents with acute and asymmetric focal lower extremity pain associated with weakness. muscle atrophy. areflexia. autonomic dysfunction, and unintentional
weight loss. There is frequently coexisting diabetic symmetrical polyneuropathy.

Diagnosis?

A

Diabetic amyotrophy

87
Q

Does toxoplasmosis usually cause one or multiple ring enhancing lesions on brain MRI?

A

Multiple

88
Q

What’s the next step in a patient who presents with a TIA and has risk factors for stroke?

A

Hospitalization for 24 - 48 hours

ABIM IM Recert (42 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions