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Step 2 > Uworld6 > Flashcards

Uworld6 Flashcards

1
Q

Difference between peripheral and central bell’s palsy

A

peripheral: inability to raise eyebrow or close eye
central: preserved eyebrow and eye movement

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2
Q

Next step for central bell’s palsy

A

brain imaging

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3
Q

treatment for solitary brain metastasis in patients with good performance status and stable extracranial disease

A

surgical resection

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4
Q

whole brain mets treatment

A

radiation therapy is typically used

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5
Q

when do you refer carotid endarterectomy

A

TIA, stroke past 6 months

70-99% stenosis

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6
Q

Cauda equina syndrome

A

radicular pain
asymmetric motor weakness
hyporeflexia/areflexia

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7
Q

Conus medullaris syndrome

A

symmetric motor weakness

hyperreflexia

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8
Q

What can cause central cord syndrome

A

hyperextension injuries

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9
Q

What type of headache awakens you from sleep

A

cluster headache

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10
Q

ptosis
“down-and-out” gaze
Diplopia
normal pupillary response

A

Ischemic oculomotor palsy
poorly controlled diabetes
Damage to inner somatic nerve fibers
Spare peripheral parasympathetic fibers

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11
Q

Lambert Eaton is associated with what malignancy

A

small cell lung cancer

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12
Q

Clinical feature of Eaton Lambert syndrome

A

symmetric proximal muscle weakness with depressed deep tendon reflexes

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13
Q

lab value for epidural abscess

A

ESR always elevated

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14
Q

equine antitoxin treats

A

botulism

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15
Q

What type of tremor is essential tremor

A

action tremor

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16
Q

Treatment for exertional heat stroke

A

ice water immersion

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17
Q

Atrophy of what part of the brain is Huntington’s disease

A

caudate nucleus

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18
Q

CSF for HSV encephalitis

A

lymphocytic pleocytosis
increased erythrocytes
elevated protein
normal glucose

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19
Q

Difference between Sensorineural and conductive hearing loss

A

Sensorineural: disorder involving inner ear, cochlea, or auditory nerve
Conductive: any cause that limits sound from gaining access to the inner ear

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20
Q

what type of hemorrhagic stroke has rapidly worsening global neurologic symptoms (vomiting, stupor, bradycardia)

A

Intercerebral

Not lacunar strokes

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21
Q

Clinical picture of putaminal hemorrhage

A

contralateral hemiparesis

contralateral sensory loss

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22
Q

What is the cushing reflex and what does it mean

A

hypertension
bradycardia
respiratory depression

Brainstem compression

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23
Q

First line treatment for idiopathic intracranial hypertension

A

acetazolamide +/- furosemide

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24
Q

location of broca

A

dominant frontal lobe

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25
Q

location of wernicke

A

temporal lobe

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26
Q

location of wallenberg syndrome

A

lateral medullary infarct

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27
Q

Patient outstretched the arms with palms up and eyes closed. Affected arm drifts downward and palm turn (pronates) toward the floor

A

Pronator drift

sign of upper motor neuron or pyramidal tract disease

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28
Q

Stand with feet together, arms to the side and eye closed. May loose balance

A

romberg test

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29
Q

what drug is effective in reducing the risk of early recurrence of ischemic stroke?

A

aspirin, give within 24 hours

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30
Q

what drug would you give for recurrent stroke on aspirin therapy

A

aspirin plus dipyridamole OR clopidogrel

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31
Q

Contralateral and motor deficit (face, arm, leg)
Homonymous hemianopia
conjugate eye deviation toward side of infarct
type of stroke?

A

middle cerebral artery occlusion

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32
Q

Contralateral somatosensory and motor deficit
urinary incontinence
type of stroke?

A

Anterior cerebral artery occlusion

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33
Q

Hemi-neglect syndrome occurs where in the brain

A

right (non-dominant) Parietal lob

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34
Q

what is the biggestest risk factor for stroke

A

hypertension

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35
Q

nerve for facial movement

A

VII 7

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36
Q

nerve for facial sensation

A

V 5

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37
Q

side effect of cisplatin

A

Nephrotoxicity
ototoxicity
neurotoxocity

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38
Q

psuedodementia

A

elderly patient with depression present with cognitive impairment

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39
Q

oligoclonal IgG bands

A

multiple sclerosis

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40
Q

Uhthoff phenomenon? what is it associated with

A

symptoms worsen during exposure to high temperatures

such as moving to Arizona in June

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41
Q

If MS patient does not respond to steroids, next drug?

A

plasma exchange

42
Q

name 2 causes of oculomotor nerve palsy

A 
nerve compression (posterior communicating aneurysm)
diabetes mellitus - microvascular nerve ischemia
43
Q

Triad of oculomotor nerve palsy

A

mydriasis
ptosis
“down and out” deviation

44
Q

when multiple sclerosis is suspected but clinical examination or MRI is not classic, next step

A

lumbar puncture

45
Q

Riley-Day syndrome

A

autonomic nervous system dysfunction with severe orthostatic hypotension

46
Q

For myasthenia gravis, if acetylcholine receptor antibody is present, what is the next step

A

CT of chest to rule out thymoma

47
Q

problem in motor neuron cell body

A

ALS

48
Q

Damage to white matter tracts

A

multiple sclerosis

49
Q

Decreased acetylcholine release from motor neurons

A

botulism

50
Q

Degeneration of myenteric plexus neurons

A

achalaisa

51
Q

Fibrous tissue replacement of smooth muscles

A

systemic sclerosis

52
Q

Worsens with repetitive motions of the same muscle groups and improves with rest

A

myasthenia gravis

53
Q

Treatment for myasthenia gravis crisis

A

plasmapheresis (or IVIG) and steroids

54
Q

What causes neuroleptic malignant syndrome

A

drug reaction to dopamine antagonist

55
Q

3 cardinal signs of parkinson disease

A

resting tremor
rigidity
bradykinesia
2/3 for clinical diagnosis

56
Q

What parkinson drug induce acute closure glaucoma

A

trihexyphenidyl/benztropine

anything anti-cholinergic

57
Q

14-3-3 proteins in cerebrospinal fluid sample

A

Creutzfeldt-Jakob disease

58
Q

what muscle is responsible for initiating the 1st degress of abduction

A

supraspinatus

59
Q

What the hallmark of prolonged seizures and can lead to persistent neurologic deficits and recurrent seizures

A

cortical laminar necrosis

60
Q

What is a complication 3 days after subarachnoid hemorrahge? treatment

A

vasospasm
CT angiogram
Nimodipine

61
Q

Upper extremity ischemia (pain, fatigue, paresthesias)
Vertebrobasilar insufficiency (dizziness, ataxia, dysequilirbrium)
Worsened by upper extremity exercise

A

subclavian steal syndrome

62
Q

rupture of bridging veins

A

subdural

63
Q

Syringomyelia is associated with?

A

Arnold Chiari malformation type 1

64
Q

Toxin-medited neurotranmission blockage

A

tetanus

65
Q

T-lymphocyte mediated skeletal muscle injury

A

polymyositits

66
Q

what molecules do tetanus block

A

glycine and GABA

67
Q

What is the difference between guillan barrie and tick-borne paralysis

A

GBS: symmetric paralysis over days to weeks
tick: asymmetrical paralysis within hours

68
Q

Initial treatment for TIA

A

aspirin and statin

69
Q

difference between MS episodes and TIA

A

TIA <24 hours

MS episodes last for days to weeks

70
Q

MOA of sumatriptan

A

vascular serotonin agonist

71
Q

Location of ulnar nerve entrapment

A

elbow

72
Q

Methylmalonic acid deviation

A

B12 deficiency

73
Q

Unfavorable metabolic side effects of thiazide diuretics

A

hyperglycemia
increased LDL cholesterol
increaed plasma triglycerides
hyperuricemia

74
Q

most comm on form of glomerulopathy with HIV

A

focal and segmental glomerulosclerosis

75
Q

what causes the pain in PE

A

pulmonary infarction not pulmonary arterial dilation

76
Q

what type of heart block does digitalis induce

A

atrial tachycardia with AV block

77
Q

What are respiratory concerns for Granulomatosis with polyangiitis

A

URI: most common
Lower respiratory tract: narrowing with ulceration
chest x-ray: multiple lung nodules with cavitation

78
Q

does TB have kidney and upperairway invovlement

A

no

79
Q

Psychogenic polydipsia ? sodium levels

A

excessive free water intake by patient

hyponatremic

80
Q

diabetes insipidus sodium level?

A

hypernatremic

81
Q

pneumothorax on x-ray

A

radiolucent black region

82
Q

COPD and acute-onset shortness of breath, hypoxia and unulaterally decreased breath sounds

A

secondary spontaneous pneumothorax

-large alveolar blebs which rupture

83
Q

fluid accumulation in the avleolar spaces

A

pulmonary edema

84
Q

liver transplant: hyperacute rejection

A

less than 1 week

85
Q

difference between acute cellular rejection and bacterial infection in liver transplant

A

bacterial infection: rapid-onset hemodynamic instability
significant leukocytosis
high fever

86
Q

what type of diarrhea is CMV

A

bloody

87
Q

when do you give Tdap or Td

A

tdap –> single dose age 11-18 and pregnancy

td –> every 10 years

88
Q

what vitamin causes thyroid dysfunction, cardiomyopathy,immune dysfunction

A

selenium

89
Q

what decreases the risk of septic embolic events in patients with native valve infective endocarditis (even if they have right sided weakness)

A

IV abs

no need for heparin or antiplatelet

90
Q

what will cause severe headache and impaired level of consciousness. focal neurologic findings are uncommon

A

subarachnoid hemorrhage

91
Q

isoniazid interferes with what vitamin

A

niacin

92
Q

anti-histone abs

A

drug-induced lupus

93
Q

cyclic cirtullinated paptide anbs

A

rheumatoid arthritis

94
Q

which has a greater impact on respiratory acidosis: chloride shift or kidney compensation

A

kidney compensation

95
Q

what makes tick-borne paralysis different from GBS

A

absence of fever
absence of sensory abnormalities
normal CSF examination

96
Q

Treatment for acute hyponatremic encephalopathy

A

hypertonic (3%) saline with close monitoring of electrolytes

97
Q

Auer rods

A

AML

98
Q

characterize acute promeylocytic leukemia

A

life-threatening coagulopathy due to DIC

99
Q

Lupus anticoagulant (anti-phospholipid antibody) changes what lab value

A

prolongs PTT

100
Q

treatment for autoimmune hemolytic anemia

A

steroids

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