Yellow Pages Flashcards

1
Q

Unilateral hearing loss and ataxia

A

Acoustic schwannoma

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2
Q

Cerebellopontine angle meningioma

A

If large enough, can cause hearing loss and V and VII dysfunction

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3
Q

Welling up sensation of doom or fearfulness can be due to what neurological condition

A

Complex partial seizures

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4
Q

What can cause transient tingling in hands and feet

A

Hyperventilation

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5
Q

Meniere’s dz

A

Peripheral Vertigo. Tinnitus, Nausea

>1 episode vertigo. Eventually low freq. hearing loss.

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6
Q

Meniere’s tx

A

Labyrinthine ablation with gentamicin

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7
Q

What processes can occur subacutely?

A

Infectious/inflammatory, demyelinating, and autoimmune.

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8
Q

Anti-Yo antibody is

A

Anti-Purkinje cell.

Associated with small cell lung cancer, gynecologic, and nonHodgkin’s lymphoma.

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9
Q

Where is the Foramen of Monro

A

Between Lateral and 3rd ventricle

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10
Q

Where is the Cerebral aqueduct (aqueduct of Sylvius)

A

Between 3rd and 4th ventricle

In the midbrain

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11
Q

Where is the third ventricle

A

It is sandwiched between both thalami. Above is the Foramen of Monro, below is the cerebral aqueduct

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12
Q

Where is the fourth ventricle

A

It is ventral to the cerebellum and dorsal to the pons.

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13
Q

Where does the CSF go from the fourth ventricle

A

It goes into the Subarachnoid space through the Lateral apertures (Luschka) and midline foramen of Magendie.

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14
Q

How to treat NPH?

A

Shunt

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15
Q

What can meningitis due to Ventricular/CSF system

A

Scars arachnoid granulations

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16
Q

What is the region of the leg motor fibers in the brain..

A

The parasagittal region: meningiomas can affect this

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17
Q

GBS CSF

A

CSF formula is albuminocytologic dissociation

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18
Q

Increased ICP may affect which nerve

A

Sixth nerve dysfunction (the “nonlocalizing” abducens deficit)

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19
Q

Brainstem astrocytomas, more common in adults or children?

A

Children

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20
Q

Pediatric tumors are supra or infratentorial

A

Usually infratentorial, reverse for adults

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21
Q

Transient global aphasia is recurrent and has lasting effects, true or false?

A

False, it resolves and rarely comes back

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22
Q

Paraneoplastic disorders are reversible?

A

Nope, generally irreversible damage

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23
Q

Testicular cancer has what paraneopastic disorder?

A

Anti-Ma

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24
Q

Pump head is what

A

Hypoxic-ischemic encephalopathy

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25
Q

How to diagnose Creutzfeldt-Jakob

A

Charactersitic abnormalities in posterior hemispheres on diffusion weighted MRI and presence of 14-3-3 protein in CSF. Disease unlikely if both negative.

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26
Q

Early Alzheimer’s presents with

A

Paranoia, hoarding behavior, and visuospatial deficits

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27
Q

Treatment of early Alzheimer’s

A

Can include Quetiapine

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28
Q

Difference between Mild Cognitive Impairment and Dementia

A

Dementia impairs occupational and social functioning. Both can be amnestic.

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29
Q

MCI prognosis

A

Can progress to Dementia, stabilize, or get better

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30
Q

Preventing MCI

A

Challenging the brain like board games or musical instruments

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31
Q

Disease modifying drugs for early AD

A

Galantamine, donepezil, and rivastigmine

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32
Q

potent enzyme inducer drug

A

phenytoin and oxcarbazepine

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33
Q

What chemotherapy drugs cause peripheral neuropathies

A

Docetaxel, paclitaxel, vincristine, platinum

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34
Q

Chemotherapy and cerebellar ataxias

A

Cytosine arabinoside or 5-FU

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35
Q

Some causes of PRES

A

preeclampsia, chemotherapy drugs, cyclosporine, and tacrolimus

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36
Q

PRES syndrome findings

A

HTN, confusion, seizures, and visual changes

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37
Q

Pregnant hypertensive differential

A

PRES, eclampsia, cerebral venous thrombosis

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38
Q

Treatment for dystonia

A

Diphenhydramine, why not benztropine?

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39
Q

Erythromycin drug-drug interactions

A

Can elevate Carbamazepine

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40
Q

AED toxicity

A

Ataxia, nystagmus, diplopia

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41
Q

Oxcarbazepine bad side effect

A

AED most associated with hyponatremia

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42
Q

Anticholinergic toxicity sxs

A

Tachycardia, blurred vision, fever, mental status changes

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43
Q

What does RPLS stand for?

A

Reversible Posterior Leukoencephalopathy Syndrome

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44
Q

Diabetic sixth nerve palsy cause

A

Infarct

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45
Q

Pituitary apoplexy is also called

A

Sheehan’s syndrome

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46
Q

When does Sheehan’s happen

A

Peripartum

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47
Q

Eyes and chronic steroids

A

Cataracts

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48
Q

Cluster HA more in men or women

A

Young men

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49
Q

Cause of INO in old person

A

Paramedian pontine perforating vessel stroke

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50
Q

Cause of INO in young person

A

Demyelination

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51
Q

Signs of optic neuritis

A

Pain on eye movement; central scotoma, normal fundus, poor vision

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52
Q

Papilledema causes what visual field issues

A

Enlarged blindspot and a centrocecal scotoma

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53
Q

Giant cell arteritis eye complication

A

Central retinal artery occlusion

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54
Q

Basilar migraine in a child would be what in an adult

A

Vertebrobasilar TIAs

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55
Q

Posterior Communicating Artery aneurysm leads to

A

Painful, pupil involving third nerve palsy

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56
Q

What to do for P.comm aneurysm

A
  1. CT, 2. LP, 3. Angiography
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57
Q

What happens if an aneurysm is clipped/coiled and deteriorates 3 days later?

A

Vasospasm. tx with nimodipine

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58
Q

Review herniation syndromes

A
Uncal
Cerebellar Tonsillar
Subfalcine
Central
Upward
Locked in
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59
Q

Medical cause of acute angle closure glaucoma

A

Topiramate

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60
Q

Tunnel vision that doesn’t reveal more as the testing screen is moved further away

A

Functional, malingering or conversion

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61
Q

Neurofibromatosis type I and eye problem

A

Optic Nerve glioma

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62
Q

When do you see optic atrophy in optic neuritis

A

4-6 weeks after the acute event, until then the fundus is likely normal

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63
Q

Most common cause of of Acute Optic neuropathy in patients older than 50

A

Ischemic Optic Neuropathies

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64
Q

Anterior Ischemic Optic Neuropathy

A

Can be due to temporal arteritis
Presents with painless vision loss developing over hours to days
Blurred vision and frequently altitudinal field defect.
Generally remains stable.

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65
Q

Risk factors for ION

A

Congenitally small optic cup, HTN, diabetes

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66
Q

Posterior Ischemic Optic Neuropathy causes

A

Spinal surgery: irreversible vision loss

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67
Q

Drug causes of ION

A

Amiodarone, interferon alpha, nasal decongestants, viagra

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68
Q

Cause of a left homonymous hemianopia…

A

PCA stroke

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69
Q

Why is there Macular sparing if you get a PCA stroke

A

MCA also supplies macula

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70
Q

How to treat tic douloureux

A

Carbamazepine

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71
Q

Signs of Temporal Arteritis

A

ESR elevated; anemia; jaw claudication; diagnose with temporal artery biopsy

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72
Q

Parasagittal lesion that is hyperdense, enhances uniformly is…

A

Meningioma (extra-axial)

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73
Q

How does a GBM enhance

A

Heterogeneously and it is intra-axial

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74
Q

What is used for prophylaxis of migraines?

A

Antihypertensives: Beta blockers, CCBs, ACE inhibitors/Angiotensin Receptor Blocker
Anticonvulsants: Valproate, Topiramate, Gabapentin

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75
Q

Contraindications for triptans

A

uncontrolled HTN and CAD

76
Q

How do venous sinus thromboses present

A

Cavernous sinus
Straight sinus
Sagittal sinus

77
Q

Know the CSF formulas, draw up an excel sheet

A

….

78
Q

Most common opportunistic infection in CD4 range of around 120

A

Cryptococcus.

79
Q

Crypto findings in the brain

A

Very elevated ICP. Which leads to nonlocalizing sixths.

80
Q

Treatment for Crypto

A

Amphotericin B and flucytosine

81
Q

TB meningitis signs

A

Basilar meningitis with multiple cranial neuropathies, raised ICP and hydrocephalus, and low sugar.

82
Q

Guilllain Barre CSF

A

Albuminocytologic dissociation

83
Q

Albuminocytologic dissociation

A

increase in the level of albumin in cerebrospinal fluid without an accompanying increase in the number of cells.

84
Q

What is CIDP

A

Chronic inflammatory demyelinating polyneuropathy: Chronic GBS

85
Q

Ramsay-Hunt Syndrome

A

Reactivation of Zoster in facial nerve geniculate ganglion, leads to loss of facial movements with erythematous rash, ageusia, ear pain, dry eyes and mouth

86
Q

How to treat Ramsay-Hunt syndrome

A

IV acyclovir

87
Q

Periventricular masses in HIV+ that still grow with toxo tx

A

CNS lymphoma from EBV

88
Q

Bilateral facial weakness infection (bilateral peripheral VII nerve palsies)

A

Neuroborreliosis

89
Q

When to think of Crypto

A

Immunosuppressed, high opening pressure

90
Q

Calcified lesions in someone from the DR

A

Cysticercosis (T. solium)

91
Q

Prophylaxis for N. meningitides

A

Rifampin to reduce NP colonization, can also use ciprofloxacin

92
Q

Congenital CMV

A

Hearing loss, spasticity, hyperintensities along the ventricular margins on MRI

93
Q

Cerebral palsy signs

A

Generalized hyperreflexia, bilateral Babinski signs, heel cord contractures, writing movements of the upper limbs.

94
Q

Charcot-Marie-Tooth disease

A

High arched feet and tripping.
Slowly progressive weakness in distal limbs with loss of proprioception and vibration sense.
Legs before arms.
Onset <30 years.

95
Q

Myotonic dystrophy signs

A

DMII, frontal balding, ptosis, slow relaxation of grip is the myotonia

96
Q

NF2 and acoustic neuromas

A

Bilateral

97
Q

NF1 vs. NF2

A

NF1 is 10x more common

98
Q

Which type of tuberous sclerosis is better

A

Type I is less severe with normal intellect

99
Q

What is tuberous sclerosis

A

Neurocutaneous disorder with widespread hamartomas in CNS, skin, and viscera.
Ash Leaf spots on skin.

100
Q

A common Acute intermittent porphyria sx

A

Abdominal pain

101
Q

Acute intermittent porphyria treatment

A

IV hematin

102
Q

Acute intermittent porphyria precipitants

A

Sulfonamides, hormones, barbiturates

103
Q

McArdle’s disease

A

Look for symptoms after exercise: muscle cramping, weakness, dark urine

104
Q

CMV tx

A

Gangcyclovir

105
Q

Congenital CMV

A

Retardation, microcephaly, seizures, hearing defects. Hyperdensities along margins of the lateral ventricles.

106
Q

Friedreich’s ataxia

A

Most frequently inherited ataxia in Whites. Kyphoscoliosis and pes cavus and gait difficulty. Can also have retinitis pigmentosa. Spinocerebellar signs: limb ataxia, dysarthria, absent reflexes.

107
Q

Friedreich’s ataxia pathology

A

Posterior columns, dorsal and ventral spinocerebellar tracts and lateral corticospinal tracts.

108
Q

Friedreich’s ataxia tx

A

Idebenone, coenzyme Q10 analogues that is a free radical scavenger

109
Q

Isoniazid tx and vitamin deficiency

A

Pyridoxine (B6) depletion leading to peripheral neuropathy

110
Q

How to treat organophosphate poisoning

A

OPs are ACEIs so they cause a massive parasympathetic response, block with Atropine (anti-muscarinic) and pralidoxime (anti-nicotinic)

111
Q

Pseudotumor MRI findings

A

Normal or small, slit-like ventricles

112
Q

Carbon monoxide damages what

A

Globus pallidus necrosis few weeks out

113
Q

Vitamin E deficiency

A

Spinocerebellar syndrome. Ataxia, hyporeflexia, and loss of proprioceptive and vibratory sensation. A skeletal myopathy and pigmented retinopathy also may be present

114
Q

Lead poisoning

A

Predominance of extensor muscle weakness (wrist and foot drop) and autonomic symptoms, microcytic anemia (sideroblasts)

115
Q

Subacute Combined Degeneration

A

B12 deficiency Dorsal columns

116
Q

Causes of excess manganese

A

TPN or cirrhosis

117
Q

Excess manganese on MRI

A

Basal ganglia increased signal on T1

118
Q

Excess manganese signs

A

Cogwheeling, tremulous (Basal ganglia affected)

119
Q

Most common electrolyte abnormality in any CNS process

A

Hyponatremia

120
Q

Arsenic poisoning signs

A

N/V, tinnitus, total body rash, oval patches on neck and increased pigmentation around the axillae.

121
Q

Causes of elevated MCV

A

B12 deficiency, Alcoholism, folate deficiency

122
Q

Causes of decreased MCV

A

Iron-deficiency, thalassemia, chronic disease, sideroblastic anemia (lead poisoning)

123
Q

Ethylene glycol poisoning signs

A

Profound peripheral nerve and CN dysfunction (almost locked in)

124
Q

How does straight leg raising work…

A

Nerves have slack when lower body is not flexed, but it tightens up with flexion (straight leg raising)

125
Q

Ankle reflex nerve root

A

S1

126
Q

Sciatica signs

A

…….

127
Q

Syringomyelia associated with

A

Arnold-Chiari Malformation

128
Q

Chiari malformation types

A

Type I: cerebellar tonsils squeeze lower brainstem

Type 2: Associated with meningomyelocele

129
Q

Myasthenia diagnosis

A

Edrophonium (Tensilon) test: Reversible AChEI

130
Q

Myasthenia tx

A

AChEI like pyridostigmine

131
Q

Myasthenic symptoms, what else to consider

A

Thyroid disease and thymoma

132
Q

Eaton-Lambert syndrome

A

Paraneoplastic, antibodies to calcium channels presynaptic, improves with exertion

133
Q

Deep peroneal nerve Sensory

A

Region of the first interosseous space

134
Q

Patellar reflex

A

L4

135
Q

L5 radiculopathy

A

Lateral thigh and anterolateral leg, sensory loss in the dorsal aspect of the foot. L5 radiculopathy, inversion is affected as well.

136
Q

Acute tx for suspected spinal cord compression

A

High dose methylprednisolone

137
Q

How do steroids reduce ICP?

A

It has been suggested that corticosteroids produce their anti-edema effect by reducing the permeability of tumor capillaries.

138
Q

Polymyositis signs

A

Proximal distribution of weakness, elevated CK, and EMG signs

139
Q

Steroid myopathy

A

Proximal, painless myopathy

140
Q

Hypothyroidism associated findings

A

Weight gain, cold intolerance, cognitive slowing, myopathy

141
Q

Brown-Sequard

A

Typically ipsilateral, but if it is caused by compression from a mass then it could affect the contralateral spinothalamic/corticospinal tracts

142
Q

Trigeminal neuralgia tx

A

Carbamazepine

143
Q

Tx for neuropathic pain

A

Gabapentin, pregabalin, duloxetine, nortriptyline, amitriptyline.

144
Q

Why gabapentin instead of TCAs

A

They will cause urinary retention in older patients from teh anticholinergic effect

145
Q

EMG of myopathy will show…

A
  1. No insertional fibrillations (usually)
  2. Low amplitude small motor units
  3. Early recruitment of motor units but normal interference pattern
146
Q

EMG of neuropathic disease

A
  1. Fibrillation potential on needle insertion
  2. Large motor units
  3. Reduced interference pattern when patient asked to contract muscle more strongly
147
Q

Visual field of papilledema

A

Enlarged blindspot with some peripheral field constriction

148
Q

Toxo tx

A

Pyrimethamine/sulfadiazine

149
Q

CNS lymphoma diagnosis

A

EBV by pcr in CSF or brain biopsy

150
Q

Hemiballismus and what brain structure

A

Subthalamic nucleus

151
Q

Parinaud’s or dorsal midbrains yndrome

A

Pineal region…

152
Q

Supraoptic nucleus and eating

A

…..

153
Q

Eaton-Lambert syndrome is associated with what disease

A

Small Cell Lung cancer

154
Q

Charcot joint

A

Diabetic neuropathy leading to fucked up ankle b/c you can’t feel it

155
Q

Lateral Medullary Syndrome

A

Lower CN dysfunction and crossed sensory signs.
Caused by vertebral artery occlusion or PICA occlusion.
Tx with warfarin.

156
Q

When to use warfarin

A

Valvular a. fib, mechanical valves, cerebral venous sinus thrombosis, decreased ejection fraction, mural thrombus and DVTs. NOT intracranial vascular stenosis.

157
Q

When to use heparin

A

Extracranial arterial dissections, stuttering TIA, acute 100% large vessel occlusion, basilar artery thrombosis, DVTs.

158
Q

How do you get crossed signs with lateral medullary syndrome?

A

Spinothalamic tracts from contralateral side and trigeminal ganglion from ipsilateral side.

159
Q

Wedge shaped infarcts

A

Start out on the surface and go inwards

160
Q

When can you do an endarterectomy

A

Stenosis >70%

161
Q

Time frame for TIA to stroke

A

<48 hrs, admit TIAs

162
Q

Tx for essential tremor

A

Topiramate, beta blockers

163
Q

Drug class of topiramate

A

Anticonvulsant

164
Q

Biggest risk factor for stroke

A

HTN

165
Q

Suddenly comatose?

A

Brainstem disease: pontine hemorrhage or basilar occlusion: pinpoint pupils, quadriparesis, impaired eye movements. OR bilateral supratentorial disease (unlikely)

166
Q

Persistent Vegetative State

A

Takes 6 weeks for formal criteria. Patient awake but not alert.

167
Q

Minimally conscious state

A

More apparent interaction with the environment

168
Q

REM Behavior disease leads to what

A

Parkinsons

169
Q

MUPS

A

Medically Unexplained Physical Symptoms (patients want care, not cure)

170
Q

MS bladder

A

Small capacity, detrusor hyperreflexia.

171
Q

How to treat detrusor hyperreflexia

A

Oxybutynin or Tolterodine (anticholinergics)

172
Q

Lambert-Eaton and eye problems

A

It does NOT involve ocular muscles

173
Q

Know the side effects of major AEDs, steroids, neuroleptics, chemotherapeutic agents. Also know ingestions, drug-drug interactions.

A

….

174
Q

Third nerve palsy involving pupil

A

P.Comm aneurysm

175
Q

Papilledema visual field

A

Enlarged blind spot

176
Q

Optic neuritis/Ischemnic optic neuropathy visual field

A

Central scotoma

177
Q

Headache prophylaxis

A

Propranolol, topiramate

178
Q

Pseudotumor MRI

A

NORMAL MRI or slit-like ventricles, diagnose by LP

179
Q

Ratio for a blood tap?

A

….

180
Q

Necrotizing encephalitis

A

Think HSV

181
Q

Huntington’s in 3 phrases

A

Triplet repeats, caudate atrophy, choreiform movements

182
Q

Nerve roots vs. Peripheral Nerve

A

Lesions to roots cause more localized or incomplete weakness

183
Q

Earliest imaging for infarction

A

Diffusion Weighted Imaging

184
Q

Trigeminal Autonomic Cephalgias

A

Cluster HA, Paroxysmal Hemicrania

185
Q

Lateral Medullary Syndrome (Wallenberg syndrome)

A

Loss of pain and temperature sensation on the contralateral side of the body and ipsilateral side of the face. This crossed finding is diagnostic for the syndrome.
Swallowing difficulty, or dysphagia, slurred speech, ataxia, facial pain, vertigo, nystagmus, Horner syndrome, diplopia, and possibly palatal myoclonus.