Zagat

Question 1

1) Persistent vegetative state diagnosis takes how many weeks to meet criteria?

Answer 1

6 weeks

Question 2

2) Patient has episodes of sudden muscle laxity in response to strong emotions. Symptom name? Disease Dx? Treatment?

Answer 2

Cataplexy as part of narcolepsy. Treat with modafinil

Question 3

3) Elderly patient beats up his wife in bed while sleeping. Diagnosis and disease association?

Answer 3

REM sleep behavior disorder

Harbinger for Lewy Body dementia (sometimes Parkinson’s)

Question 4

7) Elderly patient presents with muscle rigidity, ataxia, with sudden lurching forward, and memory problems. Dx? Classic associated Sx?

Answer 4

Progressive supranuclear palsy

Sx: trouble with vertical (up or down) gaze, balance issues with sudden lunging forward/backward, and dementias

Question 5

10) Patient presents with ptosis, muscle swallowing weakness, and diplopia that gets worse as the day goes along. Diagnosis? Sister Diagnosis? Distinguish the two based on body region tropism?

Answer 5

Myasthenia gravis. Remember, progressive weakening throughout the day especially involving eye, oropharynx, and jaw muscles (3 most commonly involved muscles) is MG.
Sister: Eaton-Lambert and does not involve ocular muscles!