Neurology 1 - 7

Front 1

What are the 2 most common locations of aneurysms in the Circle of Willis?

Back 1

anterior and posterior communicating artery

Front 2

What are of the brain has a lesion that causes:
Contralateral hemiballismus

Back 2

subthalamic nucleus

Front 3

What are of the brain has a lesion that causes:
Hemispatial neglect syndrome

Back 3

non-dominant parietal lobe

Front 4

What are of the brain has a lesion that causes:
Coma

Back 4

Reticular activating system

Front 5

What are of the brain has a lesion that causes:
Poor comprehension

Back 5

Wernike's Area

Front 6

What are of the brain has a lesion that causes:
Poor vocal expression

Back 6

Broca's area

Front 7

What are of the brain has a lesion that causes:
Resting Tremor

Back 7

Basal Ganglia

Front 8

What are of the brain has a lesion that causes:
Intention Tremor

Back 8

Cerebellar Hemisphere

Front 9

What are of the brain has a lesion that causes:
Personality Changes

Back 9

Frontal Lobe

Front 10

What are of the brain has a lesion that causes:
Agraphia and Acalculia (inability to write, inability to do mathematical calculations)

Back 10

Dominant Parietal Lobe

Front 11

Where does this spinal tract cross over:
Dorsal Columns

Back 11

Medulla

Front 12

Where does this spinal tract cross over:
Lateral Corticospinal Tract

Back 12

Medullary Pyramids

Front 13

Where does this spinal tract cross over:
Spinothalamic Tract

Back 13

Anterior Commissure

Front 14

What cerebral artery infarct can cause aphasia?

Back 14

Middle Cerebral Artery

Front 15

What are the characteristic features of Brown-Sequard syndrome?

Back 15

- Ipsilateral loss of vibration & and touch discrimination below lesion (dorsal column)
- Ipsilateral spastic paralysis below lesion (corticospinal tract)
- Ipsilateral flaccid paralysis at level of lesion (anterior horn disruption)

Front 16

What are the common organisms and empiric IV antibiotics choices for bacterial meningitis?
<1 month of age

Back 16

- Group B strep, E. coli, Listeria

- ampicillin + cefotaxime or gentamycin

Front 17

What are the common organisms and empiric IV antibiotics choices for bacterial meningitis?
1 month to 60 yo of age

Back 17

- Strep p., Neisseria m. (teens), Listeria

1. cefotaxime or ceftriaxone, 2. Vancomycin (for Staph), 3. dexamethasone IV q6hrs x 4d (if over 6m of age)

Front 18

What are the common organisms and empiric IV antibiotics choices for bacterial meningitis?
>60 years, alcoholism, or debilitating comorbidities

Back 18

- Strep p., Listeria m., Neisseria m. Gram (-) bacilli

1. ampicillin (listeria coverage), 2. cefotaxime or ceftriaxone, 3. vancomycin 4. dexamethasone IV 16hrs x 4d

Front 19

What drug is used to treat HSV meningitis?

Back 19

Acyclovir

Front 20

What organism is responsible for bacterial meningitis on CSF examination?
Gram positive diplococci

Back 20

Strep. pneumoniae

Front 21

What organism is responsible for bacterial meningitis on CSF examination?
Gram negative diplococci

Back 21

N. meningitidis

Front 22

What organism is responsible for bacterial meningitis on CSF examination?
Small Pleomorphic gram-neg coccobacilli

Back 22

H. influenzae

Front 23

What organism is responsible for bacterial meningitis on CSF examination?
Gram-positive rods and coccobacilli

Back 23

Listeria

Front 24

What medication should be given to close contacts of those with either meningococcal or Haemophilus influenzae type B meningitis?

Back 24

Rifampin or Ciprofloxacin

Front 25

When should a CT scan be performed as a next step instead of an LP in a pt suspected of having meningitis?

Back 25

- Signs of ICP: focal neuro deficits, pupil asymmetry, papilledema, seizure, suspicion of mass effect
- soft tissue infection at LP site
- bleeding diathesis
- cardiopulmonary instability

Front 26

What are the four most common sequelae of meningitis in children?

Back 26

- Hearing loss
- mental retardation
- seizure disorder
- spastic paralysis

Front 27

What is the treatment for fungal meningitis?

Back 27

Amphotericin B

Front 28

What medications are used in combination in the treatment of TB meningitis?

Back 28

Rifampin
Isoniazide
Pyrazinamide
Ethembutol

Front 29

What is the most effective way to prevent bacterial meningitis in newborns?

Back 29

Ampicillin during labor

Front 30

What other drug should be given just before or along with the first dose of antibiotics in a patient suspected of having bacterial meningitis?

Back 30

Dexamethasone

Front 31

What is the most common location of a berry aneurysm?

Back 31

Anterior communicating artery

Front 32

Pt with presumptive viral meningitis shows a lesion within the right temporal lobe. With which pathogen is this pattern most consistent?

Back 32

HSV

Front 33

What are the features of Reye syndrome?

Back 33

(Hepatoencephalitis)
- Hypoglycemia
- Encephalitis

Front 34

In addition to West Nile Virus, what major infections are associated with birds?

Back 34

- West Nile
- Avian Influenza (Bird Flu)
- Enerococcous
- Histoplasmosis
- Psittacosis (Chlamydophia psittaci)

Front 35

How should you treat a patient that has been bitten by an animal suspected of having rabies, or an animal that cannot be observed for 10 days?

Back 35

Clean wound, admin rabies immunoglobulin and vacine, tetnaus ppx

Front 36

A patient is brought in to the ER with progressive muscle weakness, retained sensation, headache, vomting, neck pain, fever. CSF analysis shows increased lymphocytes and normal glucose and protein. What life threatening complication can result if this disease progresses?

Back 36

- Poliomyolitis
-Respiratory muscle paralysis

Front 37

How do the symptoms of encephalitis differ from those meningitis?

Back 37

- altered mental status
- focal neuro deficits

Front 38

What other term should you remember when thinking about Reye syndrome?

Back 38

hepatoencephaltitis

Front 39

What are the acute Tx of:
Tension Headaches

Back 39

NSAIDs (Ketorolac)

Front 40

What are the acute Tx of:
Cluster Headache

Back 40

100% O2 (6+ L/min on non-rebreather for 20+ min) and sumatriptan or dihydroergotamine

Front 41

What are the acute Tx of:
Migraine Headache

Back 41

Sumatripatin, dihydroergotamine, NSAIDs, and/or antiemetics (chlorpromazine, prochlorperazine, metoclopramide)

Front 42

What agents can be used for PPx for migraine headaches?

Back 42

CCB - Verapamil (often 1st line)
BB - propranolol, petoprolol (if comorbid HTN)
TCAs - amitriptyline, nortriptyline (comorbid depression, insomnia, pain syndrome)
NSAIDs - naproxen (menstrual migrane or comorbid OA)
Anticonvulsants - valproic acid (good if have Bi-polar), topiramate, gabapentin

Front 43

What are the characteristics of pseudotumor cerebri?

Back 43

Young, obese woman, daily morning headaches that are pulsitile, pain worse w/ eye movement, papilledema, worried about vision loss.
CT: normal, absence of ventricular dilation
CSF: elevated >200 in non-obese; >250 in obese
Tx: acetazolamide

Front 44

What type of headache based on these descriptions:
Made worse by foods containing tyramine

Back 44

Migrane

Front 45

What type of headache based on these descriptions:
Obese woman with papilledema

Back 45

Pseudotumor cerebri

Front 46

What type of headache based on these descriptions:
Jaw muscle pain when chewing

Back 46

Temporal Arteritis

Front 47

What type of headache based on these descriptions:
Periorbital pain with pstosis and miosis

Back 47

Cluster

Front 48

What type of headache based on these descriptions:
Photophobia and/or phonophobia

Back 48

Migraine

Front 49

What type of headache based on these descriptions:
B/L frontal/occipital pressure

Back 49

Tension

Front 50

What type of headache based on these descriptions:
Lacrimation and/or rhinorrhea

Back 50

Cluster

Front 51

What type of headache based on these descriptions:
Elevates ESR

Back 51

Temporal arteritis

Front 52

What type of headache based on these descriptions:
"Wost headache of my life"

Back 52

Sub-arachnoid hemorrhage

Front 53

What type of headache based on these descriptions:
Headache + extraocular muscle palsies

Back 53

Cavernous sinus thrombosis

Front 54

What type of headache based on these descriptions:
Scintillating scotoms prior to headache

Back 54

Migraine with aura

Front 55

What type of headache based on these descriptions:
HA occurring before of after orgasm

Back 55

Post-coital cephalgia

Front 56

What type of headache based on these descriptions:
Responsive to 100% Ox supplementation

Back 56

Cluster

Front 57

What type of headache based on these descriptions:
Trauma to the head --> headache begins days after the event, persists for over a week and does not go away

Back 57

Subdural hematoma

Front 58

What is the pattern of pain in a migraine and a tension headache?

Back 58

Migraine: unilateral and throbbing
Tension: B/L pain or tightness, associated with neck pain

Front 59

Most likely cause of headache in a 40 yo woman with frontal headache that is made worse by bending over?

Back 59

Sinus headache

Front 60

A 30 year old woman is in the office with a complaint of facial pain. SHe describes that whenever her face is lightly touched that she experiences incredible electrical-like pain. What is the 1st line treatment for this condition?

Back 60

Carbamazepine

Front 61

What is the anticoagulant of choice in a pt with a Hx of stroke or TIA with each condition:
First TIA

Back 61

ASA

Front 62

What is the anticoagulant of choice in a pt with a Hx of stroke or TIA with each condition:
TIA/Stroke due to atrial fibrillation

Back 62

Warfarin

Front 63

What is the anticoagulant of choice in a pt with a Hx of stroke or TIA with each condition:
TIA/stroke + coronary artery disease

Back 63

Clopidogrel

Front 64

What is the anticoagulant of choice in a pt with a Hx of stroke or TIA with each condition:
Repeat TIA/stroke while on ASA

Back 64

Aggrenox or Clopidogril

Front 65

What is the description of this lacunar syndrome that may arise from a lacunar infarct:
Pure Motor Hemiparesis

Back 65

Weakness of face, arm, and leg on one side of body + absent sensory or cortical signs (aphasia, neglect, apraxia, hemianopsia)

Front 66

What is the description of this lacunar syndrome that may arise from a lacunar infarct?
Pure Sensory Stroke

Back 66

Sensory defect of the face, arm, and leg on one side of the body + absent motor or cortical signs

Front 67

What is the description of this lacunar syndrome that may arise from a lacunar infarct?
Ataxia Hemiparesis

Back 67

Ipsilateral weakness and limb ataxia out of proportion to the motor defect, possible gait deviation to the affected side + ABSENT CORTIAL SIGNS

Front 68

What is the description of this lacunar syndrome that may arise from a lacunar infarct?
Sensorimotor Stroke

Back 68

Weakness and numbness of the face, arm, and lef on one side of the body + absent cortical signs

Front 69

What is the description of this lacunar syndrome that may arise from a lacunar infarct?
Dysarthria-clumsy Hand Syndrome

Back 69

Facial weakness, dysartria, dysphagia, and slight weakness and clumsiness of one hand + absent sensory or cortial signs (least common)

Front 70

How long must a focal neurologic deficit last to qualify as a stroke?

Back 70

>24 hrs

Front 71

In what time frame must thrombolytic therapy be instituted in cases of ischemic stroke?

Back 71

3-4.5 hrs

Front 72

What is the principle cause of lacunar infarct?

Back 72

HTN

Front 73

A patient with a DVT develops a stroke. What study would most likely identify the underlying etiology of the stroke?

Back 73

TEE

Front 74

A child presents to the ER with mental status changes, hypoglycemia, and lesions suggestive of chicken pox. What is the most likely diagnosis?

Back 74

Reye syndrome

Front 75

CSF analysis shows low glucose, elevates neutrophils, and Gram-Positive diplococci. What is the diagnosis?

Back 75

Strep. pneumoniae meningitis

(if Gram neg will be nieserria)

Front 76

In what scenario is seizure prophylaxis with anticonvulsants recommended? Parenchymal hemorrhage or subarachnoid hemorrhage?

Back 76

Parenchymal hemorrhage - always start

SAH - only start if seizures develop

Front 77

What are 3 feared complications of parenchymal hemorrhage?

Back 77

uncal herniation
obstruction of CSF flow
Death

Front 78

What are the most common causes of Epidural Hematoma and Subdural Hematoma?

Back 78

Epidural Hematoma - Rupture of middle meningeal artery

Subdural Hematoma - Rupture of bridging veins

Front 79

What is the treatment for subarachnoid hemorrhage?

Back 79

Stop anticoagulants, keep SBP <150, Labetalol (avoid nitroprusside & NTG due to increased ICP)
optimize brain environment (prevent hypoxia, normalize blood glucose, pH, osmolarity, volume status, prevent fever)
Address cause of the hemorrhage

Front 80

A ring enhancing brain lesion on CT in a patient with seizures suggests what?

Back 80

Brain abcess
Neurocysticercosis
Toxoplasma

Front 81

What CSF findings would you see in a case of subarachnoid hemorrhage?

Back 81

Increased CSF
RBCs in every CSF tube
Xanthochromia if occured few days prior due to RBCs breaking down to bilirubin

Front 82

WHich medications are known for causing seizures?

Back 82

Bupropion
Buspirone
Enflurane
Theophylline

Front 83

What seizure medications are used for prevention of the following types of recurrent seizures:
Grand mal (tonic-clonic)

Back 83

Valproate, carbamazepine, phenytoin, lamotrigine, topiramate

Front 84

What seizure medications are used for prevention of the following types of recurrent seizures:
Partial Seizure

Back 84

Carbamazepine, Lamotrigine, phenytoin > valproate, topiramate

Front 85

What seizure medications are used for prevention of the following types of recurrent seizures:
Absence Seizure

Back 85

Ethosuximide, Valproic Acid

Front 86

What seizure medications are used for prevention of the following types of recurrent seizures:
Myoclonic Seizures

Back 86

Valproic acid

Front 87

Which seizure medication matches the following description:
Gingival Hyperplasia

Back 87

Phenytoid

Front 88

Which seizure medication matches the following description:
Drug of Choice for absence seizures

Back 88

Ethosuximide

Front 89

Which seizure medication matches the following description:
Second choice for absence seizures

Back 89

Valproic Acid

Front 90

Which seizure medication matches the following description:
Drug of choice for Trigeminal Neuralgia

Back 90

Carbamazepine

Front 91

Which drugs are known for cuasing Stevens-Johnson Syndrome?

Back 91

Anticonvulsants: Lamotrigine, Ethosuximide, Carbamazepine, Phenobarbital, Phenytoin
Antibiotics: Penicillins, Sulf drugs
Allopurinol

Front 92

Which drugs are known for inducing cytochrome P450 system thereby speeding-up the metabolism of other drugs sich as OCPs and warfarin?

Back 92

"Kenytoin" Rides Shotgun in Barbie's Girl Car

Phenytoin, Rifampin, St. John's Wort, Barbiturates, Griseofulvin, Carbamazepine

Front 93

What anticonvulsants are associated with blood dyscrasias?

Back 93

Carbamazemine and Ethosuximide