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120 Cards in this Set

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  • Back
Myasthenia gravis peak age in females
20-30
Myasthenia gravis peak age in males
60-70
Mumps or measles encephalitis: effect on reflexes
Exaggerated DTRs, absent superficial reflexes, and pathologic reflexes.
Hallmark symptom of vestibular disease
Vertigo
Signs of vertigo secondary to a peripheral lesion
Tinnitus, marked vertigo
Vertical nystagmus: sign of peripheral or central vertigo?
Central.
CSF fluid in bacterial meningitis contains...
High PMN leukocytes, high protein, low glucose
Organisms that cause viral encephalitis include...
Herpes simples, arbovirus, CMV, myxovirus
At what age is the Moro reflex NORMAL?
Newborn, and usually disappears between 3 and 6 months
Treatment for herpes encephalitis
Acyclovir 10mg/kg IV every 8 hours
Bell's palsy occurs most commonly in what patient population?
Teenage girls and women in their 20s.
True or false: A non-reactive CSF-VDRL rules out neurosyphilis
False. CSF-VDRL is nonreactive in 30-57% of patients with neurosyphilis.
Mechanism of action of the antiparkinson agent pergolide
Directly stimulates postsynaptic receptors. Pergolide is often used in combination with levodopa/carbidopa.
Resting tremor, pill rolling, cogwheeling, bradykinesia, diminished postural reflexes
Parkinson's disease.
Signs and symptoms of acute bacterial meningitis may develop over what length of time?
2 hours to 1 day
Most common type of ischemic event in a patient with prior CVA
Thrombotic, followed by embolic and intracerebral or subarachnoid hemorrhage
Medications for Alzheimers
Acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine), and NMDA receptor agonist (memantine)
Prenatal genetic testing should be assessed at what gestational age?
15-18 weeks
3 common antibiotics used in acute bacterial meningitis in patients older than 2 months
ampicillin, chloramphenicol, and ceftriaxone
Type of shock that results in a disruption of spinal cord function and is characterized by hypotension, paralysis below the level of injury, and bradycardia or normal pulse
Neurogenic shock
Absence seizures are also known as...
Petit mal seizures
Class of anticonvulsants recommended for treatment of grand mal seizures
Hydantoin (phenytoin). It stabilizes neurons from hyperexcitability by controlling cellular sodium.
Most common pathogen causing acute bacterial meningitis in adults
Streptococcus pneumoniae
Most common pathogen causing acute bacterial meningitis in children aged 3 months to 5 years
H. flu
Atropine is in what class of drugs?
Muscarinic antagonist.
Autosomal recessive disease characterized by blond hair, blue eyes, "mousy" odor of urine, eczema, convulsions, mental retardation
Phenylketonuria
30 year old woman presents with difficulty chewing, an insidious onset of diplopia, ptosis, dysphagia, regurgitation of fluids, and weak limbs. Likely diagnosis?
Myasthenia gravis
Amaurosis fugax is...
transient monocular blindness, a manifestation of TIA. Like a window shade pulled down over the eye, lasts minutes.
Diagnostic test to confirm muscular dystrophy in a child
EMG
Type of muscular dystrophy diagnosed when the child demonstrates weakness at the first attempts to walk
Duchenne
Focal neurologic deficits that last 10-15 minutes, with a return to baseline, is likely..
TIA
Drug of choice for treatment of a febrile seizure
Tylenol, and other methods to reduce fever.
Most lumbral/sacral disc herniations occur at which 2 levels?
L4-L5 and L5-S1
Bladder dysfunction secondary to lumbar disc herniation is most likely what?
Cauda equina syndrome
18 year old male with resting tremor, rigidity, drooling, deposits in the cornea, and abnormal liver function tests. Likely diagnosis?
Wilson's disease
Rapid writhing movements in a 40 year old, associated with dementia.
Huntington's chorea
A patient on high-dose corticosteroids presents with meningitis. The CSF has a positive India ink stain. Likely pathogen?
Cryptococcus
Bilateral bandlike sensation around the head; dull, steady pain that may last days or weeks; possible occipital or nuchal soreness.
Tension headache
Unilateral non-throbbing headache more common in males, associated with nasal stuffiness and lacrimation
Cluster headaches
Unilateral headache with localized scalp tenderness in an older adult. May have transient visual loss.
Temporal arteritis
EEG shows 3-per-second spike-and-wave discharges. Likely type of seizure?
Absence (petit mal) seizures
Type of seizure associated with loss of postural muscle tone and brief loss of consciousness.
Atonic seizure
Where is the cerebrovascular lesion located if there are symptoms of unilateral or bilateral weakness, sensory loss, disorder of ocular motility, loss of facial sensation, ataxia?
Midbasilar artery. The cranial nerves affected are the Oculomotor and Facial nerves, which are supplied by the midbasilar artery.
Where is the cerebrovascular lesion located if there are symptoms of contralateral weakness and sensory loss, worse in face and arm; homonymous hemianopsia; aphasia
Middle cerebral artery
Where is the cerebrovascular lesion located if there are symptoms of pure motor hemiparesis involving the face, arm, and leg
Penetrating branch of the middle cerebral artery
18 year old female with periodic episodes that begin with severely decreased vision, followed by ataxia, dysarthria, and tinnitus. They last for 30 minutes and are followed by a throbbing occipital headache. Likely diagnosis?
Basilar migraine
If a patient has right homonymous hemianopsia, where is the lesion located?
Left optic radiations
A 40 year old woman complains of episodes of severe unilateral stabbing facial pain that is intermittent for several hours, then disappears for several days. PE is normal. Likely diagnosis?
Trigeminal neuralgia, or tic douloureux.
Most effective therapy for trigeminal neuralgia
Carbamazepine
Acute, autoimmune neuropathy affecting the peripheral nervous system, characterized by progressive ascending paralysis noted by weakness in legs that spreads to upper limbs and face along with complete loss of DTRs
Guillain-Barre syndrome
Symptoms of vertigo and tinnitus is most likely due to...
a peripheral lesion (peripheral vertigo)
Etiology of Benign Paroxysmal Positional Vertigo (BPPV)
Unknown etiology
Most likely type of seizure with an MRI finding of temporal lobe sclerosis.
Complex partial seizures
Type of seizures that start in childhood and is often mistake for "daydreaming"
Absence (petit mal) seizures
Unilateral throbbing headaches that are preceded by scintillating scotomas
Classic migraine
What diagnostic class is "conversion disorder"?
Somatoform disorders
What diagnostic class is "cyclothymic disorder"?
Mood disorders
What diagnostic class is multiple personality disorder?
Dissociative disorder
"Elvis speaks to me and tells me what to do with my life." This is a...
Delusion
What side effect of antipsychotic agents is characterized by feelings of restlessness and a need to be in constant motion?
Akathisia
A chronic relapsing condition characterized by compulsive drug seeking and abuse, and by long-lasting chemical changes in the brain.
Addiction
A physiologic state of adaption to a drug, often characterized by the development of tolerance.
Dependence
What eating disorder is characterized by low estrogen, LH, FSH, TSH, and osteoporosis?
Anorexia nervosa
What eating disorder is characterized by the refusal to maintain body weight for age and height?
Anorexia nervosa
What eating disorder causes death by cardiac arrest, hypokalemia, and ipecac toxicity?
Bulimia nervosa
Most common initial symptom of Alzheimer's disease
Memory loss
A patient has impaired proprioception, vibratory sense, and deep pain sensation; Argyll Robertson pupils; lower extremity joint damage; and CSF positive for mononuclear pleocytosis. Likely diagnosis?
Neurosyphilis
Tests to confirm muscular dystrophy
EMG and muscle biopsy
When a patient is on lithium, what lab test needs to be monitored?
Creatinine (renal function testing)
What drug category is Mirtazepine (Remeron)?
Antidepressant
What drug category is Buspirone (Buspar)?
Anxiolytic
What drug category is zolpidem (Ambien)?
Sedative/hypnotic
What drug category is olanzapine (Zyprexa)?
2nd generation antipsychotic
Unilateral, severe periorbital headache with tearing and conjunctival erythema.
Cluster headache
Prophylactic treatment for migraine
Beta blockers, CCBs, TCAs
What is the most common pituitary tumor?
Prolactinoma
What is the treatment for prolactinoma?
Bromocriptine (dopamine agonist)
A 55 year old patient presents with acute "broken speech". What type of aphasia is this?
Broca's aphasia
What lobe and vascular distribution causes Broca's aphasia?
Frontal lobe, left MCA distribution
Most common cause of subarachnoid hemorrhage
Trauma
Second most common cause of SAH
Berry aneurysm
A crescent-shaped hyperdensity does not cross the midline is seen on CT of the brain
Subdural hematoma (bridging veins are torn)
A history significant for initial altered mental status with an intervening lucid interval. Most likely diagnosis?
Epidural hematoma most likely from the middle meningeal artery. Refer to neurosurgeon.
What are the CSF findings in SAH?
Elevated ICP, RBCs, xanthochromia
You instruct a new medical assistant to clean out a patient's ears that has cerumen impaction. After flushing cold water into the patients ear, she reports that his "eyes vibrated" and then he vomited. Is this normal or pathological?
Normal. She should've used warm water.
What are the most common primary sources of metastasis to the brain?
Lung, breast, skin (melanoma), kidney, GI tract
What type of seizure may be seen in children who are accused of inattention in class, and confused with ADHD?
Absence seizures
What is the most frequent presentation of intracranial neoplasm?
Headache
What is the most common causes of seizures in young adults (18-35 years)?
Trauma, alcohol withdrawal, brain tumor
First line medication for status epilepticus
IV Benzodiazepine
Most common causes of seizures in children (2-10 years)?
Infection, febrile seizures, trauma, idiopathic
Confusion, confabulation, ophthalmoplegia, ataxia. Likely diagnosis?
Wernicke's encephalopathy due to thiamine deficiency
What % lesion is an indication for carotid endarterectomy?
70% if stenosis is symptomatic
What are the 2 most common causes of dementia?
Alzheimer's and multi-infarct
What syndrome is a combination of an upper motor neuron and lower motor neuron disorder?
ALS
Rigidity and stiffness with resting tremor and masked facies
Parkinsons
What is the mainstay treatment of Parkinsons?
Levodopa/carbidopa
What is the treatment for Guillain-Barre syndrome?
IVIG or plasmaphoresis
Rigidity and stiffness that progress to choreiform movements, accompanied by moodiness and altered behavior. Likely diagnosis?
Huntington's disease
A 6 year old girl presents with a port-wine stain in the V2 distribution as well as with mental retardation, seizures, and leptomeningeal angioma. Likely diagnosis?
Sturge-Weber syndrome
More than 6 cafe au lait spots on the skin indicate what disease?
Neurofibromatosis 1
What is administered to a symptomatic patient to confirm the diagnosis of myasthenia gravis?
Edrophonium (Tensilon)
First line therapy for depression
SSRIs
What class of antidepressants is associated with hypertensive crisis?
MAOIs
What psychiatric class of drugs will cause the side effects of galactorrhea, impotence, menstrual dysfunction, and decreased libido?
Dopamine antagonists
A 20 year old female has right arm paralysis after her boyfriend dies in a car crash. No medical cause is found. Likely diagnosis?
Conversion disorder
Life-threatening muscle rigidity, fever, and rhabdomyolysis. Likely diagnosis?
Neuroleptic malignant syndrome
Amenorrhea, bradycardia, and abnormal body image in a young female most likely indicates what
Anorexia nervosa
A 30 year old male has recurrent episodes of palpitations, diaphoresis, and fear of going crazy. Likely diagnosis?
Panic disorder
What is the most serious side effect of clozapine?
Agranulocytosis
A 21 year old male has a 3 month history of social withdrawal, worsening grades, flattened affect, and concrete thinking. Diagnosis?
Schizophreniform disorder. (A diagnosis of schizophrenia requires a history of >6 months)
What are the key side effects of atypical antipsychotics?
Weight gain, type 2 DM, QT prolongation
A young athlete receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis?
Acute dystonia (oculogyric crisis). Treat with benzotropine or diphenhydramine.
What medication should be avoided in patients with a history of alcohol withdrawal syndrome?
Neuroleptics
A 13 year old boy has a history of theft, vandalism, and violence toward family pets. Diagnosis?
Conduct disorder
A 5 month old girl has decreased head growth, truncal dyscoordination, and decreased social interaction. Likely diagnosis?
Rett's disorder
A nurse presents with severe hypoglycemia. However the blood analysis reveals no elevation in C-peptide. Likely diagnosis?
Munchausen syndrome (insulin abuse)
A woman who was abused as a child frequently feels outside or detached from her body. Diagnosis?
Depersonalization syndrome
A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis?
Tardive dyskinesia. D/C haldol consider a different antipsychotic
A man unexpectedly flies across flies across the country, takes a new name, and has no memory of his prior life.
Dissociative fugue