Mksap 16 Q&a Neurology

Front 1

most sensitive test for detecting the thrombus and the occluded dural sinus or vein and thus is the test of choice for diagnosing dural sinus venous thrombosis

Back 1

magnetic resonance venography

Front 2

characteristic of headache produced by increased ICP

Back 2

headache, which is worse in the morning and with performing the Valsalva maneuve

Front 3

positive apnea test

Back 3

increase in arterial PCO2 is greater than 20 mm Hg (2.7 kPa) without observed respirations

Front 4

disease-modifying agent used in the treatment of multiple sclerosis (MS)

Back 4

glatiramer

Front 5

how is concussion graded?

Back 5

grade 1 and 2 no LOC; symptoms of grade 1 concussion resolving within 15 minutes and those of grade 2 lasting longer than 15 minutes; grade 3 concussions = LOC

Front 6

when can an athlete return to game after concussion?

Back 6

grade 1 can return to game; grade 2 cannot for the day; grade 3, 1 week.

Front 7

when should imaging be done for concussion?

Back 7

grade 2 or 3 concussion with persistent neurologic defects

Front 8

AED of choice for female patient with seizures who is desirous of pregnancy

Back 8

carbamazepine

Front 9

BP goal for patient on TPA

Back 9

180/105; can do tPA if <185/110

Front 10

diagnostic test for LEMS

Back 10

NCV

Front 11

treatment of cluster headaches

Back 11

oxygen 10l/min x 10 minutes; intranasal sumatriptan may be considered but not oral

Front 12

self-limited chorea that happens in pregnancy

Back 12

chorea gravidarum (results from elevated estrogen levels and will resolve after pregnancy)

Front 13

group of disorders characterized by recurrent thunderclap headache associated with transient segmental cerebral vasoconstriction, severe headaches of the thunderclap variety occurring over a few days or weeks, often without abnormalities on clinical examination

Back 13

reversible cerebral vasoconstriction

Front 14

most likely etiology of Bell's palsy?

Back 14

human herpesvirus 1

Front 15

what is the interaction between OCP and lamotrigine?

Back 15

lamotrigine is metabolized by the process of glucuronidation which is induced by estrogen; so patients on lamotrigine started on OCPs should have their AED dose increased

Front 16

disease condition suggested by visual hallucinations, dream enactment behavior (rapid eye movement [REM] sleep behavior disorder), and atremulous parkinsonism

Back 16

dementia with Lewy bodies

Front 17

treatment of dyskinesia in Parkinson disease patient on high doses of levodopa

Back 17

deep brain stimulation of subthalamic nucleus or globus pallidus, not withdrawal and reintroduction of meds

Front 18

when to intervene with antihypertensives in patients with acute stroke not going for tPA?

Back 18

if BP >220/120

Front 19

delusion that family member is an impostor or living area is a replica of real home

Back 19

Capgras syndrome

Front 20

what is anosognosia?

Back 20

unawareness of neurologic deficit

Front 21

current definition of status epilepticus

Back 21

old definition >30mins; most seizures last 1-3 mins so treat as status if longer than 5 minutes

Front 22

usual presentation of idiopathic intracranial hypertension or pseudotumor cerebri

Back 22

obese, young women, presents with headache, visual changes and tinnitus

Front 23

when is anticoagulation indicated post-stroke with intracranial bleed?

Back 23

if stable, on day 4

Front 24

treatment of MS-related fatigue

Back 24

amantadine / modafinil

Front 25

AEDs used for migraine prophylaxis that carry an increased risk of kidney stone formation

Back 25

topiramate and zonisamide

Front 26

first-line drug for treating partial and generalized epilepsy that is well tolerated in older patients. It has been shown to have the highest rate of retention and best efficacy in this population.

Back 26

lamotrigine

Front 27

diagnostic criteria for migraine

Back 27

at least two of four pain features (unilateral location, pulsatile nature, moderate to severe intensity, and aggravation by routine activity) and at least one of two associated features (nausea or photophobia/phonophobia).

Front 28

drugs that inhibit cytochrome P3A4

Back 28

macrolides, fibrates, and protease inhibitors (such as itraconazole)

Front 29

meds with documented the efficacy for chronic migraine prophylaxis

Back 29

topiramate and injectable onabotulinumtoxinA

Front 30

should be considered first-line preventive medications for episodic migraine

Back 30

topiramate, propranolol, timolol, amitriptyline, and divalproex sodium

Front 31

only two neurologic conditions can produce rapid deterioration in cognition and behavior (not including, infection, trauma, intoxiccation)

Back 31

prion disorder (such as Creutzfeldt-Jakob disease) and a paraneoplastic syndrome (such as limbic encephalitis).

Front 32

potential complication of natalizumab in the treatment of multiple sclerosis

Back 32

progressive multiforcal leukoencephhalopathy

Front 33

treatment of tardive dystonia

Back 33

gradual discontinuation of the offending agent, treatment with anticholinergic or dopamine receptor-depleting agents, and the judicious use of botulinum toxin injections

Front 34

these drugs have strongest evidence for prophylaxiis against migraaine

Back 34

TCAs s.a. amitriptylline; propranolol, timolol, divalproex sodium, and topiramate

Front 35

agent used for prophylaxis against cluster headache

Back 35

verapamil

Front 36

characterized by excessive, compulsive, repetitive complex activity that serves no essential purpose

Back 36

punding (caused by ropinirole)

Front 37

why pick keppra as first lline agent in treatment of seizures for Asians?

Back 37

In an Asian patient with the HLA-B*1502 allele, the risk of Stevens-Johnson syndrome is increased with exposure to carbamazepine, lamotrigine, oxcarbazepine, and phenytoin

Front 38

what is the ABCD2 score?

Back 38

one point for an Age of 60 years or greater, one point for a Blood pressure of 140/90 mm Hg or greater, two points for the Clinical symptom of hemiparesis, two points for Duration of 60 minutes or greater, and one point for the presence of Diabetes mellitus

Front 39

how to use ABCD2 score?

Back 39

American Heart Association guidelines recommend hospital admission for all patients with probable TIAs whose ABCD2 scores are 3 or greater within 72 hours of symptom onset

Front 40

what to monitor with interferon therapy

Back 40

LFTs q6 monnths

Front 41

treatment of spasmodic torticollis

Back 41

botulinum toxin injection, not bacloofen

Front 42

first line trreatment for trigeminal neuralgia

Back 42

carbamazepine

Front 43

myelopathy that localizes to dorsal columns and CS tracts

Back 43

vitamin B12 deficiency, neurosyphilis, and copper deficiency