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Flashcards in NBME Deck (28)
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1
Q

Transfusion of RBCs - when? (guidelines)

A

Hgb under 7 (= about 21% Hct)

2
Q

Lambert Eaton Syndrome

vs MG

A

Lambert Eaton Syndrome:

  • Ab vs voltage gated Ca2+ channels
  • Small cell lung cancer
  • Proximal muscle weakness
  • Absent DTRs
  • Autonomic (decreased Ach) findings (dry mouth)
  • No sensory findings

MG

  • Ptosis, diplopia, weakness Worsens with muscle use
  • *does not have to be tested for worsened muscle use
  • Cx: thymoma
3
Q

craniopharyngioma vs pituitary adenoma

A

same: bitemporal hemianopsia, frontal headache

pituitary adenoma - will also cause secondary sex characteristic traits

4
Q

microcytic anemia + foot drop + neurologic Sx= ?

A
  • lead poisoning

- moonshine has lead in it

5
Q

Froment’s sign

A

Froment’s sign: ulnar nerve lesion at wrist

-perform electrophysiology testing to find dmg

6
Q

visual acuity decreased in one eye, fundoscopy normal, accompanied by headache

A

-optic neuritis seen in MS

7
Q

PANDAS (pediatric autoimmune neuropsychiatric disorders)

A

PANDAS: pediatric population 1-2 months after strep infection. Symptom is Tic+OCD. Usually occurs in prepuberty, sudden onset. Motor hyperactivity and choreiform movements. Treated with antibiotics+SSRI+CBT

8
Q

Polymyalgia rheumatica

A
  • SYMPTOMS: Pain/stiffness in shoulders and hips, fever, malaise, weight loss
  • NO muscular weakness
  • giant cell (temporal) arteritis
  • FINDINGS: inc ESR, inc CRP, normal CK
  • TREATMENT: Rapid response to low-dose corticosteroids
9
Q

Polymyositis/dermatomyositis

A

inc CK, ⊕ ANA, ⊕ anti-Jo-1, ⊕ anti-SRP, ⊕ anti-Mi-2 antibodies. Treatment: steroids followed by long-term immunosuppressant therapy (eg, methotrexate).

10
Q

Polymyositis vs dermatomyositis

A

Polymyositis: Progressive symmetric proximal muscle weakness *Test: EMG/NCS

Dermatomyositis: polymyositis with skin:
-malar rash (similar to SLE), Gottron papules A , heliotrope (erythematous periorbital) rash B, “shawl and face” rash C, “mechanic’s hands.” risk of occult malignancy

11
Q

Diabetic radiculopathy

A

band-waist pattern (can be half waist)

12
Q

Steroids and spinal cord mass - immediate Tx

A

steroids have been found to be effective in reducing the neurological deficit

13
Q

What controls urination (micturition)

A

-inhibitory action of midbrain upon the parasympathic nerve S2-S4 which is responsible for micturition

14
Q

Tx narcolepsy and cataplexy

A

Modafanil in the morning for Daytime sleepiness & Sodium Oxybate for Cataplexy at bed time & night

15
Q

Neurocysticercosis - on MRI

A
  • see calcifications and brain mass (in most likely healthy individual)
  • immigration?
16
Q

Flame hemorrhage

A

hypertensive encephalopathy

17
Q

Acoustic Neuroma (schwannoma)

A

-impacts facial movement (CN7) and can impact hearing and balance (bc CN 8 is next to CN 7)

18
Q

NMS “FEVER”

A
-bc decreased DA!
Fever
Encephalopathy
Vitals unstable
Enzymes 
Rigidity of muscles
19
Q

Balbar palsy

A

-CN 9, 10, 11, 12 involvement in medulla

20
Q

Atrophic gastritis

A

-dmg parietal cells –> no intrinsic factor –> no B12 = decreased vibration, proprioception, numbness and tingling

21
Q

CO poisoning affects brain where?

A

Globus pallidus (above middle)

22
Q

Tx cervical artery dissection

A

1 - can use clopidogrel and ASA
2 - IV heparin (followed by warfarin)
*goal is to stop clot formation

23
Q

Stroke vs idiopathic bells palsy

A

If pt is healthy/fit and gets facial paralysis = idiopathic bells palsy (not a stroke without risk factors)

24
Q

uremic encephalopathy vs hepatic encephalopathy

A

uremic = renal, hepatic = liver (alcoholics)

25
Q

spondylosis = ?

A

cervical osteoarthritis

26
Q

Ballder UMN signs

A

detrusor hyperreflexia!

27
Q

Acute cerebellar ataxia of childhood

A
  • childhood condition characterized by an unsteady gait, most likely secondary to an autoimmune of postinfectious cause, drug induced or paraneoplastic.[1] Most common virus causing acute cerebellar ataxia are Chickenpox virus and Epstein Barr Virus. It is a diagnosis of exclusion.[2]
  • 2-3 wks after initial infection
  • 50% bilateral horizontal nystagmus
28
Q

Rx to quickly lower high BP

A

1 - Labetalol
2 - Nicardipine
3 - Hydralizine
4 - Nitroprusside