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Flashcards in Neuro Deck (67)
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1
Q

An EEG showing interictal spikes should make you think of what diagnosis?

A

Complex partial seizure

2
Q

What is the most commonly herniated vertebral disc?

A

L4-L5 followed by L5-S1

3
Q

What three symptoms are classic for normal pressure hydrocephalus?

A

Gait disturbance, dementia, and urinary inconintence

4
Q

A patient presents with inability to speak and right sided weakness. He seems to understand speech and follows commands well. Wha type of aphasia should you be thinking of?

A

Broca’s aphasia

5
Q

Alcohol is a major factor in which encephalopathy?

A

Wernicke’s

6
Q

A patient complains of muscle weakness and fatiguability that improves with rest. What is the most likely diagnosis?

A

Myasthenia gravis

7
Q

Lead pipe or cogwheel rigidity should make you think of what diagnosis?

A

Parkinson’s disease

8
Q

A patient presents following a seizure. Just before the seizure she remembers seeing flashing lights all around her. What diagnosis should be at the top of your differential?

A

Complex partial (AURA)

9
Q

Duchenne’s and Becker’s muscular dystrophy have what genetic characteristic?

A

X-linked recessive

10
Q

What is the age range for Duchenne’s muscular dystrophy?

A

3-5 years old

11
Q

An EEG showing generalized spikes and associated slow waves should make you think of what diagnosis?

A

Generalized or absence seizure

12
Q

What ist he most common primary intracranial neoplasm?

A

Glioma

13
Q

What is the most common cause of SAH aside from trauma?

A

Ruptured cerebral aneurysm**

14
Q

What are the most common primary cancer sites that metastasize to the brain?

A

Lung, breast, kidney

15
Q

A resting or pill-rolling tremor should make you think of what diagnosis?

A

Parkinson’s disease

16
Q

Weakness and numbness in the left hand might be a blockage in which carotid artery?

A

RIGHT

17
Q

A patient has an intracranial neoplasm causing auditory illusions, olfactory hallucinations, and emotional changes. What lobe is the lesion likely in?

A

Temporal

18
Q

If you are looking for lesions associated with MS and your order an MRI, do you order with gadolinium or without?

A

WITH

19
Q

What is the defining symptoms of alzheimers?

A

Progressive memory impairment

20
Q

Which nerve root is responsible for the knee-jerk reflex?

A

L3-L4

21
Q

List 2 medications you might use to treat an essential tremor.

A

Beta blocker (propranolol), primidone

22
Q

What age to symptoms of huntington’s disease first appear?

A

30

23
Q

A 35 year old patient comes to your office cause his wife made him. He has been increasingly irritable and moody. She has also noticed that he is very restless. You order a CT scan which shows cerebral atrophy as well as atrophy of the caudate nucleus. Most likely diagnosis?

A

Huntington’s disease

24
Q

What is the medication of choice for a patient with Tourette’s syndrome?

A

Haldol

25
Q

A slit lamp shows kayer-flescher rings. What is the most likely diagnosis?

A

Wilson’s disease

26
Q

Wilson’s disease is associated with a buildup of what mineral?

A

Deficiency of copper building protein and therefore a buildup of copper

27
Q

What cranial nerve is affected by Bell’s palsy?

A

7

28
Q

A lumbar puncture for a patient with bacterial meningitis will show increased or decreased WBCs? Glucose? Protein?

A

Increased WBC, decreased glucose, increased protein

29
Q

What symptoms is associated with a classic migraine?

A

Having an aura

30
Q

Elevated circulating acetylcholine receptor antibodies should make you think of what diagnosis?

A

Myasthenia gravis

31
Q

Six meds for migraine prophylaxis

A

Beta blockers, tricyclics, CCB, NSAIDs, valproic acid

32
Q

A patient presents with what appears to be an inability to understand speech. Which aphasia should be at the top of your differential?

A

Wernicke’s

33
Q

A patient presents with facial paresis, arm drift, and abnormal speech. What are the first three tests to order?

A

Thinking of stroke you should order a non-contrast CT or MRI, serum glucose, and oxygen saturation

34
Q

A patient is brought in following a seizure in which she DID NOT LOSE CONSCIOUSNESS. What is the most likely diagnosis?

A

Simple partial

35
Q

A patient is having a stroke and there is no evidence of hemorrhage. What is the first line medical treatment?

A

Within the first 4 hours and with no contraindications thrombolytics should be given (NOTE this question said 48 hours but I know from lecture 3-4.5, not sure why it says that)

36
Q

A patient presents with painful ipsilateral third nerve palsy. What is the most likely diagnosis?

A

Posterior communicating artery aneurysm

37
Q

What seizure medication may cause overgrowth of gums?

A

Phenytoin

38
Q

A sudden “thunderclap” headache should make you think of what diagnosis?

A

Subarachnoid hematoma/hemorrhage

39
Q

What is kernigs sign?

A

Patient lies supine, flexes hip while keeping knee straight. Back pain is positive.

40
Q

Imaging is negative for blood, but you strongly believe there is a subarachnoid hemorrhage. What test can you order that will be definitive?

A

Lumbar puncture

41
Q

A patient presents with a lateralizing throbbing headache. He is also complaining of nausea, vomiting, and photophobia. What type of headache is most likely?

A

Migraine

42
Q

A middle aged ale presents with unilateral periorbital headaches occurring daily for several weeks. These headaches are extremely painful. Which type of headache is the most likely cause?

A

Cluster

43
Q

List three drugs that treat cluster headaches

A

Oxygen, sumatriptan, stadol

44
Q

A 34 year old presents with symptoms that are relapsing and remiting over the last few weeks. These include visual problems and weakness in her right arm. What is the most likely diagnosis?

A

MS

45
Q

A patient has a tremor with motion in his hands. What medication might you prescribe?

A

This patient has an ACTIVE tremor. A beta blocker like propranolol is a good start.

46
Q

A shuffling gait should make you think of what diagnosis?

A

Parkinson’s

47
Q

Give two classes of drug therapy for treating parkinsons

A

Dopaminergic (levodopa) anticholinergics are second line

48
Q

Decreased GABA and substance P should make you think of what diagnosis?

A

Huntingtons

49
Q

Is huntingtons autosomal dominant or recessive?

A

Dominant

50
Q

A patient presents with weakness that he has felt in his lower legs and now feels in his knees and hips bilaterally. He has decreased deep tendon reflexes. He has been getting progressively worse. What is the most likely diagnosis

A

Gillian barre

51
Q

What percentage of strokes are ischemic? What percentage are hemorrhagic?

A

80% ischemic 20% hemorrhagic

52
Q

You believe a patient has had a stroke. He presents with aphasia, los of hearing in one ear and loss of vision in his left eye. Is the blockage likely anterior or posterior?

A

anterior

53
Q

Under what conditions would aspirin or clopidogrel be used following a TIA as prophylaxis?

A

They would be used unless there is a known cardiac etiology for the embolism. Patients with a cardiac cause should use heparin or coumadin.

54
Q

A patient who is asx should consider having an endarterectomy at what percent blockage of the carotid artery. How about in a symptomatic patient?

A

70% in an asx patient and greater than 60% in a sx patient

55
Q

A patient presents complaining of the worst headache of his life. What might you expect his BP to be?

A

This is the description of SAH. BP should be elevated.

56
Q

Name one abortive drug for migraines

A

Triptans

57
Q

An EEG shows focal rhythmic discharge at onset of seizure should amen you think of what diagnosis?

A

Simple partial

58
Q

What is the signal most important thing to be concerned about with a patient in status epileptics?

A

AIRWAY, followed my management of hyperthermia

59
Q

Describe Brudzinski’s sign

A

When you lift the patient’s head the patient bends his hips

60
Q

Name 3 meds you can use to break a seizure

A

Diazepam, lorazepam, phenytoin or fosphenytoin

61
Q

There is an MRI result of multiple foci of demyelination in the white matter. What is the most likely diagnosis?

A

MS

62
Q

What ist he most common cause of dementia?

A

Alzheimers, it may be as high as 80%

63
Q

What 4 chromosomes have been linked to dementia?

A

1, 14, 19, 21

64
Q

Is the ankle jerk reflex of lumbar or sacral origin?

A

Sacral

65
Q

A study result comes back with intracellular neurofibrillary tangled and extracellular neuritic plaques. What is the most likely diagnosis?

A

Alzheimer’s disease

66
Q

A patient complains of an aching headache which feels like a band around his head. What is the most likely diagnosis?

A

Tension headache

67
Q

A patient presents to your office complaining of a tremor in his right hand. He states after a beer it goes away completely. What is the most likely diagnosis?

A

Benign essential tremor or familial tremor