Neurology

Question 0

Treatment options Parkinson’s disease:

Answer 0

Carbidopa-levodopa
Bromocriptine, Pramipexole (D-agonist)
Selegiline (MAO B inhibitor)
Amantadine
Trihexyphenidyl, benztropine (anti-Ach)
Amitriptyline
Deep Brain Stimulation

Question 1

Treatment options for Tourette’s syndrome:

Answer 1

Clonidine
Pimozide
Haloperidol

Question 2

Rx that cause Parkinsonian side effects

Answer 2

Neuroeleptics: chlorpromazine, haloperidol, perphenazine

Metoclopramide

Reserpine

Question 3

Huntington’s chorea Rx

Answer 3

Dopamine blockers to help psychosis and improve chorea

Anxiolytic and antidepressants

Question 4

Rx for Alzheimer’s

Answer 4

Donepezil
Rivastigmine
Galantamine

Ginko
Lecithin

Vitamin E

Question 5

Locked-in syndrome

Answer 5

Infarction or hemorrhage of the ventral pons

Question 6

Neurofibromas todos Type I

Answer 6

AD cafe au lair spots, neurofibromas, CNS tumors (gliomas, meningiomas), anxillary or inguinal freckling , iris hamartomas (Lisch’s nodules) boney lesions.

Scoliosis , pheo, optic nerve glioma, renal artery stenosis, tibial dysplasia

Question 7

Neurofibromatosis Type II

Answer 7

AD less common than type I, bilateral acoustic neuromas, multiple meningiomas, cafe au lait spots, neurofibromas less common than type I and cataracts

Question 8

Sturge Weber syndrome

Answer 8

Port wine stain
Facial vascular nevi
Cap angiomatoses of pia mater
Epilepsy and mental retardation

Question 9

Von hipple lindau

Answer 9

Hemangiomas of brain or brain stem
Renal angiomas
Cysts in multiple organs
Renal cell carcinomas
Pheo

Question 10

Syringomyelia

Answer 10

Most commonly associated with Arnold-chiary malformation, post trauma, post infectious, tethered cord, intramedullary tumors

Most asympt, incidental on MRI

Bilateral loss of pain and temp sensation over the shoulders (cape like distribution) - lateral spinothalamic tract involvement,preservation of touch, thoracic scoliosis, muscle atrophy

Question 11

Brown Sequard syndrome

Answer 11

Spinal cord hemisection usually at cervical level, caused by trauma, crush injury to spinal cord, tumors, abscess

Contra pain and temp loss - spinothalamic tract

Ipsilateral hemiparesis - corticospinal tract

Ipsilateral loss of position/ vibration - dorsal columns

Good prognosis

Question 12

Transverse Myelitis

Answer 12

Thoracic spine
Rapid progression
Lower extremity weakness or plegia, back pain, sensory deficits below the level of the lesion, sphincter disturbance

Question 13

Poliomyelitis

Answer 13

Anterior horn cells and motor neurons so spinal cord and brainstem

Asymmetric muscle weakness (most commonly legs) absent deep tendon reflexes, flaccid strophic muscles and normal sensation

Bulbar involvement CN IX and CN X lead to respiratory and cardiovascular impairment

Question 14

Tonic clinic seizures Rx

Answer 14

Phenytoin and carbamazepine

Phenolbarbital, valproate, primidone

Question 15

Petit mal (absence seizures)

Answer 15

Ethosuximide and valoproic acid

Question 16

Bells Palsy differentials

Answer 16

Trauma
Lyme dx
Tumor: acoustic neuroma, neurofibroma, cholesteatoma
Gillian Barre bilateral palsy
Herpes Zoster