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Flashcards in neurology Deck (121)
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What diagnosis should you consider in a patient who has signs of encephalitis after mosquito bites and lives in a warm climate ?

Arbovirus - west Nile or St Louis encephalitis

1

What diagnosis should you consider in a patient with confusion and irritability after being in contact with a person with diagnosis of meningitis?

Enterovirus encephalitis

2

What diagnosis should you consider in a teenager who is unimmunized and presents with parotitis and neurological symptoms ?

Mumps encephalitis

3

What medication should you give in a febrile toddler who presents with a fever and lethargy for one hour post seizure?

Acyclovir and antibiotics

4

What is the treatment for a teenager with frontal headache which is "band like" and "pressure"?

Eliminating the environmental stressors

5

What is the first line treatment for migraine headache?

Ibuprofen
Tylenol
Fluids
Rest

6

What is the appropriate next step in a patient with several months of frontotemporal headache unrelieved wth daily Tylenol and Motrin ?

Stop medication as effect is blunted by chronic use

7

What diagnosis should you consider in a patient with headache and progressive and intermittent visual disturbances ?

Increased ICP

8

How can you differentiate migraines from increased ICP in a patient with headache and visual disturbances?

Migraines present with blurry vision only before the headache
Progressive visual loss is consistent with increased ICP

9

If a patient presents with abrupt onset of altered mental status what are the two most likely causes?

Trauma or CVA

10

If a patient presents with altered mental status that occurred over several hours, what is the more likely diagnosis?

Toxic ingestion

11

What is the probable diagnosis in a patient with hypoglycemia that is resistant to glucose replacement ?

Ingestion of hypoglycemic medication

12

If you are presented with a non responsive neonate, what labs should you order (other than to rule out sepsis)?

Ammonia
Organic acid levels

13

What diagnosis should you consider if you see greenish-yellow rings at the edge of the cornea on slit lamp exam?

Wilson's disease

14

What are 4 abnormal lab results that help in diagnosis of Wilson's disease?

Low ceruloplasmin
Low serum copper
Increased urinary copper
Hemolytic anemia

15

How would you treat Wilson disease ?

Penicillamine and low copper diet

16

What diagnosis presents as a neonate with hydrocephalus and hx of heart failure who has a cranial bruit on physical exam?

Vein of Galen malformation

17

What diagnosis should you consider in a patient with tremors, depression and abnormal eye movements as well as acute liver failure ?

Wilson's disease

18

What are the 5 major causes of acute ataxia?

Toxic ingestion
Infection
Metabolic problems
Trauma
Neoplasm

19

What types of malignancy are patients with ataxia telangiectasia at risk for?

Hodgkin lymphoma and leukemia

20

What diagnosis should you consider in a patient with abnormal gait and abnormal pigmentation of the eyes?

Ataxia telangiectasia

21

Why do children with ataxia telangiectasia present with frequent upper and lower respiratory infections ?

Decreased levels of immunoglobulin and T cell dysfunction

22

What disease presents in late childhood with slow/clumsy gait as well as elevated plantar arch and absence of DTR in lower extremities?

Friedreich ataxia

23

Why do children with friedreich ataxia present with abnormal gait?

Cerebellar problem and loss of proprioception

24

What 2 (non neurological) problems are common in children with friedreich ataxia?

Diabetes
Cardiomyopathy leading to CHF

25

What is the treatment for friedreich ataxia?

Supportive

26

What diagnosis should you consider in a patient with quick random jerky movements and poor tone who has difficulty paying attention in school and emotional lability?

Sydenham chorea

27

What lab test effectively rules out Sydenham chorea?

None! A negative ASO does not rule out Sydenham chorea!!!

28

What is the treatment for Sydenham chorea?

Supportive
Antipsychotics (dopamine blocking agents)

29

What is inheritance pattern of Huntington chorea?

Autosomal dominant