NBME neuro 2 – Flashcards
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"woman w/aids, acting weird, hyperreflexia, w/multiple ring enhancing lesions" Dx? tx?
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Toxo give sulfadiezene & pyrimethamine
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"seizure, fever, +rbc/wbc in CSF w/EEG: b/l, periodic epileptiform discharges usu over temporal regions" dx? test? tx? eeg?
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hsv encephalitis hsv pcr on csf acyclovir inte intermittent high amp slow waves over temporal lobe + PLEDs
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"degeneration of striatial gaba neurons"
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Huntington's dz
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"accumulation of cerebral cortical plaques and tangles"
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Alzheimer's
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"degen of DA neurons of sub nigra"
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Parkinsons
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"ophthalmoplegia w/partial vision loss s/p head infxn"
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cavernous sinus thrombosis
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"paresthesias of hands and feet and an unsteady gait that is worse in the dark"
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think b12 def
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transient loss of consciousness..think?
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seizure vs syncope pale, clammy, tachy-->syncope aura-->seizure not TIA-no LoC
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"woman w/crawling tightness in calves, worse with sitting or lying in bed. better w/walking" dx tx
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RLS Pramipexole-DA agonist
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"pt w/hx of rheumatic heart dz...sudden onset speech difficulty, paralysis on right face and UE. been sick,vegetations on echo" dx tx
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septic embolization to MCA give antbiotcs!
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"acute onset eye pain, global HA, blurred vision. red conjunctiva, midrange pupil, nonreactive" dx test tx
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Acute closed angle glaucoma tonometry mannitol, acetazolamde, timolol, pilocarpine
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medications that can cause parkinsonism
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domperidone (Motilium) or ondansetron, metaclopramide, prochlorperazine, neuroleptics
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"3 day hx of leg weakness & shooting pains, diff rising from chair, climbing stairs. decreased strength and DTR." thoughts?
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GBS-LMN, acute onset
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Neiseria ppx
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Rifampin (or CTX or cipro)
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"child w/3 mos daily ha, blurred vision, urinary frequency. bitemporal visual field deficits, papilledema, b/l wkns of eye abduction" dx?
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likely some sort of suprasellar mass (craniopharyngioma if cystic w/ca)
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pt found by neighbor, winter, not seen for awhile, refurbishing new home. comatose, nl vitals, PERRLA, + babinski, Edema on ct.Dx?
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CO poisoning
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carotid dissection rx acutely
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IV heparin
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gardener w/ n/v ringing, rash 10 days, oval patches on neck, decreased sensation to pinprick, absent ankle reflexes, increased axillary pigmentation, nails-leukonychia striata"
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arsenic poisoning
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carotid artery stenosis <70%
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ASA if greater and sx--> CEA
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prevention of delirium
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decrease noise and number of interruptions at nigth
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post delivery-sudden headache w/n/v often associated with a rapidly worsening visual field defect or double vision, bitemporal hemianopia
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pituitary apoplexy
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CTS management
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splinting, steroid injxns, surgery
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"bulbar palsy and descending paralysis, lack of fever, and clear senses and mental status" dx
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botulism
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intense pain, vesicles in ear, facial paralysis
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ramsay hunt syndrome
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spinocerebellar ataxia, eye sx, absent reflexes, decreased immune response, myopathy
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vitamin E deficiency
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how differentiate b/t median nerve compression at wrist vs elbow?
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check thumb flexion- if intact-->wrist if not-->elbow also if lose sensation over thenar-->elbow
