question

most common aura in migraine

answer

flashing light or enlarging blind spot rimmed with shimmering edge or jagged lines in peripheral vision

question

how is a "typical" aura defined?

answer

any combination of visual, hemisensory or language abnormalities developing over >5 mins and lasting max of 60 mins

question

when should auras be investigated (in migraines)

answer

>60mins, involve any focal motor weakness, display brainstem symptoms

question

two types of migraines

answer

episodic migraine (<15d/month) or chronic (15 least 15d/month x more than 3 months)

question

risk factors for transformation of episodic to chronic migraine

answer

age, stress, female sex, low educ/socioeconomic status, head/neck trauma, obesity, comorbid pain and sleep or psych disorders, high caffeine or nicotine intake, overtreatment with acute headache meds

question

overtreatment with acute headache medication resuls in

answer

medication overuse headache

question

acute headache meds that lead to chronic migraine; and their duration of use

answer

opiates (8d/mo), barbiturates (5d/month) and NSAIDs and triptans (10-14d/month)

question

treatments for acute migraine that are evidence-based

answer

NSAIDs, dihydroergotamine, triptans

question

contraindications to triptans

answer

vasospastic or ischemic vascular disorders, uncontrolled HTN, hemiplegia or basilar migraine subtypes

question

goal of migraine treatment

answer

cmoplete resolution within 1-2 hours and return to normal function within 24 hours

question

define status migrainosus

answer

single migraine attack extending >72 hours

question

the cornerstone of inpatient management of refractory migraine

answer

IV dihydroergotamine is extremely effective for patients who have not take triptans or ergots within 24 hours

question

in-patient meds for migraine

answer

IV ketorolac, sodium valproic acid; dexa lowers recurrence; IV dopamine agonists with IV diphenhydramine

question

six situations where migraine prophylaxis is indicated

answer

>2d/wk or 8d/month; use of acute meds >2d/wk; disabling symptoms despite intervention; prolonged (>1h) or complex aura; C/I to acute therapies, patient preference

question

major classes of agents available for migraine prevention

answer

NSAIDS, B blockers, calcium blockers, antidepressants, anticonvulsants, serotonin receptor antagonists

question

agents with strongest evidence for prevention of episodic migraines

answer

propranolol, timolol, amitriptyline, divalproex sodium, topiramate

question

only 2 agents for chronic migraine

answer

topiramate PO and injectable onabotulinumtoxinA

question

contraindications to topiramate

answer

kidney stones

question

how long should you give prophylactic agents in migraine?

answer

6-12month maintenance phase after response (50% reduction in headache frequency); followed by a tapering phase

question

define menstrually-related migraine vs. pure menstrual migraines

answer

menstrually-related migraines occur during (D2-3) and outside menses; pure menstrual migraine occurs exclusively during the menstrual period

question

treatment for pregnant woman with migraine

answer

acetaminophen, metoclopramide, certain opiates and NSAIDs; avoid NSAIDs after week 32; other agents include prednisone; triptans are category C use only when benefit outweighs risks

question

duration to consider generalized convulsive status epilepticus

answer

lasting longer than 30 minutes

question

first line of management for status epilepticus

answer

IV ativan ffd by phenytoin

question

why is fosphenytoin favored over phenytoin?

answer

adminstered faster and does not carry risk of thrombophlebitis or skin necrosis associated with phenytoin extravasation

question

all immunocompromised patients with first seizure episode should have these two tests

answer

MRI and lumbar puncture

question

why ask about the "aura" in seizure history?

answer

provides a clue to the cortical origin of the seizure

question

seizure that involves the cortex diffusely

answer

generalized seizure

question

seizure that has its onset in a limited region of the cortex

answer

partial seizure

question

focal seizure that does not impair awareness

answer

simple partial seizure

question

a focal seizure that involves alteration of consciouness

answer

complex partial seizure

question

a simple partial motor seizure characterized by thythmic contraction of a group of muscles (fingers) ffd by spread to arm and then ipsilateral face

answer

classic jacksonian march

question

simple partial seizures which cause purely subjective symptoms

answer

epileptic auras

question

limb weakness contralateral to the site of seizure onset

answer

Todd paralysis

question

causes of acute ataxia

answer

intoxicant, benzodiazepine, phenytoin or vascular event (cerebellar or brainstem hemorrhage or ischemic stroke)

question

causes of subacute ataxia

answer

paraneoplastic syndrome (s.a. paraneoplastic cerebellar degeneration) or prion disease

question

causes of chronic ataxia

answer

cerebellar degeneration

question

most common adult-onset progressive ataxia syndrome

answer

multiple system atrophy cerebellar type (olivopontocerebellar atrophy) and spinocerebellar atrophy disordres including Machado-Joseph disease (spinocerebellar ataxia tyupe 3)

question

drugs that cause or exacerbate tremor

answer

beta agonists, stimulants, cyclosporine, IFN, valproic acid, lithium, steroids, serotonin reuptake inhibitors

question

treatment of essential tremor

answer

propranolol and primidone (oldest and most effective), gabapentin, methazolamide, topiramate

question

treatment of medication-refractory essential tremor

answer

deep brain stimulation of ventral intermediate thalamic nucleus (VITN)

question

tremor + ataxia, dysarthria, parkinsonism, dementia

answer

consider Fragile X tremor ataxia syndrome

question

dystonia always involves this brain structure

answer

basal ganglia

question

treatment of focal dystonia

answer

botulinum A or B injections

question

first line drugs for treatment of generalized dystonia

answer

high-dose anticholinergic agents and baclofen

question

treatment of tardive dystonia

answer

may respond to dopamine-depleting agents reserpine and tetrabenzine

question

treatment of refractory dystonia

answer

bilateral continuous electrical stimulation of globus pallidus internal nuclei

question

what is mild cognitive impairment

answer

loss of cognitive ability greater than expected by age, but does not interfere significantly with ADLs

question

risk factors for progression of MCI to dementia

answer

family history of Alzheimer's, memory deficit >1.5 SD below normal; apolipoprotein E4 allele, reduced hippocampal volumes on neuroimaging

question

tests for evaluation of cognitive function

answer

Folstein MMSE, Montreal cognitive assessment

question

What score indicates dementia on the screening tests?

answer

less than 22

question

differentials for rapidly progressive dementia (weeks to months)

answer

suggests a paraneoplastic disorder such as limbic encephalitis or prion disease s.a. CJD

question

tests that can be ordered (judiciously) as part of work-up for dementia

answer

CBC, CT head, MRI brain, ESR TFTs B12 VDRL

question

when is LP indicated in the evaluation of dementia?

answer

rapid progression, age <60y; systemic cancer, infection or autoimmune disease; immunosuppressed, (+) syphilis serology

question

most definitive diagnostic test for dementia

answer

brain biopsy

question

mutation in this gene for tau protein metabolism accounts for a fraction of Alzheimer's dementia

answer

presenilin

question

the key pathologic agent involved in Alzheimer's disease

answer

beta-amyloid protein

question

What is Capgras syndrome?

answer

"family members are imposters"(misidentification delusion in Alzheimer's)

question

diagnosis of Alzheimer's disease

answer

no biologic markers exist; diagnosis depends on exclusion of other causes of dementia

question

pathologic features of Alzheimer's brain (gross and microscopic)

answer

grossly, diffuse brain atrophy, widening of sulci and enlargement of ventricles; histologically, "tangles + amyloid + degenerating neurson", neurofibrillary tangles, amyloid-containing neuritic plaques and granulovacuolar degeneration of neurons

question

most severely affected brain regions in Alzheimer's dementia

answer

temperal lobe, hippocampus, Ach-containing basal nucleus of Meynert

question

name the Alzheimer's disease medications

answer

Gallant Don Rivas Tacker (NMDA) - galantamine, donepezil, rivastigmine, tacrine, memantine

question

MOA of alzheimer's meds

answer

acetylcholinesterase inhibitor; except for memantine which is an NMDA inhibitor; galantamine is also a nicotinic receptor agonist

question

these agents may reduce the rates of institutionalization in patients with Alzheimer's disease

answer

selegiline and Vitamin E

question

second most common cause of dementia

answer

dementia with Lewy bodies

question

pathologic hallmark of dementia with Lewy bodies

answer

widespread presence of Lewy bodies (eosinophilic intracytoplasmic accumulations of alpha-synuclein reveiled by ubiquitin and alpha-synuclein immunohistochemical staining techniques)

question

treatment for Lewy body dementia

answer

same as for Alzheimer's dementia; levodopa to treat motor symptoms (often develop parkinsonism)

question

which antipsychotic agent should be used with Lewy body dementia?

answer

agents that do not block dopamine receptors, s.a. clozapine

question

What is the cause of frontotemporal dementia?

answer

mutations in tau protein --> become hyperphosphorylated --> aggregates in neurons or glia

question

original name of frontotemperal dementia

answer

Pick disease (mutation in tau protein on Chromosome 17)

question

triad of normal pressure hydrocephalus

answer

DUMB WALKER URINATES = cognitive decline, gait abnormalities, urinary incontinence in the setting of normal CSF pressure (usually <150mmH20)

question

first diagnostic step in patient with suspected NPH

answer

MRI brain - ventricles expand without sulcal atrophy or obstruction

question

best predictor for shunt-responsive hydrocephalus

answer

clinical improvement in gait after continuous lumbar drainage procedure over 2-3 days at a rate of 10ml/hr

question

treatment of NPH

answer

shunt placement with programmable valve

question

signs and symptoms of hemorrhagic stroke

answer

HA, vomiting, diastolic >110; meningisimus, seizures at onset, coma

question

this study can reveal hyperintensity within minutes of acute cerebral infarction

answer

diffusion-weighted MRI

question

gold standard for evaluating cerebral vasculature

answer

catheter-based angiography

question

other tests to evaluate cerebral vasculature that is less invasive

answer

MRA without contrast; CT angio, doppler-flow ultrasonography

question

new definition of TIA as per AHA/American Stroke Association?

answer

transient neurologic deficit resulting from focal brain, SC or retinal ischemia without acute infarction

question

Which TIA patients get admitted?

answer

ABCD2 score identifies TIA patients with highest risk of subsequent stroke - all within 72 hours of initial symptoms with score >/= 3 should be admitted (transient monocular blindness should also be admitted)

question

ABCD2 stands for

answer

age >/=60, BP>140/90, clinical presentation, duration of symptoms and presence of DM

question

ICA disease and race - is there a connection?

answer

ICA disease most common in Europeans; intracranial atherosclerosis most common in Asians and Africans

question

causes of lacunar infarcts

answer

LIPOHYALINOSIS of small penetrating arteries that feed off the MCA, ACA, PCA and vertebrobasilar arteries

question

two types of intracerebral hemorrhage syndromes

answer

DEEP hemorrhage (basal ganglia or cerebellum) likely due to HTN and LOBAR hemorrhage likely due to cerebral amyloid angiopathy

question

important caveat about diagnostic imaging of intracerebral hemorrhages

answer

repeat imaging study 4-6 weeks after initial event because hemorrhage may obscure an underlying tumor

question

MOA of tPA

answer

converts plasminogen to plasmin in the presence of fibrin to initiate fibrinolysis

question

time frame for endovascular clot removal

answer

within 8 hours

question

BP goal for stroke patients undergoing tPA

answer

185/110

question

antihypertensive agent of choice for stroke patients undergoing tPA

answer

labetalol or nicardipine (avoid NTG or nitroprusside - lowers BP excessively)

question

after rtPA infusion, BP target?

answer

<180/105

question

BP goal for stroke patients not undergoing tPA

answer

permit BP up to 220/120

question

BP target in ICH

answer

160/90 or MAP of 110

question

when should ICH be removed surgically?

answer

cerebellar ICH >3cm in size, or with neurologic deterioration or superficial hemorrhage >30ml

question

characteristic neurologic syndrome in cavernous sinus thrombosis

answer

lesions of CN 3, 4, 5 (V1 and V2) and sometimes 6

question

CT scan finding in dural sinus venous thrombosis

answer

CT shows filling defects in the dural sinuses "empty delta sign" at the confluence

question

treatment of dural sinus venous thrombosis

answer

not established, heparin ffd by warfarin x 6 mos even in the setting of ICH

question

HA + neck pain --> partial Horner syndrome (ptosis, miosis)

answer

cervicocephalic dissection

question

Imaging of choice for cervicocephalic dissection

answer

MRI of soft tissues of neck; MRA and CTA will only show narrowing.

question

incidental finding of intracerebral aneurysm - when is an aneurysm at risk for rupture?

answer

anterior circulation >12 mm; post circulation >7 mm

question

the only nonsurgical intervention known to reduce mortality in stroke

answer

admission to a stroke unit

question

when should carotid revascularization be considered in ICA atherosclerosis

answer

symptomatic extracranial ICA stenosis >70%

question

risks of angioplasty and stenting vs carotid endarterectomy

answer

ANGIO you get stroke, ENDARTERECTOMY you get MI = angioplasty + stenting higher risk of perioperative stroke; carotid endarterectomy has higher risk of perioperative MI

question

when should anticoagulation be started after hemorrhagic stroke

answer

start by day 1 to 4 as long as source of bleeding identified and treated or there is no evidence of active intracranial bleeding

question

s/p cardiothoracic surgery, patient develops stroke; most common cause of perioperative stroke?

answer

post-operative AF

question

trauma-induced alteration in mental status that is sometimes associated with a loss of consciousness

answer

concussion

question

2 hallmarks of concussion

answer

Confusion and amnesia

question

AAN Grade 1 concussion

answer

no LOC, but only momentary confusion or changes in mental status

question

AAN Grade 2 concussion

answer

no LOC, but with symptoms or signs of concussion or changes in MS > 15 minutes

question

AAN Grade 3 concussion

answer

Any loss of consciousness, either brief (seconds) or prolonged

question

return to play with multiple grade 3 concussions

answer

1 month or longer, based on the clinical determination of the evaluating physician

question

return to play with grade-3 concussion with prolonged (minutes) loss of consciousness

answer

2 weeks

question

return to play with Multiple grade-2 concussions

answer

2 weeks

question

return to play with grade 2 concussions, single or multiple grade 1 concussions

answer

1 week

question

who should undergo imaging in patients with TBI

answer

Sx of SDH, on anticoagu or with bleeding disorder; headache >72h; change in behavior, or alertness, neurologic SSx:level of behavior, consciousness, or alertness; or focal or lateralizing neurologic symptoms

question

unilateral, low-frequency resting tremor

answer

Parkinson's disease

question

bilateral, high-frequency, kinetic, and postural tremor (with both limb movement and sustained posture)

answer

essential tremor

question

sustained contraction of agonist and antagonist muscles

answer

dystonia

question

brief, irregular, nonstereotypical, nonrhythmic movements and can involve the extremities, head, trunk, and face

answer

chorea

question

impaired initiation and coordination of movements and can involve speech, gait, and the extremities

answer

cerebellar ataxia

question

abnormal lightning-like jerking extremity movements

answer

myoclonus

question

refers to a set of clinical features that include rigidity, resting tremor, bradykinesia, and postural instability

answer

parkinsonism

question

a specific clinical parkinsonian disorder characterized by its distinct clinical and pathologic features and by its robust therapeutic response to dopaminergic medication

answer

Parkinson disease

question

recognized by a wide-based stance and lurching, irregular steps that are worse with turning

answer

cerebellar ataxia

question

characterized by poor initiation of gait, freezing or complete cessation of gait, postural instability, and a slow, shuffling gait pattern

answer

akinetic / rigid parkinson gait

question

Unilateral ataxia suggests

answer

structural cause due to stroke, tumor, or demyelinating disease

question

truncal and leg ataxia, with the arms left unaffected

answer

Chronic alcohol abuse

question

rapidly progressive ataxia in conjunction with signs of progressive cognitive dysfunction

answer

Creutzfeldt-Jakob disease or a paraneoplastic disorder

question

parkinsonism or dysautonomia in a patient with chronic, progressive cerebellar ataxia

answer

multiple system atrophy

question

primary inherited cerebellar ataxic disorders in adults

answer

spinocerebellar ataxia, Friedreich ataxia, and fragile X tremor ataxia syndrome

question

Wernicke encephalopathy results in ataxia with these associated features

answer

ophthalmoplegia, confusion, peripheral neuropathy, seizures

question

Patients with paraneoplastic ataxia often have these other neurologic manifestations

answer

peripheral neuropathy or encephalomyelitis

question

the only treatable inherited ataxias

answer

Refsum disease, cerebrotendinous xanthomatosis, and ataxia with isolated vitamin E deficiency

question

most common autosomal recessive ataxic disorder

answer

Friedreich ataxia

question

how is Friedreich ataxia diagnosed?

answer

demonstrate trinucleotide (GAA) repeat in the X25 gene "fried rice"

question

Diagnosis of Parkinson's disease

answer

REMAINS CLINICAL based on a cardinal set of clinical features -- resting tremor, bradykinesia, rigidity, and postural instability; the tremor, bradykinesia, and rigidity are asymmetric

question

MOA for carvidopa

answer

inhibits peripheral conversion of levodopa to dopamine

question

dopamine agonists

answer

ropinirole and pramipexole (DOPE ROPE PRAMI)

question

choreiform and dystonic movements, which are involuntary and related to dopamine therapy

answer

dyskinesias

question

treatment for disabling dyskinesias on levodopa monotherapy

answer

add a dopamine agonist

question

first-line agents for treating depression in patients with Parkinson's disease

answer

SSRIs or SNRIs

question

these findings help distinguish progressive supranuclear palsy from Parkinson disease

answer

symmetric bradykinesia and axial rigidity, lack of resting tremor, and restriction of vertical saccades

question

first line agents for severe essential tremor

answer

propranolol and primidone; alternative agents include gabapentin, topiramate, alprazolam, and sotalol

question

this demyelinating disease affects the optic nerves and spinal cord but spares the brain

answer

DEVIC disease or neuromyelitis optica

question

how is MS differentiated from acute disseminated encephalomyelitis?

answer

ADEM = fevers + enceph, greater brain involvement on MRI; more CSF lymphocytosis

question

temporary worsening of any MS symptom in the presence of elevations in body temperaturs

answer

Uhthoff phenomenon

question

three patterns of MS

answer

relapsing-remitting, secondary progressive or primary progressive disease

question

predictor of long-term progression rates in MS

answer

early disability

question

features of primary progressive MS

answer

presents later in life, associated with fewer lesions on MRI

question

how does pregnancy affect MS?

answer

"gets better until baby is born" - reduces relapse on 3rd trimester but increases risk of relapse in first 3 months after delivery

question

how does smoking affect MS?

answer

increases risk of secondary progression threefold

question

what is pseudorelapse in MS?

answer

transient worsening of underlying neurologic symptoms in the setting of infection or another systemic illness

question

treatment of MS relapse

answer

methylpred 1g/d x 3-5d ffd by 10-14d oral prenisone taper (optional); if refractory, plasmapheresis

question

effect of steroid treatment on MS relapse

answer

"faster recover, same disability long term" - does not affect long term disability sustained in relapse but substantially hastens rate of recoverty

question

disease modifying therapies for MS

answer

F-I-N-G-M - IFNB1a and IFNB1b; glatiramer, natalizumab, fingolimod, mitoxantrone

question

how does IFN beta work in MS?

answer

directs immune response away from autoimmunity and protects the BBB

question

how does glatiramer work in MS?

answer

copolymer of 4 AAs that may bind MHC complex molecules and shifts immune response away from autoimmunity

question

MOA of natalizumab

answer

monoclonal Ab that binds alpha4 integrin cellular adhesion molecules on activated T cells and inhibits ability to bind to vascular endothelium and prevents transmigration into CNS

question

if natalizumab is highly effective, why is it not used as first line meds in MS? (cf IFN and glatiramer)

answer

increased risk of multifocal leukoencephalopathy - demyelinating disease casused by reactivation of JC virus

question

the only oral disease-modifying MS agent

answer

"finger is oral" fingolimod

question

MOA of fingolimod

answer

sphingosine-1-phosphate modulator restricts activated lymphocytes into LN and may have direct neuroprotective effects

question

how does mitoxantrone work

answer

antrhracenedione chemo agent that reduces lymphocyte proliferation

question

the only disease modifying MS agent that has shown benefit for secondary progressive MS

answer

mitoxantrone

question

risks of mitoxantrone

answer

cardiac toxicity and secondary leukemia

question

agents for primary progressive MS

answer

none

question

treatment of MS-related fatigue

answer

"tired? give her a man, a mod" modafinil, amantadine

question

pharmacologic treatment of gait impairment in MS

answer

dalfampridine (improves walking speed and leg strength)

question

apnea test is considered positive if...

answer

pCO2 rises 20mm Hg without observed respirations

question

differentiate concussion grades

answer

grade 1-2 no LOC, only amnesia or altered mental status; 1 is 15 mins. Grade 3 - has LOC; grade 1 can go back to game; 2 and 3 cannot go back to game; grade 3 needs to be asymptomatic x 1 week before going back to game; CT scan only if persistent symptoms

question

AED of choice for women of reproductive age

answer

"L. O. C. K." - carbamazepine (also keppra, lamotrigine and oxcarbazepine)

question

BP goal after tPA administration

answer

180/105 or less

question

the three indications for acute anticoagulation for acute ischemic stroke

answer

mechanical valves, AF with small infarcts after cardiac surgery, cervicocephalic dissection

question

the trial that demonstrated high dose statins reduce recurrent stroke risk in patients with LDL >100

answer

SPARCL - stroke prevention by aggressive reduction in cholesterol levels

question

When is corpus callostomy indicated?

answer

palliative treatment for symptomatic generalized epilepsy with tonic or atonic seizures

question

treatment of tension type headache

answer

acetaminophen and ibuprofen, no evidence for TCAs and cyclobenzaprine

question

Effectiveness of glatiramer acetate in MS

answer

reduces risk of MS development in the first 3 years by 45%

question

what is MCI?

answer

mild cognitive impairment - loss of cognitive ability that exceeds the expected age-related memory loss but does not interfere significantly with daily activities

question

Woman of reproductive age, with seizure; wants to go on OCP, which meds need adjustments?

answer

lamotrigine needs to be increased if estrogen is used; if carbamazepine or oxcarbazepine or phenytoin or topiramate is used, OCPs are less effective

question

hallmark features of frontotemporal dementia

answer

APHID - apathy, perseveration, hoarding and disinhibition

question

features of Lewy body dementia

answer

"Loopy Body Dementia- sees things, enacts dreams" - visual hallucinations, dream enactment behavior, atremulous parkinsonism

question

differentials for cluster headache

answer

chronic paroxysmal HEMICRANIA and SUNCT syndrome or short-lasting unilateral neuralgiform headache with conjunctival injection and tearing

question

differentiate cluster from hemicrania and SUNCT

answer

hemicrania usually lasts for 15 minutes and occurs about 40x/day; cluster lasts 1-2 hours and occurs <8x/day; SUNCT lasts for seconds and occurs hundreds of times per day

question

treatment of hemicrania

answer

responds dramatically to INDOMETHACIN

question

treatment of dyskinesia in Parkinson's patient who has been on increasing doses of levodopa

answer

deep brain stimulation

question

delusion that a relative is an impostor or that someone's home is a replica and not real

answer

Capgras syndrome

question

opposite of Capgras syndrome (that hospital is his home)

answer

reduplicative paramnesia

question

what is secondary headache?

answer

headache that is unstable or progressive in temporal pattern and usually raise a red flag

question

diagnostic test of choice for cerebral vasculitis

answer

CTA

question

limbic encephalitis associated with ovarian teratomas

answer

anti-NMDA receptor encephalitis

question

paraneoplastic syndrome in small cell lung cancer where patients present with motor or sensory symptoms

answer

anti-Hu paraneoplastic encephalitis

question

post-intracerebral bleed, stable, when to start DVT prophylaxis

answer

day 4

question

treatment for MS-related fatigue

answer

amantadine or modafinil

question

migraine prophylaxis drug that is contraindicated in patients with kidney stones

answer

TOPIRAMATE (mild CAI, increases calcium phosphate stones

question

treatment of disruptive tics

answer

clonidine, pimozide,haldol

question

differentiate akathisia from restless legs syndrome

answer

akathisia is a form of restlessness coupled with urge to move but not accompanied by dysesthesia of RLS or periodic limb movements of sleep

question

treatment of restless legs syndrome

answer

opiates or dopamine agonists (pramiprexole or ropinirole)

question

treatment of MS-related spasticity

answer

tizanidine (central alpha-2-adrenergic agonist), baclofen or cyclobenzaprine; if severe, trial of botulinum toxin injections or intrathecal baclofen pump

question

most common causes of neuroleptic malignant syndrome

answer

haloperidol and fluphenazine

question

differentiate NMS from malignant hyperthermia

answer

the drugs involved - haldol and fluphenazine for NMS; inhalational anesthetic agents and depolarizing muscle relaxants in malignant hyperthermia

question

treatment for ICA dissection

answer

treat the stroke - STENTING not proven to improve outcomes

question

AED of choice for older patients >60y/o

answer

lamotrigine

question

lab test to monitor on patients with MS started on IFN beta 1b

answer

LFTs

question

treatment of choice for dystonias, specifically torticollis

answer

botulinum toxin infections

question

nutrient deficiencies that causes myelopathy of the posterior columns of the spinal cord

answer

B12, copper (syphilis is another infectious cause)

MKSAP 16 Neurology – Flashcards

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