YOU'RE GETTING ON MY NERVES
NOW YOU'RE REALLY ANNOYING ME
THAT'S IT, I'M GOING TO STAB YOU IN THE SPINE
100
PATIENT PRESENTING WITH AN UNREMARKABLE EXAM OF THE HEAD AND NECK WITH NO NEURO DEFICITS COMPLAINING OF UNILATERAL FACIAL PAIN WITH NONPAINFUL TRIGGERS IS LIKELY TO HAVE THIS CONDITION
TRIGEMINAL NEURALGIA
WHAT IS THE TREATMENT?
LANCINATING PAROXYSMS OF PAIN IN THE LIPS, TEETH, GUMS OR CHIN
100
ASYMMETRICAL SENSORINEURAL HEARING LOSS IS THE HALLMARK OF THIS
VESTIBULAR SCHWANNOMA
100
A LESION HERE CAUSES WHAT SYMPTOMS
IPSILATERAL POSITION AND VIBRATION SENSE LOSS, CONTRALATERAL PAIN AND TEMP SENSATION LOSS, IPSILATERAL MOTOR LOSS
WHAT IS THIS SYNDROME CALLED
200
PATIENT PRESENTING WITH INABILITY TO MOVE THE EYE DOWNWARD AND LATERALLY LIKELY HAS DYSFUNCTION OF THIS NERVE
CRANIAL NERVE IV, TROCHLEAR NERVE
WHICH MUSCLE DOES THIS NERVE INNERVATE?
200
WHAT TEST CAN YOU DO TO DISCERN BETWEEN CONDUCTIVE AND SENSORINEURAL HEARING LOSS?
200
UPPER EXTREMITY WEAKNESS THAT IS MORE PRONOUNCED DISTALLY THAN PROXIMALLY AFTER A FALL CAUSING A HYPEREXTENSION INJURY IS CONCERNING FOR THIS
CENTRAL CORD SYNDROME
PATIENTS MAY COMPLAIN OF BURNING SENSATION IN THE UPPER EXTREMITIES
300
THIS NERVE IS PRONE TO INJURY DUE TO ITS LENGTH AND POSITION
CRANIAL NERVE VI, ABDUCENS NERVE
THIS NERVE CONTROLS WHAT EYE MUSCLE?
300
DIABETIC MONONEUROPATHY WILL SPARE THE ____ INNERVATION OF THE OCULOMOTOR NERVE
PARASYMPATHETIC
PARASYMPATHETIC FIBERS ARE ON THE BORDER OF THE NERVE
CAUSED BY OCCLUSION OF ARTERIES SUPPLYING DEEPER PORTION OF THE NERVE
300
ANTERIOR CORD SYNDROME WILL CAUSE WHAT SENSORY AND MOTOR LOSS
LOSS OF PINPRICK AND TOUCH SENSATION WITH VIBRATION AND POSITION PRESERVED
MOTOR LOSS OR WEAKNESS BELOW CORD LEVEL
MORE OFTEN ASSOCIATED WTH FLEXION INJURIES
400
BELL'S PALSY CAUSES AN UPPER OR LOWER MOTOR NEURON LESION?
LOWER MOTOR NEURON
400
CONSIDER THIS IN A PATIENT PRESENTING WITH UNEXPLAINED HEADACHE WITH A FOCAL NEURO DEFICIT, PAPILLEDEMA OR SEIZURE
CENTRAL VENOUS THROMBOSIS
MORE PRONE TO HEMORRHAGIC INFARCTS AND LOCAL NEURO DEFICIT COMPARED TO SINUS THROMBOSIS (SYMPTOMS TYPICALLY THAT OF INTRACRANIAL HTN)
400
A 28 YO MALE PRESENTING AFTER BEING EJECTED IS UNABLE TO FEEL OR MOVE HIS LOWER EXTREMITIES. HE IS ALSO HYPOTENSIVE AND HAS A PRIAPISM. THIS IS CONCERNING FOR WHAT SPINAL CORD INJURY
COMPLETE CORD SYNDROME
500
RAMSAY HUNT SYNDROME
500
UNILATERAL EYE PAIN WITH ASSOCIATED CENTRAL VISUAL FIELD LOSS IS CONCERNING FOR THIS CONDITION
OPTIC NEURITIS
500
THIS FINDING HAS A SENSITIVITY OF 90% IN REGARDS TO CAUDA EQUINA SYNDROME
URINARY RETENTION
POST-VOID RESIDUAL OF MORE THAN 100-200 ML SHOULD PROMPT EVAL FOR NEUROLOGIC CAUSE OF BLADDER DYSFUNCTION
600
THESE 2 DISEASES ARE ASSOCIATED WITH BILATERAL FACIAN NERVE PALSY
LYME, INFECTIOUS MONONUCLEOSIS
600
OPTIC NEURITIS IS THE MOST COMMON CRANIAL NERVE ABNORMALITY ASSOCIATED WITH THIS CONDITION
MULTIPLE SCLEROSIS
BROAD RANGE OF SYMPTOMS INCLUDING: COGNITIVE DIFFICULTY, CRANIAL NERVE DYSFUNCTION, SPASTICITY, EXAGGERATED DTRs, CLONUS, PARESTHESIAS, BOWEL/BLADDER DYSFUNCTION, SEXUAL DYSFUNCTION
600
THIS IMAGING STUDY CAN BE DONE IF THERE IS CONCERN FOR CORD COMPRESSION IN SOMEONE UNABLE TO UNDERGO MRI
CT MYELOGRAPHY
700
WHAT CONDITION CAN BE SEEN IN AN IMMUNOCOMPROMISED PATIENT PRESENTING WITH EAR PAIN AND FACIAL PARALYSIS ON THE SAME SIDE?
MALIGNANT OTITIS EXTERNA
PSEUDOMONAL INFECTION TYPICALLY
700
THIS PHENOMENON OCCURS IN MS PATIENTS DUE TO SMALL INCREASES IN BODY TEMP
UHTHOFF'S PHENOMENON
700
THIS IS THE MOST FREQUENT MANIFESTATION OF MS INVOLVEMENT OF THE SPINAL CORD
MOTOR SYSTEM DYSFUNCTION
WILL CAUSE UMN FINDINGS
800
CONSIDER THIS IN A PATIENT WITH RECURRENTL IPSILATERAL FACIAL PARALYSIS, SIGNIFICANT PAIN, PROLONGED SYMPTOMS OR ANY OTHER CONCOMITANT FACIAL NERVE ABNORMALITY
NEOPLASM
800
PATIENTS WITH MS FLARE ARE ADMITTED FOR TREATMENT WITH THIS CLASS OF MEDICATION
STEROIDS
HIGH DOSE METHYLPREDNISOLONE
800
THIS DISEASE WILL CAUSE PARAPLEGIA, TRANSVERSE LEVEL OF SENSORY IMPAIRMENT, SPHINCTER DISTURBANCE
TRANSVERSE MYELITIS
THORACIC CORD MORE COMMONLY INVOLVED
FOLLOWED BY VIRAL INFECTION IN 30% OF CASES
COMMONLY COMPLAIN OF BACK PAIN AND FEVER
900
THIS NONINFECTIOUS CONDITION TYPICALLY CAUSES DEFICITS THAT INCLUDE EXTREMITY NUMBNESS, WEAKNESS, SPHINCTER DYSFUNCTION AND SOMETIMES MENINGEAL SIGNS
SPINAL SUBARACHNOID HEMORRHAGE
USUALLY DUE TO AV MALFORMATION
1000
A PATIENT WHO IS CURRENLY BEING TREATED FOR A DVT WITH XARELTO PRESENTS WITH ATRAUMATIC BACK PAIN OF SUDDEN ONSET WITH RADIATION INTO THE LEFT LEG. WHAT SHOULD YOU BE CONSIDERING?
SPINAL EPIDURAL HEMATOMA
PAIN OFTEN CAUSES PATIENT TO SEEK CARE BEFORE NEUROLOGIC SYMPTOMS DEVELOP, POSSIBLY LEADING TO DELAYED DIAGNOSIS
PAIN WILL BE SIGNIFICANT
1100
A PATIENT COMES IN FOR 5 DAYS OF BACK PAIN. THEY STATE THAT INITIALLY IT WAS ONLY A MILD ACHE, BUT HAS NOW LOCALIZED TO THE MIDLINE OF THE LOW BACK. THEY ARE AFEBRILE BUT REPORT NIGHT SWEATS AND RIGORS. THEY DENY IV DRUG USE, BUT DRINK HEAVILY. WHAT SHOULD BE HIGH ON YOUR DIFFERENTIAL?
SPINAL EPIDURAL ABSCESS
CLASSIC TRIAD OF BACK PAIN, FEVER, AND PROGRESSIVE NEURO DEFICITS IS NOT COMMON, LEADING TO DELAYED DIAGNOSIS
MAJOR RISK FACTORS INCUDE: DM, IVDA, CRF, ETOH, IMMUNOSUPPRESSION
1200
A PATIENT PRESENTS WITH SEVERE BACK PAIN AT ROUGHLY THE LEVEL OF L4. THEY DENY TRAUMA. THERE ARE NO NEURO DEFICITS, BUT THEY HAVE RADICULAR SYMPTOMS BILATERALLY. PAIN IS WORSE WITH ANY MOVEMENT OF THE SPINE. THEY HAVE A FEVER ON ARRIVAL. WHAT ARE YOU WORRIED ABOUT?
DISKITIS
INFECTION OF NUCLEUS PULPOSUS
MOST HAVE RADICULAR SYMPTOMS, BUT ARE NEUROLOGICALLY INTACT
L SPINE MOST COMMON SITE
FEVER NOTED IN MAJORITY OF PATIENTS
1300
THIS CONDITION WILL USUALLY PRESENT AS CONSTANT BACK PAIN THAT IS WORSE WHEN LYING DOWN, CAUSING MORE PAIN AT NIGHT
SPINAL NEOPLASM
CONSTITUTES A TRUE EMERGENCY IF ANY SYMPTOMS OF CORD COMPRESSION ARE PRESENT