Clinical Medicine
What does the pneumonic TRAP refer to in Parksinon's disease?
Tremors
Rigidity
Bradykinesia (akinesia)
Postural instability
Which anti-epileptic drugs are inducers?
Carbamazepine, Phenobarbitol, Phenytoin, Topiramate, Oxcarbazepine
What is the neurotransmitter depleted in Parkinson's disease?
Dopamine
CSF findings for bacterial meningitis show what?
Increased PMNs, Decreased Glucose, Increased Protein
Are meningiomas usually benign or malignant?
Benign
Fatigable weakness that improves with rest, worsens with repetitive use. What test confirms diagnosis?
Acetylcholine receptor antibody testing.
What is the first-line drug and route for status epilepticus? What is after that?
IV lorazepam then phenytoin
A stroke causing contralateral face and arm weakness more than leg is likely in which artery?
Middle Cerebral Artery
Lumbar puncture, CSF w/ xanthrochromia
Which metabolic disorder is commonly associated with restless leg syndrome and should be checked?
Iron deficiency (check ferritin).
What finding differentiates ALS from MS?
No loss of sensory function.
Name one COMT inhibitor used as adjunct therapy to levodopa.
What is entacapone (or tolcapone)?
What is the most likely diagnosis?
Pain over SI joint, hip, posterolateral thigh and leg to heel
Numbness in back of calf, lateral heel, foot and toe
Weak plantarflexion
Achilles reflex diminished or absent
S1 Radiculopathy
What are the gram positive cocci bacteria in bacterial meningitis?
Streptococcus pneumoniae
ALS involves degeneration of which neurons?
UMN and LMN
A 22-year-old has recurrent episodes of lip-smacking, picking at clothes, and postictal confusion.
What two drugs can be used in younger Parkinson's patients to delay the need for levodopa?
Pramipexole or Ropinirole
When do you get an MRI?
Back pain AND history of cancer
Back pain AND fever or concern for infection
Objective extremity weakness (not due to pain)
Loss of bowel or bladder control
What classic finding is seen on fundoscopic exam in pseudotumor cerebri?
Papilledema
Which MS subtype shows steady progression without relapses?
Primary progressive MS (PPMS)?
A 27-year-old woman has intermittent episodes of electric-shock sensations down her spine when flexing her neck, plus vision changes that improved with steroids 6 months ago. What is the condition that she has and what is this specific sign called?
Multiple Sclerosis w/ Lhermitte's Sign
What medication is first-line for trigeminal neuralgia?
Carbamazepine
Which part of the basal ganglia atrophies in Huntington’s disease?
The caudate nucleus.
Which lab is most likely elevated in temporal arteritis?
Elevated ESRs (Erythrocyte Sedimentation Rate)
What are the three ways that brain tumors can cause problems?
1. Mass effect: tumor pushes on normal brain
2. Edema: swelling of normal brain
3. Local invasion: tumors invade normal brain