A Toast to Stroke
Parkinson's + Parkinson's Plus
What's on tap?
TIFFs and Tumors
FLAIR Witch Project
100
An elderly patient with diabetes, hypertension, and hyperlipidemia presents with persistent vertigo. Where is the suspected lesion?
Basilar artery (vertebral/vertebrobasilar; posterior circulation)
100
What is the drug of choice in essential tremor?
Propranolol or primidone
100
What CSF finding can diagnose subarachnoid hemorrhage in patients with high clinical suspicion but a negative CT scan?
Xanthochromia
100
Shown below on MRI, what is the most common primary brain tumor?
meningioma
100
Mary-Kate and Ashley starred in Double, Double, Toil and Trouble, whose title was taken from Shakespeare's Macbeth. What's the next line in that play?
"Fire burn and cauldron bubble."
200
What is the blood pressure goal for acute intracerebral hemorrhage?
<140 mmHg SBP
200
Associated with progressive chorea, dystonia, and dementia, Huntington disease follows what pattern of inheritance?
autosomal dominant
200
Describe or name the pattern of CSF findings associated with Guillain-Barre syndrome.
Cytoalbuminologic dissociation (elevated CSF protein with normal WBC)
200
Steroids should particularly be avoided prior to biopsy of what neurologic malignancy?
Primary CNS Lymphoma
200
A spray-painted mask of William Shatner was used as the mask of what classic Halloween villain?
Michael Myers (from Halloween)
300
How long should aspirin administration be delayed after IV thrombolytic therapy for acute ischemic stroke?
24 hours
300
Early dysautonomia (including postural instability) is a classic feature of what movement disorder?
Multiple system atrophy (MSA) / Shy-Drager syndrome
300
Name two indications to get a CT Head prior to proceeding with lumbar puncture.
Immunocompromised state
Papilledema/suspected increased ICP or mass
Focal neurologic deficits
Altered mental status
History of CNS disease (mass, CVA, focal infection)
*Recent seizure
300
A woman with known history of ovarian teratoma presents with fever, personality changes with psychosis, seizures, and oral dyskinesias. Contrasted MRI Brain is normal. CSF gram stain is negative. What disease associated with her medical history should be evaluated for?
anti-NMDA encephalitis
300
In The Shining, what sentence does the protagonist type over and over again while writing his book?
"All work and no play makes Jack a dull boy."
400
Name four (4) ABSOLUTE contraindications to IV thrombolytic therapy for ischemic stroke.
Acute or prior intracerebral hemorrhage
Known cerebral AV malformation
Known cerebral neoplasm
Ischemic stroke within 3 months
Suspected aortic dissection
Active bleeding or bleeding diathesis ( INR > 1.4)
Significant head trauma in past 3 months
Thrombocytopenia <100,000
Glucose <50 or >400 mg/dL
400
Name the four cardinal features of Parkinson's Disease.
Resting tremor
Rigidity
Akinesia/Bradykinesia
Postural instability
400
A patient with suspected meningitis presents with the following CSF gram stain:
What is first line therapy for the causative organism?
Ampicillin or penicillin (+/- aminoglycoside) for Listeria monocytogenes
400
43 yo F presents with severe thoracic pain and paresthesias and weakness of the lower extremities. She was treated for recurrent optic neuritis several years earlier.
A demyelinating disorder is suspected. According to Dr. Salhab's lecture, which distinct characteristic of this MRI finding is most helpful in determining the diagnosis?
MRI lesion extends over 3 or more complete vertebral segments (suggests NMO rather than MS)
400
In universally-adored Halloween classic Ernest Scared Stupid, what weakness do the trolls have?
milk, NOT miak (and "the heart of a child")
