Neurology

Clinical Medicine

100

What does the pneumonic TRAP refer to in Parksinon's disease?

Tremors

Rigidity

Bradykinesia (akinesia)

Postural instability

200

Fatigable weakness that improves with rest, worsens with repetitive use. What test confirms diagnosis?

Acetylcholine receptor antibody testing.

300

What finding differentiates ALS from MS?

No loss of sensory function.

400

A 22-year-old has recurrent episodes of lip-smacking, picking at clothes, and postictal confusion.

Complex focal seizures (partial impaired-awareness)

500

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

Pharmacology

100

Which anti-epileptic drugs are inducers?

Carbamazepine, Phenobarbitol, Phenytoin, Topiramate, Oxcarbazepine 

200

What is the first-line drug and route for status epilepticus? What is after that?

IV lorazepam then phenytoin 

300

Name one COMT inhibitor used as adjunct therapy to levodopa.

What is entacapone (or tolcapone)?

400

What two drugs can be used in younger Parkinson's patients to delay the need for levodopa? 

Pramipexole or Ropinirole

500

What medication is first-line for trigeminal neuralgia?

Carbamazepine

Neuroanatomy

100

What is the neurotransmitter depleted in Parkinson's disease?

Dopamine

200

A stroke causing contralateral face and arm weakness more than leg is likely in which artery?

Middle Cerebral Artery

300

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 

400

When do you get an MRI?

1. Back pain AND history of cancer

2. Back pain AND fever or concern for infection

3. Objective extremity weakness (not due to pain)

4. Loss of bowel or bladder control

500

Which part of the basal ganglia atrophies in Huntington’s disease?

The caudate nucleus. 

Diagnostics

100

CSF findings for bacterial meningitis show what?

Increased PMNs, Decreased Glucose, Increased Protein

200

A non-contrast CT is negative for Subarachnoid Hemorrhage. What is the next step and what would you look for?

Lumbar puncture, CSF w/ xanthrochromia

300

What are the gram positive cocci bacteria in bacterial meningitis?

Streptococcus pneumoniae

400

What classic finding is seen on fundoscopic exam in pseudotumor cerebri?

Papilledema 

500

Which lab is most likely elevated in temporal arteritis?

Elevated ESRs (Erythrocyte Sedimentation Rate)

Pathophysiology

100

Are meningiomas usually benign or malignant?

Benign

200

Which metabolic disorder is commonly associated with restless leg syndrome and should be checked?

Iron deficiency (check ferritin). 

300

ALS involves degeneration of which neurons?

UMN and LMN

400

Which MS subtype shows steady progression without relapses?

Primary progressive MS (PPMS)?

500

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