Block 13 Jeopardy

Dr. Shahab

100

3 ASMs safe in pregnancy

Lamotrigine

Keppra

Oxcarbazapine

200

What dose of folic acid should be supplemented in pregnancy? Is there harm with too much?

0.4mg daily

Question of increased cancer in children with high doses of folic acid

300

What sequence can you see open ring sign and what diagnosis does it make you think of?

T1 post contrast

Tumefactive MS

400

For which MS medication is genetic testing required prior to starting?

Siponimod 

CYP2C9 gene

500

Types of catamenial epilepsy and pathophysiology behind this

C1 - perimenstrual, drop in progesterone

C2 - Periovulatory, rise in estrogen

C3 - Inadequate luteal phase, second half of menstrual cycle. Inadequate progesterone secretion. 

Pediatric stroke

100

True or False:

Many children who present with initial stroke have significant medical history and were previously unwell. 

FALSE 

200

Symptom variation with pediatric stroke presentation compared to adults (2)

Stuttering presentation rather than abrupt

Headache

Seizure

300

What is the acute management of stroke secondary to sickle cell disease?

Emergent blood transfusion with goal to reduce percentage of hemoglobin S to under 30% and increase hematocrit to 30%

IVF

Oxygen

400

Most common cause of stroke in otherwise previously healthy children (2)

Cervicocephalic dissection

Inflammatory intracranial focal cerebral arteriopathy

500

The STOP trial identified screening patients with sickle cell disease with this modality identified those most at risk for stroke

Transcranial Doppler

elevated velocities of TCD in MCA patients got regular transfusions for at least one year and reduced risk of initial stroke by 92% 

Higher visual functioning

100

Syndrome from lesion of occipital lobe and splenium of corpus callosum

What is alexia without agraphia?

200

Formed visual hallucinations secondary to ocular disease (macular degeneration often)

What is Charles Bonnet Syndrome?

300

Loss of primary vision often with denial and confabulation

What is Anton's syndrome

400

Disorder of shapes and sizes, often seen with migraine

What is metamorphopsia?

Alice in Wonderland syndrome 

Room inversion syndrome

500

Lesion location for Kluver-Bucy Syndrome

Bilateral anterior temporal lobes (hippocampus and amygdala)

Optic Neuropathy

100

Explain RAPD and where it localizes 

Relative afferent pupillary defect

Optic Nerve (CNII)

200

5 ways to test the optic nerve

1. Visual fields

2. Acuity

3. Color

4. Pupillary reflex

5. Fundoscopy

300

Clinical features characteristic of optic neuritis (3)

Monocular, Painful eye movements, RAPD, subacute, reduced contrast and color vision. 

Rule of 2's - onset 2h to 2 days, nadir within 2 weeks, improvement over next 2 months

400

Sudden, unilateral, painless and progressive vision loss after TLIF surgery

Posterior ischemic optic neuropathy 

500

Treatment regimen for AAION

Pulse steroids --> high dose steroid with taper 

Tocilizumab or methotrexate

ALS & MND

100

Most common comorbidity with ALS affecting cognition

What is frontotemporal dementia? 

15%, higher risk genetic variation 

200

Mode of inheritance for Kennedy's Disease, name 3 unique clinical findings compared to ALS. 

X-linked, CAG trinucleotide expansion on androgen receptor gene

Sensory involvement, endocrine dysfunction, tremor, perioral fasciculations, gynecomastia, testicular atrophy, reduced fertility

300

Isolated UMN syndrome for 5 years with limb spasticity and dysarthria

What is Primary lateral sclerosis?

400

Two most common genes associated with hereditary ALS

SOD1

C9orf72

500

ALS mimic with conduction block on NCS and stabilizes with IVIG. Spares bulbar and respiratory muscles

What is multifocal motor neuropathy.