NBME neuro 2

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1. "3 day hx of leg weakness & shooting GBS-LMN, acute 14. medications that can cause domperidone
pains, diff rising from chair, climbing onset parkinsonism (Motilium) or
stairs. decreased strength and DTR." ondansetron,
thoughts? metaclopramide,
prochlorperazine,
2. "accumulation of cerebral cortical Alzheimer's
neuroleptics
plaques and tangles"
15. Neiseria ppx Rifampin (or CTX or
3. "acute onset eye pain, global HA, Acute closed angle
cipro)
blurred vision. red conjunctiva, glaucoma
midrange pupil, nonreactive" 16. "ophthalmoplegia w/partial vision cavernous sinus
dx tonometry loss s/p head infxn" thrombosis
test
17. "paresthesias of hands and feet and think b12 def
tx mannitol,
an unsteady gait that is worse in the
acetazolamde,
dark"
timolol, pilocarpine
18. post delivery-sudden headache pituitary apoplexy
4. "bulbar palsy and descending botulism
w/n/v often associated with a
paralysis, lack of fever, and clear
rapidly worsening visual field defect
senses and mental status"
or double vision, bitemporal
dx
hemianopia
5. carotid artery stenosis <70% ASA
19. prevention of delirium decrease noise and
if greater and sx-->
number of
CEA
interruptions at nigth
6. carotid dissection rx acutely IV heparin
20. pt found by neighbor, winter, not CO poisoning
7. "child w/3 mos daily ha, blurred vision, likely some sort of seen for awhile, refurbishing new
urinary frequency. bitemporal visual suprasellar mass home. comatose, nl vitals, PERRLA, +
field deficits, papilledema, b/l wkns of (craniopharyngioma babinski, Edema on ct.Dx?
eye abduction" if cystic w/ca)
21. "pt w/hx of rheumatic heart septic embolization
dx?
dz...sudden onset speech difficulty, to MCA
8. CTS management splinting, steroid paralysis on right face and UE. been
injxns, surgery sick,vegetations on echo" give antbiotcs!
dx
9. "degeneration of striatial gaba Huntington's dz
tx
neurons"
22. "seizure, fever, +rbc/wbc in CSF hsv encephalitis
10. "degen of DA neurons of sub nigra" Parkinsons
w/EEG: b/l, periodic epileptiform
11. gardener w/ n/v ringing, rash 10 days, arsenic poisoning discharges usu over temporal hsv pcr on csf
oval patches on neck, decreased regions"
sensation to pinprick, absent ankle dx? acyclovir
reflexes, increased axillary test? inte
pigmentation, nails-leukonychia tx? intermittent high amp
striata" eeg? slow waves over
12. how differentiate b/t median nerve check thumb temporal lobe +
compression at wrist vs elbow? flexion- if intact-- PLEDs
>wrist 23. spinocerebellar ataxia, eye sx, vitamin E deficiency
if not-->elbow absent reflexes, decreased immune
response, myopathy
also if lose
24. transient loss of seizure vs syncope
sensation over
consciousness..think? pale, clammy, tachy--
thenar-->elbow
>syncope
13. intense pain, vesicles in ear, facial ramsay hunt aura-->seizure
paralysis syndrome
not TIA-no LoC
25. "woman w/aids, acting weird, hyperreflexia, w/multiple ring enhancing lesions" Toxo
Dx?
tx? give sulfadiezene & pyrimethamine
26. "woman w/crawling tightness in calves, worse with sitting or lying in bed. better w/walking" RLS
dx
tx Pramipexole-DA agonist