NEURO FORM 1

Boy has hyperfeflexia nad papilledema from

falling from tree 2 weeks ago
Subdural hematoma
SE of metoclopramide Looks like parkinsons!
Unconscious, laying in vomitous, obtunded, HTN Brain bleed, high ICP
First step in unconscious pt w/ possible
intracerebral bleed (fell over)
Intubate intubate intubate intubate intubate
intubate intubate intubate.
Unkempt, icteric w occult blood Hepatic encephalopathy
“irregular lapses of postural tone when arms
extended”
Hepatic encephalopathy (astrexis)
Difference btwn lambert eaton and polymyositis Lambert: lung cancer, improve w/ stimulation
polymyositis: develops over 6 weeks or so, no
lung issues.
Tx of vertebral artery dissection Oral warfarin
Vegetation + regurge (two major dukes criteria) ENDOCARDITIS  GIVE ABX ASAP (pt can stroke
out)
Baby w/ sunken anterior fontanelle, sunken eyes,
dry mucous membrane + seizure
Dehydration  seizure; dx dehydration by
measuring serum sodium
Aerosolized bio weapon Botulism (flaccid motor paralysis starting at neck
and shoulders downward)
Bilateral weakness that started w/ “shooting
pains” in both legs and weakness in bilateral
hands later.
Guillain barre syndrome.
Child awakens from sleep w/ leg pain Growing pains
Schober test Decreased spine flexion seen in ankylosing
spondylitis
Kid has heel pain, can’t bend over, fam hx Ankylosing spondylitis (high ESR)
Function of inferior oblizue Look up
Man can’t look up after being hit in face w/ ball Entrapment of inferior oblique
Past hx of l acoustic neuroma, pt has what dz.
Years later, her other year has hearing loss.
Neurofibromatosis (bilateral acoustic neuromas,
but not at the same time)
Abdominal pain, diarrhea, lacrimation, salivating Organophosphate  INCREASED cholinergic
activity 2/2 blockage of acetylcholinesterase
Tx of organiphosphate Atrophine + pralidoxime
Acute onset back pain w/ positive straight leg
test in construction worker
Slipped disk, no further testing needed (get MRI
or xray if pt has red flags ‐ >50, malignancy, neuro
deficit)
NMS neurotransmitter that’s responsible Massive glutamate release
NEURO FORM 2
Ipsliat blindness due to central retinal artery
occlusion
Temporal arteritis
Double vision, droopy eyelid, tired looking up, dx
and tx?
Myasthenia  pyridostigmine
Riskfactor for temporal arteritis Polymyalgia rheumatica
NBME CMS forms 1‐4 NEURO
Tibia fracture after MVA/painw/ cast  PAIN W/
EXTENSION OF TOES
Compartment syndrome  measure
compartment pressure  emergency fasciotomy.
Pulses are normal.
Back pain + pain w/ passive straight leg+
bowel/bladder incontinence
Cauda equina syndrome  get MRI ASAP.
PT JUST HAS BACK PAIN and + SLT, SHOULD U
GET MRI?
NO
What anatomical location damaged in horners Lower neck (above T1), stellate ganglion
(dissection), spinal cord (pancost),
Child not saying intelligible words, bables,
screams, next step?
Test hearing, audiometry
Heacache relieved by acetaminophine, physical
exam is normal
Tension headache
Abrupt Romberg, “constricted “visual fields on
close and far testing (tunnel vision), “collapsing
effort” on strength, loss of vibration exactly at
midline.
All signs of Conversion disorder.
“left eye doesn’t move past midline” Lateral rectus palsy, seen in wernicke’s
encephalopathy (B1 dif)
Triad of wernickes encephalopathy Encephalopathy, opthalmoplegia, ataxia.
Diagnostic test in pt w/ rheumatoid arthritis MRI of cervical spine to check for cervical
subluxation deformity
Vertigo, hearing loss tinnitus, occours over and
over again
Meniere disease
How to get a endolymphatic fistula Trauma  then meinere symtoms
Neurocystercercosis (contaminated food w/
feces, seizure, ring enhancing/swiss cheese
brain)
“irrigularly irregular” heart + stroke symtoms Afib  embolic stroke.