Neuro NBME Exam Questions and Answers
100% Pass
LP with elevated RBCs and WBCs (mostly lymphocytes)
+ elevated temperature
+ FND
+ normal CT
EEG shows repetitive complexes over the right temporal region - answerHSV encephalitis
- confirm dx via PCR of CSF for HSV
acute onset eye pain & head...
LP with elevated RBCs and WBCs (mostly lymphocytes)
+ elevated temperature
+ FND
+ normal CT
EEG shows repetitive complexes over the right temporal region - answer✔HSV encephalitis
- confirm dx via PCR of CSF for HSV
acute onset eye pain & headache
+ blurred vision
+ diffuse redness of conjunctiva w/ circumcorneal prominence
+ pupil is midrange and nonreactive to lgiht
Likely dx - answer✔Acute angle closure gluacoma
- tonemetry is next step in magement
Treatment of Acute Angle Closure GLaucoma - answer✔= emergency use of topical ophthalmic
medications to reduce IOP
===> drugs may include a beta-blocker, an alpha agonist, and an agent to produce miosis.
- suggest systemic medication to decrease IOP, which may include oral or intravenous (IV)
acetazolamide or IV mannitol
Once the acute attack is controlled, definitive treatment for angle-closure glaucoma is a laser
peripheral iridotomy to provide a small drainage hole through the iris.
3. local corticosteroid injection
4. surgical release
Treatment of Restless Leg syndrome - answer✔pramipexole or ropinirole
= Dopamine agonists
Boy with episodes of falling asleep during day
+ acute weakness of neck and knee muscles randomly
likely dx - answer✔Narcolespy
= Daytime sleepiness, Cataplexy
- cataplexy usually affects a group of muscles (ie: Knees buckling)
- Cataplexy is a sudden and transient episode of muscle weakness accompanied by full conscious
awareness, typically triggered by emotions such as laughing, crying, or terror
Exam shows proptosis + opthalmoplegia + partial vision loss on right
= double vision,
+ headache
in setting os sinus infection... - answer✔Cavernous Sinus Thrombosis
57 yo with fatigeue and AMS
- hx of vokda pints per day
- Liver LFTs are WNL
- BUN is normal
Likely dx and treatment - answer✔Lactulose = Hepatic Encephalopathy
- INR >1.5 is indicator of late stage liver dz (not LFTs)
- lactulose binds ammonium
immigrant
+ numb hands
+ mildy coarsened features
- loss of pinprick and light touch sesnation, esp. over tip of nose and ears
- common peroneal nerves feel thickened
Likely Dx - answer✔Leprosy
--> treat with rifampin + dapsone add colfazamine
WOman with intermittent numbness of left shin and foot
+ decreased sensation to pinprick over dorsal left foot and left lateral shin
+ weakened dorsiflexion
What is likely Dx and cause - answer✔Peroneal nerve damage
==> common in females from leg crossing
Treatment of Sciatica w/o Red Flag signs - answer✔for non urgent backpain:
= start with conservative treatment (NSAIDs + exercise) for 4 weeks. If things don't improve, do
imaging (XR/MRI)
Treatment of psychosis/hallucinations from higher dose levidopa therapy in a parkinsons patient
- answer✔Use low potency antipsychotics with minimal D2 antagonism: Quetiapine, Clozapine,
Pimavanserin.
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