p.11
Seizures and Epilepsy Management
Which medications are alternatives for Myoclonic and Atypical Absence Syndromes?
Topiramate, Zonisamide, or Lamotrigine.
p.10
Neurotransmitters and Their Characteristics
What is the purpose of Flumazenil?
It is an antidote to benzodiazepine overdose.
p.5
CNS Infections and Their Clinical Presentations
What is the most common cause of meningitis in adults over 20 years?
Streptococcus pneumoniae.
p.10
Neurotransmitters and Their Characteristics
What are the symptoms of sedative-hypnotic poisoning?
Hypothermia, hypotension, hypoactive bowel sounds, disinhibition, coma, nystagmus.
p.1
Adrenoreceptors and Their Mechanisms of Action
What is the effect of Beta-2 receptors (B2) on smooth muscle?
Causes smooth muscle relaxation.
p.7
Cerebrovascular Diseases
What is required for a diagnosis of Transient Ischemic Attack (TIA)?
All neurologic signs and symptoms must resolve within 24 hours.
p.6
Seizures and Epilepsy Management
What is a seizure?
A paroxysmal event due to abnormal excessive or synchronous neuronal activity in the brain.
p.7
Cerebrovascular Diseases
When is endarterectomy for carotid atherosclerosis most beneficial?
Within 2 weeks of symptom onset.
p.8
Movement Disorders and Their Treatments
What condition manifests as rapidly evolving symmetric, ascending, areflexic motor paralysis?
Guillain Barre Syndrome (GBS).
p.7
Cerebrovascular Diseases
What is the most common cause of cerebral embolism?
Nonrheumatic atrial fibrillation.
p.6
Seizures and Epilepsy Management
What is the electrophysiologic hallmark of typical absence seizures?
Generalized, symmetric, 3-Hz spike-and-wave discharge that begins and ends abruptly.
p.1
Adrenoreceptors and Their Mechanisms of Action
What effect do Alpha-1 receptors (A1) have on smooth muscle?
Causes smooth muscle contraction.
p.5
CNS Infections and Their Clinical Presentations
What are the classic clinical triad symptoms of meningitis?
Fever, headache, and nuchal rigidity.
p.8
Movement Disorders and Their Treatments
What characterizes Myasthenia Gravis (MG)?
Weakness and fatigability of skeletal muscles due to a decrease in available acetylcholine receptors.
p.8
Movement Disorders and Their Treatments
What are the most common diabetic mononeuropathies?
Median neuropathy at the wrist and ulnar neuropathy at the elbow.
p.7
Cerebrovascular Diseases
What occurs if neurologic signs last for more than 24 hours?
It is classified as a stroke.
p.4
Brain Tumors and Diagnostic Approaches
What is the most common malignant brain tumor overall?
Grade IV astrocytoma (Glioblastoma).
p.6
Seizures and Epilepsy Management
What is the best initial choice for the treatment of primary generalized tonic-clonic seizures?
Valproic acid, Lamotrigine, or Levetiracetam.
p.3
Headaches and Their Clinical Features
What are the most common primary headache syndromes?
Migraine, tension-type headache, and cluster headache.
p.9
Movement Disorders and Their Treatments
What are the standard drug therapies for essential tremors?
Beta-blockers or primidone.
p.11
Seizures and Epilepsy Management
What is the first-line treatment for Typical Absence Seizures?
Ethosuximide or Valproic acid.
p.8
Movement Disorders and Their Treatments
What is the most common form of peripheral neuropathy associated with HIV infection?
Distal symmetric polyneuropathy.
p.5
CNS Infections and Their Clinical Presentations
What is the classic clinical triad of a brain abscess?
Headache, fever, and focal neurologic deficit.
p.10
Neurotransmitters and Their Characteristics
What is the effect of methanol poisoning?
Visual dysfunction due to formaldehyde accumulation.
p.9
Movement Disorders and Their Treatments
What is the most common cause of secondary Parkinsonism?
Dopamine blocking agents.
p.7
Cerebrovascular Diseases
What is the most common cause of lobar hemorrhage in the elderly?
Cerebral amyloid angiopathy.
p.4
Brain Tumors and Diagnostic Approaches
What malignancies can mimic meningioma due to their propensity to metastasize to the dura?
Prostate and breast cancer.
p.4
Brain Tumors and Diagnostic Approaches
What is the primary radiation oncology approach to brain metastases?
Stereotactic radiosurgery.
p.1
Adrenoreceptors and Their Mechanisms of Action
Where are Beta-1 receptors (B1) primarily located?
Heart (SA Node, AV Node, ventricles) and kidneys.
p.4
Brain Tumors and Diagnostic Approaches
What is the most common type of schwannoma?
Vestibular schwannomas (acoustic neuromas).
p.9
Movement Disorders and Their Treatments
What are the major differentials for tremors?
Dystonic tremor or Parkinson's Disease.
p.3
Brain Tumors and Diagnostic Approaches
What is the preferred diagnostic test for any patient suspected of having a brain tumor?
Cranial MRI with gadolinium contrast administration.
p.9
Movement Disorders and Their Treatments
What is the most common psychogenic movement disorder?
Tremor affecting the upper limbs.
p.11
Seizures and Epilepsy Management
What is the first-line drug for Generalized Tonic-Clonic Seizures?
Lamotrigine or Valproic acid.
p.11
Seizures and Epilepsy Management
What are some alternative drugs for Generalized Tonic-Clonic Seizures?
Levetiracetam, Topiramate, or Phenobarbital.
p.8
Movement Disorders and Their Treatments
What is Guillain Barre Syndrome associated with?
Campylobacter jejuni found in undercooked chicken.
p.7
Cerebrovascular Diseases
Where does atherosclerosis most commonly occur in the carotid artery?
At the common carotid bifurcation and proximal internal carotid artery.
p.6
Seizures and Epilepsy Management
What is the most common seizure type resulting from metabolic derangements?
Generalized tonic-clonic seizures.
p.5
CNS Infections and Their Clinical Presentations
What virus is associated with temporal encephalitis?
HSV (Herpes Simplex Virus).
p.4
Brain Tumors and Diagnostic Approaches
What is the most common site of brain metastases?
Gray matter-white matter junction.
p.11
Seizures and Epilepsy Management
Which drug is commonly used for Focal Seizures?
Carbamazepine, Oxcarbazepine, or Phenytoin.
p.11
Seizures and Epilepsy Management
Which drug is used as an alternative for Focal Seizures?
Levetiracetam or Oxcarbazepine.
p.7
Cerebrovascular Diseases
What is the ischemic penumbra?
Tissue surrounding the core region of infarction that is reversibly dysfunctional.
p.6
Seizures and Epilepsy Management
What are the three components of the triad of Lennox-Gastaut Syndrome?
Multiple seizure types, EEG showing slow spike-and-wave discharges, and impaired cognitive function.
p.4
Brain Tumors and Diagnostic Approaches
Where are meningiomas most commonly located?
Over the cerebral convexities.
p.9
Movement Disorders and Their Treatments
What is the most significant pathogenic mechanism in Parkinsonism?
Protein misfolding and accumulation and mitochondrial dysfunction.
p.3
Headaches and Their Clinical Features
What classic headache is associated with a brain tumor?
Most evident in the morning and improves during the day.
p.5
CNS Infections and Their Clinical Presentations
What is the first task in the approach to CNS infection?
Identify evidence of either generalized or focal involvement of brain tissue.
p.5
CNS Infections and Their Clinical Presentations
What are the most common etiologic organisms of community-acquired bacterial meningitis?
Streptococcus pneumoniae and Neisseria meningitidis.
p.7
Cerebrovascular Diseases
What is the hallmark of top of the basilar artery occlusion?
Sudden onset of bilateral signs, including ptosis and papillary asymmetry.
p.3
Headaches and Their Clinical Features
Which triptans are considered most efficacious in migraine treatment?
Rizatriptan and eletriptan.
p.10
Neurotransmitters and Their Characteristics
What is Thiopental used for?
Anesthesia induction, lethal injection, truth serum.
p.5
CNS Infections and Their Clinical Presentations
What is an important clue to the diagnosis of meningococcal infection?
Petechial or purpuric skin lesions.
p.10
Neurotransmitters and Their Characteristics
What syndrome can ethanol overdose cause?
Wernicke-Korsakoff syndrome.
p.9
Movement Disorders and Their Treatments
What is the most common cause of Familial Parkinson's Disease?
Mutations of the LRRK2 gene.
p.7
Cerebrovascular Diseases
What is the gold standard for identifying and quantifying atherosclerotic stenoses of arteries?
Conventional x-ray cerebral angiography.
p.4
Brain Tumors and Diagnostic Approaches
What is the definitive method to demonstrate tumor cells in CSF for leptomeningeal metastases?
CSF cytologic examination.
p.4
Brain Tumors and Diagnostic Approaches
What is the best test for epidural metastasis?
MRI of the complete spine.
p.10
Neurotransmitters and Their Characteristics
What is Midazolam used for?
Acute anxiety attacks, anesthesia induction, preoperative sedation.
p.11
Seizures and Epilepsy Management
What is a common alternative for Typical Absence Seizures?
Lamotrigine or Valproic acid.
p.10
Neurotransmitters and Their Characteristics
What is Phenobarbital used for?
Seizure disorders in children, can precipitate porphyria, potent inducer of CYP450.
p.9
Movement Disorders and Their Treatments
What is the most common form of Parkinsonism?
Parkinson's Disease (PD).
p.9
Movement Disorders and Their Treatments
What is the most common systemic disorder that causes chorea?
Systemic Lupus Erythematosus (SLE).
p.10
Neurotransmitters and Their Characteristics
What conditions is Diazepam used to treat?
Seizure disorders (status epilepticus), alcohol withdrawal, as a tranquilizer.
p.5
CNS Infections and Their Clinical Presentations
What is the pathognomonic sign of meningeal irritation?
Nuchal rigidity (stiff neck).
p.4
Brain Tumors and Diagnostic Approaches
What virus frequently plays a role in the pathogenesis of HIV-related primary CNS lymphoma?
Epstein-Barr Virus (EBV).
p.10
Neurotransmitters and Their Characteristics
What is the role of acetaldehyde dehydrogenase inhibitors?
They are involved in the metabolism of alcohol.
p.3
Brain Tumors and Diagnostic Approaches
What are the only established risk factors for primary brain tumors?
Exposure to ionizing radiation and immunosuppression.
p.6
Seizures and Epilepsy Management
What is the first goal in the approach to a seizure?
Determine if the event was truly a seizure.
p.6
Seizures and Epilepsy Management
What is the most common surgical procedure for patients with temporal lobe epilepsy?
Resection of the anteromedial temporal lobe (temporal lobectomy) or amygdalohippocampectomy.
p.3
Headaches and Their Clinical Features
What is the key pathway for pain in migraine?
Trigeminovascular input from the meningeal vessels.
p.9
Movement Disorders and Their Treatments
What is the most common cause of drug-induced dystonia?
Neuroleptic drugs or chronic levodopa treatment in Parkinson's Disease patients.
p.3
Headaches and Their Clinical Features
What symptom is highly characteristic of posterior fossa brain tumors?
Vomiting that precedes headache.
p.3
Headaches and Their Clinical Features
What are the most effective drug classes in the treatment of migraine?
Anti-inflammatory agents, 5-HT 1e/10 receptor agonists (triptans), and dopamine receptor antagonists.
p.3
Headaches and Their Clinical Features
What is the most satisfactory treatment in cluster headache?
Administration of drugs to prevent cluster attacks until the bout is over.
p.4
Brain Tumors and Diagnostic Approaches
What is the surgical procedure of choice for epidural metastasis?
Complete removal of the mass, typically anterior to the spinal canal.
p.10
Neurotransmitters and Their Characteristics
Which drugs can cause disulfiram-like reactions?
Chlorpropamide, Cefoperazone, Cefamandole, CefoTetan, Procarbazine, Metronidazole.
p.5
CNS Infections and Their Clinical Presentations
What is the optimal therapy for a brain abscess?
Combination of high dose parenteral antibiotics and neurosurgical drainage.
p.3
Brain Tumors and Diagnostic Approaches
What is the most common primary brain tumor of childhood?
Grade I astrocytomas: pilocytic astrocytomas (WHO grade I).
