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543 - Block Exam 1 (Neuro) 2025/
Pharmacological PRINCIPLES OF
CLINICAL THERAPEUTICS EXAM
QUESTIONS AND CORRECT ANSWERS.
Trigeminal neuralgia definition: unilateral electric shock-like pains of the face etiology: compression of trigeminal nerve root CN V (V2, V3) ↳MC few mm entry into pons types: classic: related to vascular compression secondary: underlying disease clinical manifestations:
shock/stabbing pains ↳triggered by chewing/brushing teeth tx:
- 1st line: carbamazepine or oxcarbazepine Bell's Palsy definition: unilateral facial paralysis & weakness (CN VII) etiology:
- viral (HSV/Zoster) MC clinical manifestations:
- inability to wrinkle brow
- drooping eyelid; inability to close eye
etiology:
- multifactoral; muscular and psychogenic clinical manifestations:
- non-pulsatile (bilateral) band distribution
- no focal neuro sx tx:
- tylenol or NSAIDs Migraine types: classic (aura) common (no aura) etiology:
- family hx; autosomal dominant clinical manifestations: classic: ↳prodromal aura < 60 mins ↳visual sx MC; Scintillating scotoma ↳throbbing, pulsatile ↳N/V common: ↳unilateral & localized pain MC frontotemporal & ocular areas dx: 1st line: CT tx: mild: NSAIDs, tylenol, ASA
- 1st line prophylaxis: verapamil Post-Traumatic HA etiology: HA from trauma to head or neck ↳typically from whiplash (MVC) or TBI dx:
- mental status evaluation tx:
- tylenol and ibuprofen Viral meningitis definition:
inflammation of the leptomeninges as a manifestation of CNS infection etiology: HSV 2 MC cause clinical manifestions:
- parotitis THEN triad: ↳fever ↳vomiting ↳HA
- pericarditis, myocarditis, conjunctivitis, HFMD
- Morbilliform rash dx: LP & CT
- LP first if no focal neuro sx
triad ↳fever ↳HA + AMS ↳nuchal rigidity (stiff neck)
- Brudzinski's & Kernig's signs
- bulging fontanelles dx: LP & CT
- LP first if no focal neuro sx
- CT head first if hx mass lesion, stroke, AMS cell count: > 1000 - 2000 neutrophils glucose: < 45 (low)
protein: > 250 tx: ages 0-4 wks: ampicillin + cefotaxime age 1 mo - 50 YO: vanco + ceftriaxone age > 50 YO: vanco + ampicillin + ceftriaxone Brain abscess definition: focal purulent collection in brain parenchyma etiology:
- streptococcus MC cause clinical manifestations:
- HA MC complaint
- MC elderly clinical manifestation: triad: ↳dementia/cognitive dysfunction (wacky) ↳gait disturbance (wobbly) earliest sx ↳urinary incontinence (wet) dx: MRI tx: tx of choice: ventriculoperitoneal shunt Encephalitis definition:
infection of brain parenchyma etiology: HSV and arborviruses MC neonates: HFE HSV-1 MC adults & peds: HFE HSV-2 MC clinical manifestations:
- photophobia**
- vesicular lesions**
- hemiparesis
- focal seizures dx: LP & MRI
- LP; viral cultures & PCR for HSV
genetic link; autosomal dominant (MC) ↳ LRRK2 or SNCA clinical manifestations: triad ↳ tremor ↳ bradykinesia ↳ rigidity (cogwheel) hallmark ↳ loss of pigmented dopaminergic neurons of substantia nigra pars compacta ↳ (+) Lewy bodies
- visual hallucinations MC psychotic sx
- stooped posture
- shuffling gait dx: (+) Lewy body on bx tx:
- 1st line: levodopa-carbidopa ↳Let's PARK the Car Huntington's disease definition:
- incurable, adult-onset inherited disorder etiology:
- defective CAG; autosomal dominant clinical manifestations:
etiology:
- genetic clinical manifestations:
- tremors which worsens w/ intentional movement (stress)
- tremor improves w/ small amount of EtOH & rest tx: if needed, propanolol 1st line Tourette's syndrome definition: neuro disorder manifested by sudden, brief, intermittent motor and phonic tics etiology: excess dopamine + GABA deficiency
clinical manifestations:
- hallmark: tics dx:
- motor tics + phonic tics PLUS
- onset of tics before 21 YO tx: 1st line: habit reversal Benign neoplasm (Brain) definition: Neoplasm arising from meninges etiology:
