Neurology Board Review

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  1. Most common pathogens for bacterial meningitis in neonates (3)
    • Group B strep
    • E coli
    • Listeria monocytogenes
  2. Most common pathogen for bacterial meningitis in Children (2)
    • Streptococcus pneumoniae
    • Neisseria meningitidis
  3. Most common pathogens for bacterial meningitis in adults (5)
    • Streptococcus pneumoniae
    • N. meningitidis
    • L. monocytogenes
    • staph
    • Gram negative bacilli
  4. Patient with fever, headache, seizures. Died after a few days. This is the pathology. What is the diagnosis?

    Image Upload 1
    • Bacterial meningitis
    • Note: PMNs exudates within leptomeninges
    • Fibrinoid necrosis of leptomeningeal and cortical arteries and veins
    • Thrombosis of leptomeningeal and cortical blood vessels
  5. Role of corticosteroid use in bacterial meningitis
    • Reduces vasogenic edema, meningeal inflammation, and inflammatory response of meningitis.
    • Improves outcome and reduces mortality in infants, children and adults with bacterial meningitis.
    • Reduces incidence of neurologic sequelae (sensory neural hearing loss)
  6. Most common sites for cerebral abcess (2)
    Frontal and temporal lobes
  7. Major stages in the formation of brain abcesses (4).
    • Early cerebritis
    • Late cerebritis
    • Early capsule formation
    • Late capsule formation
  8. Patient with fever, severe left temporal headache, right hemiparesis. Prior history of mastoiditis.
    Image Upload 2 
    Epidural abcess
  9. Most common location of spinal epidural abcesses
    Posterior to the cord in thoracic segment
  10. Most common pathogen in spinal epidural abcesses
    Staph aureus
  11. Treatment for neuroborreliosis
  12. Syphilitic meningitis occurs in :
    A) Secondary syphilis
    B) Terciary syphilis
    C) Primary syphilis
    A) whithin 2 years of primary infection. Characterized by headache, nausea, vomiting, meningismus, ams, seizures, cranial neuropathies
    (this multiple choice question has been scrambled)
  13. Tabes dorsalis presents clinically:
    Propioceptive loss, sensory ataxia, lancinating and lighnting-like pains, arreflexia.
  14. Image Upload 3
    Argyll Robertson Pupils: Poor consensual pupillary reflexes, but preserved constriction to accomodation.
  15. Immigrant from Southeast asia, presents with loss of pain and temperature, hypopigmented and anhidrotic skin lesions. Preseved vibration and propioceptive sensation. Most likely diagnosis.
    Leprosy: caused by Mycobacterium leprae
  16. Male with maculopapular, petechial and eccymotic rash (involving palms and soles), with high fever, nausea, malaise, headaches, ams, seizures. Most likely diagnosis.
    Rocky mountain spotted fever: treatment doxy.
  17. Most common cause of arbovirus meningoencephalits
    La Crosse (California) encephalitis
  18. The most common agent believed to cause benign recurrent lymphocytic meningitis (Mollaret's meningitis)
    HSV type 2
  19. Predilection for inferior frontal and temporal lobes, behavioral dysfunction, personality change, aphasia, complex partial seizures, PLEDS. What is the bug involved?
  20. Image Upload 4HSV-1 infection, is characterized by the following pathologic findings
    • Perivascular mononuclear infiltrates
    • Necrotizing inflammation
    • Foci of hemorrhage
    • Intranuclear viral inclussions
  21. Most common cause of encephalitis world wide
    Japanese encephalitis (flavivirus)
  22. Most common virus in southern, western and midwestern US.
    St Louis encephalitis virus
  23. Which is the prominent and distinguishing feature of West Nile virus infection
    • Tremor
    • Other extrapyramidal symptoms: myoclonus and parkinsonism.
  24. What is Ramsey Hunt syndrome?
    Painful facial weakness acoompanied by vesicular eruption involving external auditory canal.
  25. Features of congenital CMV infection
    Variable: sensorineural hearing loss, developmental delay, microcephaly, microgyria, seizures, cerebral calcifications, choreoretinitis.
  26. Clinical features of rabies
    Fluctuations in mentation, behavior and consciousness, psychiatric disturbance, persistent fever, hydrophobia or aerophobia, hypersalivation, other autonomic features.
  27. Subacute sclerosisng panencephalitis is related to infection with-----------
    Measles: paramyxovirus
  28. Risk factors associated with HIV dementia
    • low CD4 count (<200)
    • anemia,
    • high viral load,
    • history of hepatitis C injection
    • female gender
    • older age
  29. 24 year old man with persistent headaches (wakes up by headaches, vomiting, increased headaches with Valsalva).  
    MRI and pathology show the following.Image Upload 5
    Image Upload 6

    What is the diagnosis?
    Lhermitte Duclos syndrome
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Neurology Board Review
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