1
Q
What is the most common neurologic cause for an action tremor?
A
Essential tremor
2
Q
What is the initial pharmacologic treatment for essential tremor?
A
Propranolol
3
Q
Fill in the blank:
Essential tremor symptoms often diminish with the use of ______.
A
alcohol
4
Q
Which beta blocker can be used for essential tremor in patients with asthma?
A
Atenolol
5
Q
True or False:
Essential tremor is associated with neurological deficits.
A
False
6
Q
What is the most common cause of a rest tremor?
A
Parkinson’s disease
7
Q
What is the primary treatment for improving motor function in Parkinson’s disease?
A
Levodopa
8
Q
Fill in the blank:
Parkinson’s disease typically presents with tremor, bradykinesia, and ______.
A
rigidity
9
Q
What type of headache requires ER referral due to its sudden onset and maximal intensity within seconds?
A
Thunderclap headache
10
Q
List at least three symptoms that indicate an ER referral for headaches.
A
- Papilledema
- Neurological symptoms
- Headache with exertion or position changes
- Sudden, severe “thunderclap” headache
- Fever, neck stiffness, or rash (possible meningitis)
- Headache after trauma
- New-onset headache in patients >50 years old
- Headache with altered mental status or seizures
11
Q
What is the most prevalent type of headache?
A
Tension headache
12
Q
Which medication is used for preventative treatment of tension headaches?
A
Amitriptyline
13
Q
What is the primary treatment for cluster headaches?
A
Oxygen
14
Q
Which medication is contraindicated in ischemic heart disease and used for cluster headaches?
A
Triptans
15
Q
Fill in the blank:
Migraine diagnosis requires at least 5 attacks lasting 4 to 72 hours with at least 2 of the following: unilateral, pulsating, moderate to severe intensity, and worsens with ______.
A
activity
16
Q
What are common preventative treatment options for migraines?
A
- Beta blockers
- Antidepressants
- Anticonvulsants
17
Q
What is the most common systemic vasculitis in patients over 50 years old?
A
Temporal arteritis
18
Q
What is the confirmatory test for diagnosing temporal arteritis?
A
- Temporal artery biopsy
- Temporal artery color doppler ultrasound
19
Q
What is the most common cause of peripheral vertigo?
A
Benign positional paroxysmal vertigo
(BPPV)
20
Q
What maneuver is used to diagnose BPPV?
A
Dix-Hallpike maneuver
21
Q
What is the treatment maneuver for BPPV?
A
Epley maneuver
22
Q
What type of vertigo is associated with severe instability and often requires ER referral?
A
Central vertigo
23
Q
What is the most common type of dementia?
A
Dementia with Lewy bodies
24
Q
What screening tool is used to assess cognitive function in dementia?
A
Mini-Mental State Examination
(MMSE)
25
What is the **primary treatment** for mild to moderate **dementia**?
Cholinesterase inhibitors
26
What **cranial nerve** is affected in Bell's Palsy?
Facial nerve
| (cranial nerve VII)
27
Which **cranial nerve** is responsible for eye movement and pupil reflex?
Cranial Nerve III: Oculomotor
28
What are the **normal findings** for the pupillary response when examining Cranial Nerve III?
Pupils are equal, round, and reactive to light and accommodation (PERRLA).
29
# Fill in the blank:
Cranial Nerve IV is responsible for \_\_\_\_\_\_.
eye movement
30
What is **assessed** during the examination of Cranial Nerve VI?
Lateral eye movement
31
Which **cranial nerve** is tested using the whisper test?
Cranial Nerve VIII: Vestibulocochlear
32
What are the **normal findings** for the **Weber Test**?
Sound is heard equally in both ears.
33
What is the **normal finding** for the **Rinne Test**?
Air conduction is greater than bone conduction bilaterally.
34
Which **cranial nerve** is responsible for taste and facial movements?
Cranial Nerve VII: Facial
35
What is the **normal finding** when assessing the **gag reflex** for Cranial Nerve IX?
Gag reflex is present bilaterally.
36
Which **cranial nerve** is responsible for neck movement and innervates the sternocleidomastoid and trapezius muscles?
Cranial Nerve XI: Accessory
37
What are the **normal findings** for the motor function of **Cranial Nerve XII**?
Tongue protrudes midline without deviation, no atrophy noted. Able to move the tongue from side to side without difficulty.
38
What is the **normal finding** for **palatal elevation** when assessing Cranial Nerve X?
Soft palate elevates symmetrically, and the uvula remains midline.
39
# Fill in the blank:
Cranial Nerve I is responsible for \_\_\_\_\_\_.
smell
40
What are the **normal findings** for the **fundoscopic exam** of Cranial Nerve II?
Optic discs are sharp, with normal color and cup-to-disc ratio. No hemorrhages, exudates, or papilledema noted.
41
Which **cranial nerve** is assessed by asking the patient to perform various **facial expressions**?
Cranial Nerve VII: Facial
42
What is the **normal finding** when assessing balance with the Romberg test for **Cranial Nerve VIII**?
Maintains balance with eyes closed. No swaying or loss of balance.
43
# True or False:
Cranial Nerve V is responsible for hearing and balance.
False
44
Which **cranial nerve** is assessed by observing the patient's **ability to swallow**?
Cranial Nerve IX: Glossopharyngeal
45
What is the **normal finding** for voice quality when assessing **Cranial Nerve X**?
Voice is clear and resonant. No hoarseness.
46
What is the **classic presentation** for essential tremor?
* Bilateral arm tremor
* With or without tremor anywhere else
* For a minimum of 3 years
* Absence of neurological symptoms
47
Which **medication** is used for essential tremor if unresponsive to first-line treatment or more symptomatic?
Primidone
48
What are the **presentation characteristics** of Parkinson’s disease?
* Tremor
* Bradykinesia
* Rigidity
49
Which **alternative medications** can be used for Parkinson’s disease?
* MAO B inhibitors: rasagiline, safinamide, selegiline
* Dopamine agonists: bromocriptine, pramipexole, ropinirole, rotigotine
* Amantadine
50
What does the **SNNOOP10** acronym stand for in headache evaluation?
* Systemic symptoms including fever
* Neoplasm history
* Neurologic deficit
* Onset is abrupt
* Older than 50 years
* Pattern change
* Positional headache
* Precipitated by sneezing, coughing, or exercise
* Papilledema
* Progressive headache and atypical presentation
* Pregnancy or postpartum
* Painful eye with autonomic features
* Post-traumatic onset of headache
* Pathology of the immune system (e.g., HIV)
* Painkiller (analgesic) overuse
51
What are the **presentation characteristics** of a cluster headache?
* Sharp or stabbing in quality
* Unilateral, often around one eye
* Pain is episodic, lasting 15 minutes to 3 hours
* Occurs 1 to 8 times a day
* May experience remission for 3 to 12 months
* Autonomic symptoms ipsilateral to the headache
52
What **initial evaluation** should be done for suspected cluster headaches?
MRI to rule out a structural abnormality
53
What **treatments** are used for cluster headaches?
* Oxygen
* Triptans
* Verapamil for preventative treatment
54
What are the **four phases** of a migraine?
* Prodrome: increased yawning, euphoria, depression, irritability, food cravings, constipation, neck stiffness
* Aura: about 25% experience an aura, most often visual
* Headache: generally unilateral, throbbing or pulsating, nausea, vomiting, photophobia, phonophobia
* Postdrome: exhaustion or euphoria
55
What are the **diagnostic criteria** for migraine without aura?
* 5+ attacks
* Lasts 4 to 72 hours
* At least 2 of the following: unilateral, pulsating, moderate to severe intensity, worsens with activity
* At least 1 of the following: nausea/vomiting, photophobia, phonophobia
56
What **treatments** are used for acute migraine attacks?
* Simple analgesics
* Triptans
* NSAIDs
* Anti-emetics
57
What are the **indications** for preventative migraine treatment?
* 4 or more attacks a month
* Non-responsive to acute therapies
* Negatively affects quality of life
58
What are the **presentation characteristics** of a tension headache?
* Bilateral, non-throbbing headache
* Described as “band-like” pressure
* Normal neurologic exam
59
What **treatments** are used for tension headaches?
* Simple analgesics
* Caffeine
60
What are the **indications** for preventative treatment of tension headaches?
* Headaches >2 days a week
* Headaches >4 hours
* Headaches unresponsive to acute therapies
* Headaches impair daily functions
61
What is the **most common systemic vasculitis**?
Temporal arteritis
62
What are the **presentation characteristics** of temporal arteritis?
* New headache or change in headaches
* Abrupt vision changes
* Jaw claudication
* Unexplained fever or other systemic symptoms
* Evidence of vascular compromise
63
What **increases** the likelihood of **temporal arteritis**?
Current diagnosis or history of polymyalgia rheumatica
64
What is the **treatment** for temporal arteritis?
High dose systemic glucocorticoids
65
What are the **presentation characteristics** of BPPV?
Recurrent, brief (<1 minute) episodes of vertigo provoked by head movement
66
What are **examples** of what may cause central vertigo?
* Brainstem ischemia
* Cerebellar infarction
* Multiple sclerosis
67
What are the **presentation characteristics** of central vertigo?
* Severe instability, often unable to walk, or falls
* Generally, absence of hearing loss or tinnitus
* Neurological symptoms often present
68
What **screenings** are used for **dementia**?
* Mini-Mental State Examination (MMSE)
* Montreal Cognitive Assessment (MoCA)
69
What are the **DSM-5 diagnostic criteria** for dementia?
* Evidence of significant cognitive decline in cognitive domains
* Cognitive deficits interfere with independence
* Deficits do not occur exclusively in the context of delirium
* Deficits are not better explained by another mental disorder
70
What should be **checked** in dementia diagnosis due to potential cognitive changes?
Drug interactions, e.g., analgesics, anticholinergics, sedatives
71
What **imaging** is considered with initial dementia diagnosis?
MRI or CT of the head
72
What **treatments** are used for mild to moderate dementia?
Trial cholinesterase inhibitors
73
What **treatments** are used for moderate to severe dementia?
Memantine as monotherapy or adjunct therapy
74
What is **delirium**?
A clinical syndrome caused by a medical condition, substance intoxication or withdrawal, or medication side effect
75
What are the **presentation characteristics** of delirium?
* Abrupt decline
* Impaired attention and orientation
* Fluctuating level of consciousness
* Incoherent or disorganized speech
* Variable, fluctuating memory impairment
76
What **lab tests** are indicated for delirium?
* Glucose
* Electrolytes
* Complete blood count
* Urinalysis
* Toxicology screen
* Liver function testing
* Arterial blood gas if needed
77
What are the **presentation characteristics** of Bell's Palsy?
* Acute/sudden onset
* Typically over hours, up to 48 hours
* One-sided facial paralysis
* Not able to wrinkle forehead
78
How is Bell's Palsy **diagnosed**?
Made clinically
79
What is the **treatment** for Bell's Palsy?
High dose oral glucocorticoids ASAP, preferably within 3 days of symptom onset
80
What **adjunct therapy** may be used in severe cases of Bell's Palsy?
Adjunct antiviral therapy
81
What is **multiple sclerosis** (MS)?
Autoimmune disease of the spine and brain, with peak incidence between 15 and 50 years old
82
What are the **presentation characteristics** suggestive of MS?
* Optic neuritis
* Lhermitte sign
* Fatigue
* Sensation of pins and needles
* Heat sensitivity
83
How is MS **diagnosed**?
MRI
84
What is **Guillain-Barre syndrome** (GBS)?
Acute illness that may be triggered by a bacterial or viral infection
## Footnote
Campylobacter jejuni gastroenteritis is the most commonly identified precipitant of GBS.
85
What are the **presentation characteristics** of GBS?
* Progressive and symmetric muscle weakness
* Absent or depressed deep tendon reflexes
86
How is GBS **diagnosed**?
* CSF analysis
* Electrodiagnostic studies
* Elevated CSF protein with normal white blood cell count
87
What is **myasthenia gravis**?
Disorder of neuromuscular transmission
88
What are the **presentation characteristics** of myasthenia gravis?
* Fluctuating degree of weakness in ocular, bulbar, limbs, and respiratory muscles
* Muscle fatigue
89
How is myasthenia gravis **diagnosed**?
* Serologic tests for autoantibodies
* Electrophysiologic studies
90
What are the **functions** of cranial nerve I?
Olfactory: smell
91
What are the **functions** of **cranial nerve II**?
Optic: vision
92
What are the functions of **cranial nerve III**?
Oculomotor: eye movement and pupil reflex
93
What are the functions of **cranial nerve IV**?
Trochlear: eye movement
94
What are the functions of **cranial nerve V**?
Trigeminal: face sensation and chewing
95
What are the functions of **cranial nerve VI**?
Abducens: eye movement
96
What are the functions of **cranial nerve VII**?
Facial: face movement and taste
97
What are the functions of **cranial nerve VIII**?
Vestibulocochlear: hearing and balance
98
What are the functions of **cranial nerve IX**?
Glossopharyngeal: throat sensation, taste and swallowing
99
What are the functions of **cranial nerve X**?
Vagus: movement, sensation and abdominal organs
100
What are the functions of **cranial nerve XI**?
Accessory: neck movement, innervates sternocleidomastoid and trapezius muscles
101
What are the functions of **cranial nerve XII**?
Hypoglossal: tongue movement, sensation and abdominal organs
Family Nurse Practitioner (FNP)
flashcards
Decks in class (19)
# Cards
-
Musculoskeletal87
-
Endocrine29
-
Hematology53
-
Genitourinary43
-
Gastrointestinal101
-
Respiratory79
-
Cardiovascular114
-
Dermatological85
-
EENT45
-
STIs34
-
Men’s Health42
-
Women’s Health48
-
Neurological101
-
Mental Health36
-
Adult Screenings14
-
Pediatrics90
-
Diagnostic Imaging17
-
Pharmacology81
-
Non-Clinical36
