Topic: Trigeminal Neuralgia
Subject: Medicine
A man complains that recently when he shaves he has a shooting type of pain in his face. It happens once in a while and then goes away. You suspect trigeminal neuralgia.
What is the treatment of choice?
Fluoxetine
Prednisone
Acyclovir
Carbamazepine
Correct Answer :
D. Carbamazepine
Trigeminal neuralgia is severe paroxysmal facial pain due to a disorder of the 5th cranial nerve. Pain occurs along the distribution of one or more sensory divisions of the trigeminal nerve, most often the maxillary. The pain is paroxysmal, lasting seconds up to 2 min, but attacks may recur rapidly. It is lancinating, excruciating, and sometimes incapacitating. Pain is often precipitated by stimulating a facial trigger point (eg, by chewing, brushing the teeth, or smiling). Sleeping on that side of the face is often intolerable. Diagnosis is clinical. Treatment is usually with carbamazepine or gabapentin; sometimes surgery is required.
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What is the mechanism of action in organophosphate poisoning?
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Topic: Adverse Drug Effect
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Which one of the following is most associated with falls in older adults?
Diphenhydramine (Benadryl)
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A female patient complains of a severe headache and jaw pain when she chews. She also complains of shoulder pain and bilateral wrist weakness. Initial lab tests show an ESR of 75 (normal is less than 30).
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Subject: Medicine
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Parkinsonism
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Subject: Medicine
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Imipramine (Tofranil)
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Topic: Glasgow Coma Scale
Subject: Medicine
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What is his Glasgow Coma Scale score?
11
10
9
8
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Subject: Medicine
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Subdural hematoma
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Subject: Medicine
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Serum dopamine levels
Computed tomography scan
Positron emission tomography scan
Magnetic resonance imaging
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Subject: Medicine
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Subject: Medicine
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Subject: Medicine
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Levetiracetam
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Topiramate
Carbamazepine
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Subject: Medicine
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Subject: Medicine
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Levodopa
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Pergolide
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Subject: Medicine
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Subject: Medicine
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Treatment with corticosteroids
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Subject: Medicine
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Subject: Medicine
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Guillain-Barr� syndrome
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Myasthenia Gravis
Systemic Lupus Erythematosus
Topic: Seizure
Subject: Medicine
A 52-year-old male with a history of seizure attacks suffered from loss of consciousness and tonic-clonic muscular contractions. His tongue fell back into his throat and he choked.
What is the medication of choice for the treatment of this patient's condition?
Phenytoin
Valproic acid
Tiagabine
Phenobarbital
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Subject: Medicine
A 70-year-old man presented with ptosis, myosis and anhydrosis on the left side. Which one of the following is the most likely cause of this condition?
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Subject: Medicine
A 76-year-old male is brought to your office by his son. The patient complains of dizziness that has slowly been worsening over the past year. His description is vague, but he says that he notices the dizziness when he tries to walk. The review of systems is normal, except for increasing problems with his prostate in the last 6 months, with dribbling and accidents at times. The patient admits to going more often, and sometimes without warning. The son states that his father seems more forgetful, slower of speech, and not as full of life as he used to be. A neurologic examination reveals the patient to be oriented x 3, with a somewhat flat affect and a wide-based, slow, shuffling gate. The examination is otherwise normal. His Mini-Mental State Examination (MMSE) score is 22 out of 30. No tremor is noted. A CBC, creatinine level, TSH level, vitamin B12 level and VDRL are all normal.
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Order a brain MRI
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Order physical therapy
Topic: Dementia
Subject: Medicine
An 85 year old white male is brought to you for the first time by his son. The father has recently seen a neurologist who performed a workup for dementia and diagnosed moderate Alzheimers disease. Which one of the following is true regarding the use of a cholinesterase inhibitor in this patient?
It is too late to initiate cholinesterase therapy
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Subject: Medicine
A previously alert, otherwise healthy 74-year-old black male has a history of slowly developing progressive memory loss and dementia associated with urinary incontinence and gait disturbance resembling ataxia.
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Normal pressure hydrocephalus
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Subject: Medicine
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MMPI
WAIS
Thematic Apperception Test
Mini-Mental State Exam
Topic: Seizure
Subject: Medicine
A 32-year-old female experiences an episode of unresponsiveness associated with jerking movements of her arms and legs. Which one of the following presentations would make a diagnosis of true seizure more likely?
Post-event confusion
Eye closure during the event
A history of fibromyalgia
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Topic: Seizure
Subject: Medicine
A 52-year-old male with a history of seizure attacks suffered from loss of consciousness and tonic and clonic muscular contractions. His tongue fell back into the throat and he choked. What is the most likely diagnosis of this presentation?
Petit mal seizure
Grand mal seizure
Myoclonic seizure
Atonic seizure
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Subject: Medicine
In which of the following diseases would you see a gloves and stocking neuropathy?
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Subject: Medicine
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Lorazepam
Phenytoin
Phenobarbital
Carbamazepine
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Subject: Medicine
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Isoniazid
Diazepam
Primidone
Clonidine
Topic: Horner's Syndrome
Subject: Medicine
A 66-year-old diabetic man presents with constriction of the pupil, drooping of the upper lid, and anhidrosis on the left. Which one of the following nerves is most likely involved?
Oculomotor
Sympathetic
Trochlear
Trigeminal