Unit 5-CMN 568 - Exam Questions And Answers
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what are the classic features of glomerulonephritis? - ANSWER
hematuria, edema, HTN, red blood cell casts in urine
what are the classic features of nephrotic syndrome? - ANSWER
proteinuria, hypoalbuminemia, edema, HLD, clinical findings
what tx is given for nephrotic syndrome and for how long - ANSWER
corticosteroid tx. prednisone 2mg/kg/d (max dose 60/day) for 6 wks q day
then same dose given alternate day schedule for 6 wks. if remission not
reached by week 4 then consult nephrology.
what is gold standard for diagnosing UTIs? - ANSWER urine
culture
what is most common cause of psuedotumor cerebri (idiopathic
IH)? - ANSWER obesity
what is main complication of IIH? - ANSWER vision loss
Just because imaging is normal for HA does not exclude what
possible dx? - ANSWER SAH
what are the 3 critical components of exam for HA? - ANSWER
vital signs, neuro exam, vision testing with funduscopic exam
when doing visual exam for HAs, what is crucial to assess for
vision? - ANSWER visual acuity, ocular gaze, visual fields,
pupillary defects, optic disc and retinal vein pulsations.
If you find any abnormality on neuro exam for HA then what? -
ANSWER emergency neuroimaging
,what is the criteria for the OTTAWA SAH clinical decision rule? -
ANSWER 40 or older, neck pain/stiffness, witnessed LOC, onset during
exertion, thunderclap HA, limited neck flexion (on exam)
what medications are avoided as 1st line for HA? - ANSWER
morphine/hydromorphine
what are the characteristics of migraines? - ANSWER pulsatile HA lasts
4-72 hours, unilateral, aggravated by routine physical activity,
photophobia, phonophobia, common for no aura with HA
To avoid over use of medications for HA, what is the recommendation for
limited analgesics? - ANSWER less than 15 days/month, combo
analgesics to less then 10 days/month
who can not take Ergotamines for migraines? - ANSWER
pregnant, CV disease or RF, pts taking CYP3A4 inhibitors
what is the most common primary HA disorder? - ANSWER
tension-type HA
how are tension type HA described? - ANSWER vise-like or tight,
not pulsatile, not associated with focal neuro symptoms.
what medication do you NOT give to tension type HAs? -
ANSWER triptans
First line tx of cluster HAs? - ANSWER sumatriptan subq/intranasal or
inhaled 100% o2 via 12-15 L/min non-rebreather for 15 mins
what medications lead to overuse headache if taken more than 10
days per month? - ANSWER ergotamines, triptans, meds with
butalbital, and opioids.
,what medications can lead to overuse HA if taken more than 15 days per
month? - ANSWER acetaminophen, acetylsalicyclic acid, and NSAIDs
what diagnostic imaging should be done on all primary cough HA
and why? - ANSWER CT or MRI due to possible intracranial
lesions, brain tumors.
what is used for tx in primary cough HA? - ANSWER
indomethacin
what is the key feature of HA due to intracranial mass? -
ANSWER new or worsening HA in middle or later life.
what is the essentials to dx trigeminal neuralgia? - ANSWER
brief episodes of stabbing facial pain, pain in territory of the 2nd
and 3rd division of trigeminal nerve, pain worse with touch
what is first line tx of trigeminal neuralgia? - ANSWER oxcarbazepine or
carbamazepine but monitor serial blood counts and liver biochemical tests
what hx aids in dx of postherpetic neuralgia? - ANSWER hx of
shingles and presence of cutaneous scarring from shingles.
what is primary prevention for postherpetic neuralgia? -
ANSWER recombinant zoster vaccine to pts over 50
what med is given for vasospasm management in spontaneous SAH? -
ANSWER nimodipine 60mg every 4 hours po or NG tube within 4 days of
aneurysmal rupture. continue for 21 days for all patients
what symptoms or signs occur in SAH? - ANSWER sudden, thunderclap
HA with severity never had before, n/v, loc transient or progresses to
coma/death, if pt regains consciousness then irritable and confused,
meningeal irritation
, A patient presents with Ha with nausea and neck stiffness. What do you
suspect could be the cause and what is the name of these
symptoms together? - ANSWER aneurysms. can be asymptomatic until
rupture but sometimes will have these symptoms few hours to days before
rupture. called the "warning leak"
For pt with renal salt wasting in SAH, what do you measure daily and
why? - ANSWER Na daily because renal salt wasting can lead to
hyponatremia which then leads to cerebral edema and worsens
intracranial HTN
what confirms dx of idiopathic intracranial HTN? - ANSWER CSF
fluid is normal, confirms presence of intracranial HTN
what is tx of psudotumor cerebri-idiopathic intracranial HTN? -
ANSWER acetazolamide 3x/day reduces formation of CSF
what is an important indicator of chronic intracranial HTN? - ANSWER
pulse-synchronous tinnitus-described as whooshing, whistling, hummor,
or marching sound heard in one or both ears in sync with pulse and only
heard by pt.
what is risk factors for idiopathich IH? - ANSWER overweight
women, 20-44 yrs
what meds would you d/c to control causes of increased ICP in IH? -
ANSWER tetracycline, oral contraceptives, or vitamin A. if steroid was
stopped suddenly, then restart and taper gradually
if IH left untreated, it can cause what? - ANSWER secondary
optic atrophy, permanent vision loss
what would be found on physical exam for IH? - ANSWER
papilledema
when would you admit IH? - ANSWER worsening vision requiring
Verified 100% Correct
what are the classic features of glomerulonephritis? - ANSWER
hematuria, edema, HTN, red blood cell casts in urine
what are the classic features of nephrotic syndrome? - ANSWER
proteinuria, hypoalbuminemia, edema, HLD, clinical findings
what tx is given for nephrotic syndrome and for how long - ANSWER
corticosteroid tx. prednisone 2mg/kg/d (max dose 60/day) for 6 wks q day
then same dose given alternate day schedule for 6 wks. if remission not
reached by week 4 then consult nephrology.
what is gold standard for diagnosing UTIs? - ANSWER urine
culture
what is most common cause of psuedotumor cerebri (idiopathic
IH)? - ANSWER obesity
what is main complication of IIH? - ANSWER vision loss
Just because imaging is normal for HA does not exclude what
possible dx? - ANSWER SAH
what are the 3 critical components of exam for HA? - ANSWER
vital signs, neuro exam, vision testing with funduscopic exam
when doing visual exam for HAs, what is crucial to assess for
vision? - ANSWER visual acuity, ocular gaze, visual fields,
pupillary defects, optic disc and retinal vein pulsations.
If you find any abnormality on neuro exam for HA then what? -
ANSWER emergency neuroimaging
,what is the criteria for the OTTAWA SAH clinical decision rule? -
ANSWER 40 or older, neck pain/stiffness, witnessed LOC, onset during
exertion, thunderclap HA, limited neck flexion (on exam)
what medications are avoided as 1st line for HA? - ANSWER
morphine/hydromorphine
what are the characteristics of migraines? - ANSWER pulsatile HA lasts
4-72 hours, unilateral, aggravated by routine physical activity,
photophobia, phonophobia, common for no aura with HA
To avoid over use of medications for HA, what is the recommendation for
limited analgesics? - ANSWER less than 15 days/month, combo
analgesics to less then 10 days/month
who can not take Ergotamines for migraines? - ANSWER
pregnant, CV disease or RF, pts taking CYP3A4 inhibitors
what is the most common primary HA disorder? - ANSWER
tension-type HA
how are tension type HA described? - ANSWER vise-like or tight,
not pulsatile, not associated with focal neuro symptoms.
what medication do you NOT give to tension type HAs? -
ANSWER triptans
First line tx of cluster HAs? - ANSWER sumatriptan subq/intranasal or
inhaled 100% o2 via 12-15 L/min non-rebreather for 15 mins
what medications lead to overuse headache if taken more than 10
days per month? - ANSWER ergotamines, triptans, meds with
butalbital, and opioids.
,what medications can lead to overuse HA if taken more than 15 days per
month? - ANSWER acetaminophen, acetylsalicyclic acid, and NSAIDs
what diagnostic imaging should be done on all primary cough HA
and why? - ANSWER CT or MRI due to possible intracranial
lesions, brain tumors.
what is used for tx in primary cough HA? - ANSWER
indomethacin
what is the key feature of HA due to intracranial mass? -
ANSWER new or worsening HA in middle or later life.
what is the essentials to dx trigeminal neuralgia? - ANSWER
brief episodes of stabbing facial pain, pain in territory of the 2nd
and 3rd division of trigeminal nerve, pain worse with touch
what is first line tx of trigeminal neuralgia? - ANSWER oxcarbazepine or
carbamazepine but monitor serial blood counts and liver biochemical tests
what hx aids in dx of postherpetic neuralgia? - ANSWER hx of
shingles and presence of cutaneous scarring from shingles.
what is primary prevention for postherpetic neuralgia? -
ANSWER recombinant zoster vaccine to pts over 50
what med is given for vasospasm management in spontaneous SAH? -
ANSWER nimodipine 60mg every 4 hours po or NG tube within 4 days of
aneurysmal rupture. continue for 21 days for all patients
what symptoms or signs occur in SAH? - ANSWER sudden, thunderclap
HA with severity never had before, n/v, loc transient or progresses to
coma/death, if pt regains consciousness then irritable and confused,
meningeal irritation
, A patient presents with Ha with nausea and neck stiffness. What do you
suspect could be the cause and what is the name of these
symptoms together? - ANSWER aneurysms. can be asymptomatic until
rupture but sometimes will have these symptoms few hours to days before
rupture. called the "warning leak"
For pt with renal salt wasting in SAH, what do you measure daily and
why? - ANSWER Na daily because renal salt wasting can lead to
hyponatremia which then leads to cerebral edema and worsens
intracranial HTN
what confirms dx of idiopathic intracranial HTN? - ANSWER CSF
fluid is normal, confirms presence of intracranial HTN
what is tx of psudotumor cerebri-idiopathic intracranial HTN? -
ANSWER acetazolamide 3x/day reduces formation of CSF
what is an important indicator of chronic intracranial HTN? - ANSWER
pulse-synchronous tinnitus-described as whooshing, whistling, hummor,
or marching sound heard in one or both ears in sync with pulse and only
heard by pt.
what is risk factors for idiopathich IH? - ANSWER overweight
women, 20-44 yrs
what meds would you d/c to control causes of increased ICP in IH? -
ANSWER tetracycline, oral contraceptives, or vitamin A. if steroid was
stopped suddenly, then restart and taper gradually
if IH left untreated, it can cause what? - ANSWER secondary
optic atrophy, permanent vision loss
what would be found on physical exam for IH? - ANSWER
papilledema
when would you admit IH? - ANSWER worsening vision requiring
