1. Book Review

2. Amyotrophic Lateral sclerosis results in the degeneration of:
A) Upper Motor Neurons
B) Lower Motor Neurons
C) Both Upper and Lower Motor Neurons
D) Neither Upper nor Lower Motor Neurons

3. Amyotrophic Lateral sclerosis results in the degeneration of:
A) Upper Motor Neurons
B) Lower Motor Neurons
C) Both Upper and Lower Motor Neurons
D) Neither Upper nor Lower Motor Neurons

4. Upper Motor Neuron dysfunction results in:
A) Limb spasticity
B) Hyperreflexia
C) Brisk jaw-jerk reflex
D) “Emo”
E) All of the above

5. Upper Motor Neuron dysfunction results in:
A) Limb spasticity
B) Hyperreflexia
C) Brisk jaw-jerk reflex
D) “Emo”
E) All of the above

6. Lower Motor Neuron dysfunction causes:
A) Limb muscle weakness
B) Atrophy
C) Cramps
D) Fasciculations
E) All of the above

7. Lower Motor Neuron dysfunction causes:
A) Limb muscle weakness
B) Atrophy
C) Cramps
D) Fasciculations
E) All of the above

8. Signs of both upper and lower motor neuron dysfunction without other CNS dysfunction should lead you to suspect:
A) ALS
B) BLS
C) CLS
D) A middle motor neuron condition

9. Signs of both upper and lower motor neuron dysfunction without other CNS dysfunction should lead you to suspect:
A) ALS
B) BLS
C) CLS
D) A middle motor neuron condition

10. Which of the following is an autoimmune disease characterized by muscle weakness and fatigue, seen especially with repetitive use of voluntary muscles?
A) ALS
B) Myasthenia Gravis
C) Botulism
D) MS

11. Which of the following is an autoimmune disease characterized by muscle weakness and fatigue, seen especially with repetitive use of voluntary muscles?
A) ALS
B) Myasthenia Gravis
C) Botulism
D) MS

12. What Movie?

14. Prior to the establishment of a definitive diagnosis, most MG patients have general weakness of:
A) Proximal extremities
B) Neck Extensors
C) Facial or Bulbar muscles
D) All of the above

15. Prior to the establishment of a definitive diagnosis, most MG patients have general weakness of:
A) Proximal extremities
B) Neck Extensors
C) Facial or Bulbar muscles
D) All of the above

16. Patient complaints of ocular disturbances or proximal limb muscle weakness not associated with systemic causes of generalized fatigue which worsens as the day progresses should prompt a diagnosis of:
A) ALS
B) Myasthenia Gravis
C) Botulism
D) MS

17. Patient complaints of ocular disturbances or proximal limb muscle weakness not associated with systemic causes of generalized fatigue which worsens as the day progresses should prompt a diagnosis of:
A) ALS
B) Myasthenia Gravis
C) Botulism
D) MS

18. An MG patient who complains of extreme weakness in the muscles of respiration resulting in respiratory failure is termed:
A) Lateral Sclerosis Crisis
B) Myasthenic crisis
C) Botulism crisis
D) Multiple Sclerosis Crisis

19. An MG patient who complains of extreme weakness in the muscles of respiration resulting in respiratory failure is termed:
A) Lateral Sclerosis Crisis
B) Myasthenic crisis
C) Botulism crisis
D) Multiple Sclerosis Crisis

20. Administration of edrophonium which causes resolution of the muscle weakness within a few minutes is considered a:
A) Failure
B) Negative Tensilon
C) Positive Tensilon
D) Cholinergic crisis
E) All of the above

21. Administration of edrophonium which causes resolution of the muscle weakness within a few minutes is considered a:
A) Failure
B) Negative Tensilon
C) Positive Tensilon
D) Cholinergic crisis
E) All of the above

22. Administration of edrophonium which causes muscle fasiculations, respiratory depression, increased salivation, lacrimation, urination, defecation, GI upset or emesis is considered a:
A) Failure
B) Positive Tensilon
C) Cholinergic crisis
D) All of the above

23. Administration of edrophonium which causes muscle fasiculations, respiratory depression, increased salivation, lacrimation, urination, defecation, GI upset or emesis is considered a:
A) Failure
B) Positive Tensilon
C) Cholinergic crisis
D) All of the above

24. What Movie?

26. Bonus: What was the name of the missing character?
Winston Zeddemore

27. To establish a diagnosis of MG, which of the following is administered?
A) Botulinum anti-toxin
B) Edrophonium chloride
C) Dihydrostreptomycin
D) Penicillamine

28. To establish a diagnosis of MG, which of the following is administered?
A) Botulinum anti-toxin
B) Edrophonium chloride
C) Dihydrostreptomycin
D) Penicillamine

29. The management of MG includes the administration of:
A) Acteylcholinesterase inhibitors
B) Thymectomy
C) Chronic immune suppression
D) Plasma exchanges
E) All of the above

30. The management of MG includes the administration of:
A) Acteylcholinesterase inhibitors
B) Thymectomy
C) Chronic immune suppression
D) Plasma exchanges
E) All of the above

31. Which of the following induction agents should be avoided in the myasthenia gravis patient?
A) Succinylcholine
B) Etomidate
C) Fentanyl
D) Propofol
E) All of the above

32. Which of the following induction agents should be avoided in the myasthenia gravis patient?
A) Succinylcholine
B) Etomidate
C) Fentanyl
D) Propofol
E) All of the above

33. The neurologic disorder which causes variable motor, sensory, visual and cerebellar dysfunction as a result of CNS myelin destruction is:
A) ALS
B) Myasthenia Gravis
C) Botulism
D) MS

34. The neurologic disorder which causes variable motor, sensory, visual and cerebellar dysfunction as a result of CNS myelin destruction is:
A) ALS
B) Myasthenia Gravis
C) Botulism
D) MS

35. Flexion of the neck causing an electric shock sensation, a vibration or pain radiating down the back and often into the arms or legs is termed:
A) Termite sign
B) Lhermitte sign
C) Smurfette sign
D) Malingering

36. Movie?

38. Flexion of the neck causing an electric shock sensation, a vibration or pain radiating down the back and often into the arms or legs is termed:
A) Termite sign
B) Lhermitte sign
C) Smurfette sign
D) Malingering

39. Presentation with complete or near-complete loss of motor function is termed:
A) Optic neuritis
B) Lhermitte sign
C) Acute transverse myelitis
D) Uhthoff phenomenon

40. Presentation with complete or near-complete loss of motor function is termed:
A) Optic neuritis
B) Lhermitte sign
C) Acute transverse myelitis
D) Uhthoff phenomenon

41. Unilateral retrobulbar pain reproduced with palpation is termed:
A) Optic neuritis
B) Lhermitte sign
C) Acute transverse myelitis
D) Uhthoff phenomenon

42. Unilateral retrobulbar pain reproduced with palpation is termed:
A) Optic neuritis
B) Lhermitte sign
C) Acute transverse myelitis
D) Uhthoff phenomenon

43. Visual acuity which worsens due to increases in body temperature is termed:
A) Optic neuritis
B) Lhermitte sign
C) Acute transverse myelitis
D) Uhthoff phenomenon

44. Visual acuity which worsens due to increases in body temperature is termed:
A) Optic neuritis
B) Lhermitte sign
C) Acute transverse myelitis
D) Uhthoff phenomenon

45. Which of the following is most effective early in the disease course of an exacerbation of MS?
A) Succinylcholine
B) Solu-Medrol
C) Fluid bolus
D) Levodopa

46. Which of the following is most effective early in the disease course of an exacerbation of MS?
A) Succinylcholine
B) Solu-Medrol
C) Fluid bolus
D) Levodopa

47. Movie?

49. A disorder characterized by the presence of a resting tremor, cogwheel rigidity, bradykinesias or akinesias and impared postural reflexes is:
A) Lambert-Eaton myasthenic syndrome
B) MS
C) Parkinson Disease
D) Poliomyelitis

50. A disorder characterized by the presence of a resting tremor, cogwheel rigidity, bradykinesias or akinesias and impared postural reflexes is:
A) Lambert-Eaton myasthenic syndrome
B) MS
C) Parkinson Disease
D) Poliomyelitis

51. Which of the following is a hallmark of parkinson disease:
A) Resting tremor
B) Cogwheel rigidity
C) Bradykinesia or akinesia
D) Impairment in posture and equilibrium
E) All of the above

52. Which of the following is a hallmark of parkinson disease:
A) Resting tremor
B) Cogwheel rigidity
C) Bradykinesia or akinesia
D) Impairment in posture and equilibrium
E) All of the above

53. Which of the following is effective in patients with parkinson disease?
A) Succinylcholine
B) Solu-Medrol
C) Fluid bolus
D) Levodopa

54. Which of the following is effective in patients with parkinson disease?
A) Succinylcholine
B) Solu-Medrol
C) Fluid bolus
D) Levodopa

55. Which of the following can cause tardive dyskinesia in Parkinson patients?
A) Succinylcholine
B) Solu-Medrol
C) Haloperidol
D) Levodopa

56. Which of the following can cause tardive dyskinesia in Parkinson patients?
A) Succinylcholine
B) Solu-Medrol
C) Haloperidol
D) Levodopa

57. Spinal polio is characterized by:
A) Flaccid and weak muscles
B) Absent tendon reflexes
C) Fasciculations
D) All of the above

58. Spinal polio is characterized by:
A) Flaccid and weak muscles
B) Absent tendon reflexes
C) Fasciculations
D) All of the above

59. Movie?

61. Which of the following should be considered whenever an at-risk patient presents with acute febrile illness, aseptic meningitis and asymmetric flaccid paralysis associated with the loss of deep tendon reflexes and normal sensation?
A) Lambert-Eaton myasthenic syndrome
B) MS
C) Parkinson Disease
D) Poliomyelitis

62. Which of the following should be considered whenever an at-risk patient presents with acute febrile illness, aseptic meningitis and asymmetric flaccid paralysis associated with the loss of deep tendon reflexes and normal sensation?
A) Lambert-Eaton myasthenic syndrome
B) MS
C) Parkinson Disease
D) Poliomyelitis

63. The predominant cause of meningitis in children 1 month or older is:
A) S. pneumoniae and N. meningitidis
B) S. pneumoniae and L. monocytogenes
C) S. aureus and S. epidermidis
D) H. influenzae and L. monocytogenes

64. The predominant cause of meningitis in children 1 month or older is:
A) S. pneumoniae and N. meningitidis
B) S. pneumoniae and L. monocytogenes
C) S. aureus and S. epidermidis
D) H. influenzae and L. monocytogenes

65. Which of the following organisms is associated with army barracks and college dormitories?
A) N. meningitidis
B) S. pneumoniae
C) S. epidermidis
D) H. influenzae

66. Which of the following organisms is associated with army barracks and college dormitories?
A) N. meningitidis
B) S. pneumoniae
C) S. epidermidis
D) H. influenzae

67. Which of the following organisms is associated with day-care centers?
A) N. meningitidis
B) S. pneumoniae
C) S. epidermidis
D) H. influenzae

68. Which of the following organisms is associated with day-care centers?
A) N. meningitidis
B) S. pneumoniae
C) S. epidermidis
D) H. influenzae

69. Which of the following organisms is associated with a history of head trauma?
A) N. meningitidis
B) S. pneumoniae
C) S. epidermidis
D) H. influenzae

70. Which of the following organisms is associated with a history of head trauma?
A) N. meningitidis
B) S. pneumoniae
C) S. epidermidis
D) H. influenzae

71. Movie?

73. Additional testing if Lyme disease is suspected is:
A) Acid-fast stain and culture
B) India ink or serum cryptococcal antigen
C) Borrelia antibodies
D) Viral cultures

74. Additional testing if Lyme disease is suspected is:
A) Acid-fast stain and culture
B) India ink or serum cryptococcal antigen
C) Borrelia antibodies
D) Viral cultures

75. Additional testing if aseptic meningitis is suspected is:
A) Acid-fast stain and culture
B) India ink or serum cryptococcal antigen
C) Borrelia antibodies
D) Viral cultures

76. Additional testing if aseptic meningitis is suspected is:
A) Acid-fast stain and culture
B) India ink or serum cryptococcal antigen
C) Borrelia antibodies
D) Viral cultures

77. Additional testing if tuberculous meningitis is suspected is:
A) Acid-fast stain and culture
B) India ink or serum cryptococcal antigen
C) Borrelia antibodies
D) Viral cultures

78. Additional testing if tuberculous meningitis is suspected is:
A) Acid-fast stain and culture
B) India ink or serum cryptococcal antigen
C) Borrelia antibodies
D) Viral cultures

79. Additional testing if meningitis is suspected in an immunocompromised patient:
A) Acid-fast stain and culture
B) India ink or serum cryptococcal antigen
C) Borrelia antibodies
D) Viral cultures

80. Additional testing if meningitis is suspected in an immunocompromised patient:
A) Acid-fast stain and culture
B) India ink or serum cryptococcal antigen
C) Borrelia antibodies
D) Viral cultures

81. If you suspect meningococcal disease, and must administer antibiotics prior to your LP, the CSF will be considered sterile in:
A) 2 hours
B) 4 hours
C) 6 hours
D) 8 hours

82. If you suspect meningococcal disease, and must administer antibiotics prior to your LP, the CSF will be considered sterile in:
A) 2 hours
B) 4 hours
C) 6 hours
D) 8 hours

83. Movie?

85. If you suspect pneumococcal disease, and must administer antibiotics prior to your LP, the CSF will be considered sterile in:
A) 2 hours
B) 4 hours
C) 6 hours
D) 8 hours

86. If you suspect pneumococcal disease, and must administer antibiotics prior to your LP, the CSF will be considered sterile in:
A) 2 hours
B) 4 hours
C) 6 hours
D) 8 hours

87. Empirical treatment for bacterial meningitis in patients aged 18-50 is:
A) Ampicillin and gentamycin
B) Ceftriaxone plus ampicillin
C) Ceftriaxone plus vancomycin
D) Ceftriaxone
E) Ceftazidime and gentamycin
F) Acyclovir

88. Empirical treatment for bacterial meningitis in patients aged 18-50 is:
A) Ampicillin and gentamycin
B) Ceftriaxone plus ampicillin
C) Ceftriaxone plus vancomycin
D) Ceftriaxone
E) Ceftazidime and gentamycin
F) Acyclovir

89. Empirical treatment for bacterial meningitis in patients aged >50 is:
A) Ampicillin and gentamycin
B) Ceftriaxone plus ampicillin
C) Ceftriaxone plus vancomycin
D) Ceftriaxone
E) Ceftazidime and gentamycin
F) Acyclovir

90. Empirical treatment for bacterial meningitis in patients aged >50 is:
A) Ampicillin and gentamycin
B) Ceftriaxone plus ampicillin
C) Ceftriaxone plus vancomycin
D) Ceftriaxone
E) Ceftazidime and gentamycin
F) Acyclovir

91. Empirical treatment for bacterial meningitis with gram-positive cocci in clusters is:
A) Ampicillin and gentamycin
B) Ceftriaxone plus ampicillin
C) Ceftriaxone plus vancomycin
D) Ceftriaxone
E) Ceftazidime and gentamycin
F) Acyclovir

92. Empirical treatment for bacterial meningitis with gram-positive cocci in clusters is:
A) Ampicillin and gentamycin
B) Ceftriaxone plus ampicillin
C) Ceftriaxone plus vancomycin
D) Ceftriaxone
E) Ceftazidime and gentamycin
F) Acyclovir

93. Empirical treatment for bacterial meningitis with gram-positive rods is:
A) Ampicillin and gentamycin
B) Ceftriaxone plus ampicillin
C) Ceftriaxone plus vancomycin
D) Ceftriaxone
E) Ceftazidime and gentamycin
F) Acyclovir

94. Empirical treatment for bacterial meningitis with gram-positive rods is:
A) Ampicillin and gentamycin
B) Ceftriaxone plus ampicillin
C) Ceftriaxone plus vancomycin
D) Ceftriaxone
E) Ceftazidime and gentamycin
F) Acyclovir

95. Movie?

97. Empirical treatment for bacterial meningitis with gram-negative rods is:
A) Ampicillin and gentamycin
B) Ceftriaxone plus ampicillin
C) Ceftriaxone plus vancomycin
D) Ceftriaxone
E) Ceftazidime and gentamycin
F) Acyclovir

98. Empirical treatment for bacterial meningitis with gram-negative rods is:
A) Ampicillin and gentamycin
B) Ceftriaxone plus ampicillin
C) Ceftriaxone plus vancomycin
D) Ceftriaxone
E) Ceftazidime and gentamycin
F) Acyclovir

99. Empirical treatment for meningitis with HSV is:
A) Ampicillin and gentamycin
B) Ceftriaxone plus ampicillin
C) Ceftriaxone plus vancomycin
D) Ceftriaxone
E) Ceftazidime and gentamycin
F) Acyclovir

100. Empirical treatment for meningitis with HSV is:
A) Ampicillin and gentamycin
B) Ceftriaxone plus ampicillin
C) Ceftriaxone plus vancomycin
D) Ceftriaxone
E) Ceftazidime and gentamycin
F) Acyclovir

101. ACEP recommends CT scanning for first-time seizures
A) True
B) False

102. ACEP recommends CT scanning for first-time seizures
A) True
B) False