Practice Test Geeks(ABEM) American Board of Emergency Medicine Practice Test
← All ABEM Flashcard Decks

Neurological & Psychiatric Disorders Flashcards

7 cards from real ABEM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Neurological & Psychiatric Disorders flashcards as text

  1. A 68-year-old man presents with sudden-onset vertigo, ipsilateral facial numbness, contralateral body numbness, hoarseness, and dysphagia. What is the most likely diagnosis?

    Answer: Wallenberg syndrome (lateral medullary syndrome)

    Wallenberg syndrome results from posterior inferior cerebellar artery (PICA) occlusion causing lateral medullary infarction with crossed sensory deficits and cranial nerve findings.

  2. A patient on lithium presents with coarse tremor, ataxia, and confusion with a lithium level of 2.8 mEq/L. Which intervention is most critical?

    Answer: Begin hemodialysis

    Severe lithium toxicity (level >2.5 mEq/L with neurological symptoms) requires hemodialysis, as lithium is not protein-bound and is dialyzable.

  3. A 25-year-old woman presents with ascending weakness starting in the legs over 3 days, areflexia, and mild autonomic instability. CSF shows albuminocytologic dissociation. What is the priority concern?

    Answer: Imminent respiratory failure

    In Guillain-Barré syndrome, respiratory muscle involvement causing respiratory failure is the most immediately life-threatening complication requiring serial FVC monitoring.

  4. A 45-year-old with known alcoholism presents after a seizure. He last drank 48 hours ago. His blood alcohol level is 0. What is the MOST appropriate next step?

    Answer: Administer lorazepam and thiamine

    Alcohol withdrawal seizures are best treated with benzodiazepines; thiamine must be given prior to or concurrently with glucose to prevent precipitating Wernicke encephalopathy.

  5. A 30-year-old presents with acute onset of severe agitation, hyperthermia (40.5°C), diaphoresis, myoclonus, and hyperreflexia after starting a new medication. Which drug combination most likely caused this?

    Answer: Tramadol and sertraline

    Serotonin syndrome is caused by excess serotonergic activity, classically from combining opioids with serotonin activity (tramadol) and SSRIs.

  6. A 72-year-old nursing home patient presents with gradual cognitive decline, urinary incontinence, and a wide-based magnetic gait. CT shows enlarged ventricles disproportionate to cortical atrophy. What condition should be ruled out?

    Answer: Normal pressure hydrocephalus

    Normal pressure hydrocephalus presents with the classic triad of gait apraxia, urinary incontinence, and dementia, and is potentially reversible with VP shunting.

  7. A 55-year-old presents with thunderclap headache of maximal intensity at onset. CT head is negative. What is the next most appropriate step?

    Answer: Perform lumbar puncture to evaluate for xanthochromia

    A negative CT does not rule out subarachnoid hemorrhage; lumbar puncture to detect xanthochromia is required when CT is negative in the setting of thunderclap headache.