PAEA Internal Medicine EOR WITH CORRECT ANSWERS LATEST
EDITION 2026!
1 - What is bell's palsy
2 - S/S of Bell's Palsy - ANSWER⭐☑️1 - Causes CN 7 dysfunction
2 - Has forehead involvement (whereas a stroke does not affect forehead movement), facial weakness,
inability to keep one eye closed
Treatment for Bell's palsy - ANSWER⭐☑️Prednisone 60mg x 5 days, artificial tears, lacri lube at night
When can I use tPA? - ANSWER⭐☑️ischemic stroke presenting within <3 hrs and CT head negative
How do you treat high BP with stroke? - ANSWER⭐☑️Nitroprusside (short half life, easy to titrate) or IV
labetalol
What do you use for anticoagulation/antiplatelet therapy in stroke? - ANSWER⭐☑️ASA (not in
hemorrhagic), heparin for thrombosis
What do you do differently to treat hemorrhagic stroke? - ANSWER⭐☑️Give prophylactic anticonvulsant
like phenytoin because of increased seizure risk, antiplatelet therapy contraindicated
Types of Hemorrhagic Stroke - ANSWER⭐☑️1. Intracerebral (10%): results from rupture of small
arterioles
2. Subarachnoid (3%): rupture of arterial aneurysms (hemorrhage into subarachnoid space)
Causes of Intracerebral hemorrhagic stroke are what? - ANSWER⭐☑️HTN, amyloidosis, iatrogenic
anticoagulation, vascular malformations, cocaine use
,Causes of Subarachnoid hemorrhagic stroke are what? - ANSWER⭐☑️berry aneurysm rupture, vascular
malformation rupture
Signs and symptoms of Intracerebral hemorrhagic stroke are what? - ANSWER⭐☑️ICP rises,
vasoconstriction-sweating
Signs and symptoms of Subarachnoid hemorrhagic stroke are what? - ANSWER⭐☑️may be preceded by
warning headache, neck/back pain, "worst headache of my life," thunderclap, may have loss of
consciousness
Treatment of Subarachnoid hemorrhage - ANSWER⭐☑️surgery (clips vs coils), control hypertension,
analgesics
What is Complex regional pain syndrome (CRPS) - ANSWER⭐☑️Chronic arm or leg pain developing after
injury, surgery, stroke, or heart attack.
Signs and symptoms of complex regional pain syndrome are what? - ANSWER⭐☑️Pain out of proportion
to injury. ANS sx: swelling, extremity color changes, increased nail and hair growth.
Treatment for complex regional pain syndrome - ANSWER⭐☑️Amitriptyline, nortriptyline, gabapentin,
pregabalin, lamotrigine; NSAIDs; Calcitonin to reduce pain as adjunctive therapy; Bisphosphonates, IVIG,
regional nerve blocks, dorsal column stimulation
Vit C prophylaxis after fx
Imaging modality used to diagnose Subarachnoid Hemorrhage? - ANSWER⭐☑️CT without contrast. If CT
negative but still suspect SAH, do LP to look for RBC or xanthochromia (will not develop until 12hrs after
onset)
Delirium - ANSWER⭐☑️transient disorder characterized by impaired attention, perception, memory and
cognition. Sleep wake cycles interrupted ("sundowning"). Reduced alertness, activity levels change
rapidly.
,Treatment of Delirium - ANSWER⭐☑️treat underlying cause, Haloperidol 5-10mg for agitation,
Lorazepam 0.5-2 mg
Dementia - ANSWER⭐☑️Loss of mental capacity. Psychosocial level and cognitive abilities deteriorate
and behavioral problems develop. Largest categories are Alzheimer dz and vascular dementia.
Hallucinations, delusion, depression, repetitive behavior are common.
Treatment of Dementia - ANSWER⭐☑️Antipsychotics to manage psychosis
Essential tremor does not occur at rest, occurs bilaterally, and has no indication of other neuro signs.
How do you treat essential tremor? - ANSWER⭐☑️Propranolol, Primidone (can combine these 2 if
needed)
Guillian Barre Syndrome - ANSWER⭐☑️Idiopathic polyneuropathy often following minor infections,
immunizations or surgical procedures. Most times no cause is identified.
How long does Guillian Barre Syndrome last? - ANSWER⭐☑️worst at 2-4 weeks after onset, plateaus
next 2-4 weeks, remits weeks-moats
Signs and symptoms of Guillian Barre Syndrome - ANSWER⭐☑️ascending symmetric weakness and loss
of DTR's, proximal muscles affected more than distal. Sensory abnormalities, pain, tachycardia,
sweating, impaired pulmonary function, paralytic ileus
How do you diagnose Guillian Barre? - ANSWER⭐☑️no fever at onset, CSF protein >45 and low WBC,
MRI shows selective enhancement of anterior spinal nerve roots
Treatment of Guillian Barre Syndrome - ANSWER⭐☑️--IVIG or plasmapheresis,
--may need intubation. --Hospitalized pt with close monitoring.
--Recovery is slow but approximately 60% make full recovery within 1 year.
, What disease is a systemic inflammatory condition of medium and large vessels affecting people over 50
years old, coexists with polymyalgia rheumatica and can cause blindness if not treated appropriately? -
ANSWER⭐☑️Giant cell arteritis
Signs and symptoms of Giant Cell Arteritis - ANSWER⭐☑️headache, scalp tenderness, jaw claudication,
throat pain, diplopia
Symptoms of polymyalgia rheumatica: pain of shoulder/pelvis
Giant Cell Arteritis Treatment - ANSWER⭐☑️Steroids immediately, do not wait for biopsy results. Give
low dose aspirin too.
Describe a Migraine Headache? - ANSWER⭐☑️unilateral location, pulsatile quality, moderate to severe
intensity, aggravated by movement, nausea, vomiting, photophobia, phonophobia
lasting 4-72 hours
Migraine treatment - ANSWER⭐☑️NSAIDs, Triptans, antiemetics
What is a Cluster Headache? - ANSWER⭐☑️--severe, unilateral headache localized to
periorbital/temporal area
--accompanied by lacrimation, rhinorrhea, ptosis, myosis, nasal congestion, eyelid edema
--Occurs in clusters meaning 1-8 daily attacks lasting 15-90 minutes for 4-6 weeks... followed by pain
free interval 3-6 months
Cluster headache treatment - ANSWER⭐☑️--Oxygen, Sumatriptan 6mg SQ,
--start preventive therapy as soon as headache onset to suppress attacks over expected duration of
cluster period
Preventive therapies for cluster headache lasting more than 2 months - ANSWER⭐☑️Verapamil 240-
960mg given in 3 daily doses
What is a Tension Headache? - ANSWER⭐☑️mild to moderate intensity, located bilateral-frontal areas,
dull band like pain,
EDITION 2026!
1 - What is bell's palsy
2 - S/S of Bell's Palsy - ANSWER⭐☑️1 - Causes CN 7 dysfunction
2 - Has forehead involvement (whereas a stroke does not affect forehead movement), facial weakness,
inability to keep one eye closed
Treatment for Bell's palsy - ANSWER⭐☑️Prednisone 60mg x 5 days, artificial tears, lacri lube at night
When can I use tPA? - ANSWER⭐☑️ischemic stroke presenting within <3 hrs and CT head negative
How do you treat high BP with stroke? - ANSWER⭐☑️Nitroprusside (short half life, easy to titrate) or IV
labetalol
What do you use for anticoagulation/antiplatelet therapy in stroke? - ANSWER⭐☑️ASA (not in
hemorrhagic), heparin for thrombosis
What do you do differently to treat hemorrhagic stroke? - ANSWER⭐☑️Give prophylactic anticonvulsant
like phenytoin because of increased seizure risk, antiplatelet therapy contraindicated
Types of Hemorrhagic Stroke - ANSWER⭐☑️1. Intracerebral (10%): results from rupture of small
arterioles
2. Subarachnoid (3%): rupture of arterial aneurysms (hemorrhage into subarachnoid space)
Causes of Intracerebral hemorrhagic stroke are what? - ANSWER⭐☑️HTN, amyloidosis, iatrogenic
anticoagulation, vascular malformations, cocaine use
,Causes of Subarachnoid hemorrhagic stroke are what? - ANSWER⭐☑️berry aneurysm rupture, vascular
malformation rupture
Signs and symptoms of Intracerebral hemorrhagic stroke are what? - ANSWER⭐☑️ICP rises,
vasoconstriction-sweating
Signs and symptoms of Subarachnoid hemorrhagic stroke are what? - ANSWER⭐☑️may be preceded by
warning headache, neck/back pain, "worst headache of my life," thunderclap, may have loss of
consciousness
Treatment of Subarachnoid hemorrhage - ANSWER⭐☑️surgery (clips vs coils), control hypertension,
analgesics
What is Complex regional pain syndrome (CRPS) - ANSWER⭐☑️Chronic arm or leg pain developing after
injury, surgery, stroke, or heart attack.
Signs and symptoms of complex regional pain syndrome are what? - ANSWER⭐☑️Pain out of proportion
to injury. ANS sx: swelling, extremity color changes, increased nail and hair growth.
Treatment for complex regional pain syndrome - ANSWER⭐☑️Amitriptyline, nortriptyline, gabapentin,
pregabalin, lamotrigine; NSAIDs; Calcitonin to reduce pain as adjunctive therapy; Bisphosphonates, IVIG,
regional nerve blocks, dorsal column stimulation
Vit C prophylaxis after fx
Imaging modality used to diagnose Subarachnoid Hemorrhage? - ANSWER⭐☑️CT without contrast. If CT
negative but still suspect SAH, do LP to look for RBC or xanthochromia (will not develop until 12hrs after
onset)
Delirium - ANSWER⭐☑️transient disorder characterized by impaired attention, perception, memory and
cognition. Sleep wake cycles interrupted ("sundowning"). Reduced alertness, activity levels change
rapidly.
,Treatment of Delirium - ANSWER⭐☑️treat underlying cause, Haloperidol 5-10mg for agitation,
Lorazepam 0.5-2 mg
Dementia - ANSWER⭐☑️Loss of mental capacity. Psychosocial level and cognitive abilities deteriorate
and behavioral problems develop. Largest categories are Alzheimer dz and vascular dementia.
Hallucinations, delusion, depression, repetitive behavior are common.
Treatment of Dementia - ANSWER⭐☑️Antipsychotics to manage psychosis
Essential tremor does not occur at rest, occurs bilaterally, and has no indication of other neuro signs.
How do you treat essential tremor? - ANSWER⭐☑️Propranolol, Primidone (can combine these 2 if
needed)
Guillian Barre Syndrome - ANSWER⭐☑️Idiopathic polyneuropathy often following minor infections,
immunizations or surgical procedures. Most times no cause is identified.
How long does Guillian Barre Syndrome last? - ANSWER⭐☑️worst at 2-4 weeks after onset, plateaus
next 2-4 weeks, remits weeks-moats
Signs and symptoms of Guillian Barre Syndrome - ANSWER⭐☑️ascending symmetric weakness and loss
of DTR's, proximal muscles affected more than distal. Sensory abnormalities, pain, tachycardia,
sweating, impaired pulmonary function, paralytic ileus
How do you diagnose Guillian Barre? - ANSWER⭐☑️no fever at onset, CSF protein >45 and low WBC,
MRI shows selective enhancement of anterior spinal nerve roots
Treatment of Guillian Barre Syndrome - ANSWER⭐☑️--IVIG or plasmapheresis,
--may need intubation. --Hospitalized pt with close monitoring.
--Recovery is slow but approximately 60% make full recovery within 1 year.
, What disease is a systemic inflammatory condition of medium and large vessels affecting people over 50
years old, coexists with polymyalgia rheumatica and can cause blindness if not treated appropriately? -
ANSWER⭐☑️Giant cell arteritis
Signs and symptoms of Giant Cell Arteritis - ANSWER⭐☑️headache, scalp tenderness, jaw claudication,
throat pain, diplopia
Symptoms of polymyalgia rheumatica: pain of shoulder/pelvis
Giant Cell Arteritis Treatment - ANSWER⭐☑️Steroids immediately, do not wait for biopsy results. Give
low dose aspirin too.
Describe a Migraine Headache? - ANSWER⭐☑️unilateral location, pulsatile quality, moderate to severe
intensity, aggravated by movement, nausea, vomiting, photophobia, phonophobia
lasting 4-72 hours
Migraine treatment - ANSWER⭐☑️NSAIDs, Triptans, antiemetics
What is a Cluster Headache? - ANSWER⭐☑️--severe, unilateral headache localized to
periorbital/temporal area
--accompanied by lacrimation, rhinorrhea, ptosis, myosis, nasal congestion, eyelid edema
--Occurs in clusters meaning 1-8 daily attacks lasting 15-90 minutes for 4-6 weeks... followed by pain
free interval 3-6 months
Cluster headache treatment - ANSWER⭐☑️--Oxygen, Sumatriptan 6mg SQ,
--start preventive therapy as soon as headache onset to suppress attacks over expected duration of
cluster period
Preventive therapies for cluster headache lasting more than 2 months - ANSWER⭐☑️Verapamil 240-
960mg given in 3 daily doses
What is a Tension Headache? - ANSWER⭐☑️mild to moderate intensity, located bilateral-frontal areas,
dull band like pain,
