Amir Sam 4 - Neurology

Question 1

What 2 things do you need to identify in the history in order to make the neuro diagnosis?

Answer 1

Where is the lesion?

What is the pathology? - vascular, infective, inflammatory, metabolic, tumour

Question 2

Differentiate between UMN and LMN lesions

Answer 2

UMN = increase tone, decreased power, brisk reflexes, upgoing plantar 
LMN = decreased tone, decreased power, slow/no reflexes

Question 3

List the mnemonic that shows Sx of faulty coordination

Answer 3

DANISH 
Dysdiadokinesis 
Ataxia 
Nystagmus
Intention tremor 
Slurred speech 
Hypotonia

Question 4

Lesions in the cerebral cortex will cause changed sensation where?

Answer 4

Hemisensory loss - so contralateral side

Question 5

Lesions in the spinal cord will cause changed sensation where?

Answer 5

Below a certain level

Question 6

Lesions in the nerve roots will cause changed sensation where?

Answer 6

Dermatome

Question 7

Mononeuropathy will cause changed sensation where?

Answer 7

Specific area

Question 8

Polyneuopathy will cause changed sensation where?

Answer 8

Glove and stocking

Question 9

List metabolic causes of polyneuropathy

Answer 9

Drugs
Alcohol 
B12 deficiency 
DM 
Hypothyroid 
Ureamia 
Amyloidosis

Question 10

What is papillitis?

Answer 10

Blurred optic disc with blurred vision

Question 11

What causes papillitis?

Answer 11

Inflammation of CN2

Question 12

List causes of spastic paraparesis

Answer 12

Vascular - anterior spinal artery problem
Infection - TB
Inflammation - transverse myelitis

Question 13

Define MS

Answer 13

2 lesions seperate in time and space

Question 14

What is meralgia paraesthetica?

Answer 14

Compression of lateral cutaneous femoral nerve

Question 15

How does meralgia paraesthetica present?

Answer 15

Pain/numbness/weird sensation in one area of skin on outer thigh

Question 16

What is radiculopathy?

Answer 16

Disease of nerve roots

Question 17

What causes sciatica?

Answer 17

Compression of lumbosacral nerve root due to disc herniation or spinal canal stenosis

Question 18

List the triad of PD Sx

Answer 18

Rigidity, resting tremor, bradykinesia

Question 19

List features of Lew Body dementia

Answer 19

PD Sx and HALLUCINATIONS

Question 20

List features of PSP

Answer 20

PD Sx and upgaze problems

Question 21

List 4 categories of causes of confusion

Answer 21

Post-ictal
Dysphasia
Dementia
Depression (pseudodementia)

Question 22

List causes of a LOC

Answer 22

Hypoglycaemia 
Vascular - bleed / SDH 
Infection 
Inflammation 
Malignancy 
Metabolic

Question 23

List the components of an AMTS

Answer 23

DoB
Age 
Time 
Year 
Place 
Recall address 
Recognise Dr / Nurse 
Prime minister 
2nd WW 
Count back from 20 to 1

Question 24

What is Kernigs sign?

Answer 24

Pain in the back of knee when straightening the knee - shows meningitis

Question 25

List features of meningitis

Answer 25

Fever, neck stiffness, Kernigs sign

Question 26

Sudden onset headache with xanthochromia on LP?

Answer 26

SAH

Question 27

50+ y/o, raised ESR with unilateral headache?

Answer 27

Giant cell arthritis

Question 28

Shoulder girdle pain, stiffness, constitutional upset?

Answer 28

Polymyalgia rheumatica

Question 29

Throbbing headache, vomitting, photophobia?

Answer 29

Migraine

Question 30

What is Tx for pituitary apoplexy?

Answer 30

IV hydrocortisone

Question 31

What is the Tx for stroke 3hrs ago with clear CT head?

Answer 31

<4.5hrs = thrombolysis

Question 32

What is the Tx for stroke 9hrs ago with clear CT head?

Answer 32

> 4.5hrs = aspirin, swallow assessment, fluid, O2

Question 33

What is the Tx for TIA?

Answer 33

Aspirin

Question 34

LMN weakness with backache?

Answer 34

Guillian Barre syndrome

Question 35

List causes of collapse

Answer 35

Hypoglycaemia
Heart - vasovagal, outflow obstruction, arrhythmia, postural hypotension
Brain - seizure