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Z Year 3 Misc > CCC - Neuro > Flashcards

CCC - Neuro Flashcards

1
Q

What anatomy can be affected in a neurological lesion?

A
  1. Brain
  2. Spinal Cord
  3. Nerve roots
  4. Peripheral nerve(s)
  5. Neuromuscular junction
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2
Q

What is the possible pathology of a neurological lesion?

A
  1. Vascular
  2. Infection
  3. Inflammation/Autoimmune
  4. Toxic/Metabolic
  5. Tumour/Malignancy
  6. Hereditary/congential
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3
Q

How do you test CNI?

A

sense of smell

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4
Q

How do you test CNII?

A
  1. VA
  2. VF
  3. pupils
  4. fundoscopy
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5
Q

How do you test CNIII, IV, VI?

A

diplopia

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6
Q

How do you test CNV?

A

sensation, corneal reflex

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7
Q

How do you test CNVII?

A

facial palsy

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8
Q

How do you test CNVIII?

A

hearing

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9
Q

How do you test cranial nerve IX, X?

A

speech, swallowing

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10
Q

How do you test CNXI?

A

sternocloidmastoid, trapezius

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11
Q

How do you test CNXII?

A

tongue muscle

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12
Q

How do you test upper and lower limbs?

A
  1. Inspection
  2. Tone
  3. Power
  4. Reflex
  5. Coordination
  6. Sensation
  7. Gait
  8. Back
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13
Q

What are UMN signs?

A
  1. Increased tone (spasticity)
  2. Decreased power
  3. Increased reflexes (increase plantar)
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14
Q

What are LMN signs?

A
  1. decreased tone (flaccid)
  2. decreased power
  3. decreased reflexes
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15
Q

If the problem is everywhere across body where might the lesion be?

A

NMJ

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16
Q

What anatomy is affected when there is hemisensory loss (reduced sensation contralateral)?

A

cerebral cortex

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17
Q

What anatomy is affected when there us sensory loss at a certain level (e.g. umbbilicus)?

A

spinal cord

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18
Q

What anatomy is affected when there is sensory loss in a dermatome(s)?

A

nerve root (radiculopathy)

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19
Q

What anatomy is affected when there is sensory loss in a specific area?

A

mononeuropathy

20
Q

What anatomy is affected in glove and stocking distributions sensory loss?

A

polyneuropathy

21
Q

What are cerbellar signs of coordination?

A
  1. Ataxia
  2. Nystagmus
  3. Dysdiadochokinesia
  4. Intention tremor
  5. Speech: slurred, scanning
22
Q

What would you prescribe if glove and stocking distribution sensory loss?

A

duloxetine

23
Q

What are toxic metabolic causes and clues for peipheral neuropathy?

A
  1. Drugs: Hx
  2. Alcohol: Hx + high GGT and MCV
  3. B12 deficiency: Anaemia + high MCV
  4. Diabetes: history, glucose/HbA1c
  5. Hypothyroidism: TFTs
  6. Uraemia: U+Es
  7. amyloidosis: history of myeloma or chronic infection/inflammation
24
Q

What are infection causes of peripheral neuropathy?

25
Q

What are inflammatory/autoimmune causes of peripheral neuropathy?

A
  1. vasculitis
  2. CTD
  3. Inflammatory demyelinating neuropathy
26
Q

What are the tumour/malignancy causes of peripheral neuropathy?

A
  1. paraneoplastic

2. paraproteinaemia

27
Q

What are the hereditary causes of peripheral neuropathy?

A
  1. hereditary sensory motor neuropathy (e.g. pescavus)
28
Q

When might there be amurosis fugax?

A

sudden loss

29
Q

What is anterior uveitis?

A

painful red eye

30
Q

When may there be papilloedema?

A

raised ICP - blind stop might be different, enlarged blind spots

31
Q

What is papillitis (optic neuritis)?

A
  1. blurred optic disc margins
  2. blurred vision
  3. pain on eye movement
    - Optic nerve affected
32
Q

When would there be vitreous haemorrhage?

A

sudden loss

33
Q

What are possible causes of spastic paraparesis?

A
  1. Vascular
  2. Infection
  3. Inflammation (demyelination) - traverse myelitis
  4. Toxic/metabolic
  5. Tumour/malignancy
34
Q

How can you diagnose MS?

A
  1. Two lesions

2. Separated in time and space

35
Q

What is the effect if the lesion is in the cortex?

A

contralateral weakness

36
Q

What is meralgia paraesthetica?

A

compression of lateral cutaneous nerve

37
Q

How do you treat meralgia paraesthetica?

A
  1. reassure
  2. avoid tight garments
  3. lose weight
    - if perisitent
  4. carbamazepine
  5. gabapentin
38
Q

What is radiculopathy?

A

disease of nerve roots

39
Q

What is the compression caused by?

A
  1. disc herniation

2. spinal canal stenosis

40
Q

What is the pathophysiology of parkinsons?

A

loss dopaminergic neurons in substantia nigra

41
Q

What are the features of parkinson’s disease?

A
  1. tremor
  2. rigidity
  3. bradykinesia
42
Q

What are the features of PSP?

A
  1. Parkinsonian features

2. Upgaze abnoramlity

43
Q

What are the features of lewy body dementia?

A
  1. features of alzheimer’s disease
  2. Parkinson’s
  3. hallucinations
44
Q

What are DDx of apparent confusion/reduced AMTS?

A
  1. Post-ictal: Hx of seizures?
  2. Dysphasia (receptive or expressive): any other features of stroke/TIA?
  3. Dementia
  4. Depressive pseudodementia: elderly, withdrawn, poor eye contact, precipitating factors (e.g. berevaement)
45
Q

What are different types of dementia that can cause apparent confusion / reduced AMTS?

A
  1. vascular (multi-infarct): history of IHD/PVD
  2. alcoholic: signs of excess alcohol
  3. alzehimers
  4. inherited e.g. Huntington’s disease: other features of HD

Z Year 3 Misc (11 decks)

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