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Congition, Movement and Senses > Cognition Movement and Senses > Flashcards

Cognition Movement and Senses Flashcards

1
Q

Give three causes of acute neurological lesion

A

Vascular
Epileptic seizure
Trauma

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2
Q

Give three causes of a subacute (days to week onset) neuro lesion

A

Inflammation
Infection
Expanding mass/tumor

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3
Q

Give two causes of chronic onset neuro lesion

A

Alzheimer’s

Parkinson’s

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4
Q

Wasting: UMN or LMN lesion?

A

LMN

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5
Q

Fasiculation: UMN or LMN lesion?

A

LMN

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6
Q

Increased tone: UMN or LMN lesion?

A

UMN

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7
Q

Increased reflexes: UMN or LMN lesion?

A

UMN

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8
Q

Babinski (upwards plantar reflex): UMN or LMN lesion?

A

UMN

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9
Q

Give 5 signs of LMN lesion

A 
Wasting
Fasiculations
Decreased tone
Decreased reflexes
Down going plantar reflex
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10
Q

Give 3 signs of UMN lesion

A

Increased tone
Increased reflex
Babinski sign

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11
Q

What is key feature of cerebellar lesions?

A

Incoordination - dysdiadochokinasia: unable to do rapid alternating movements eg. Flipping one hand on the other

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12
Q

Give 7 signs of cortical lesions

A 
Aphasia
Apraxia
Agnosia 
Hemianopia (blind in half of vision)
Decreased memory
Changes in executive function/cognition
Loss of smell
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13
Q

Give three signs of anterior chord syndrome

A

Loss of ascending pain and temp
Loss of decending motor
Vibration and propriception sense preserved

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14
Q

Give three signs of post chord syndrome

A

Loss of ascending vibration and proprioception sense
Temp and pain sensation preserved
Motor preserved

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15
Q

What are the three signs of lateral chord syndrome (Brown-Sequard syndrome)?

A

Loss of:
Ipsilateral motor
Ipsilateral ascending vibrations and proprioception
Contralateral pain and temp sensation

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16
Q

What is the classic reported symptom of lateral chord syndrome (Brown-Sequard)?

A

‘One leg weak, one leg numb’

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17
Q

Give two symptoms of central chord syndrome

A

Bilateral loss of pain and temp sensation
Bit of loss of bilateral motor
cape like distribution

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18
Q

Give three classic symptoms/signs of MS

A

Optic neuritis
Internuclear Ophthalmoplegia
Lhermitte’s sign

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19
Q

What is Lhermitte’s sign?

A

Electric shock like sensation at back of neck when Pt puts chin on chest

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20
Q

What’s the classic triad on Ménière’s disease?

A

Vertigo
Hearing loss
Low frequency roaring tinnitus

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21
Q

Give four features of vestibular nystagmus

A

Horizontal oscillations
Increased when looking in direction of fast phase
Jerk with linear slow phase
Optic fixation suppresses it

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22
Q

What is the main symptom differentiating vestibular neuritis and Ménière’s disease?

A

Hearing loss in meneries

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23
Q

Give two treatments to prevent meneries attacks

A

Low salt diet

Thiazide diuretics

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24
Q

Give four permanant treatment options for meneries

A

Intratympanic gentamycin and coritcosteroid
Endolynphatic sac decompression
Vestibular neurectomy
Labyrinthectomy

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25
Give three classic symptoms/signs of Giant cell arthritis you should rule out in sudden vision loss pts
Sudden severe painful vision loss Jaw claudication Non pulsatile, tender temporal arteries
26
What are the features of Guiilain Barre syndrome?
Motor loss Loss of deep tendon reflexes Pareasthesia without objective sensory loss Often precipitated by gasteroenteritis
27
Give 4 symptoms of acute angle closure glaucoma
Unilateral loss of vision Painful eye Unilateral red eye Halos around lights
28
What is papilloedema?
Swollen optic nerve head secondary to raised ICP - usually bilateral
29
Give three causes of bilateral optic disc swelling
Raised ICP (papilloedema) Malignant hypertension Optic disc drusen (calcium deposits)
30
Give 5 features of ALS presentation
Upper exreamity weakness stiffness with poor coordination and balence unsteady gait Drooling Emotional lability (inappropriate outbursts of laughing or crying)
31
Signs of chylamidia conjunctivitis of newborn?
Creamy white discharge | 5-12 days after birth
32
Signs of Gonorrhoea conjunctivitis in newborn
D 2-5 | Rapid progressing
33
Signs of staphylococcus conjunctivitis in newborn?
Yellow discharge
34
Triad of shaken baby syndrome
Encephalopathy Subdural heamhorrage Retinal heamhorrage
35
What is leucocoria?
White pupil
36
What is phoria?
Eye misalignment but corrected through subconscious effort
37
What is trophia?
Eye deviation that cannot be controlled
38
What is retinopathy of prematurity?
Abnormal retinal changes that may occur in preterm babies
39
Give 5 chronic causes of blurred vision
``` Diabetic retinopathy Diabetic maculopathy Glaucoma Cataract Age related macular degeneration ```
40
Give 3 ddx of acute blurred vision with painful red eye
Corneal ulcer Uveitis Acute angle closure glaucoma
41
Give three signs of primary open angle glaucoma
Optic disk cupping (cup:disk ratio of >0.6 is suspicious) Raised IOP Progressive visual field defect
42
How do you measure IOP?
Tonometry
43
How do you lower IOP in glaucoma?
Suppress humor production - beta blocker - alpha agonists - carbonic anhydrase inhibitor Increase outflow - prostaglandin analogues
44
Give three symptoms of cateract
Gradual decrease in acuity and blurred vision Myopia Glare
45
Give three examinations to test for cataracts
Measure acuity Check red reflex (reduced in cataracts) Obscured view of fundus on ophthalmoscopy
46
Give 2 antimuscarinics
Oxybutynin | Atropine
47
What investigation is used to examine micro vascular leakage in wet age related macular degeneration?
Fluorescein angiography
48
Give 5 signs of Uveitis
``` Circumcorneal injection (red around cornea) Hypopynon Keratic precipitates Watery discharge Small and irregular pupil ```
49
Give 5 ddx of chronic blurred vision
``` Diabetic retinopathy Age related macular degeneration (dry) Cataract Glaucoma Diabetetic maculopathy ```
50
Give three ddx of acute painful red eye causing blurry vision
Acute closed angle glaucoma Uveitis Corneal ulcer
51
Give 6 ddx of acute painless white eye blurred vision
``` Central retinal artery occlusion Central retinal vein occlusion Wet age related macular degeneration Non arteritic anterior is chewing optic neuropathy Giant cell arteritis Retinal detachment ```
52
Give 5 ddx of chronic blurred vision
``` Diabetic retinopathy Age related macular degeneration (dry) Cataract Glaucoma Diabetetic maculopathy ```
53
Give three ddx of acute painful red eye causing blurry vision
Acute closed angle glaucoma Uveitis Corneal ulcer
54
Give 6 ddx of acute painless white eye blurred vision
``` Central retinal artery occlusion Central retinal vein occlusion Wet age related macular degeneration Non arteritic anterior is chewing optic neuropathy Giant cell arteritis Retinal detachment ```
55
Give two symptoms of tension headache
Right band around head | No aura
56
what microbe causes Tracheoma?
Chylamydia Trachomatis
57
What are 2 complication of repeated tracheoma conjuctivitis
``` conjuctival scarring (cicatrisation) Corneal scarring/opacity ```
58
what 3 regions are onchoceriasis endemic to
equatorial africa Central america south america
59
What antiparasitic drug is used to treat onchoceriasis?
Ivermectin
60
Xerophthalmia is a deficeincy in which nutrient?
Vitamin A
61
Give 4 complications of xerophthalmia (vit a deficency)
Nightblindness Corneal/conjunctival driness and keratinisation corneal ulcers which may lead to perforation corneal necrosis
62
What three drug classes can you give for acute migraine treatment?
NSAIDS Tryptans Antiemetic
63
What antiepileptic can be used to treat migraines and cluster headaches acutely?
Topiramate
64
What drug abolishes paroxysmal hemicrania and hemicrania continua? And is used for diagnosis?
Indomethacin
65
Give a symptom to differentiate a headache as cerebreal venous thrombosis
altered conciousness
66
what is the pattern of pain in a headache causes by arterial dissection
Thunderclap and on neck and radiates to side of head
67
Give four eye symptoms/signs in idiopathic intracranial hypertension
gradual decrease in visual acuity visual feild defects papilloedema diplopia (if abducens palsy)
68
What vitamin deficiency is associated with MS
D (supplement should be given in management)
69
What antiepileptic is generally best for generalised seizures?
Valporate
70
Which antiepileptic is best for focal seizures?
Lamotrigine
71
Give four antiepileptic drugs
valporate lamotrigine phenytoin carbamyazapine
72
What is the diagnosis criteria for epilepsy (and thus the indication antiepileptic treratment)
2 unprovoked seizures >24 hours apart | not from brain injury, ischemia, encephalitis
73
What antiepileptic carries the highest risk of teratogenesis?
valporate (exclude pregnancy before starting)
74
Give one eye sign of uncal herniation
fixed dilated pupil
75
Give 6 criteria that must all be fullfilled to confirm brain death
``` Absence of all brain stem reflexes Apnoea (w pCO2 >60) No response to deep central pain core temp >34C Systolic BP >90mmHg No drugs that could simulate brain death ```
76
Give four lacuna syndromes (showing a subcortical lacuna stroke)
Pure motor stroke (hemiparesis) Pure Sensory Stoke (paraesthesia) Ataxic hemiparesis (incoordination) Clumsy hand - dysarthria (severe dysarthria)
77
What imaging finding would make you suspicous of a lacuna stroke?
No lesion or deep infarct in location inconsistent with clinical picture
78
What is the IV thrombolysis drug given in ischeamic stroke?
Tissue Plasminogen Activator
79
What is the maxmimum time after stroke that you can give IV thrombolysis?
<4.5 hours
80
What drug should be given as a prophylactic adjunct in stroke thrombolysis?
Asprin (300mg)
81
Give two indications for decompressive surgury after a stroke
Malignant MCA syndrome (increasing pressure after MCA occlusion in young people) Large Cerebellar infarct
82
Give two primary causes of haemhorragic stroke
hypertension | Amyloid angiography
83
Give four situations where seizures may occur
Epilepesy Alchohol withdrawl Psychogenic/functional febrile convulsions
84
What two forms of epilepsy affecting under 5s causes moderate mental handicap and poor prognosis?
``` Infantile spams (west's syndrome) Lennox-Gastaut Syndrome ```
85
What peadiatric epilepsey causes symptoms of facial pareasthesia on waking?
Benign Rolandic
86
Give three presentations of juvenille myoclonic epilepsey
infrequent morning generalised seizures Daytime absence seizures Sudden chocklike myoclonicic seizures
87
What demographic is affected by juvenille myoclonic epilepsey?
teenage girls
88
Give four possible complications of cataract surgury
Endophthalmitis Post. capsule rupture Suprachoroidal heamhorrage post. capsule opacification
89
What type of glioma has the worst prognosis?
Glioblastoma multiforme
90
Give a prostaglandin analougue used to increased uveosclero outflow in open angle glaucoma
Latanoprost
91
Give a carbonic anhydrase inhibitor used to decrease aqueous humor production in open angle glaucoma
acetazolamide
92
give four drugs / drug classes that can cause hypokalemia
Sulphonylurea SSRI Tricyclic
93
Give three functions of CN3
``` eye movement (failiure results in down and out eye) parasympathetic innervation (failiure results in fixed dilation) Levator muscle innervation (failiure results in ptosis) ```
94
Give two conditions that would give a +ve RAPD test?
``` Retinal detatchment Optic neuritis (eg. in MS) ```
95
Give 2 symptoms of a ACA stroke
contralateral hemiparesis and sensory loss | lower limb more affected than upper
96
Give 4 symptoms of MCA stroke
contralateral hemiparesis and sensory loss lower limb more affected than upper Contralateral homonymous hemianopia aphasia
97
Give two symptoms of PCA stroke
Contralateral homonymous hemianopia (macular sparing) | Visual agnosia
98
Give two symptoms of stroke effecting PCA branches supplying midbrain (Weber's syndrome)
Contralateral upper and lower limb weakness | ipsilateral CN3 palsy (down and out eye ect.)
99
Give four symptoms/signs of post inferior cerebellar artery infarct - lateral medulla affected (Lateral medullary/wallenberg syndrome)
ipsilateral facial pain and temp loss contralateral tosa + limb pain and temp loss ataxia nystagmus
100
Give four signs/ symptoms of ant. inf. cerebellar artery infarct - lateral pons affected (lateral pontine syndrome)
Ipsilateral facial paralysis and deafness contralateral torso+limb pain and temp loss ataxia nystagmus
101
What is the classic sign of basillar artery infarction
Locked in syndrome
102
What is the only focal seizure that can cause loss of conciousness?
Temporal lobe (complex partial seizure)
103
Give 5 auras of temporal lobe seizures
``` Epigastric sensation Fear/elation autonomic (flushing, salivation, palpitations) De ja vu olfactory hallucination ```
104
what spinal tract is most likely affected in B12 deficiency?
Doral columns (vibration and proprioception)
105
Give 2 blood findings in B12 deficeincy
Lowered Hb Increased MCV (megaloblastic aneamia)
106
Give 4 causes of posterior cord syndrome
B12 deficiency Syphylis HIV Myelopathy Demylination
107
Which tract crosses over at the level in lateral cord syndrome and what is its function
spinalthalamic (pain and temp sensation)
108
What is the typical pattern of distribution of sensory loss in central cord syndrome?
Cape like distribution
109
Give 4 causes of central cord syndrome
Syringiomyelia (expansion of central canal) Intrinsic cord tumor Demyelinationn disease Trauma
110
What are the nerve roots of the bicep reflex?
C5-C6
111
what are the nerve roots of Tricep reflex
c6-C7
112
What are the nerve roots of Knee reflex
L2-L4
113
What are the roots of the ankle reflex?
S1-S2
114
Give two symptoms of focal nerve compression
Tempory pareasthesia | Loss of sensation
115
What is the typical pattern of sensory loss in generalised periferal neuropathy eg. diabetic neuropathy
Glove and Stocking
116
Give four symptoms of generalised periferal neuropathy (eg. diabetic neuropathy)
Glove and stocking distribution Gradual onset Affecting distal limbs (decreased weakness and sensation) Loss of reflexes
117
How do you test median nerve?
Thumb abduction (away from palm)
118
How do you test ulnar nerve?
Finger abduction and aduction (interossei)
119
How do you test common peroneal nerve?
Ankle dorsiflexion
120
How do you test sciatic nerve?
Knee flexion
121
How do you test tibeal nerve?
Ankle plantar flexion
122
How do you test femoral nerve?
Knee extension/hip flexion
123
What is the hallmark symptoms of myesthenia gravis?
Fatiguability | no sensory loss
124
What are the two hallmark signs of ALS?
Mix of upper and lower MN symptoms | No sensory loss
125
What ALS subtype has the fastest progression?
Bulbar onset
126
Give 5 symptoms of behavioral variant frontotemporal dementia?
``` v early loss of insight disinhibition loss of empathy and reactivity sterotyped/conpulsive behavior becomes completely self centered ```
127
Give two disgnosing features of semantic dementia variatn of language variant frontotemporallobe dementia
Loss of single word meaning | Repetition is preserved
128
GIve two features of non fluent aphasia variant of frontotemporal lobe dementia
Effortful, hesitant speech | Preserved single word meaning
129
Give four symptoms of hyperureamia
Asterixis confusion incoherence hallucination
130
What drugs is used to treat organophosphate poisoning
Atropine
131
What is the triad of Wernikes-Korsakoffs syndrome?
Ataxia Ophthalmoplegia Confusion
132
What are you looking for on blood test for limbic encephalitis?
Anti-NMDA receptor antibodies
133
What condition is limbic encephalitis commonly associated with?
Ovarian Teratoma
134
What type of episodes are typical of vestibular neuritis (labyrinthitis)
Single, intense lasting a few days
135
Give three vestibular suppressants
Benzodaizepines Meclonide Proclorperazine
136
Give three antiemetics
Promethazine Metoclopramide Prochlorperazine
137
What are the episodes like in BPPV
seconds to mins, provokes by specific head movements
138
What are the episodes like in Meniere's
Occur in clusters, each episode lasting 30 min to 1hr
139
How do you treat BPPV?
Epley Maneuver
140
What is the classic prodrome of meniere's?
Aural fullness
141
What are the diagnosic criteria for MS
Two more more episodes plus objective clinical evidence of two or more lesions
142
Are MS symptoms UMN or LMN lesions
UMN
143
Give 7 signs / symptoms of optic neuritis
``` Loss of colour vision (particularly red) Smudge across vision decreased acuity Central scotoma RAPD pain on movement Swollen optic disk on fundoscopy ```
144
Give 2 signs/ symptoms of internuclear ophthalmoplegia
When Pt looks away from affected side, the inward movement of the affected eye is impaired Pt reports double/blurry vision when this happens
145
How do you acutely manage MS relapse (2 steps)
treat any concomittant infection that may have triggered it (if applicable) Oral Methyprednisolone
146
Give three symptoms of keratitis
Unilateral painful reed eye Photophobia Forign body sensation
147
Give three signs of keratitis
conjuctival injection white corneal infiltrate (over the ulcer) hyponon
148
What topical Abx should you give for keratitis?
Ofloxacin
149
What is the cut off time for TIA to be classified as a stroke
24hr
150
How do you differentiate migraine aura from epilepsey?
Both have positive symptoms Epilepsey spreads (eg. visual to language) over seconds Migraine Aura spreads over mins (spreads slower)
151
Give three signs of parietal lobe lesion
Apraxia (contra hemiparaesis) Inf. homonymous quadrantanopia Sensory inattention
152
Give symptoms of temporal lobe lesion
Neologism w fluent speech sup. honomymous quadrant anopia auditory agnosia
153
Give one symptom of occiptal lobe lesion
vision changes (homonynous hemianopia)
154
Give three symptoms of frontal lobe lesion
Non fluent speech Disinhibition anosmia
155
Inn which lobes do the optic radiations from the sup and inf quadrants of the visual feild run?
Sup = temporal inf = parietal lobe (up is down!)
156
What visual feild defect is a paretal lobe lesion likely to cause?
Homonymous inf. quadrantanopia
157
What type of visual field defect is a temporal lobe lesion likely to cause?
Homnymous superiorquadrantanopia
158
Where is brocas and Wernickes areas found and an what is their blood supply
Brocas = frontal lobe Wernickes = temporal lobe Both supplied by MCA
159
Give four features of Wernickes Aphasia
Fluent speech Neologism/word substituion impaired comprehension (Receptve aphasia) preserved repetition
160
Give three features of Brocas aphasia
Non fluent, laboured speech Preserved comprehension Impaired repetition
161
What is conduction aphasia
lesion of arcuate fasiculus connecting Wernickes to Brocas area only presenting feature is impaired repetition (commprehension preserved and speech is fluent)
162
Give two features of proliferative diabetic retinopathy
Neovascularisation at disk | Tractional retinal detachment
163
Give three features of nonproliferative diabetic retinopathy
Microanursysms Dot heamhorrages Cotton wool spots
164
Give two aneasthetics that may be given as eyedrops if examination of a forign body is painful
Proymetacaine | tetracaine
165
What may white corneal infiltrate in corneal forign body pt be a sign of?
Bacterial Keratitis -> refer to ophthalmology
166
How do you manage superfiscial corneal FB?
Topical aneastheisa (Promethacaine, Tetracaine) Remove w moist cotton bud 1 week of chloamphenicol drops (Abx)
167
What can missed ferous intraoccular FB cause as a complication
Siderosis (retinotoxic ions leak into eye) - irreverside retinal function loss
168
Give 4 signs of penetrating eye injury
visible entry would on cornea or sclera reduced red reflex ocular inflammation distorted pupil
169
What imaging modality is contraindicated if metal intraoccular FB is suspected
MRI (magnetic feild may move FB through eye) | Use XR or CT if high index of suspicion
170
What is commitio Retinae
Retinal odema as a result of blunt trauma
171
What type of chemical injury is most destructive to the eye
alkali
172
What is the management for chemical eye injury
immediate copius irrigation for 30 mins | check pH after 10 mins then continue irrigating
173
What is the conjunctival presentation in alkalli eye injury
Appears deceptively white and uninflammed as alkali closes the conjunctival vessles
174
What is the first line immediate management for traumatic opticneuropathy
Urgent CT to rule out displaced orbital fracture and intracranial heamhorrage
175
What is the most common orbital fracture
Blowout fracture (orbital floor)
176
Give 5 signs of an orbital floor (blowout) fracture
``` sunken orbits vertical diplopia (restricted eye movement) eyelid swelling nose bleed loss of cheek and upper gum sensation ```
177
What is the most common cause of an orbital fracture
punch!
178
What is enophthalmos?
Herniation of the orbit downward into maxially sinus
179
What xray findings will be seen in a orbital blowout fracture
Fluid level (blood) in maxillary sinus
180
What 2 situations would you refer an eyelid lacteration to ophthalmology?
lid margin involvement | Nasolacrimal duct involvement
181
In an orbital fracture, pain is worst looking in which direction?
Upwards
182
How do you manage B12 deficincey
IM hydroxocobalamin if no neuroinvolement | give B12/folate first to prevent precipitating spinal cord degeneration
183
What Investigation can be used to confirm difference between AION and Giant Cell Arteritis
ESR: Only giant cell has raised
184
What is the characteristic finding of retinal artery occlusion on fundoscopy?
Cherry red spot at center of Macula
185
What is the characteristic finding of retinal vein occlusion
cotton wool spots
186
What are the three symptoms of retinal detatchment?
Flashing lights Floaters Visual Field loss
187
What part of Hx in acute painful red eye vision loss may ake you suspect acute closed angle glaucoma?
Halos around lights
188
What is the subtype of diabetic retinopathy with neovascularisation at the disk?
Proliferative (the worse one! May result in vision loss through vitreous heamhorrage from the new vessles)
189
What is the typical pattern of visual field loss in open angle glaucoma?
Starts at periferal vision | Later gets Arcuate Scotoma (around macula)
190
Give 4 post operative risks of cataract surgury
Endophthalmitis Posterior capsule rupture Suprachoroidal heamhorrage Post capsule opacification (residual lens cells proliferate and opacify the new lens)
191
Give the 2 differentiating factors of age related macular degeneration as seen on fundoscopy
Drusen (yellow spots on retina) | Mottled appearing retina (due to areas of hyper and hypopigmentation)
192
Give three signs of wet age related macular degeneration not found on dry
grey/green lesion yellow exudates retinal heamhorrage
193
What invesetigation do you do for wet age related macular degeneration
Flourescein angiography (to identify areas of microvascular leakage)
194
What two investigations can be used to spot a corneal lesion/defect in diagnosing bacterial keratitis?
Flourscein staining | Slit lamp
195
How may you differentiate Keratitis with uveitis
Keratitis may have a corneal lesion as seen on flourscein staining ( as its a corneal problem) Uveitis may have a small and irregularly shaped pupil (as its an iris problem)
196
How do you differentiate bacterial and viral conjunctivitis?
Bacterail : mucopurulent discharge | Viral : Watery discharge (also has follicular conjunctivitis)
197
What do you consider chylamydial conjunctivtis?
Bacterial conjunctivits (mucopurulent discharge) lasting >3 weeks
198
How do you differentiate subconjunctival heamhorrage with episcleritis (both have localsied eye redness)
Episcleritis has acute onset grittiness
199
What is chalazion?
chronic painless, mildly tender, round eyelid swelling | common with acne or ecsema (seborrheic dermatitis)
200
What is tonic pupil (holmes adie pupil)
abnormally large due to parasympathetic denervation. 'near' constriction is better than light constriction
201
Give 4 causes of pathologically dilated pupil
Tonic pupil (holmes-adie pupil) CN3 palsy Traumatic mydriasis Iris rubeosis
202
Which cranial nerve innervates levator muscle
CN3
203
what is presbyopia?
Age related loss of accomdation ability of the eye
204
+ve or -ve lens needed for hypermetropia (long sighted)?
+ve
205
+ve or -ve lens needed for myopia?
-ve
206
What is the main sign of keratocornus?
Cornea becomes cone shaped
207
What is a tropia strabismus?
Eyes misallgined and cant be corrected by effort
208
What is a phoria strabismus?
eyes misalligned but can be corrected through concious effort
209
Give 4 symptoms/ signs of ideopathic intracranial HTN | and state the demographic it typically affects
Head ache Blurred vision Papilloedema CN 6 palsy (Pt cant look outwards toward affected side)
210
What is the tinnel test for carpel tunnel syndrome
Tap at palmar crease and it causes pareasthesia
211
What is the Phalens test for carpel tunnel syndrome
Hand held flexed under gravity. Produces pareasthesia
212
Give 4 signs/ exam findings in carpel tunnel syndrome
Index sensation decreased more than little finger sensory impariment splits ring finger weak thumb abduction thenar wasting
213
Give 3 symptoms of carpel tunnel syndrome
pareasthesia for a few mins when waking at night or gripping weakness of thumb or hand wrist pain
214
How do you test radial nerve motor function
Extend thumb IP joint under resistence
215
How do you test median nerve motor function
thumb abduction
216
How do you test the ulnar nerve motor
abduct fingers against resistence
217
If Bells palsy Pt can frown, is it upper or lower motor neurone?
Upper
218
Give 1 differentiating factors between demylianting and axonal periferal neuropathy
Axonal - small amplitude, normal velocity | demylnating - slow velocity
219
What is the main symptom of length dependant poly neuropathy
Starts in toes and ends up as glove and stocking distrbution
220
What is the chronic form of Guillian Barre called
Chronic Inflammatory Demylinating Polyradiculoneuropathy
221
Give the 3 criteria to diagnose essential tremor
isolated bilateral action tremor >3 years duration absence of other neurological signs
222
Give the 2 main drugs used to treat severe essential tremor
``` Propanolol Primidone (antiepileptic) ```
223
Give a feature of the tremor in dystonic tremor syndrome
V irregular and jerky
224
Give 6 drugs which may be used for migraine prophylaxis
``` Metoprolol Topiramate (antiepileptic) Valporate Mg Candesartan (ARB) Botox ```
225
When is migraine preventative medication indicated?
>8 migraine days in a month
226
Give 2 forms of acute treatment for cluster headache
100% O2 | triptans
227
Give three drugs that may be used for preventative treatment of cluster headache
Verapamil topiramate Lithium
228
give 2 features of conduction aphasia (arcuate fasiculus stroke)
Fluent speech Repetition impaired (doesnt fit picture of either wernickes or brocas aphasia)
229
Giver the triad of symptoms of korsakoffs amneisa/syndrome
``` Anterograde amnesia (cant form new memories) Reterograde amnesia (loss of old memories) Confabulation (making up new memories) ``` in addition to the wernickes triad
230
What is monoccular diplopia and give 3 causes?
Persists when one eye is closed Corneal scarring uncorrected refractive error cataract
231
What is binocular diplopia and give 5 causes
Only exists when both eyes are open ``` Strabismus Cranial nerve palsy eye displacement within socket (eg tumor) Extraoccular muscle disease thyroid eye disease ```
232
Give 3 signs of trochlear nerve palsy?
aquired diplopia eye turns upward as it looks towards nose head tilted away from lesion side
233
What course of action should be taken in pediatric leucocoria?
Urgent Ophthalmolgy referal
234
What preterm babies should be screened for retinopathy of prematurity?
<1500g | <32 weeks
235
what is the hallmark symptom of limbic encephalitis?
Short term memory loss (but may have seizures ect.)
236
give 6 features of function seizure (to differentiate from epileptic seizure)
``` trashing with little spasticity eyes forced closed and resist opening lasts over 5 mins (epilepsey last <3) Retains some awareness despite looking like a generalised seizure fast resp rate (ceases in epilepsy) side to side head movement ```
237
Give 4 symptoms/signs of ideopathic intracranial hypertension
dull bilateral fronto/retrorbital headache cough/valsalva/exercise makes it worses (raised pressure headache) decreased visual acuity and visual field defects Papilloedema
238
What three drugs can be used for cluster headache prevention
Topiramate (antiepileptic) Verapamil (Ca channel blocker) lithium
239
What is an ictal syncope?
Seizure affecting area of brain contolling blood pressure | syncope superimposed on top of seizure
240
Give 4 features of a temporal lobe focal seizure?
Staring
241
Give 2 features of anti epileptic drug hypersensitivity reactio, give a risk factor and what drug is most likely to cause it?
multiorgan syndrome and a rash Han chinese predisposition Carbamazapine
242
Give three negative consequences to fetus of maternal seizures
small for gestational age Fetal heart rate deccelerations (v serious) decreased verbal IQ

Congition, Movement and Senses (1 decks)

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