Deck 4 - PH

Question 1

Q. Name 3 vaccine-preventable neurological infections

Answer 1

A. Poliomyelitis; tetanus

B. Measles; H. influenzae; Meningococcus; Tuberculosis

Question 2

Q. Name 4 RFs for stroke

Answer 2

A. Age, male sex, smoking, HTN, alcohol consumption, cardiac disease, DM and

high lipids

Question 3

Name two known RFs for variant CJD

Answer 3

Age (median onset 36), UK residence between 1970-1990 and methionine

homozygosity at codon 129 of the prion protein gene

B. No cases since 2013 – more cases may occur if different genetic subgroups

with longer incubation periods exist

Question 4

Q. What occurs in variant CJD?

Answer 4

A. Progressive neuropsychiatric disorder, > 6 months

B. Early psych symptoms: depression/anxiety/apthy/delusions

C. Persistent painful sensory symptoms, ataxia, myoclonus or chorea or

dystonia

D. EEG: does not show typical sporadic CID, bilateral pulvinar high signal of MRI

E. +ve tonsil biopsy

Question 5

Q. What are denticulate ligaments?

Answer 5

The pia mater of the spinal cord has a pair of denticulate ligaments (one on

each side) with 21 attachments per side. These attach it to the arachnoid and

dura mater.

Question 6

Q. How many nerves are in each section of the spinal cord?

Answer 6

A. Cervical: 7 vertebrae, 8 nerve (C1 atlas, C2 axis)

B. Thoracic: 12v, 12 nerves

C. Lumbar: 5, 5

D. Sacral: sacrum, 5 nerves

E. Coccygeal: coccyx: 1 nerve = 31 nerves in total

Question 7

Q. Name 5 possible symptoms of cauda equine syndrome

Answer 7

A. (extreme pressure and swelling of nerves at the end of the spinal cord) –

medical emergency

B. Bilateral sciatica, saddle anaesthesia, bladder/bowel dysfunction, erectile

dysfunction, variable leg weakness, (may be partial)

Question 8

Q. What is seen in radiculopathy?

Answer 8

Spinal nerve root disease = long standing pain down dermatome supplied by root and weakness down myotome supplied by root (no UMP, chronic = LMN signs) can be at more than one level

Question 9

Q. What is seen in acute disc herniation with sciatica?

Answer 9

A. Radiating pain – no weakness or sensory deficits – worsening symptoms

B. Tx conservatively – NSAIDS and physio

C. Be wary of cauda equine syndrome!

Question 10

Q. What is myelopathy? Radiculopathy? Spondylosis?

Answer 10

A. Myelopathy is UMN, spinal cord disease

B. Radiculopathy is spinal nerve root disease = LMN

C. Spondylosis – degenerative disc disease