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Year 3 DPD > DPD Amir Sam 4 > Flashcards

DPD Amir Sam 4 Flashcards

Neuro

1
Q

What are the associated symptoms you should ask for in a neuro history?

A 
Top to toe:
Headache
Visual changes
Hearing changes
Swallowing changes
Neck stiffness
Limb weakness/paraesthesia
Bowels and bladder
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2
Q

What are the two things you should think about when taking a neuro history?

A

Anatomy and pathology

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3
Q

What are the different anatomical areas in which a lesion may occur?

A 
Brain
Spinal cord
Nerve root
Peripheral nerve
Neuromuscular junction
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4
Q

How may a brain lesion present as a sensory defect?

A

Hemiparesis

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5
Q

How may a spinal cord lesion present as a sensory defect?

A

Paraparesis

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6
Q

How may a nerve root lesion present as a sensory defect?

A

Dermatomal paraesthesia

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7
Q

How may a peripheral nerve lesion present as a sensory defect?

A

Specific area/s (mono/polyneuropathy)

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8
Q

How may a NMJ lesion present as a sensory defect?

A

Generalised, systematic

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9
Q

What are the different pathologies that help differentiate a presentation?

A 
Vascular
Infection
Inflammation/autoimmune
Toxic/metabolic
Tumour/metastases
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10
Q

What are the signs in the limbs of an upper motor lesion?

A

Spastic tone
Decreased power
Brisk reflexes
Upgoing plantars

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11
Q

What are the signs in the limbs of a lower motor lesion?

A

Flaccid tone
Decreased power
Decreased reflexes

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12
Q

What are the signs of cerebellar dysfunction?

A 
DANISH
Dysdiodochokinesia
Ataxia
Nystagmus
Intention tremor
Staccato speech
Hypotonia/Heel-shin test positive
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13
Q

What type of lesion does a glove and stocking distribution imply?

A

Polyneuropathy

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14
Q

What is the management for diabetic neuropathy?

A

Duloxetine

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15
Q

What are the causes of peripheral neuropathy?

A

V DUA LIPA

Vit B12 deficiency
Diabetes
Uraemia
Alcohol
Low T4 (hypothyroidism)
Iatrogenic- drugs
Paraneoplasm
Amyloidosis (Hx of myeloma/chronif infx/inflammation)
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16
Q

What is the likely cause of a sudden loss of vision?

A. Amaurosis fugax
B. Anterior uveitis
C. Papilloedema
D. Papillitis
E. Vitreous haemorrhage
A

E. Vitreous haemorrhage

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17
Q

What is the likely diagnosis in a female with blurred vision who had limb paraesthesia 2 weeks ago?

A. Amaurosis fugax
B. Anterior uveitis
C. Papilloedema
D. Papillitis
E. Vitreous haemorrhage
A

D. Papillitis

This Pt has MS, which commonly presents with optic neuritis aka papillitis

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18
Q

What is the likely cause of a gradual loss of vision, like curtains are closing across the eyes?

A. Amaurosis fugax
B. Anterior uveitis
C. Papilloedema
D. Papillitis
E. Vitreous haemorrhage
A

A. Amaurosis fugax

19
Q

What is the likely cause of a Pt’s blurred vision who has had 2 months of a gradually increasing headache?

A. Amaurosis fugax
B. Anterior uveitis
C. Papilloedema
D. Papillitis
E. Vitreous haemorrhage
A

C. Papilloedema

20
Q

What is the likely cause of a Pt with a red itchy eye?

A. Amaurosis fugax
B. Anterior uveitis
C. Papilloedema
D. Papillitis
E. Vitreous haemorrhage
A

B. Anterior uveitis

21
Q

What are the causes of spastic paraparesis?

A 
V- (can't think of one)
I- HIV
I- transverse myelitis, MS
T- B12 deficiency
T- paraneoplasm
22
Q

What is meralgia paraesthetica?

A

Compression of the lateral femoral cutaneous nerve

23
Q

What is the management for meralgia paraesthetica?

A

Assure the Pt
Advise weight loss
Give carbemazepine/gabapentin if persistent

24
Q

What are the signs of a median nerve lesion?

A

Weak abductor pollicis brevis
Weak opposition
Paraesthesia in the palmar lateral 3 1/2 fingers

25
Q

What are the signs of a radial nerve lesion?

A

Wrist drop

Paraesthesia in the dorsal medial half

26
Q

What are the signs of a ulnar nerve lesion?

A

Paraesthesia in the dorsal lateral half + medial 1 1/2 fingers

27
Q

What are some causes of sciatica?

A

Disc herniation
Spinal cord stenosis
Malignancy- eg. prostatic met compression

28
Q

What condition causes Parkinsonism with an upgaze abnormality?

A

Progressive supranuclear palsy

29
Q

What condition causes Parkinsonism, Alzheimer’s, and hallucinations?

A

Lewy body dementia

30
Q 
55 M confusion and chest pain
No headache/neck stiffness
Recently moved house with malfunctioning heating system
Temp 37C, HR 110, BP 120/60
Normal examinations
ECG- sinus tachy, widespread ST depression
Urinalysis- NAD
Blood glucose- 7.0mmol/L
WCC- 7 CRP- <5 CT Head- NAD

What is the most likely cause (from VIITT)?

A 
V- no mention of acute presentation
I- WCC and temperature is normal
I- CRP is normal
T- potentially a toxic/metabolic cause
T- CT head is clear
31
Q

What may a post-ictal state imply?

A

Hx of seizures

32
Q

Which area presents with expressive dysphagia when a lesion is present?

A

Broca’s area

33
Q

Which area presents with receptive dysphagia when a lesion is present?

A

Wernicke’s area

34
Q

What are the causes of confusion?

A

Hypoglycaemia
Vascular- bleed (headache, collapse), subdural haematoma
Infection
Inflammation
Toxic/metabolic- Drugs, vitamin deficiencies, endocrinopathies
Tumour/malignancy

35
Q

What are the steps of the AMTS exam?

A 
DOB
Age
Location
Time of day
Year
Address (7 West St)
Current monarch
WWII end date
Recognise 2 faces
Count from 20 to 1
36
Q

What are the features of meningitis?

A 
Fever
Neck stiffness
Kernig's sign
Bruzdinski's sign
Non-blanching rash
Photophobia
37
Q

What are the features of SAH?

A

Sudden onset

Get a CT+LP for xanthochromia

38
Q

What are the features of GCA?

A 
>50
Raised ESR
PMR
Temporal tenderness
Jaw claudication
39
Q

What are the features of migraine?

A 
Throbbing
Vomiting
Photophobia
With/without aura
FHx
40
Q

What is the management for a stroke presenting <4.5hrs?

A

CT head

Thrombolysis

41
Q

What is the management for a stroke presenting >4.5hrs?

A

CT head
Aspirin 300mg
SALT assessment
Supportive care

42
Q

What is the management for a TIA?

A 
Aspirin 300mg
Dont treat BP unless >220/120 or other indications
ECG/echo (AF)
Carotid Doppler (carotid stenosis)
Modify risk factors
43
Q 
40M
Backache + LMN weakness
Admitted to HDU
Regular FVC
On cardiac monitor and IVIG

What is the most likely cause?

A. Guillain-Barre syndrome
B. Stroke
C. Cord compression
D. Cauda equina syndrome
E. Myaesthenia gravis
A

A. Guillain-Barre syndrome

44
Q

What are the causes of proximal myopathy?

A

Inflammation- myositis

Metabolic- COT (Cushing’s, osteomalacia, thyrotoxicosis)

Year 3 DPD (5 decks)

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