geeky medics neuro Flashcards
intracranial pressure increases intermittently in normal pressure hydrocephalus
unilateral temporal lobe infarctions lost the ablility to
locate sound in space
melatonin is important in sleep regualtion and is formed in the
pineal gland
Central lesions cause anhidrosis of the arm, trunk and face
Pre-ganglionic lesions cause anhidrosis of the face
occulmotor opens eye
facial nerve closes eye
subarachnoid haemorrhage is what arery
posterior communicating
Pyridostigmine is used in myasthenia gravis as an acetylcholinesterase inhibitor.
is suspect spinal cord compression give steriods immediately
if middle cerebral artery stroke and right side of body affected what side is affected on homonymous hemianopia
right
when is triptans contrainidcates
history of coronary artery disease
Prosopagnosia (also known as face blindness or facial agnosia)
Miss Yorke is presenting with relapsing-remitting multiple sclerosis (MS), therefore methylprednisolone is the correct answer
dexamethason is not used in MS
rombergs test does not test cerebellar function but it tests
sensory ataxia
shaking baby in child abuse can cause what
subdural haemorrhage
lewy body dementia is associated with
syncope
In between the posterior cerebral artery and the superior cerebellar artery is the oculomotor nerve.
left occulomotr nerve supplies the
left eye
berry aneurysms are associated with polycystic kidney disease
rupture of berry aneurysm can cause subrarachnoid haemorrhage
having low cd4 so high chance she has HIV so increased risk of
fungal meningitis
trochlear nerve palsy eye will be
up and out
Hepatic dysfunction, e.g. raised AST, is an important adverse effect of sodium valproate use and should be suspected in those presenting with ‘persistent vomiting and abdominal pai
Fasciculations are typical findings within lesions of the anterior horn cells as these are where lower motor neurons can be found.
dopamine agonist - impulse spending
ropinirole
tonic is
stiffenign
Phenytoin has a narrow therapeutic range and can lead to symptoms of toxicity such as nausea, vomiting, seizures and nystagmus.
The most likely diagnosis is metastatic spinal cord compression from a recurrence of his previously treated prostate cancer. Of the options presented, oral dexamethasone (a potent corticosteroid) would be the most appropriate choice in the hope of reducing the local mass effect exerted by the tumour on the spinal cord (by reducing oedema).
steriods given before the definitive treatment of surgery
This patient has clinical features of meningeal irritation, such as photophobia, and painful knee extension when the hip is flexed to 90 degrees (Kernig’s
The correct answer is subarachnoid haemorrhage (SAH), as this is the only option likely to present with headache and signs of meningeal irritation in an afebrile patient.
SAH can cause meningism
The CSF flows from the two lateral ventricles –> foramina of Monro –> third ventricle –> cerebral aqueduct –> fourth ventricle –> foramina of Luschka & Magendie –> subarachnoid space.
This is a classic presentation of a Marcus-Gunn pupil, which is due to a lesion to cranial nerve II, the optic nerve. Clinical findings for a Marcus-Gunn pupil include a de-afferented pupil which constricts to consensual but not to direct light.
B12 deficiency can lead to subacute degeneration of the spinal cord. This presents with a mixture of UMN signs (extensor plantars) and LMN signs (absent reflexes). Usually, the dorsal column and corticospinal tracts are most affected, whilst the spinothalamic tract may remain unaffected, even in severe disease. This explains why Jenny may still be able to feel temperature and pain sensations, but they may have lost their vibration sense.
spinothalamic tract generally not affected in subacute degeneration of the cord
The posterior limb of the internal capsule is an area of the brain that fibers of the corticospinal tract travel through and therefore a lesion to this area would result in a positive pronator drift.
The corneal reflex is an excellent way to test the sensory component of the trigeminal nerve, as well as the facial nerve. To test this reflex, the cornea is touched with a wisp of cotton and the resultant direct and consensual eye blink is noted. The afferent information for this reflex is carried by the ophthalmic division of the trigeminal nerve, and the efferent information is carried by the facial nerve.
Lumbar puncture is only indicated if the CT is negative but subarachnoid haemorrhage is still suspected.
mx for SAH
endovascular coiling and nimodipine
This vignette is describing trigeminal neuralgia for which Carbamazepine (anticonvulsant) is first-line management. Verapamil (calcium channel blocker) is used for prophylaxis.
nimodipine cab be used for prophylaxis for cerebral vasospasm
Mark, a 29-year-old male is suspected of having viral encephalitis.
Which of the following is the most likely result from CSF analysis?
Raised protein + raised lymphocytes + normal glucose
A patient that demonstrates a “clasp knife” phenomenon is virtually pathognomonic for an upper motor neuron lesion.
In patients presenting with diplopia, mydriasis and ptosis, a third nerve palsy should be suspected. The most important diagnosis to exclude is a posterior communicating artery aneurysm which could lead to a fatal subarachnoid haemorrhage. The first line investigation is a CT Angio head which will allow visualisation of the cerebral vasculature.
huntingtons
striatum affected
