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Neuro - C.U > General facts > Flashcards

General facts Flashcards

1
Q

Subdural haematoma is a bleed in?

A

Veins of the brain

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2
Q

What is kernigs sign?

A

Kernigs sign is positive when the thigh is flexed at the hip and knee at 90 degree angles, and subsequent extension in the knee is painful

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3
Q

What is GCA associated with?

A

Polymyalgia rheumatica

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4
Q

Liehthem’s disease is?

A

Degeneration of the posterior and lateral columns of the spinal cord.

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5
Q

Liehthem’s disease is a due to a deficiency in? (2)

A

B12 or copper

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6
Q

Two types of cavernous sinus thrombosis

A

Septic and aseptic

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7
Q

Posterior column involves fibres for?

A

Vibration, light touch and proprioception sensation

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8
Q

Lateral column involves fibres for?

A

Motor

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9
Q

Anterior column involves fibres for?

A

Pain and temperature sensation

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10
Q

Paraperesis

A

Bilateral UMN signs in the legs

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11
Q

How does a brown sequared lesion present? (unilateral lesion of the whole spinal cord)

A

Ipsilateral UMN signs in the leg
Ipsilateral loss of joint position and vibration
contralateral loss of pain and temp

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12
Q

5 causes of spinal cord compression

A 
Trauma 
Degenerative disease 
Tumours 
Infective lesions 
Epidural haemorrhage
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13
Q

LMN signs (5)

A 
Weakness 
Atrophy
Fasiculations 
Reduced / normal tendon reflexes 
Plantar response not present
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14
Q

Common type of anterior horn disease

A

Motor neurone disease

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15
Q

Polyneuropathy common causes (2)

A

Diabetes

B12 deficiency

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16
Q

Pyramidal weakness means there is….

A

Loss of power in the extensors of the UL and in the flexors of the LL

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17
Q

Where is proximal weakness common (2)

A

Myopathy and myasthenia gravis

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18
Q

Lesion above the pyramidal track, the weakness is …

A

on the contralateral side

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19
Q

Lesion below the pyramidal track, the weakness is…

A

Ipsilateral side

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20
Q

Clinical features of an UMN lesion (6)

A 
Spastic tone 
Pyramidal pattern of weakness 
Absence of muscle wasting 
Absence of fasiculations 
Brisk tendon reflexes 
Extensor plantar response
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21
Q

Classification of tremors (3)

A

Resting / Posture / Kinetic (intension / terminal)

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22
Q

Causes of a physiological tremor (4)

A

Anxiety
Metabolic problem (low glucose)
Alcohol withdrawal
Drugs - Beta agonist

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23
Q

What may diminish physiological tremors?

A

beta blockers

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24
Q

Characteristics of an essential tremor?

A 
Bilateral 
Progressive 
Worse on concentration 
Usually terminal 
Improves with alcohol
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25
Q

Oral anti cholinesterase used in MG

A

pyridostigmine

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26
Q

Guillain-Barre syndrome usually follows what type of infections?

A

Resp / GI (diarrhoea)

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27
Q

What is GB syndrome?

A

Post infective inflammatory demyelinating neuropathy

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28
Q

What is shown on LP in GB syndrome?

A

Cytoalbuminologic dissociation
Normal cell count
Elevated protein

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29
Q

What is a bells palsy?

A

Acute LMN facial palsy

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30
Q

What is ramsay hunt syndrome?

A

Herpes zoster responsible for a bells palsy

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31
Q

Usual recovery time for bells palsy

A

80% within 2-8 weeks

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32
Q

Treatment for bells palsy

A

high dose steroids within the 1st week

eye care

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33
Q

Treatment for acute migraine

A

Triptan
NSAIDS
Metoclopromide (antiemetic)

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34
Q

Prophylactic treatment for migraine

A

Propanolol / topiramate

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35
Q

Treatment for acute cluster headache

A

O2 support

Sublingual / nasal triptan

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36
Q

Contraindications for triptans (2)

A

History of IHD/ TIA

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37
Q

Antibiotic given in suspected bacterial meningitis

A

Cefotaxime

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38
Q

When is an LP contraindicated in suspected B.meningitis (4)

A

Signs of raised ICP
Sepsis
Trauma
Major coagulopathy

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39
Q

Normal range of csf pressure on LP

A

7-18CM

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40
Q

extradural haematoma is a …… type of bleed.

A

arterial

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41
Q

presentation of an extradural haematoma on a scan

A

midline shift
ventricular swelling
blood on the scan
soft tissues swelling outside the skill

42
Q

Who are at risk of a subdural haematoma?

A

elderly / alcoholics (can occur even after a trivial injury)

43
Q

Charcot-Marie tooth disease is?

A

Hereditary demyelinating neuropathy

44
Q

Motor characteristics of CMT

A

Distal wasting of LL (eventually spread to UL)

Reduced reflexes

45
Q

Sensation characteristics of CMT

A

Glove and stocking sensation loss

46
Q

Foot deformities in CMT (2)

A

Pes cavus and toe clawing

47
Q

Extra tests in those having strokes <55 y/o

A

‘Young’ stroke blood tests include thrombophilia and autoimmune screening - performed in those under 55 with no obvious cause of a stroke

48
Q

Most common brain tumour

49
Q

where do secondary brain tumours often metastasie from

A

lung
breast
kidney
malignant melanoma

50
Q

3 ways brain tumour may present

A

Epileptic fit
Symptoms of raised ICP
Neurological deficit

51
Q

Fredreich’s ataxia genetics

A

autosomal recessive

52
Q

onset of Fredreich’s ataxia (age)

53
Q

Clinical features of fredreichs ataxia

A 
Ataxia Sensory +/- cerebellar 
Foot deformities 
Weakness 
Distal wasting 
Loss of LL tendon reflexes 
Gradual sensory loss 
Nystagmus
54
Q

Testing in Fredreich’s ataxia

A

MR

Genetics

55
Q

Drugs commonly causing parkinsonism

A

neuroleptics

56
Q

Suspect what in pt who is <40y/o with Parkinsonism

A

Wilsons disease

57
Q

Blood test in muscular dystrophy

A

Creatinine kinase

58
Q

What organ needs monitoring in muscular dystrophy?

59
Q

prognosis of those with muscular dystrophy

60
Q

Vertigo

A

illusion of rotatory movement

61
Q

vetigo usually due to pathology of?

A

inner ear or 8th CN

62
Q

Causes of dizziness

A 
Anaemis 
Hypo 
Anxiety 
Hypoventilation 
Postural hypotension 
Pyrexia
63
Q

Disorders of the inner ear causing vertigo

A

BPPB
Menieres
Otitis media
Labyrinthitis

64
Q

8th CN pathology causing vertigo

A

Acoustic neuroma
Otoxic drugs
HZV

65
Q

Associated symptoms with dizziness

A 
Nausea 
Vom 
Sweating 
Ear symptoms 
Neuro symptoms 
Aura - migraine
66
Q

Caloric tests

A

Use cold water in the ear to cause nystagmus

reflex lost with 8th CN pathology

67
Q

Tests in dizziness

A

Lying and standing BP
ECG
Vital signs
Hearing tests

FBC
ESR

Brain scan

68
Q

Signs of raised ICP

A

Worse in morning
Vomiting
Visual disturbance

69
Q

Associated symptoms with headache

A 
Vision 
Vomiting 
Neck stiffness 
Drowsiness  
Fever / rash
70
Q

Important blood test in temporal arteritis

71
Q

Treatment of SAH

A

Angiography then endovascular coiling or clipping

72
Q

Primary headache

A

No underlying pathology

73
Q

Secondary headache

A

Underlying pathology e.g. tumour / vasculitis

74
Q

When does GB syndrome reach a peak

75
Q

Pathogenesis of GB syndrome

A

acute inflammatory demyelination of peripheral nerves

76
Q

AB to check for in GB syndrome

A

Antiganglioside antibodies

77
Q

Special tests in GB syndrome

A

ECG
EMG and nerve conduction studies
LP for CSF analysis

78
Q

Acute treatment of GB syndrome

A 
Medical emergency 
ABCDE 
Admit 
ITU involvement early with resp support 
IV immunoglobulin
79
Q

Medication for SAH

A

Nimodipine

80
Q

Guillain-Barre syndrome presentation

A

Bilateral glove and stocking parathesia
Distal symmetrical weakness
CN dysfunction
2/3 autonomic dysfunction

81
Q

symptoms assoc with migraine

A

nausea
photophobia
phonophobia

82
Q

Common triggers for migraines

A 
tiredness, stress
alcohol
combined oral contraceptive pill
lack of food or dehydration
cheese, chocolate, red wines, citrus fruits
menstruation
bright lights
83
Q

when should triptans be taken for a migraine?

A

as soon after the start of the headache

84
Q

SE of triptans

A 
tingling 
heat 
tightness in throat and chest
heaviness
pressure
85
Q

Contraindications for triptans

A

Hx of or risk of IHD or CV disease

86
Q

Which gland is often abnormal in Myasthenia gravis?

87
Q

myasthenia gravis pathophysiology

A

antibodies directed against acetylcholine receptors in the post synaptic muscle membrane

88
Q

Treatment of myasthenia gravis

A

Medical - pyridostigmine, immunosuppressants

Surgical - thymectomy

89
Q

Treatment of a myasthenia gravis crisis

A

IV immunoglobulins

90
Q

Causes of sensory neuropathies

A

Diabetes
Alcohol
B12 deficiency
Chronic renal failure

91
Q

Causes of motor neuopathies

A

GB syndrome

CMT

92
Q

Important history points in peripheral neuropathy?

A

PMH - diabetes
SH - hx of alcohol abuse
SE - anaemia symptoms

93
Q

CMT findings on neuro exam

A 
Atrophy (peripherally) 
Hammer toe / high arch 
Weakness 
Hypo/areflexia 
Sensory loss in a glove and stocking distribution
94
Q

Causes of facial nerve palsy

A 
Idiopathic - Bells palsy 
Vascular - stroke 
Infective - Ramsey hunt syndrome (herpes zoster), Lyme disease 
Tumour - acoustic neuroma 
Sarcoidosis - parotid gland enlargement
95
Q

Carpal Tunnel syndrome is associated with

A

RA
Pregnancy
HypotT
Acromegaly

96
Q

Management of CTS

A

Conservative - splinting
Medical - steroid injections
Surgical - Decompression by division of flexor retinaculum

97
Q

Two systems involved in nystagmus

A

central posterior

vestibular system

98
Q

Transverse myelitis

A

Heterogeneous focal inflammatory disorder of the spinal cord characterised by acute or subacute development of motor weakness, sensory impairment, and autonomic dysfunction.

99
Q

Investigations in transverse myelitis

A

LP

MRI

MRI of the spinal cord reveals a focal hyperintense lesion and cerebrospinal fluid usually shows pleocytosis.

100
Q

Therapy in acute transverse myelitis

A

Corticosteroids

Plasmapherisis (2nd line)

101
Q

triad of normal pressure hydrocephalus

A

Ataxia, urinary incontinence and dementia

102
Q

first line treatment in trigeminal neuralgia

A

Trigeminal neuralgia - carbamazepine is first-line

Neuro - C.U (4 decks)

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