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Amir Sam Lectures > Lecture 3 - Neuro > Flashcards

Lecture 3 - Neuro Flashcards

1
Q

What are the main anatomical regions a neurological lesion can be located?

A

Brain

Spinal Cord

Nerve Roots

Peripheral Nerves

NMJ

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2
Q

How would you classify the potential causes of a neurological lesion?

A

Vascular

Infection

Inflammation/Autoimmue

Toxic/Metabolic

Tumour/Malignancy

Hereditary/Congenital

Degenerative

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3
Q

Which symptoms indicate an UMN lesion?

A

Increased spastic tone

Decreased Power

Brisk Reflexes

Upgoing Plantar (Babinski’s Sign)

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4
Q

Which symptoms would indicate a LMN lesion?

A

Flaccid Tone

Decreased Power

Decreased/Absent Reflexes.

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5
Q

Which cranial nerves could be damaged in a patient presenting with diplopia?

A

III, IV, VI

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6
Q

Which cranial nerves could be damaged in a patient presenting with dysphagia (due to a neurological deficit)?

A

IX, X

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7
Q

How would Botulism typically present?

A

Multiple, separate cranial nerve lesions (ie. Diplopia and Dysphagia)

Abscesses on Limbs (Due to IV drug use)

Symmetric, descending muscle weakness

Slurred Speech

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8
Q

Which signs point to a lesion in the cerebellum?

A

Ataxia

Nystagmus

Dysdiadokinesia

Intention Tremor

Speech - Slurred & Scanning

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9
Q

How would sensation be changed in a patient with a lesion in the cerebral cortex?

A

Hemisensory Loss

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10
Q

How would sensation be changed in a patient with a lesion in the spinal cord?

A

Sensation is lost either below or above the specific level of the lesion.

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11
Q

How would sensation be changed in a patient with a lesion in the nerve roots (radiculopathy)?

A

Loss of sensation in a particular dermatome.

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12
Q

How would sensation be changed in a patient with a mononuropathy?

A

A specific area will lose sensation.

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13
Q

How would sensation be changed in a patient with a polyneuropathy?

A

Glove & Stocking distribution of sensory loss.

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14
Q

How would you manage a patient with Diabetic Peripheral Neuropathy?

A

Duloxetine

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15
Q

What are the causes of peripheral neuropathy?

A

Infection - HIV

Inflammation/Autoimmune - Vasculitis, CTD, Inflammatory demyelinating neuropathy (GBS)

Toxic/Metabolic

Tumour/Malignancy - Paraneoplasia, paraproteinaemia

Hereditary - Hereditary sensory motor neuropathy (identified by the presence of long-term stigmata, ie. Pes Cavus)

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16
Q

What are the toxic/metabolic causes of peripheral neuropathy?

A

Drugs (Hx)

Alcohol (Hx, raised GGT/MCV)

B12 Deficiency (Macrocytic Anaemia)

Diabetes (HbA1C)

Hypothyroidism (TFTs)

Uraemia (U&Es)

Amyloidosis (Hx of Myeloma/chronic infection/inflammation)

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17
Q

What are the two causes of a blurred optic disc on fundoscopy?

A

Papillitis (Younger, presence of inflammation, painful, blurred vision) [Optic Neuritis]

Papilloedema (Older, raised ICP, not painful)

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18
Q

What does a spastic paraparesis describe?

A

Increased tone and weakness on both sides - UMN lesion.

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19
Q

Which artery supplies the anterior side of the spinal cord?

A

Anterior Spinal Artery

20
Q

What is TB affecting the spine called?

A

Pott’s Disease (Tuberculosis spondylitis)

21
Q

What are the causes of a spastic paraparesis?

A

Vascular (Stroke) - sudden onset

Infection (Abscess, Pott’s)

Inflammation (Demyelination) - Transverse Myelitis

Toxic/Metabolic - B12 Deficiency

Tumour

22
Q

What could 2 lesions separated in time/space in a single patient indicate?

A

Multiple Sclerosis

23
Q

What is Meralgia Paraesthetica?

A

Compression of the lateral femoral cutaneous nerve

24
Q

How does Meralgia paraesthetica present?

A

Pain & Paraesthesia on Anteriolateral thigh

25
Q

How would you manage a case of Meralgia Paraesthetica?

A

Reassure

Avoid tight garments

Lose weight

If persistent:

Carbamazepine

Gabapentin

26
Q

What is sciatica?

A

Compression of the Lumbosacral Nerve, due to disc herniation or spinal canal stenosis.

Presents as pain in the buttock, which radiates down the leg below the knee.

Form of Radiculopathy

27
Q

What would Parkinsonism & Limited upgaze indicate?

A

Progressive Supranuclear Palsy (Steele-Richardson Syndrome)

28
Q

What are the key symptoms to remember for Parkinson’s?

A

Tremor

Rigidity

Bradykinesia

29
Q

What causes Parkinson’s Disease?

A

Destruction of dopaminergic neurons in the Substantia Nigra

30
Q

What are the key symptoms of Lewy Body Dementia?

A

Features of Alzheimer’s Disease

Parkinson’s

Vivid Hallucinations

31
Q

What are the main causes of confusion, excluding VIITT causes?

A

V I I T T

&

Post-Ictal

May only be apparent confusion due to Dysphasia (eg. after a stroke)

Dementia

Depressive Pseudodementia

32
Q

What are the main causes of confusion?

A

Hypoglycaemia (DNEFG)

Vascular:

  • Bleed (associated with headache, collapse)
  • Subdural Haematoma (fluctuating consciousness, Hx of fall)

Infection (?Fever, ?Intracranial, ?extra-cranial)

Inflammation (?raised CRP)

Malignancy

Metabolic (Drugs, U&Es, LFTs, Vitamin deficiencies, endocrinopathies)

33
Q

What are the most important conditions to exclude when a patient presents with headache?

A

Meningitis

SAH

Giant Cell Arteritis

Migraine

34
Q

What are the key symptoms to recognise in a patient with Meningitis?

A

Headache

Fever

Neck Stiffness

Non-blanching rash (severe)

Kernig’s Sign (Pain on extension of the knee)

35
Q

Which symptoms would raise concerns that a patient has suffered from a Sub-Arachnoid Haemorrhage?

A

Sudden-onset, worst ever headache.

‘ThunderClap’

36
Q

How would you investigate a possible SAH?

A

CT Head

LP (Xanthochromia would be positive, breakdown of RBCs in CSF - Straw yellow)

37
Q

How does Giant Cell Arteritis present?

A

Over 50s

Headache, painful on touch (ie. combing hair)

Temporal region

Jaw claudification and Blindness

38
Q

How would you manage a case of Giant Cell Arteritis?

A

Steroids, to prevent blindness

Check ESR and perform a temporal artery biopsy.

39
Q

Which symptoms are indicative of a migraine?

A

Throbbing Headache

Vomiting

Photo/phonophobia

FHx

Aura preceding the attack.

40
Q

How would you manage a stroke that began <4.5 hours ago?

A

CT Head to exclude Haemorrhage

Thrombolysis (If no contraindications)

41
Q

How would you manage a stroke that began >4.5 Hours ago?

A

CT Head, to exclude haemorrhage

Asprin 300g & Swallow assessment

Maintain hydration, oxygenation, monitor glucose.

42
Q

How would you manage a TIA?

A

Aspirin

Only treat BP acutely if malignant (over 220/120)

ECG, Echo

Carotid Doppler

Risk Factor modification

43
Q

What is important to regularly monitor in a patient with Guillain-Barre Syndrome?

A

FVC

44
Q

Fuck off Adam

A

These cards are quality

45
Q
A

Amir Sam Lectures (6 decks)

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