Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MCCQE1 > Medicine- neurology > Flashcards

Medicine- neurology Flashcards

1
Q

Cerebellar signs

A

Disdiadochokinesia

Ataxia

Nystagmus

Intention tremor

Scanning/ staccato/ slurred speech

Hypotonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

LMN signs

A

Flaccid paresis

Hypotonia

Hyporeflexia

Atrophy

Fasciculations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

UMN signs

A

Hyperreflexia

Positive Babinski sign (extensor plantar response)

Spasticity

No muscle weakness (early on)

Pyramidal pattern of weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Contraindications to lumbar puncture

A
  • Mass lesion causing increased ICP (risk of cerebral herniation)
  • Infection over LP site/suspected epidural abscess
  • Low platelets (<50,000) or anticoagulated
  • Uncooperative patient
  • Confirmed/suspected spinal trauma or congenital spinal abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

CNIII palsy signs

A

Ptosis

Pupil down and out

Pupil dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What EEG findings are associated with absence seizures?

A

3 Hz spike and slow wave activity on EEG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

EEG findings suggestive of epilepsy

A

Abnormal spikes Polyspike discharges, Spike-wave complexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Definition of status epilepticus

A

Medical emergency involving unremitting seizure or successive seizures without return to baseline state of >5 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Vit B12 deficiency signs

A

Macrocytic anemia, pallor, SOB, fatigue, chest pain, palpitations

  • Confusion or change in mental status (if advanced)
  • Decreased vibration sense
  • Distal numbness and paresthesia
  • Weakness with UMN findings
  • Diarrhea, anorexia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name the disorder

Visual hallucinations

Parkinsonism

Fluctuating cognition

A

Lewy body dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Lewy Body dementia is associated with what kind of response to neuroleptics?

A

Severe sensitivity (rigidity, neuroleptic malignant syndrome, extrapyramidal symptoms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Canadian CT head rules: high risk (5)

A

High risk (for neurosurgical interventions)

GCS score <15 at two hours after injury

Suspected open or depressed skull fracture

Any sign of basal skull fracture (haemotympanum, “panda” eyes, cerebrospinal fluid otorrhoea, Battle’s sign).

Vomiting more than once

Age≥65 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Canadian CT head rules: medium risk (2)

A

Medium risk (for brain injury on CT) * Persistent retrograde amnesia of greater than 30 minutes Dangerous mechanism of injury (pedestrian struck by vehicle, ejection from vehicle, fall from greater than three feet or five stairs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Canadian CT head rules exclusion criteria

A

Exclusion criteria

anticoagulant medication or bleeding disorder

age <16 years seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Major neuropathological findings in Parkinsons (2)

A
  • Loss of pigmented dopaminergic neurons in the substantiata nigra
  • Lewy bodies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

PD investigations (2)

A

PET SPECT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Serum ceruloplasmin is a screening test for what?

A

Wilson disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cluster headache characteristics

A

Unilateral Pain in orbital or supra-orbital region

Assoc w nasal congestion or conjunctival injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The genetic basis of Huntintgons Disease

A

expansion of a CAG repeat encoding a polyglutamine tract in the N terminus of the protein product called Huntingtin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Signs of raised intracranial pressure

A

Headache

Reduced LOC

Papillodema

Reduced HR

Hypertension

Respiratory depression

Maybe apparent VI palsy (paralysis of lateral gaze)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Tonometry measures what?

A

Intraocular pressure. Used for diagnosis of glaucoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Optic chiasm lesion results in what?

A

Bitemporal hemianopsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does ALS not affect?

A

Bowel + bladder function

Sensation

Mental function

Eye muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the relationship between smoking and Parkinsons disease?

A

It lowers risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Typical presentation of myasthenia gravis
Fatgued Muscle weakness Improvement with rest Diplopia
26
What (pathologically) causes the symptoms of Guillan-Barre syndrome?
Loss of myelin
27
Dementia, gait instability + urinary incontinence suggests what?
Normal pressure hydrocephalus These symptoms are Adam's triad (or Hakim's triad); 'wet, whacky + wobbly'
28
What is The Miller Fisher test?
High-volume lumbar puncture (LP) with removal of 30–50 ml of CSF. Gait and cognitive function are typically tested just before and within 2–3 hours after the LP to assess for signs of symptomatic improvement.
29
First line treatment of normal pressure hydrocephalus
Shunting is the first-line treatment. The most common type used to treat NPH is ventriculoperitoneal (VP) shunts
30
Presentation of Cauda Equina Syndrome
- Severe back pain - Saddle anesthesia ie S3 to S5 dermatomes, including the perineum, external genitalia and anus; or more descriptively, numbness or "pins-and-needles" sensations of the groin and inner thighs - Bladder and bowel dysfunction, caused by decreased tone of the urinary and anal sphincters. - Sciatica-type pain on one side or both sides, although pain may be wholly absent - Weakness of the muscles of the lower legs (often paraplegia) - Achilles (ankle) reflex absent on both sides. - Sexual dysfunction - Absent anal reflex and bulbocavernosus reflex - Gait disturbance
31
Typical cause of Cauda Equina Syndrome
Herniated lumbar disc below L2
32
Neuropathic pain criteria (4)
1. Distribution of pain that is neuroanatomically plausible 2. Hx suggesting disease or lesion of somatosensory system 3. A Dx test confirming a lesion or disease that can explain neuropathic pain 4. Neg or pos symptoms confined to the innervation territory of the damaged nervous structure
33
First line treatments for cluster headaches
The evidence-based acute treatments for cluster headaches are 1. subcutaneous sumatriptan 2. intranasal sumatriptan and zolmitriptan 3. high-flow oxygen via a non-rebreather mask 4. in episodic cluster alone, non-invasive vagus nerve stimulation (nVNS).
34
Diplopia on upward gaze
Myasthenia Gravis
35
Myasthenia Gravis is associated with what pathology?
Thymomas
36
Charcot Marie Tooth mode of inheritance
Autosomal dominant
37
Classical features of Charcot Marie Tooth syndrome
High foot arches (pes cavus) Distal muscle wasting causing “inverted champagne bottle legs” Weakness in the lower legs, particularly loss of ankle dorsiflexion Weakness in the hands Reduced tendon reflexes Reduced muscle tone Peripheral sensory loss
38
A neurological disorder associated with genetic anticipation
Huntingtons disease Huntington’s chorea displays something called genetic “anticipation”. Anticipation is a feature of trinucleotide repeat disorders. This is where successive generations have more repeats in the gene, resulting in: Earlier age of onset Increased severity of disease
39
UMN facial nerve palsy is associated with what pathology? How can you distinguish between UMN and LMN facial nerve palsy?
Usually a stroke UMN - the forehead is spared
40
Treatment for Bell’s palsy if you present within 72h
Prednisone
41
Vesicular rash near the ear and LMN facial nerve palsy
Ramsay Hunt Syndrome
42
Cause of Ramsay Hunt syndrome
Varicella zoster virus
43
Rx Ramsay Hunt syndrome
Treatment should ideally be initiated within 72 hours. Treatment is with: Prednisolone Aciclovir Patients also require lubricating eye drops.
44
Benign intentional tremor does what with intentional movement?
Gets worse
45
Postural headache worse on standing, lying or bending over- think what?
Raised ICP
46
Sudden onset occipital headache
Subarachnoid
47
First line Rx trigeminal neuralgia
Carbamazepine
48
A virus implicated in multiple sclerosis
EBV
49
CSF findings in multiple sclerosis
Oligoclonal bands
50
Key features of optic neuritis
Central **scotoma.** This is an enlarged blind spot. **Pain** on eye movement **Impaired colour** vision Relative afferent pupillary defect Note ON is the presenting feature of MS in 20% of cases and 50% of MS pts will get it.
51
Typical presentation Guillain Barre syndrome
Symmetrical **ascending weakness** (starting at the feet and moving up body) **Reduced reflexes** There may be peripheral **loss of sensation** or neuropathic pain It may progress to the cranial nerves and cause facial nerve weakness
52
Bilateral acoustic neuromas almost always indicate what?
Neurofibromatosis II
53
Inheritance of neurofibromatosis I + II
Autosomal dominant
54
Diagnostic criteria for neurofibromatosis I
_Need 2 of 7_: C – Café-au-lait spots (6 or more) measuring ≥ 5mm in children or ≥ 15mm in adults R – Relative with NF1 A – Axillary or inguinal freckles BB – Bony dysplasia such as Bowing of a long bone or sphenoid wing dysplasia I – Iris hamartomas (Lisch nodules) (2 or more) are yellow brown spots on the iris N – Neurofibromas (2 or more) or 1 plexiform neurofibroma G – Glioma of the optic nerve
55
Complications of NF1
Migraines Epilepsy Renal artery stenosis causing hypertension Learning and behavioural problems (e.g. ADHD) Scoliosis of the spine Vision loss (secondary to optic nerve gliomas) Malignant peripheral nerve sheath tumours Gastrointestinal stromal tumour (a type of sarcoma) Brain tumours Spinal cord tumours with associated neurology (e.g. paraplegia) Increased risk of cancer (e.g. breast cancer) Leukaemia
56
Skin signs of tuberous sclerosis
- **Ash leaf spots** are depigmented areas of skin shaped like an ash leaf - **Shagreen patches** are thickened, dimpled, pigmented patches of skin - **Angiofibromas** are small skin coloured or pigmented papules that occur over the nose and cheeks - **Subungual fibromata** are fibromas growing from the nail bed. They are usually circular painless lumps that grow slowly and displace the nail - **Cafe-au-lait spots** are light brown “coffee and milk” coloured flat pigmented lesions on the skin - **Poliosis** is an isolated patch of white hair on the head, eyebrows, eyelashes or beard
57
CSF findings in GBS
High protein
58
Periodic synchronous bi- or triphasic sharp wave complexes on EEG
Creutzfeldt-Jacob disease
59
Classical presentation of CJD
Rapid progressive mental deterioration and myoclonus
60
First line agents for migraine prophylaxis
Amitryptiline Venlafaxine Propanolol Topiramate
61
Which AED causes kidney stones?
Topiramate
62
Trigeminal neuralgia occurs in young people with which disorder?
MS
63
Treating MS relapses
Relapses can be treated with steroids. NICE recommend methylprednisolone: 500mg orally daily for 5 days 1g intravenously daily for 3–5 days where oral treatment has failed previously or where relapses are severe
64
A drug to slow the progression of ALS
Riluzole
65
What is Natazulimab? What has it been associated with?
A synthetic monoclonal antibody used to treat relapsing/ remitting MS. Associated with progressive multifocal leukoencephalopathy
66
First line therapy for Grand Mal seizures
Valproic acid
67
Action of valproic acid
Increases GABA by altering properties of voltage gated sodium channels
68
Migraine triggers
Caffeine withdrawal Chocolate Sleep deprivation Tyramines (red wine, ripe cheese) Nitrites (processed meats)
69
Most common neurological manifestation of vitamin B12 deficiency
Subacute degeneration of the cord
70
Polyneuropathy + dilated cardiomyopathy
Thiamine deficiency
71
Effacement of the supra cellar cistern on non-contrast CT is associated with what?
Subarachnoid haemorrhage
72
Subarachnoid haemorrhage risk factors
Trauma Berry aneurysm (+polycystic kidney disease) Female gender Hypertension Connective tissue disease (eg Ehlers Danlos)
73
A major complication of subarachnoid haemorrhage + prophylactic treatment
Cerebral vasospasm Triple H therapy + calcium channel blockers
74
Diagnostic test for myasthenia gravis
The Tensilon test Using Edrophonium 10mg
75
Rx for benign essential tremor (2)
Propranolol (a non-selective beta blocker) Primidone (a barbiturate anti-epileptic medication)
76
Classical presentation of tuberous sclerosis
classical presentation is a child presenting with epilepsy found to have skin features of tuberous sclerosis
77
Factors thought to be implicated in multiple sclerosis
Multiple genes Epstein–Barr virus (EBV) Low vitamin D Smoking Obesity
78
What is Lhermitte’s sign?
Lhermitte’s sign in MS is an electric shock sensation which travels down the spine and into the limbs when flexing the neck. It indicates disease in the cervical spinal cord in the dorsal column. It is caused by stretching the demyelinated dorsal column.
79
Diagnosis of multiple sclerosis
MRI scans can demonstrate typical lesions Lumbar puncture can detect “oligoclonal bands” in the cerebrospinal fluid (CSF)
80
What % of ppl with optic neuritis develop MS?
Around 50% of patients with a single episode of optic neuritis will go on to develop MS over the next 15 years
81
Management of spasticity in MS
Baclofen, gabapentin and physiotherapy
82
Biggest source of brain mets
Lung Breast Skin Kidney GI tract
83
Lisch nodules (iris hamartomas) Neurofibromatosis
84
CNIII palsy
85
Charcot Marie Tooth
86
Shagreen patch Tuberous sclerosis
87
Ash leaf spots Tuberous sclerosis
88
Ramsay Hunt Syndrome
89
Normal pressure hydrocephalus
90
Entry point for lumbar puncture
L3-L4 or L4-L5

MCCQE1 (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions