Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Family Medicine > Misc 2 > Flashcards

Misc 2 Flashcards

1
Q

What complications are associated with Takayasu’s arteritis?

A

Renal artery stenosis

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

What is phlegmasia cerulean dolens?

A

Rare complication of DVT
Presents suddenly with complete venous occlusion
Triad of lower extremity oedema, cyanosis + severe pain after 24hrs of blanching + edema

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

Management of phlegmasia cerulean dolens

A

Catheter directed thrombolysis

2nd line = thrombectomy

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

What is an ape hand deformity?

A

Occurs in median nerve damage

Inability to abduct + oppose thumb due to paralysis of thenar muscle

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

Describe the presentation of GPA

A

URT: epistaxis, sinusitis, nasal crusting
LRT: SOB, haemoptysis
Glomerulonephritis
Saddle shaped nose

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

Describe the 2 types of scleroderma

A 
Limited = skin involvement limited to face + hands/ elbows only. CREST symptoms 
Diffuse = limited + full body skin involvement + renal damage + pulmonary fibrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What antibody is linked to diffuse + limited scleroderma?

A 
Limited = anti-centromere
Diffuse = Scl70
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you manage scleroderma?

A

DMARDS, cyclophosphamide, biologics

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

What diseases are associated with ANCA?

A

Vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What disease is associated with anti-Ro?

A

Sjogrens syndrome

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

Describe rheumatic fever

A 
Caused by strep pyogenes (sore throat) 
Erythema marginatum 
Sydenham’s chorea 
Polyarthritis 
Carditis 
Subcutaneous nodules
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you treat myositis?

A

Steroids, DMARDS, biologics, IVIG

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

What other conditions is PMR related to?

A

GCA + temporal arteritis

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

Where does PMR usually affect?

A

Shoulders + thighs

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

What is pseudogout?

A

Acute CPP crystal arthritis (CPP = calcium pyrophosphate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Presentation of acute CPP crystal arthritis

A

Sudden pain + stiffness (commonly knee)
Swelling, red, inflamed skin over joint
Fever

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

Presentation of acute calcific tendonitis

A

Painful swelling around joint, usually shoulder
Redness + tenderness
Settles in 2-4 weeks

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

Systemic sclerosis presentation

A

Stiffening, hardening or tightening of skin
Dysphagia + heartburn
Raynauds
Joint/ muscle pain/ stiffness

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

Investigation results for osteomalacia

A

Low Vit D, rasied ALP, low calcium, low phosphate

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

Blood results for osteoporosis

A

Normal bloods

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

Investigation results + presentation for Paget’s disease

A

Rise in ALP
Characteristic x ray changes; thickened skull vault, bowing of tibia + bossing of skull
Bone pain

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

Management of Pagets

A

Bisphosphonate

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

What do you need to check before starting azathioprine?

A

Check thiopurine methyltransferase deficiency (TPMT) before treatment

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

What score is used to measure RA impact?

A

DAS28

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the associated features of ankylosing spondylitis?

A 
Apical fibrosis
Anterior uveitis
Aortic regurgitation
Achilles tendonitis
AV node block
Amyloidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the most specific test for systemic sclerosis?

A

Anti-centromere antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What antibodies are associated with RA?

A

Anti-CCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is a serious complication of dermatomyositis?

A

Ovarian, breast and lung tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is Felty’s syndrome?

A

Splenomegaly
Neutropenia
Occurs in a pt with RA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What disease are cANCA + pANCA associated with?

A 
cANCA = granulomatosis with polyangiitis
pANCA = EGPA + others
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What disease is associated with anti-Scl-70 ab?

A

Diffuse scleroderma (systemic sclerosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What disease is associated with anti-dsDNA ab?

A

SLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What disease is associated with anti-CCP ab?

A

RA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What disease is associated with AMA?

A

Primary biliary sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Causes of drug induced SLE

A 
Procainamide 
Hydralazine 
Isoniazid 
Minocycline 
Phenytoin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What ab are positive in SLE?

A

99% are ANA positive
20% are rheumatoid factor positive
anti-dsDNA: highly specific (> 99%), but less sensitive (70%)
anti-Smith: most specific (> 99%), sensitivity (30%)
also: anti-U1 RNP, SS-A (anti-Ro) and SS-B (anti-La)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Management of AS

A

NSAIDs then TNF inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Presentation of Sjogrens syndrome

A 
dry eyes: keratoconjunctivitis sicca
dry mouth
vaginal dryness
arthralgia
Raynaud's, myalgia
sensory polyneuropathy
recurrent episodes of parotitis
renal tubular acidosis (usually subclinical)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is blue sclera associated with?

A

Osteogenesis imperfecta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the presentation of antiphospholipid syndrome?

A

Arterial/ venous thrombosis
Miscarriage
Livedo reticularis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is Takayasu’s arteritis + what is the presentation?

A

Inflammatory arteritis of aorta
Upper limb claudication
Absent pulses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is polyarteritis nodosu + what is the presentation?

A

Systemic necrotizing vasculitis of small + medium vessels

Common with hep B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is wegeners granulomatosis + what is the presentation?

A

Small + medium sized necrotizing vasculitis

Cutaneous vascular lesions seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is a posterior femoral nerve stretch indicative of?

A

Referred lumbar spine pain as a cause of hip pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is Marfans caused by?

A

Autosomal dominant connective tissue disorder
Defect in FBN1 gene on chromosome 15
Defect in fibrillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What are plantar spur and pencil + cup deformities typical of?

A

X ray features of psoriatic arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What DMARD is safe in pregnancy?

A

Hydroxychloroquine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What does joint aspiration show in gout?

A

Needle shaped negatively birefringent crystals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is a Z score on a DEXA scan adjusted for?

A

Age, gender + ethnicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What antibody is positive in myositis?

A

Anti-Jo1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

If someone is positive for Anti-Jo1 ab predispose you to?

A

Lung fibrosis (antisynthetase syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Describe the presentation of adult onset Stills

A

Joint pain, spiking fevers and pink bumpy rash

High serum ferritin and leukocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

RF for osteoporosis

A 
Steroid use 
RA
Alcohol excess
Hx of parental hip fracture 
Low bmi 
Current smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What structure is divided in surgical management of carpal tunnel?

A

Flexor retinaculum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Burning thigh pain is indicative of what?

A

Meralgia paraesthetica – lateral cutaneous nerve compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is the most common cause of compartment syndrome?

A

Tibial fracture + supracondylar fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are the complications of compartment syndrome in the kidneys?

A

Rhabdomyolysis caused myoglobin release in the blod
Deposits in renal tubules causing AKI
Results in dark brown urine, + for blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Treatment of intracapsular fractures, based on mobility + displacement

A 
Undisplaced = internal fixation 
Undisplaced + significant comorbidities = hemiarthroplasty 
Displaced <70 = internal fixation 
Displaced >70 = total hip replacement 
Displaced + immobile = hemiarthroplasty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Treatment of reverse oblique, transverse or subtrochanteric fracture

A

Intramedullary nail

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Treatment of intertrochanteric fracture

A

Dynamic hip screw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What imaging is best for ?Achilles tendon rupture?

A

US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is cubital tunnel syndrome?

A

Compression of ulnar nerve

Causes pins + needles in 4th + 5th finger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

How does subacromial impingement present?

A

Painful arc of abduction (worse between 90 + 120 degrees)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is adhesive capsulitis?

A

Frozen shoulder

Common in middle aged females, associated with DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Describe the features of L3 nerve root compression

A

Sensory loss over anterior thigh
Weak quads
Reduced knee reflex
Positive femoral stretch test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Describe the features of L4 nerve root compression

A

Sensory loss over anterior aspect of knee
Weak quads
Reduced knee reflex
Positive femoral stretch test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Describe the features of L5 nerve root compression

A

Sensory loss over dorsum of foot
Weak in foot + big toe dorsiflexion
Reflexes intact
Positive sciatic nerve stretch test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Describe the features of S1 nerve root compression

A

Sensory loss over posterolateral aspect of leg + lateral aspect of foot
Weak in plantar flexion of foot
Reduced ankle reflex
Positive sciatic nerve stretch test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Describe plantar fasciitis

A

Most common cause of heel pain
Pain in medial calcaneal tuberosity
Worse when walking on toes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

When should a DEXA scan be done?

A

FRAX score >10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is Morton’s neuroma?

A

Benign neuroma affecting intermetatarsal plantar nerve, commonly 3rd MTP space
Causes forefoot pain, worse on walking
Mulder’s click if pressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is the motor, sensory nerve + typical injury that occurs to C5-C7?

A

Musculocutaneous nerve
Motor = elbow flexion + supination
Sensory = lateral part of forearm
Injured in brachial plexus injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is the motor, sensory nerve + typical injury that occurs to C5, C6?

A

Axillary nerve
Motor = shoulder abduction (deltoid)
Sensory = inferior region of deltoid
Injured in humeral neck fracture, results in flattened deltoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is the motor, sensory nerve + typical injury that occurs to C5-C8?

A

Radial nerve
Motor = Extension of forearm, wrist, fingers, thumb
Sensory = small area between dorsal aspect of 1st + 2nd metacarpals
Injured in humeral midshaft fracture, palsy results in wrist drop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is the motor, sensory nerve + typical injury that occurs to C6, C8, T1?

A

Median nerve
Motor = LOAF muscles
Sensory = palmar aspect of lateral 3.5 figners
Causes carpal tunnel syndrome when compressed at wrist
Loss of pronation + weak wrist flexion when damaged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is the motor, sensory nerve + typical injury that occurs to C8, T1?

A 
Ulnar nerve 
Motor = intrinsic hand muscles, wrist flexion 
Sensory = medial 1.5 fingers 
Injured in medial epicondyle fracture 
Damage results in a ‘claw hand’
77
Q

What are the LOAF muscles?

A

Lateral 2 lumbricals
Opponens pollis
Abductor pollis brevis
Flexor polis brevis

78
Q

What is a Klumpke injury?

A

Damage of lower trunk of brachial plexus (C8, T1)
May be due to shoulder dystocia or sudden upward jerk of hand
Associated with Horner’s syndrome

79
Q

What is an Erb-Duchenne palsy?

A

Damage of upper trunk of brachial plexus (C5, C6)
May be due to shoulder dystocia
Arm hangs by side + is internally rotated

80
Q

Describe a fat embolism

A 
Occurs after trauma 
Triad of symptoms: respiratory, neuro, petechial rash 
Tachycardia, fever, SOB, hypoxia 
Confusion, retinal hemorrhages 
Petechial rash
81
Q

What is a Galeazzi fracture?

A

Dislocation of distal radioulnar joint with associated fracture of radius

82
Q

What is a Monteggia fracture?

A

Fracture of proximal ulna with associated dislocation of proximal radioulnar joint

83
Q

What is a Bennett’s fracture?

A

Fracture of base of 1st MCP that extends into CMP joint
What is a Pott’s fracture?
Bimalleolar ankle fracture
Due to forced foot eversion

84
Q

How does spinal stenosis present?

A

Gradual onset, leg pain, numbness, weakness, worse on walking
Resolves when sitting down or leaning forward

85
Q

What is syringomyelia?

A

Cystic cavity forms within spinal cord

86
Q

What is Brown-Sequard syndrome?

A

Hemisection of spinal cord due to stabbing or lateral vertebral fracture
Causes ipsilateral paralysis + loss of proprioception
Pain + temp sensation lost on contralateral side

87
Q

Leg shortening and externally rotated is indicative of what?

A

Hip fracture

88
Q

Leg shortening and internally rotated is indicative of what?

A

Hip dislocation

89
Q

What is De Quervain;s tenosynovitis?

A

Pain over radial styloid process on forced abduction or flexion of thumb (+ve Finkelstein test)

90
Q

What does a positive straight leg raise show?

A

Sciatic nerve pain

91
Q

What is a greenstick fracture?

A

Unilateral cortical breach only

92
Q

What is a toddler’s fracture?

A

Oblique tibial fracture in infants

93
Q

What is a buckle fracture?

A

Incomplete cortical disruption resulting in periosteal haematoma only

94
Q

What are Oslers nodes?

A

Tender, purple raised lesions

Due to immune complex deposition = SLE, gonorrhea, typhoid

95
Q

What is trigger finger?

A

Stiffness + snapping of finger when extending

Nodule may be felt at base of digit

96
Q

What is the Salter-Harris system used for?

A

Classifying fractures about the growth plate in children

97
Q

What is Leriche syndrome?

A

Claudication of buttocks + thighs
Atrophy of musculature of legs
Impotence (due to paralysis of L1 nerve)

98
Q

What is the weber classification used for?

A

Related to level of fibular fracture
Type A = below syndesmosis
Type B = start at level of tibial plafond, may extend to involve syndesmosis
Type C = above syndesmosis

99
Q

What is a Maisonneuve fracture?

A

May occur with spiral fibular fracture, leading to disruption of syndesmosis with windening of ankle joint

100
Q

Management of ankle fractures

A

Young patients with unstable/ high velocity/ proximal injuries = surgery
Elderly = conservative (below knee cast)

101
Q

What drug can cause Dupeytrens contracture

102
Q

What is Thessaly’s test?

A

Used to test for meniscal tear

103
Q

Difference between Cushings disease + syndrome

A 
Syndrome = collection of S+S due to prolonged exposure to cortisol 
Disease = prolonged exposure due to increased ACTH production due to pituitary adenoma
104
Q

What are the differentials for HTN with hypokalaemia?

A

Conn’s
Cushings
Renal artery stenosis
Liddle’s

105
Q

How to differentiate between Cushings, Conns, renal artery stenosis + Liddle’s?

A

Conn’s = high aldosterone, low renin
Cushings = high aldosterone, low renin
Renal artery stenosis = high aldosterone + renin
Liddle’s = low aldosterone + renin

106
Q

Describe Conn’s syndrome

A

Hypokalaemia (paraesthesia, muscle weakness, polyuria)

HTN

107
Q

What test is diagnostic for Conn’s?

A

Aldosterone to renin ratio

108
Q

Which antibody is Hashimoto’s associated with?

A

Anti-thyroid peroxidase ab (anti-TPO)
Which pneumonia bacteria is associated with erythema multiforme?
Mycoplasma pneumonia

109
Q

What is the commonest cause of Addisons?

A

Autoimmunity

110
Q

What can long term PPI therapy cause?

A

Hypomagnesaemia leading to muscle aches

111
Q

What are the live attenuated vaccines?

A 
BCG
MMR
Oral polio
Yellow fever
Oral typhoid
112
Q

Describe a type 1 hypersensitivity reaction

A

Antigen reacts with IgE bound to mast cells

Eg atopy + anaphylaxis

113
Q

Describe a type 2 hypersensitivity reaction

A

IgG or IgM

Eg ITP, Goodpasture’s, pernicious anemia, acute hemolytic transfusion reaction

114
Q

Describe a type 3 hypersensitivity reaction

A

IgA + IgG combine

Eg SLE, post strep glomerulonephritis

115
Q

Describe a type 4 hypersensitivity reaction

A 
Delayed hypersensitivity (T cell mediated)
Eg TB, allergic dermatitis, MS, GBS
116
Q

Where does a prolactinoma usually reside?

A

Anterior pituitary gland

117
Q

What is apraxia?

A

Inability to perform skilled movements

118
Q

What is agnosia?

A

Inability to recognise previously familiar sensory input ie inability to recognise objects

119
Q

What is astereognosis?

A

Ability to recognise objects by palpation in one hand but not the other

120
Q

Where does a bleed usually occur in subdural haemorrhage?

A

Bridging veins between cortex + venous sinus

121
Q

What is corticobasal degeneration?

A

Pts have a rigid limb (alien limb – moves on its own)

Develop frontal type dementia; behavior + personality changes

122
Q

How does progressive supranuclear palsy present?

A

Build up of protein Tau
Backward falls, early speech and swallowing problems
Lose voluntary gaze; can’t move eyes up and down

123
Q

What investigations can be used to assess multi system atrophy vs Parkinsons?

A

Tilt test = shows postural hypo (MSA)
Hot cross bun sign on MRI = multi system atrophy
MSA is symmetrical

124
Q

What medications can cause Parkinsonian symptoms?

A

Anti-emetics = metoclopramide

Anti-psychotics

125
Q

What are the differentials for HTN with hypokalaemia?

A

Conn’s
Cushings
Renal artery stenosis
Liddle’s

126
Q

How to differentiate between Cushings, Conns, renal artery stenosis + Liddle’s?

A

Conn’s = high aldosterone, low renin
Cushings = high aldosterone, low renin
Renal artery stenosis = high aldosterone + renin
Liddle’s = low aldosterone + renin

127
Q

Describe Conn’s syndrome

A

Hypokalaemia (paraesthesia, muscle weakness, polyuria)

HTN

128
Q

What test is diagnostic for Conn’s?

A

Aldosterone to renin ratio

129
Q

Which antibody is Hashimoto’s associated with?

A

Anti-thyroid peroxidase ab (anti-TPO)
Which pneumonia bacteria is associated with erythema multiforme?
Mycoplasma pneumonia

130
Q

What is the commonest cause of Addisons?

A

Autoimmunity

131
Q

What can long term PPI therapy cause?

A

Hypomagnesaemia leading to muscle aches

132
Q

What are the live attenuated vaccines?

A 
BCG
MMR
Oral polio
Yellow fever
Oral typhoid
133
Q

Describe a type 1 hypersensitivity reaction

A

Antigen reacts with IgE bound to mast cells

Eg atopy + anaphylaxis

134
Q

Describe a type 2 hypersensitivity reaction

A

IgG or IgM

Eg ITP, Goodpasture’s, pernicious anemia, acute hemolytic transfusion reaction

135
Q

Describe a type 3 hypersensitivity reaction

A

IgA + IgG combine

Eg SLE, post strep glomerulonephritis

136
Q

Describe a type 4 hypersensitivity reaction

A 
Delayed hypersensitivity (T cell mediated)
Eg TB, allergic dermatitis, MS, GBS
137
Q

Where does a prolactinoma usually reside?

A

Anterior pituitary gland

138
Q

What is apraxia?

A

Inability to perform skilled movements

139
Q

What is agnosia?

A

Inability to recognise previously familiar sensory input ie inability to recognise objects

140
Q

What is astereognosis?

A

Ability to recognise objects by palpation in one hand but not the other

141
Q

Where does a bleed usually occur in subdural haemorrhage?

A

Bridging veins between cortex + venous sinus

142
Q

What is corticobasal degeneration?

A

Pts have a rigid limb (alien limb – moves on its own)

Develop frontal type dementia; behavior + personality changes

143
Q

How does progressive supranuclear palsy present?

A

Build up of protein Tau
Backward falls, early speech and swallowing problems
Lose voluntary gaze; can’t move eyes up and down

144
Q

What investigations can be used to assess multi system atrophy vs Parkinsons?

A

Tilt test = shows postural hypo (MSA)
Hot cross bun sign on MRI = multi system atrophy
MSA is symmetrical

145
Q

Are Parkinsons symptoms symmetrical?

A

No – asymmetrical if idiopathic

Drug induced = symmetrical

146
Q

When to start Levodopa in Parkinsons?

A

When symptoms become intolerable

147
Q

What can be used to enhance the effect of Levodopa?

A

COMPT inhibitors – prevent breakdown of dopamine peripherally

148
Q

What are the SE of dopamine agonists?

A

Hallucinations and confusion

149
Q

Tx for trigeminal neuralgia

A

Carbamazapine

150
Q

What is Lhermitte’s sign?

A

MS disease near dorsal column of cervical cord

Tingling in hands on neck flexion

151
Q

What is Uhthoff’s phenomenon?

A

Worsening of vision following a rise in temp

152
Q

What is used for prophylaxis against migraines?

A

Topiramate or propranolol

153
Q

How soon must a thrombectomy be done after an ischaemic stroke?

A

6 hours following onset of symptoms

154
Q

How do you treat neutropenia of chemo

A

Filgrastim = granulocyte stimulating factor

155
Q

What is the most common presentation of MS?

A

Optic neuritis

156
Q

What are axillary freckles a sign of?

A

Neurofibromatosis 1

157
Q

What type of seizures do you typically get weakness after, and why?

A

Focal seizures = Todd’s palsy

158
Q

What is the ROSIER score used for?

A

Recognition of stroke in ER

159
Q

Where is the lesion in Wernicke’s aphasia?

A

Superior temporal gyrus

160
Q

Management of hepatic encephalopathy

A

Lactulose (PO or PR)

Rifaxamin 2nd line

161
Q

How do you differentiate between a true and pseudo seizure?

A

Raised prolactin = true seizure

Pelvic thrusting, crying afterwards + gradual onset = pseudo

162
Q

Describe progressive supranuclear palsy

A

Impaired balance + falls
Vertical gaze palsy
Symmetrical onset

163
Q

Describe the types of multi system atrophy

A

MSA-P – predominantly Parkinson

MSA-C – predominantly cerebellar

164
Q

What is Shy-Drager syndrome?

A

Type of multi system atrophy

165
Q

What are the symptoms of multi system atrophy?

A

Parkinsonism symptoms
Autonomic disturbance; erectile dysfunction, postural hypotension, atonic bladder
Cerebellar signs

166
Q

Lesions in the cerebellum causing ataxia; where does gait ataxia come from, and where does finger-nose ataxia come from?

A

Finger nose = cerebellar hemisphere

Gait ataxia = cerebellar vermis

167
Q

Describe the S+S of a stroke in the anterior cerebral artery

A

Contralateral hemiparesis + sensory loss

Lower extremity > upper extremity

168
Q

Describe the S+S of a stroke in the middle cerebral artery

A

Contralateral hemiparesis + sensory loss
Upper extremity > lower extremity
Contralateral homonymous hemianopia
Aphasia

169
Q

Describe the S+S of a stroke in the posterior cerebral artery

A

Contralateral homonymous hemianopia with macular sparing

Visual agnosia

170
Q

Describe the S+S of Weber’s syndrome

A

Ipsilateral CN3 palsy

Contralateral weakness of upper + lower extremity

171
Q

What is Weber’s syndrome?

A

Stroke in branches of posterior cerebral artery that supply midbrain

172
Q

Describe the S+S of a stroke in the posterior inferior cerebellar artery

A 
Wallenberg syndrome
Ipsilateral: face pain + temp loss 
Contralateral: limb/ torsa pain + temp loss 
Ataxia 
Nystagmus
173
Q

Describe the S+S of a stroke in the anterior inferior cerebellar artery

A

Ipsilateral: facial paralysis + deafness
Contralateral: limb/ torsa pain + temp loss
Ataxia
Nystagmus

174
Q

Describe the S+S of a stroke in the retinal/ ophthalmic artery

A

Amaurosis fugax

175
Q

What is Hoffman’s sign?

A

Exaggerated flexion of terminal phalaynx of thumb

Associated with upper motor neurone disease

176
Q

What is a Jacksonian movement

A

Clonic movements travelling proximally

Frontal lobe epilepsy

177
Q

What is cataplexy?

A

Sudden + transient loss of muscle tone due to strong emotion

178
Q

What is Parsonage-Turner syndrome?

A

Peripheral neuropathy that may complicate viral illnesses, resolves spontaneously

179
Q

What is palinopsia?

A

Seeing an image after the stimulus is removed

180
Q

What is Gerstmann’s syndrome?

A

Dyscalcula, inability to tell L from R, dysgraphia, finger agnosia

181
Q

Describe a hemiplegic gait

A

Asymmetrical, affected limb held in extension with feet inverted.
Affected leg circumducts
Due to unilateral UMN lesion (CVA, tumour, trauma, MS)

182
Q

Describe a diplegic gait

A

Bilateral stiff limbs held in extension

Due to spinal cord lesions: tumour, transverse myelitis, spondylosis, cerebral palsy, MS

183
Q

Describe a parkinsonian gait

A

Short stepping, shuffling, minimal arm swing, difficulty turning
Associated with cogwheel rigidity, pin-rolling tremor

184
Q

Describe an ataxic gait

A

Broad based, unsteady, foot stamping

Cerebellar, vestibular or sensory impairment: MS, B12 def, CVA, tumour

185
Q

Describe a neuropathic gait

A

Foot drop = high stepping gait, feet stamping
Due to common peroneal nerve palsy, L5 radiculopathy or generalized polyneuropathy (diabetic, Charcot-Marie Tooth, Guillain-Barre)

186
Q

Describe a sensory gait

A

Foot slamming, may be ataxic
Romberg’s positive
Due to B12 def, syphilis, diabetes, vasculitis, CMT or GBS

187
Q

Describe a myopathic gait (waddling or Trendelendburg)

A

Weak hip abductors so pelvis tips down; compensates by flexing torso away from bad leg or circumducts the leg
Due to proximal myopathy (thyroid issues, Cushings, myositis, muscular dystrophy)

188
Q

Describe a choreiform gait

A

Normal gait with involuntary choreic movements

Due to Huntingdons, cerebral palsy, Wilson’s disease, Parkinson’s meds

189
Q

Describe a antalgic gait

A

Painful gait, shortened length of time on affected leg

Due to pain: OA, inflammatory joint disease, fracture, sciatica

Family Medicine (10 decks)

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