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Phase 2A (HV) > Miscellaneous- Neuro > Flashcards

Miscellaneous- Neuro Flashcards

1
Q

A) What is Charcot Marie tooth syndrome?

B) Sx

A

An autosomal dominant condition that affects the peripheral motor and sensory nerves

Stork leg deformity, hammer toes, high arched feet, distal muscle weakness and atrophy, foot drop
hx of frequently sprained ankles

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2
Q

What is brown sequard syndrome

A

Hemisection of the spinal cord resulting in ipsilateral loss of DCLM (loss of vibration, proprioception and 2 point touch) and contralateral loss of spinothalamic pathway (pain and temp)

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3
Q

A) what is lambert Eaton myasthenia syndrome

B) Sx

A

And autoimmune condition of the neuromuscular junction (associated with small cell lung cancer) causing muscle weakness and improves temporarily after increased use of the muscle

Symmetrical muscle weakness, gait changes, dry mouth, difficulty mistrusting, ptosis

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4
Q

What autoantibody is associated with LEMS

A

Anti V/Q voltage gated calcium channel

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5
Q

Pharmacological tx for LEMS

A

Amifampridine

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6
Q

What 2 signs associated with carpal tunnel

A

Phalens
Tinnels

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7
Q

1st line tx for trigeminal neuralgia

A

Carbamazepine

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8
Q

1st line tx for GBS

A

IVIG and plasma exchange

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9
Q

1st line tx for myasthenia gravis

A

Achetylcholinesterase inhibitor- pyrodistigmine

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10
Q

Other than serology what test is essential to do in someone with myasthenia gravis

A

CT Chest- look for thymoma

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11
Q

Pharmacological tx for MND

A

Riluzole

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12
Q

1st line treatment in MS and chronic tx

A

Corticosteroids- prednisalone

Immunomodulators- beta interferon, natalizumab, fingolimod

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13
Q

Histological finings in Alzheimer’s

A

Beta amyloid -plaques
nuerofibrillary tangles (tau proteins)
Cortical atrophy
Damaged synapsess

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14
Q

Head MRI finding in MS

A

White matter lesions/plaques dessiminated in space and time

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15
Q

CSF findings in MS

A

Oligoclonal bands

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16
Q

Nerve roots of the sciatic nerve

A

L4-s3

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17
Q

Nerve root for ankle jerk reflex

A

S1

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18
Q

Nerve root for knee jerk reflex

A

L4

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19
Q

Pharmacological tx for Alzheimer’s

A

Acetylcholinesterase inhibitors- pyrodistigmine

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20
Q

What pharmacological tx may you give in frontotemporal dementia

A

Ssris e.g. sertaline

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21
Q

What is the histological findings in frontotemporal dementia

A

Pick bodies

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22
Q

Gs ix for Lewy body dementia

A

DATSCAN (SPECT)

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23
Q

Prophylaxis tx for cluster headaches

A

Verapamil

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24
Q

Tx for migraines

A

NSAIDs
Triptans- 5-HT Receptor agonists

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25
Q

Prophylaxis/preventable tx for migraines

A

Beta blockers (propanolol)
Anti-epileptic (topiramate)
Amitryptiline (TCA0)

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26
Q

Mode of inheritance of duchenne and Becker muscular dystrophy

A

X linked recessive

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27
Q

What protein in affected in Duchenne and Becker muscular dystrophy and what is its role

A

Dystrophin- links ECM to the cytoskeleton of the muscle fibre

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28
Q

What is the mode of inheritance for myotonic dystrophy

A

Autosomal dominant

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29
Q

How does alteplase work

A

Converts plasminogen to plasmin which breaks down fibrin

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30
Q

Which area of the brain does Jacksonian march affect

A

Frontal lobe

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31
Q

What primary care questionnaire can be done to assess for dementia

A

6CIT

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32
Q

What condition is frontotemporal dementia closely associated with

A

MND

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33
Q

25 patients with Alzheimer’s dementia will go on to develop what

A

Parkinsonism

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34
Q

Se of lamotrigine

A

Blistering rash and closely associated with stevens-Johnson’s syndrome

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35
Q

What is the triad of Sx associated with Ms and list them

A

Charcots triad
Dysarthria
Nystagmus
Intention tremor

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36
Q

List 3 atypical signs of ms

A

Homonymus hemianopia
Apahasia
Muscle wasting

37
Q

List 5 signs associated with cauda equina

A

Bowel and bladder dysfunction
Saddle anaesthesia
Bilateral sciatica
ED
Leg weakness

38
Q

List the subtypes of MND and a few features

A

Amyotrophic lateral sclerosis- UMN and LMN. Progressive terataparesis and resp failure
Progressive bulbar palsy- affects CN 9-12. tongue atrophy, progressive loss of speech
Primary lateral sclerosis- UMN of arms, leg and feet
Progressive muscular atrophy- LMN only

39
Q

What nt is affected in huntingtons

A

GABA

40
Q

List Sx of huntingtons disease

A

Chorea
Personality changes (irritable, depression)
Dysarthria
Dementia
Dystonia

Features typically occur after 35

41
Q

Give 5 causes of transient loss of consciousness

A

Syncope
Intoxication of alcohol
Seizures
Trauma
Ketoacidosis/hypoglycaemia

42
Q

What is the definition of a stroke

A

An acute neurological deficit characterised by a vascular lesion acccoicted with infarction of central nervous tissue

43
Q

List the symptoms accosted with a Total anterior infarct

A

Contralateral hemiplegia or hemiparesis
Contralateral homonymous hemianopia
High cerebral dysfunction (aphasia and neglect)

44
Q

What would be the result on CSF in someone with GBS

A

Raised protein, normal WBC

45
Q

Sign of ulnar nerve damage

A

Elbow trauma and and claw sign

46
Q

Dame to median nerve signs

A

Grip muscles affected and wasting of thenar eminence

47
Q

Signs of radial nerve being affected

A

Unable to open fist and extend wrist

48
Q

Cerebellar signs

A

Dysdiadochokinesia
Ataxia
Nystagmus
Intention tremor
Slurred speech
Hypotonia

49
Q

Sx of raised icp

A

Papillodema
Confusion
Headaches
Drowsiness
Vomiting

50
Q

Which disease is characterised by a step wise like progression affecting memory

A

Vascular dementian

51
Q

What investigations would you order in someone with dementia

A

MRI
Minion mental state exam
CSF analysis
Confusion screen

52
Q

How would you distuinguish between a L5 radiculopathy and common perineal nerve palsy in fort drop

A

In common peroneal nerve palsy- foot eversion is affected

In l5 radiculopathy there is weakness in ankle inversion and hip abduction

53
Q

What is danger of abruptly stopping coticosteroids

A

Adrenal crisis

54
Q

List 4 features of cluster headache

A

Rhinorrhoea
Lid welling
Lacrimation
Miosis
Sweating

55
Q

Most common infective cause of encephalitis

A

HSV- type 1

56
Q

List the triggers of a migraine

A

Chocolate
Hangovers
Orgasms
Cheese
OCP
Lie ins
Alcohol
Tumult
Exercise

57
Q

Triggers of tension headaches

A

Stress
Sleep deprivation
Hunger w
Eye strain
Anxiety

58
Q

Causes of tension headaches

A

Dehydration
Lack of posture
Tension in the muscles of neck jaw and face
Spine misalignment
Arthritis in neck

59
Q

What clinical signs can be tested for in menigism and SAH

A

Brudzinkskis (neck elevation) and kernigs (leg elevation)

60
Q

What is the alternative name for grande mal and petit mal seizures

A

Grand mal- tonic clinic

Petite mal- absence

61
Q

Which part of the substantia nigra is affected in Parkinson’s

A

Pars compacta

62
Q

List 4 causes of Gillian barre

A

EBV
CMV
Mycoplasma
Campylobacter jejune
Zika virus

63
Q

Treatment of essential tremors

A

Beta blockers
Primidone

64
Q

Common cause of meningitis is immunocompromised and pregnancy

A

Listeria minocytogenes

65
Q

Most common causative meningitis organism in neonates

A

Group b steptococcus*
Ecoli
Listeria monocutogyenes (gram +ve bacilli)

66
Q

Most common cause of meningitis in adults

A

Strep pneumonia
Nisseria meningitidis

67
Q

What is the treatment for meningitis and name the antibiotic class

A

Iv cefotaxime/ceftriaxone (cephalosporins)

Add Ov amoxicillin to cover listeria in over 50s and immunocompromised

68
Q

Where would you carry out a lumbar puncture

A

L3-l4 intervertebral space

69
Q

Gs Ix for encephalitis

A

Viral PCR of CSF fluid

70
Q

What is shingles

A

An acute unilateral painful blistering rash caused by reactivation of varicella zoster virus

71
Q

What is the most common primary tumour in adults

A

Glioblastoma

72
Q

What is a acoustic neuroma

A

A benign tumour arising form the 8th cranial nerve.

Presents with hearing loss, tinnitus and facial nerve palsy

73
Q

What cancers metastasise to the brain

A

Lung, breast renal carcinoma and malignant melanoma

74
Q

What sign is used to make a clinical diagnosis of sciatica

A

Lasegu sign- straight leg raise test is painful

75
Q

Sx of sciatica

A

Unilateral leg pain radiates to middle buttock, outer thigh
Motor weakness
Loss of reflexes
Numbness

76
Q

Causes of trigeminal neuralgia

A

Brain stem lesion
Demyelinating disease
Trigeminal nerve compression
Amyloid deposits on trigeminal pathway

77
Q

Functions of the trigeminal nerve

A

Facial sensation
Muscles of mastication
Tensor tympani

78
Q

Gs Ix for carpal tunnel

A

EMG

79
Q

Rf for carpal tunnel

A

Obesity
Pregnancy
RA
Acromegaly
Hypothyroidism

80
Q

What areas of the leg does the following nerves innervate and it’s associated action
A- superficial pernoneal nerve
B- deep peroneal nerve

A

A- LAteral leg compartment- everts foot

B- anterior compartment. Doris flex and extends digits

81
Q

Describe the pyramidal pattern of weakness
A- UMN
B-LMN

A

A- strong flexors, weak extensors
B- strong extensors, weka flexors

82
Q

List 5 UMN signs

A

Hypereflexia
Spasticity
Hyeprtonia
Babinski +ve
Clonus

83
Q

List 5 signs of LMN

A

Fasiculations
Muscle wasting
Hypotonia
Reduced/absent reflexes
Flaccid

84
Q

What is syncope

A

Transient loss of consciousness due to global cerebral hypo perfusionw/ rapid onset

85
Q

List 2 primary and w secondary causes of syncope

A

Primary- dehydration, missed meals

Secondary- arrhythmias, hypoglycaemia, anaemia

86
Q

Tx in myasthenic crisis

A

Plasmapheresis and ivig

87
Q

What is the long term management of ischaemic stroke

A

75mg clopidogrel + statin

88
Q

What is the cause of RHS and it’s Features (Ramsay hunt syndrome)

A

Reactivation of varicella zoster virus in the geniculate ganglion of cranial nerve 7
Facial nerve palsy
Vertigo
Ipsilaterla hearing loss
Herpetic rash on ipsilaterla auditory canal

Phase 2A (HV) (13 decks)

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