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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
Prophylaxis/preventable tx for migraines
Beta blockers (propanolol) Anti-epileptic (topiramate) Amitryptiline (TCA0)
26
Mode of inheritance of duchenne and Becker muscular dystrophy
X linked recessive
27
What protein in affected in Duchenne and Becker muscular dystrophy and what is its role
Dystrophin- links ECM to the cytoskeleton of the muscle fibre
28
What is the mode of inheritance for myotonic dystrophy
Autosomal dominant
29
How does alteplase work
Converts plasminogen to plasmin which breaks down fibrin
30
Which area of the brain does Jacksonian march affect
Frontal lobe
31
What primary care questionnaire can be done to assess for dementia
6CIT
32
What condition is frontotemporal dementia closely associated with
MND
33
25 patients with Alzheimer’s dementia will go on to develop what
Parkinsonism
34
Se of lamotrigine
Blistering rash and closely associated with stevens-Johnson’s syndrome
35
What is the triad of Sx associated with Ms and list them
Charcots triad Dysarthria Nystagmus Intention tremor
36
List 3 atypical signs of ms
Homonymus hemianopia Apahasia Muscle wasting
37
List 5 signs associated with cauda equina
Bowel and bladder dysfunction Saddle anaesthesia Bilateral sciatica ED Leg weakness
38
List the subtypes of MND and a few features
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
What nt is affected in huntingtons
GABA
40
List Sx of huntingtons disease
Chorea Personality changes (irritable, depression) Dysarthria Dementia Dystonia Features typically occur after 35
41
Give 5 causes of transient loss of consciousness
Syncope Intoxication of alcohol Seizures Trauma Ketoacidosis/hypoglycaemia
42
What is the definition of a stroke
An acute neurological deficit characterised by a vascular lesion acccoicted with infarction of central nervous tissue
43
List the symptoms accosted with a Total anterior infarct
Contralateral hemiplegia or hemiparesis Contralateral homonymous hemianopia High cerebral dysfunction (aphasia and neglect)
44
What would be the result on CSF in someone with GBS
Raised protein, normal WBC
45
Sign of ulnar nerve damage
Elbow trauma and and claw sign
46
Dame to median nerve signs
Grip muscles affected and wasting of thenar eminence
47
Signs of radial nerve being affected
Unable to open fist and extend wrist
48
Cerebellar signs
Dysdiadochokinesia Ataxia Nystagmus Intention tremor Slurred speech Hypotonia
49
Sx of raised icp
Papillodema Confusion Headaches Drowsiness Vomiting
50
Which disease is characterised by a step wise like progression affecting memory
Vascular dementian
51
What investigations would you order in someone with dementia
MRI Minion mental state exam CSF analysis Confusion screen
52
How would you distuinguish between a L5 radiculopathy and common perineal nerve palsy in fort drop
In common peroneal nerve palsy- foot eversion is affected In l5 radiculopathy there is weakness in ankle inversion and hip abduction
53
What is danger of abruptly stopping coticosteroids
Adrenal crisis
54
List 4 features of cluster headache
Rhinorrhoea Lid welling Lacrimation Miosis Sweating
55
Most common infective cause of encephalitis
HSV- type 1
56
List the triggers of a migraine
Chocolate Hangovers Orgasms Cheese OCP Lie ins Alcohol Tumult Exercise
57
Triggers of tension headaches
Stress Sleep deprivation Hunger w Eye strain Anxiety
58
Causes of tension headaches
Dehydration Lack of posture Tension in the muscles of neck jaw and face Spine misalignment Arthritis in neck
59
What clinical signs can be tested for in menigism and SAH
Brudzinkskis (neck elevation) and kernigs (leg elevation)
60
What is the alternative name for grande mal and petit mal seizures
Grand mal- tonic clinic Petite mal- absence
61
Which part of the substantia nigra is affected in Parkinson’s
Pars compacta
62
List 4 causes of Gillian barre
EBV CMV Mycoplasma Campylobacter jejune Zika virus
63
Treatment of essential tremors
Beta blockers Primidone
64
Common cause of meningitis is immunocompromised and pregnancy
Listeria minocytogenes
65
Most common causative meningitis organism in neonates
Group b steptococcus* Ecoli Listeria monocutogyenes (gram +ve bacilli)
66
Most common cause of meningitis in adults
Strep pneumonia Nisseria meningitidis
67
What is the treatment for meningitis and name the antibiotic class
Iv cefotaxime/ceftriaxone (cephalosporins) Add Ov amoxicillin to cover listeria in over 50s and immunocompromised
68
Where would you carry out a lumbar puncture
L3-l4 intervertebral space
69
Gs Ix for encephalitis
Viral PCR of CSF fluid
70
What is shingles
An acute unilateral painful blistering rash caused by reactivation of varicella zoster virus
71
What is the most common primary tumour in adults
Glioblastoma
72
What is a acoustic neuroma
A benign tumour arising form the 8th cranial nerve. Presents with hearing loss, tinnitus and facial nerve palsy
73
What cancers metastasise to the brain
Lung, breast renal carcinoma and malignant melanoma
74
What sign is used to make a clinical diagnosis of sciatica
Lasegu sign- straight leg raise test is painful
75
Sx of sciatica
Unilateral leg pain radiates to middle buttock, outer thigh Motor weakness Loss of reflexes Numbness
76
Causes of trigeminal neuralgia
Brain stem lesion Demyelinating disease Trigeminal nerve compression Amyloid deposits on trigeminal pathway
77
Functions of the trigeminal nerve
Facial sensation Muscles of mastication Tensor tympani
78
Gs Ix for carpal tunnel
EMG
79
Rf for carpal tunnel
Obesity Pregnancy RA Acromegaly Hypothyroidism
80
What areas of the leg does the following nerves innervate and it’s associated action A- superficial pernoneal nerve B- deep peroneal nerve
A- LAteral leg compartment- everts foot B- anterior compartment. Doris flex and extends digits
81
Describe the pyramidal pattern of weakness A- UMN B-LMN
A- strong flexors, weak extensors B- strong extensors, weka flexors
82
List 5 UMN signs
Hypereflexia Spasticity Hyeprtonia Babinski +ve Clonus
83
List 5 signs of LMN
Fasiculations Muscle wasting Hypotonia Reduced/absent reflexes Flaccid
84
What is syncope
Transient loss of consciousness due to global cerebral hypo perfusionw/ rapid onset
85
List 2 primary and w secondary causes of syncope
Primary- dehydration, missed meals Secondary- arrhythmias, hypoglycaemia, anaemia
86
Tx in myasthenic crisis
Plasmapheresis and ivig
87
What is the long term management of ischaemic stroke
75mg clopidogrel + statin
88
What is the cause of RHS and it’s Features (Ramsay hunt syndrome)
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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