Mixed Qs 10 Flashcards
Parinaud Syndrome
2o pineal gland mass ( commonest germinoma)
Presentation:- obstructive hydrocephalus
Limitation of upward gaze
Bilateral lid retraction
DRESS syndrome
Drug reaction with eosinophilia and systemic symptoms
Presentation:- 2-8/52 after exposure to
Phenytoin, carbamazepine
Allopurinol
Sulfasalazine
Minocycline and vancomycin
Fever, gen lymphadenopathy, facial oedema, diffuse skin rash, eosinophila and internal organ dysfunction
How does phenytoin cause vitamin D deficiency
Increased catabolism of 25 hydroxyvitamin D to inactive metablolites by stimulating 24 hydroxylase
Entacapone
COMT inhibitor
Works on blood side
Prevents levodopa from being broken down into 3-OMD in blood and allows more levodopa to travel to brain
Topical capsicasin
MoA:- defunctionalisation of afferent pain fibres
Depletion of substance P
Pramiprexole
Dopamine receptor agonist
Juvenile myoclonic epilepsy
Generalised onset epilepsy
Familial
Worse with sleep deprivation
Treatment:- valproate
Ramelteon
Melatonin agonist
MOA:- bind to melatonin receptors in suprachiasmatic nucleus
SE low
Use:- sedative hypnotic - insomnia esp in elderly
Neuroleptic malignant syndrome
Similar to malignant hyperthermia but due to haloperidol
Treatment :- dantrolene
Inhibit ryanodine receptor and blocks Ca release from sarcoplasmic reticulum in skeletal muscle
Drug causing uterine relaxation and hypokalaemia
B2 receptor agonist
Sporotrichosis histology
Mixed granuloma and neutrophillic microabscesses
Glioblastoma
Poorly circumscribed
Necrotic and haemorrhagic
Cerebral hemispheres
Subdural haematoma is due to
Rupture of the cortical bridging veins
Alzheimer’s disease and acetylcholine
Low level of acetylcholine
2o deficiency of choline acetyltransferase
Most notable in nucleus basalis of Meynert
Referred pain to the shoulder
Phrenic nerve innervation
C3-5
Complication of SAH day 3-12
Vasospasm
Causing delayed cerebral ischaemia
CT unchanged
Subacute combined degeneration
2o vitamin B12 deficiency
Loss of vibratory and proprioception —> dorsal columns
UMN signs —> lateral corticospinal tract
Spinocerebellar tract
Peripheral nerves—> paraesthesia
Cavernous haemangioma
Vascular malformation occur in Brain parenchyma
Risk of intracerebral haemorrhage
Surgical treatment for Parkinson’s targets which structure
Subthallamic nucleus
Syringomyelia
UL —> loss of pain and temp sensation, weakness and hyporeflexia
LL —>weakness and hyperreflexia
Frontotemporal dementia changes seen in which part of the brain
Atrophy of the prefrontal cortex and then degeneration of the anterior temporal cortex
CJD
Prion disease
Rapidly progressive dementia
With myoclonus
Accumulation of protease resistant protein
Tabes dorsal is
Neurosyphillis
Sensory ataxia —> dorsal
Pain sharp and stabbing
Absent Deep tendon reflexes
Facial nerve palsy
Compression in post fossa
Taste to ant 1/3 of tongue
Ipsilateral facial paralysis
Loss of corneal reflex
Hyperacusis