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Finals Revision - Last Min > Neuro > Flashcards

Neuro Flashcards

1
Q

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

A

L3

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2
Q

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

A

L4

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3
Q

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

A

L5

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4
Q

Sensory loss over posterolateral aspect of leg and lateral foot
Weakness of plantarflexion
Reduced ankle reflex
Positive sciatic nerve stretch test

A

S1

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5
Q

Controlled hypo/hyper-ventilation in raised ICP?

A

Hyper - lower pCO2 causes cerebral vasoconstriction

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6
Q

When to refer to ENT for bell’s palsy?

A

If no improvement after 3 weeks - refer urgently

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7
Q

4 Parkinson’s plus syndromes?

A

MSA

Lewy Body

Progressive supranuclear palsy - impairment of vertical gaze

Corticobasal degeneration - alien limb

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8
Q

For each of these where is the lesion and describe the aphasia:

  • Wernicke’s?
  • Broca’s?
  • Conduction?
  • Global?
A

Wernicke’s (Receptive):
- Comprehension impaired, speech fluent but makes no sense - ‘word salad’

Global:
- Severe receptive and expressive aphasia - can communicate using gestures

Broca’s (Expressive):

  • Inferior frontal gyrus (MCA)
  • Comprehension normal, speech is non-fluent and halting

Conduction:
- speech fluent, comprehension normal, but repetition is poor - aware of errors they are making

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9
Q

MS management:

  • acute relapse?
  • for fatigue?
  • for spasticity?
  • bladder dysfunction?
  • oscillopsia (visual field oscillation)?
A

Relapse: IV methylpred 5 days - shortens relapse but no effect on recovery

Fatigue:

  1. Rule out anaemia, thyroid, depression
  2. Amantadine
  3. Mindfulness, CBT

Spasticity:

  1. Baclofen
  2. Gabapentin
  3. Diazepam, Dantrolene or Tinzadine

Bladder - urgency, frequency, overflow, incontinence etc:
1. bladder USS to assess residual volume
2. If normal residual volume, anticholinergics may help frequency
3. If significant residual volume - intermittent self-catheterisation
(be aware anticholinergics may worsen symptoms)

Oscillopsia:
- Gabapentin

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10
Q

Hoarseness and uvula deviating to left?

A

Right vagus lesion

uvulAWAY from lesion

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11
Q

Cerebral venous thrombus Ix

A

MRI venogram

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12
Q

1st line management of absence seizures?

A

Sodium valproate or ethosuxomide

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13
Q

ACA stroke?
MCA stroke?
PCA stroke?
Basilar stroke?

A

ACA:

  • contralateral hemiparesis/sensory
  • lower extremity worse

MCA:

  • contralateral hemiparesis/sensory
  • upper worse then lower
  • contralateral homonymous hemianopia
  • Aphasia

PCA:

  • contralateral homonymous hemianopia with macular sparing
  • visual agnosia

Basilar:
- locked in syndrome

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14
Q

1st line and 2nd line options for generalised tonic clonic seizures?

A

1st - valproate

2nd line - lamotrigine, carbamazepine

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15
Q

1st line and 2nd line options for focal seizures?

A

1st line - carbamazepine or lamotrigine

2nd line - levetiracetam, oxcarbazepine, valproate

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16
Q

MND linked with which dementia?

A

Frontotemporal

17
Q

Antibodies in MG?

A

anti-AChR

anti-MuSK

18
Q

Treatment of LEMS?

A

3,4-diaminopyradine

19
Q

SE valproate?

A 
Reversible hair loss
Weight gain
Tremor
Thrombocytopaenia
Oedema
Liver stuff
20
Q

SE lamotrigine

A

Rash

SJS

21
Q

SE levetiracetam?

A

Mood swings

22
Q

SE carbamazepine?

A

Impaired balance

Blurred/double vision

23
Q

What anti-epileptics are P450 inducers and inhibitors?

A

Inducer: carbamazepine and phenytoin

Inhibitor: valproate

24
Q

CI triptans?

A

IHD

25
Q

Commonest brain tumour in kids?

Infratentorial brain tumour in kids?

A

Pilocytic astrocytoma

Medulloblastoma

26
Q

Tabes dorsalis?

A

Neurosyphilis

Loss of DCML only

27
Q

Anterior cord syndrome?

A

Bilateral spastic paresis and loss of pain/temperature

DCML normal

28
Q

Central cord syndrome?

A

Due to whiplash etc

Corticospinal - upper limbs more than lower
Spinothalamic lost as fibres decussate

29
Q

Pituitary apoplexy

  • what is it?
  • presentation?
  • Ix?
  • management?
A

Sudden enlargement of a pituitary tumour secondary to haemorrhage/infarction

‘thunderclap’ pain behind eye
Vomiting, neck stiffness
bitemporal hemianopia

MRI

Urgent steroid replacement
Surgery

30
Q

Loss of finger abduction and thumb adduction?

A

T1

31
Q

Head injury:

  • criteria for immediate CT? (6)
  • criteria for CT within 8 hours? (4)
A

Immediate:

  • GCS <13 initially
  • GCS <15 2 hours post-injury
  • suspected skull fracture
  • post-traumatic seizure
  • focal neurological deficit
  • > 1 episode of vomiting

8 hours:

  • age 65+
  • Hx of bleeding/clotting disorders
  • dangerous mechanism of injury
  • > 30 mins retrograde amnesia before event
32
Q

Diplopia and difficulty opening mouth after facial injury?

A

Zygoma fracture

33
Q

Foot drop, loss of hip abduction, all reflexes intact?

A

L5

34
Q

Initial steps in haemorrhage stroke/haemorrhagic transformation?

A

Stop/reverse any anti platelet/anticoagulant drugs

Maintain BP to a target 140mmHg systolic

Finals Revision - Last Min (12 decks)

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