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Y6 Passmed > Neuro > Flashcards

Neuro Flashcards

1
Q

What is Hoovers sign used for

A

to differentiate between organic and non organic LL weaknes

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2
Q

how do you test Hoovers sign

A

ask pt to raise weak leg

if organic: examiner will feel contralateral healthy leg push down against their hand (synergistic contraction)

if functional: contralateral healthy leg will not push down

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3
Q

what is Hoffman sign

A

UMN sign (also in cervical myelopathy)
flick pts middle finger at DIP
POSITIVE if thumb and index finger move closer together

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4
Q

what causes degenerative cervical myelopathy

A

cervical spondilitis

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5
Q

sx of degenerative cervical myelopathy

A

pain in neck and limbs
loss of autonomic dunction
loss of motor function (loss of digital dexterity)
loss of sensory function (numbness

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6
Q

how do you ix degenerative cervical myelopathy

A

cervical MRI urgent

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7
Q

what causes syringomyelia

A

development of fluid filled cyst in SC

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8
Q

sx syringomyeliA

A

cape like (neck, shoulders, arms) loss of sensation to pain and temperature

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9
Q

whatt is mode of inheritance of tuberous sclerosis

A

AD

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10
Q

fts tuberous sclerosis

A

Cutaneous features
depigmented ‘ash-leaf’ spots which fluoresce under UV light
roughened patches of skin over lumbar spine (Shagreen patches)
adenoma sebaceum (angiofibromas): butterfly distribution over nose
fibromata beneath nails (subungual fibromata)
café-au-lait spots* may be seen

Neurological features
developmental delay
epilepsy (infantile spasms or partial)
intellectual impairment

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11
Q

how can you remember multiple systems atrophy

A

Me in church when i fainted

  • autonomic dysfunction (postural hypotension)
  • ataxia (woozy))
  • rigidity, tremor
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12
Q

Brown Sequard syndrome

A

ipsilateral weakness below lesion
ipsilateral loss of proprioception and vibration

contralateral loss of pain and temperature

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13
Q

what causes brown sequard syndrome

A

lateral hemisection of the spinal cord

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14
Q

describe the tremor in parkinsons

A

Resting
Pill rolling (4-6Hx)
asymmetrical / unilatera
improves with voluntary movement

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15
Q

what can you give in Idiopathic Intracranial HTN

A

Acetazolamide - carbonic anhydrase inhibitor used in IIH to reduce CSF production to reduce intracranial pressure

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16
Q

what can withholding levodopa precipitate?

A

neuroleptic malignant syndrome

Levodopa is a CRITICAL DRUG in PD - do not forget!!

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17
Q

which drugs precipitate MG attack

A

Abel Loves PS Beer

Antibiotics (gentamicin, macrolide, quinolone, tetracycline)
Lithium
Penicillamine, Phenytoin
Beta blocker

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18
Q

when can you withdraw antiepileptics

A

when patient has been seizure free for 2 years

stop antiepileptics over 2-3 months

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19
Q

which type of brain haemorrage is the slowest developing, and when does it present’?

A

SUBDURAL haematoma

because there is slow blleding of the bridging veins > develops over 4-7 weeks > pt presents with confusion

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20
Q

explain Wernicke’s aphasia

A

Wernicke’s = receptive

speech is fluent
COMPREHENSION IMPAIRED
REPETITION IMPAIRED

Lesions here mean that sentences make no sense, they use wordd substitution and neologisms but speech remains fluent aka wor salad

21
Q

What is the function of Brocas area

A

speech production - making it fluent

22
Q

Explain Bbbrocas aphaia

A

Compreehenssion IS normal

speech is NON FLUENT, LABOURED, SLOW
Repetition is impaired

23
Q

what is conducton aphasia

A

speech is fluent
comprehenssion is sintact
REPETITION IS POOR

24
Q

what is global aphasia

A

very bad - all three domainss

can’t comprehend, speech not fluent, repetition iss poor

25
how do pts with global aphasia communicate
via gesturess
26
on what side do brainstem injures present
IPSILATERAL face signs | CONTRALATERAL body signs
27
what type of CT must you get in suspected stroke
non contrast CT
28
side effects of chronic phenytoin use
gum hypertrophy megaloblastic anaemia peripheral neuropathy
29
easy way to detect LEMS from MG
LEMS improves with exercise!!! | it also has autonomic sx (dry mouth, impotence, difficulty micturating)
30
what scale monitors functional ssatus in patients with sstroke?
Barthel index moniitors functional status and improvement post stroke describes 10 tasks > scored by the amount of time and assistance required for each task
31
which seizure type is carbamazepine ineffective in
ABSENCE and MYOCLONIC
32
how do third nerve palsies caused by microvascular infarction (poorly controlled diabetes, hypertension, and atherosclerosis) present
Ptosis PUPIL IS SPARED
33
How do third nerve palsies caused by intracranial lesions present?
ptosis, mydriasis, and the characteristic 'down and out' pupil that is not responsive to light.
34
what score system can you use to DETECT stroke in ED
ROSIER detects acute stroke (compared to stroke mimics)
35
What is the functon of the NIHSSS
Quantifies severity of stroke and predics outcome
36
how does Progressive Bulbar Palsy present
BULBAR PALSY > so it affects CN 9-12 - dysarthria - dysphagia - tongue wasting - fasciculations
37
how long does an AV fistula take to be ready for use?
6-8 week s
38
where are AV fistulas commonly found
brachiocephalic or radiocephalic | this is why you need to feel the arms in ABDO EXAM
39
complications of AV fisstula
``` infection stenosis thrombosis bleeding steal syndrome ```
40
what blood test identifies true CNS seizures
PROLACTIN (raised 10-20 mins post ictal)
41
how long must you not drive for following a TIA / Stroke?
1 month
42
how does an essential tremor present
POSTURAL (worse on arms outstretched, with sustained muscle tone) involves hands / fingers and vocal cordas
43
how do you manage an essential tremor
propanolol
44
what nerves are affected in vestibular schwannoma
V, VII and VIII ``` V = absent corneal reflex VII = facial numbness XIII= vertigo and unilateral hearing loss ```
45
what is the difference between a medical and surgical 3rd nerve palsy
``` Medical = pupil sparing Surgical = pupil involvement (pupil BLOWN) ```
46
what is the most common cause of a PAINFUL 3rd nerve palsy
posterior communicating artery aaneurysm
47
what URGENT investigation should all TIA pts have
an urgent CAROTID DOPPLER (unless not a candidate for carotid endocardectomy)
48
What does the independent result of high PROTEIN on CSF indicate
GBS

Y6 Passmed (8 decks)

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