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Year 3 difficult topics > neuro > Flashcards

neuro Flashcards

1
Q

ipsilateral hemiplegia
same said loss of proprioception and vibration

contralateral loss of pain and temp

A

brown sequard

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2
Q

causes of brown sequard

A 
cord trauma 
neoplams
disc herniation 
demyelination
epidual haemtoma
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3
Q

how does ipsilateral UMN weakness present in an exam of limbs?

tone
power
reflex

A

increased tone
hyperreflexia
leg lift

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4
Q

what are causes of bulbar palsy?

categorise them

A

absent jaw jerk
absent gag reflex
fasciculating tongue

infection: GBS,
inflammation: MG, MND
malignancy : neoplasm of brainstem
ischaemic: brainstem stroke

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5
Q

cerebeller syndrome signs?

A

DANISH

dysdiadochokinesia 
ataxia 
nystagmus 
intention tremor 
slurred speech
hypotonia
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6
Q

what causes cerebeller syndrome?

vitamin C

A

vascular: stroke; posteriro circulation
infection: lyme disease
inflammation: Multiple sclerosis
trauma
metabolic: alcohol
iotrogenic: carbamazepine
neoplastic: tumour , acoustic neuroma
hereditary: friedrichs

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7
Q

cerebeller syndrome causes simple

A

infection: Lyme
Inflammation: MS
Malignancy: acoustic neuroma, 2O mets from breast cancer, lung

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8
Q 
cag trinucleotide affected - repeats 
choero 
dementia 
dystonia
saccadic eye movements

striatal colume loss and increased size of frontal horns of lateral ventricles

what is this?
Mx?

A

huntingtons

chorea - tetrabenzine

SSRI-
psychosis : olanzapine

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9
Q

diplopia causes

categorises

A

infection: sixth nerve palsy
inflammation: Graves, MG
malignancy: neoplasm of cranial nerves

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10
Q

which drug commonly causes dystonia?

A

metocllopramide

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11
Q

mx of encephalitis

what does it present with?

A

IV acyclovir and broad spectrum abx IV ceftriaxone 2g BD IV

seizures alongside characteristic infection signs ; neck stiffness, fever
altered mental state

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12
Q

management of epilepsy

A

lamotrigine - not teratogenic
levetiracetam
valproate- teratogenic

carbamazepine and gabapentin: focal , may worsen myoclonic seizures

ethosuximide good for absence

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13
Q

gabapentin
what is it used for?
SE?

A

focal seizures

anxiety, confusion, constipation

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14
Q

lamotrigine SE

what is it used for?

A 
focal seizures 
blurred vision: diplopia 
arthralgia 
ataxia 
dizziness
headache 
rash 
tremor
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15
Q

valproate

SE

A 
anaemia 
confusion
convulsions 
deafness
extrapyramidal disorders
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16
Q

phenytoin

se

A 
acne
anorexia
constipation
dizziness
gingival hypertrophy
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17
Q

levetiracetam

A

headaches
feeling sleepy
blocked nose
itchy throat

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18
Q

what is the most common source of bleeding in a head trauma pt

pt had lucid period followed by deterioting consciousness and a headache

what would you see on a CT?

how do you differentiate between subdural

what constitues an emergency?
management?

A

this is an extradural bleed

middle meningeal artery

bi convex shape - blood is fresh so appears white as it is least dense
blood is clotted and old so appears darker, also banana shaped

midline shift on ct

burr hole

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19
Q

how can you medically manage subdural bleeds?

A

transexamic acid

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20
Q

foot drop
causes?
what level lesion?

A

L5 root lesion: radiculopathy - disc herniation

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21
Q

GBS

treatment

what infection most commonbly associated?

what are you worried about?

A

monitor ventilation- abg, serial spirometry
VTE- LMWH

medically: IV immunoglobulin, plasmapheresis

campylobacter, mycoplasma and EBV: so GI upset in a question could indicate

respiratory arrest- forced vital capacity

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22
Q

criteria for CT headl

A

More than 30 minutes retrograde amnesia.

Focal neurological deficit or seizure.

GCS <13 at any time (or <15 2 hours after injury).

More than 1 episodes of vomiting.

Loss of consciousness and any amnesia in patients who:

Are >65 years

Suffered a dangerous mechanism of injury (great height, road traffic accident)

Have evidence of coagulopathy (including anticoagulation with warfarin).

clinical evidence of skull fracture

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23
Q

horners syndrome

causes?

A

pancoast tumour
stroke
carotid artery dissection - NECK pain

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24
Q

stroke management

4.5 hours of presenting

A

alteplase - inr normal , acceptable bp

mechanical thrombectomy

aspirin 300mg 2 weeks

carotid ultrasound, CT/MR angiography

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25
Q

inferior homonymous quadrantanopia means?

where is lesion?

A

loss of vision in the same lower quadrant of visual field in both eyes
parietal lobe

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26
Q

homonymous hemianopia with macula sparing

A

occipital lobe
causes stroke
brain abscess
trauma

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27
Q

anosmia is a lesion where?

A

frontal lobe

28
Q

superior homonymous quadrantanopia?

A

lesion is in temporal lobe

in a quarter of the same visual field- so above L/R

29
Q

what is a hemianopsia?

if it is homonymous

A

loss of half the visual fiedl

1 nasal, 1 temporal

30
Q

MS- affects which nerve?

A

optic nerve -
optic neuritis : unilateral eye pain and visual problems
RAPD- marcus gunn

31
Q

anopia where is lesion?

A

total visual loss due to optic nerve

32
Q

ipsilateral nasal hemianopia

lesion is

A

lateral of optic chiasm

33
Q

homonymous hemianopia is loss of what?

where is lesion

A

lesion to optic tract

complete loss of L/R visual field
right optic tract lesion causes complete loss of left visual fiedl

34
Q

pie in the sky

A

meyer loop

35
Q

dorsal optic radiation

A

parietal lobe lesion

contralateral lower quadranopia

36
Q

central necrosis and rim that enhances with contrast

mx

A

glioblastoma- vasogenic oedema

dexamethasone

37
Q

what are symptoms of meningioma

A

arachnoid cap cells

will show contrast enhancement) and MRI, and treatment will involve either observation, radiotherapy or sur

38
Q

acoustic neuroma

associated with what?

A

facial nerve palsy
tinnitus
hearing loss

neurofibromatosi t2

39
Q

Von hippel lindau

A

cerebller hemangiomas
retinal : vitreous haemorrhages
renal cysts
phaeo

40
Q

what optic sign does wernickes present with/

A

nystagmus

41
Q

restleg leg syndrome

mx

A

dopamine agonist
pramipexole
benzo
gabapentin

42
Q

widening pulse pressure
bradycardia
irregular breathing

is what?
diagnosis?

mx?

A

cushing triad for raised ICP

head elevation 30
IV mannitol : osmotic diuretic
controlled hyperventilation

43
Q

what are two things pathogenomic of epileptic seizures?

A

tongue biting

raised serum prolactin

44
Q

(bromocriptine, cabergoline)

what problem do these drugs present in Parkinson patients

A

ergot derived
dopamine receptor agonist
impulse control

45
Q

levopopa

side effects?

A

dopamine precursor
given with decarboxylase inhibitor

palpitation 
anorexia
dry mouth
postural hypotension 
psychosis

dyskinesia at peak dose
acute dystonia if stopped abruptly

46
Q

MAO-B (Monoamine Oxidase-B) inhibitors

A

e.g. selegiline

inhibits the breakdown of dopamine secreted by the dopaminergic neurone

47
Q

Antimuscarinics

A

block cholinergic receptors
now used more to treat drug-induced parkinsonism rather than idiopathic Parkinson’s disease
help tremor and rigidity
e.g. procyclidine, benzotropine, trihexyphenidyl (benzhexol)

48
Q

refeeding syndrome

abnormality?

A

Hypophosphataemia
Hypokalaemia
Hypomagnesaemia
Abnormal fluid balance

49
Q

NMS
Ix

findings?

A

Creatine kinase
leukocytosis

pyrexia
muscle rigidity
htn, tachycardia, tachypnoea
delirium

50
Q

NF1

A

cafe au lait
iris lisch nodules
phaeo

51
Q

whihc drugs worsen MG

A 
penicillamine
quinidine, procainamide
beta-blockers
lithium
phenytoin
antibiotics: gentamicin, macrolides, quinolones, tetracyclines
52
Q

what is MG associated with?

crisis mx?

A

perncious anaemia
thymoma
RA
SLE

plasmapheresis
IV IG

53
Q

erectile dynfunction
parkinsonism
dysdiakinesia
ataxia

?

A

multiple system atrophy

54
Q

MRI findings of MS?

A

periventricular plaques

Dawson fingers: often seen on FLAIR images - hyperintense lesions penpendicular to the corpus callosum

55
Q

CSF MS

A

oligoclonal bands

intrathecal IgG

56
Q

mx of MND
prevents stimulation of glutamate receptors

what subtype?

A

ALS

riluzole

57
Q

complications of meningitis

A

sensorineural hearing loss

seizures

58
Q

CSF viral meningitis
white cells?
glucose?

A

normal protein.
very raised
really high >50%

59
Q

lamotrigine is started and patient has a skin flair up

what could this be?

A

stevens johnson syndrome

60
Q

what malignancy is lambert eaton associated with?

A

small cell lung cancer

ovarian

61
Q

Mx of Lambert eaton syndrome

A

prednisalone and aza

IV Immunoglobulin and plasma exchange

62
Q

idiopathic ICp htn?
drug causes?
COMAAR

surgical intervention?

A 
ciclosporin
oral combined pill
mineralcorticoids/ steroids 
amiodarone
abx: tetracyclines, sulhponimides

vit a
lithium

optic nerve sheath decompression and feenstration

63
Q

HSV affects which lobe?
they present with aphasia?

Mx

A

temporal lobes
petechian haemorhages

aciclovir

64
Q

what does the 4th nerve do?

what does a 4th nerve palsy look like

A

depresses eye moves it inwards- adduction

affected eye is deviated upwards and roatated outwards

65
Q

LMN facial nerve plasy

A 
Bell's palsy
Ramsay-Hunt syndrome (due to herpes zoster)
acoustic neuroma
parotid tumours
HIV
multiple sclerosis*
diabetes mellitus

Year 3 difficult topics (22 decks)

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