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4th Year > Neuro > Flashcards

Neuro Flashcards

1
Q

Name the ascending spinal tracts?

What’s their overall function?

A 
DCML
Spinothalamic (anterior and lateral)
Spinocerebellar (ant and post)
Spino-olivary
Cuneocerebellar (only higher up)
Rostral spinocerebellar (only higher up)

SENSORY

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2
Q

Name the descending spinal tracts?

What’s their overall function?

A 
Corticospinal (anterior and lateral)
Reticulospinal 
Rubrospinal
Tectospinal 
Vestibulospinal

MOTOR

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3
Q

Function of lateral STT?

A

Pain & temp

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4
Q

Function of anterior STT?

A

Crude touch pressure

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5
Q

Function of DCML ?

A

Fine touch, vibration & proprioception

Fasiculus cuneatus = upper limb (above T6)
Fasciculus gracilis = Lower limb (below T6)

IPSILATERAL - crosses at medulla

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6
Q

Function of spin-cerebellar and spine-olivary tracts

A

Unconscios proprioception - lower limbs

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7
Q

Is STT ipsilateral or contralateral?

A

Contralateral - fibres cross at vertebral level

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8
Q

Name the pyramidal tracts?
What are their function?
Are they ipsilateral or contralateral?

A

Anterior and lateral CST

Voluntary movement
Anterior = ipsilateral - fibres do not cross until the level they innervate
Lateral = contralateral - Desiccateed e.g instruction from right side of brain travels on left side of spinal cord

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9
Q

Function of rubrospinal tract?

A

Fine motor control

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10
Q

Function of medial and lateral reticulospinal tracts?

A 
Medial = Contraction and increased tone
Lateral = Inhibits contraction & decreases tone
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11
Q

Cerebellar signs?

A

DANISH

Disdiadochkinesis/dismetria (past pointing)
Ataxia 
Nystagmus 
Intention tremor
Speech - slurerred, inappropriate, slow
Hypotonia
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12
Q

Side effects of Na Valproate?

A

TERATOGENIC
liver damage
hair loss
tremor

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13
Q

1st line treatment of focal seizures?

Side effects?

A

Carbamazepine

Agranulocytosis
Aplastic anaemia
Induces the P450 system so there are many drug interactions

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14
Q

Side effects of phenytoin?

A 
Folate and vitamin D deficiency
Megaloblastic anaemia (folate deficiency)
Osteomalacia (vitamin D deficiency)
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15
Q

Important potential side effect of lamotrigine?

A

Steven Johnson syndrome

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16
Q

Definition of status epilepticus

A

Seizure duration >5 mins
OR
>3 seizures in an hour

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17
Q

Management of status epilepticus

A

ABCDE

  • give O2
  • Get IV access - give IV lorazepam 4mg and repeat after 10 mins if seizure ongoing
  • IV phenobarbital or phenytoin if seizures continue

Buccal midazolam or rectal diazepam may also be used

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18
Q

When must you inform the DVLA that you have seizures?

A

Immediately after 1st seizure - stop driving

can recommence after 6 months if no further seizures

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19
Q

When are you at most risk of seizing after moderate - heavy alcohol consumption?

A

6-48 hours after stopping drinking

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20
Q

What’s a good website for patients or parents of patients with epilepsy?

A

epilepsy.org.uk

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21
Q

When might you be able to stop taking your epilepsy medications?

A

Seizure free for 2 years

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22
Q

What investigations may you perform for epilepsy?

A 
MUST DO AN ECG
Neurological examination 
EEG
MRI - look for any causes
FBC, U&E, LFTs - assess general health
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23
Q

Dose of folic acid for pregnancy in women with epilepsy?

A

5000 micrograms vs 400 in normal population

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24
Q

anti-epileptics safe in pregnancy?

A

Lamotrigine and levetiracetam

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25
Q

Long term use of anti-epileptics increase the risk of…

A

Osteoporosis

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26
Q

What contraceptives should be avoided in enzyme inducing anti-epileptics such as carbamazepine and phenytoin?

A

COCP and POP - reduced effectiveness

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27
Q

Emergency contraceptive in epilepsy?

A

Copper IUD

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28
Q

Contraceptive advise when taking lamotrigine?

A

Non enzyme inducing but oestrogen can reduce the effectiveness of lamotrigine – Progesterone only contraceptive

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29
Q

Myelin cells in CNS?

A

Oligodendrocytes

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30
Q

Which type of hypersensitivity is MS?

A

Type IV (cell mediated)

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31
Q

Electrical shock sensation on flexion of neck?

A

Lermits sign

- problem in sensory pathway of cervical spinal cord - DCML

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32
Q

how long do symptoms have to be progressing for to be diagnosed as primary progressive MS?

A

1 year

33
Q

Features of optic neuritis?

A

Central scotoma
RAPD
Painful eye movements
Impaired colour vision

34
Q

What will an LP show in MS?

A

Oligoclonal bands

35
Q

Treatment of acute relapse of MS

A

Methylprednisolone 500mg daily for 5 days

or 1g IV if severe/oral doesn’t work

36
Q

Which spinal tract is most affected by syringomyelia?

A

STT

  • arises from centre of cord so affects fibres when they deccusate
  • cape like numbness
37
Q

Trigeminal autonomic cephalgia management acute vs prophylaxis?

A 
Acute = oxygen therapy 
Prophylaxis = verapamil
38
Q

forehead affected =

A

LMN

39
Q

plucking at clothes/smacking lips suggests what kind of seizure?

A

Focal , affecting temporal lobe

40
Q

Management of paroxysmal hemicranial?

A

absolute response to indomethacin

41
Q

spasticity in MS?

A

Baclofen & gabapentin

42
Q

Functions of the frontal lobe?

A

Voluntary movement
Expressive language
higher functioning

43
Q

Occipital lobe function?

A

Vision & memory

44
Q

Temporal lobe function?

A

understanding and processing language

45
Q

Parietal lobe function?

A

Sensory perception - taste, smell, hearing, sight
cognition
writing
speech

46
Q

Swollen neurons/Picks bodies?

A

Frontotemporal dementia

47
Q

CSF shows raised tau but normal amyloid?

A

Frontotemporal

48
Q

Intracellular fibrillary tangles

A

Alzheimers

49
Q

What must you include when stating that someone has agoraphobia?

A

Whether it is with or without panic disorder

50
Q

What are the core symptoms of depression? (3)

A

Low mood
Anhedonia
Fatigue

51
Q

Name the atypical antipsychotics

A 
Olanzapine
Clozapine
Quetiapine
Risperidone
Aripiprazole
51
Q

Name the atypical antipsychotics

A 
Olanzapine
Clozapine
Quetiapine
Risperidone
Aripiprazole
52
Q

Name the typical antipsychotics

A

High potency

  • Haloperidol
  • Prochlorperazine

Low potency
- Chlorpromazine

53
Q

IQ < ? is a learning disability?

A

<70

Average = 100

54
Q

Mild
Moderate
Severe
Profound LD ranges

A

mild = 50-69
moderate = 35-49
severe = 20 - 34
profound <20

55
Q

Indications for ECT?

A

Severe resistant depression
Intractable (prolonged) mania
4th line in resistant schizophrenia
Catatonia

56
Q

Absolute contraindications to ECT

A

MI <3 months
Recent CVA
Intracranial mass
Pheochromocytoma

57
Q

Section 47 form

A

Lack of capacity in x for x duration

58
Q

What is section 136

A

Someone found in a public place who appears to have a mental disorder can be taken by the police to a Place of Safety.

Can only be used for up to 24 hours, whilst a Mental Health Act assessment is arranged

59
Q

What is section 17a

A

Supervised Community Treatment (Community Treatment Order)
- can be used to recall a patient to hospital for treatment if they do not comply with conditions of the order in the community, such as complying with medication

60
Q

symptoms of neuroleptic malignant syndrome

A

Fever
rigidity
autonomic dysfunction

61
Q

Treatment of acute dystonia?

A

Procyclidine

62
Q

Management of MS flare?

A

Mild - symptomatic therapy
Moderate - methyl prednisolone 500mg for 5 days
Severe - admit for IV steroids

63
Q

Which antiemetics need to be avoided in Parkinson’s?

A

Metoclopramide and prochlorperazine

Low dose domperidone may be used instead

64
Q

Antidepressants in parkinson’s?

A

SSRI are effective but can worsen motor and REM sleep disorders
TCAs can also be used but beware cognitive impairment & risk of falls

65
Q

Symmetrical pill rolling tremor?

A

Drug induced Parkinsonism

66
Q

What is split hand syndrome associated with?

A

Amyotrophic lateral sclerosis (AML)

67
Q

Most common and 2nd most common MND?

A 
1 = Amyotrophic lateral sclerosis 
2 = Progressive bulbar palsy
68
Q

Treatment for muscle cramps?

A

Baclofen

Quinine

69
Q

Treatment of muscle spasms?

A

Baclofen

Tizanidine/dantrolene

70
Q

is emotional lability an UMN or LMN sign?

A

UMN

71
Q

Which dementia is common in MND?

A

Frontotemporal

72
Q

Differentials of UMN problem?

A

Spastic CP
Acquired brain injury
Tumour

73
Q

Imaging in demyelination?

A

MRI contrast

74
Q

Post exposure prophylaxis for meningitis?

A

One dose of ciprofloxacin

75
Q

Seizure where clonic movements move proximally

A

Frontal lobe

76
Q

Na Valproate is associated with weight gain.

True or false?

A

True

77
Q

visual defect with craniopharyngioma?

A

inferior quadrantanopia

4th Year (15 decks)

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