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Year 6 > Neuro > Flashcards

Neuro Flashcards

1
Q

Treatment of CVA

A

If CT shows ischaemia

Thrombolysis within 4.5 hours
Thrombectomy if within 6 hours with thrombolysis for proximal anterior circulation demonstrated by CTA

If unable to- aspirin 300mg for 2 weeks
If thrombolysis given- aspirin 24 hours after repeat CT

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2
Q

Ix for SAH

A

CT head- non contrast
>12 hrs later- LP for xanthochromia

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3
Q

CI to thrombylysis

A

ABC SHIP
Bleeding- GI bleed in 3 weeks, LP in 7 days
Coagulation problems
Stroke <3 months
Uncontrolled Hypertension- >200
Intracranial neoplasm
Pregnancy

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4
Q

Scoring systems of stroke

A

NIHSS- quantifies severity
ROSIER- differentiate between strokes and mimics

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5
Q

Mx of TIA

A

Aspirin 300mg
Unless taking warfarin, DOAC, bleeding disorder- CT head
Or >7d since sx

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6
Q

When to give carotid endarterectomy

A

When occlusion is >70%

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7
Q

What is total anterior circulation infarct and its symptoms

A

Middle and anterior cerebral

Unilateral hemiparesis +/- hemisensory
Homonymous hemianopia
Cognitive dysfunction

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8
Q

Posterior inferior cerebellar infarct symptoms

A

Lateral medullary syndrome Loss of pain and temp ipsilateral face, loss on contralateral limbs
Ataxia, nystagmus
Can get difficulty swallowing

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9
Q

Anterior inferior cerebellar infarcts

A

Loss of pain and temp ipsilateral face, loss on contralateral limbs
Ipsilateral paralysis and deafness - hearing is AICA over PICA
Ataxia, nystagmus
Can get difficulty swallowing

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10
Q

Vestibular schwannoma symptoms

A

Vertigo, hearing loss, tinnitus
Absent corneal reflex
Associated with NFM 2

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11
Q

Canvernous sinus thrombosis affects

A

Cranial nerves V1+2
3+4+6

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12
Q

What Ix for MG

A

Tenilson test
AchR AB
CXR- thymic hyperplasia

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13
Q

What can cause normal pressure hydrocephalus

A

SAH
Meningitis
Trauma

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14
Q

Types of focal seizures and symptoms

A

Aware and unaware or evolving into generalised typically tonic clonic

Temporal-hallucinations, lip smacking
Frontal- head movements
Occipital- floaters
Parietal- parasthesia

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15
Q

Symptoms of GBS

A

Ascending weakness LMN
After GE or STI

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16
Q

Secondary prevention of CVA

A

Clopidogrel 75mg

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17
Q

Tx of SAH

A

Coiling

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18
Q

Parkinsonism vs parkinsons

A

Parkinsonism- symmetrical, rapid, poor response to levadopa

Parkinsons- asymmetrical, progressive, good response

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19
Q

Parksonism

A

A group of neurological disorders that cause movement problems similar to those seen in Parkinson’s disease such as tremors, slow movement and stiffnes

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20
Q

Parkinson plus syndromes

A

MSA- autonomic dysfunction- postural hypotension, cerebellar ataxia- falls, ED

Vertical gaze palsy- postural instability falls, speech, dementia

CBD- unilateral parks, aphasia, alien limb

Dementia with LB- hallucinations

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21
Q

Tx of Parkinson’s

A

Levadopa with dopa decarboxylase
Co-careldopa

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22
Q

Tx of epilepsy

A

Tonic clonic- valproate, females- lamotrigine or leve

Absence-Ethosuximide

Myoclonic- valproate, female- leve

Tonic/atonic- valproate, female- lamo

Focal- lamo/leve

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23
Q

SE management

A

ABC
Pre-hospital- PR diazepam/buccal midazolam, hospital IV lorazepam
Second dose after 10-20 mins then phenytoin then ICU after 45 mins

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24
Q

CT head immediately guidelines

A

FFS

GCS <13
Vomit >1

Fracture of skull
Focal neurological deficit
Seizure

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25
Q

CT head within 8 hours

A

LOC/amnesis AND

Age >65
Bleeding disorder
Cant remember- Retrograde amnesia >30 mins
Dangerous MOI

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26
Q

Sx of raised ICP

A

Headache- worse leaning forward
Altered GCS- focal neuro
Cushing response- high BP, low HR, irregular breathing
Papiloedema

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27
Q

Horners syndrome

A

Miosis
Ptsosis
Anhydrosis

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28
Q

Mx of cauda equina

A

PO dexa
Decompressive laminectomy

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29
Q

Mx of spinal compression

A

Dex or surgery

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30
Q

Differentials for headache

A

Tension- tight band, bilateral
Cluster- around eye
Migraine- aura, throbbing, unilateral
Temporal arteritis- jaw claudication
Med overuse- worse with meds

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31
Q

Types of MND

A

Amyotrophic Lateral Sclerosis- LMN in arms, UMN in legs
Primary Lateral Sclerosis- UMN
Progressive Muscular Atrophy- LMN distal before- best prognosis
Progressive Bulbar Palsy- palsy of tongue, facial- worst prognosis

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32
Q

Causes of tremor

A

Parkinsons- stiff, resting
Essential – worse if outstretched, improved by rest and alcohol, FH
CO2 retention- COPD
Cerebellar- intention- with nystagmus, past pointing

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33
Q

Types of MS

A

Replase-remitting- acute attacks last 1-2m
Primary progressive
Secondary progresive- RR to this, gait and bladder too
Progressive remitting

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34
Q

Sx of MS

A

TEAM
Tingling
Eye- optic neuritis
Ataxis- other cerebellar- DANISH- dysdiadokinesia, ataxia, nystagmus, intention tremor, slurred speech, hypotonia
Motor- spastic

Warm temps- make worse

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35
Q

Ix of MS

A

Lp- IgG oligoclonal bands
AB- Anti MBP

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36
Q

Prognostic signs for MS

A

Good- female, sensory lesions, <25, long intervals in relapse

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37
Q

Mysthenic crisis sx and tx

A

Reduced RR with MG
Ix- ABG
Mx- plasmapheresis, IVIG, intubation

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38
Q

Ix of MG

A

Single fibre EMG
Anti-AchR

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39
Q

Mx of MG

A

Symptomatic- pyridostigmine after diagnosis

Immunosuppress- prednisilone eventually
Thymectomy

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40
Q

UMN signs

A

Increased tone
Reduced reflexes
Reduced power
Babinski +ve- upgoing plantars

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41
Q

Causes of peripheral neuropathy

A

Infection
Metabolic- DM, sensory predominant , ETOH sensory then motor
Autoimmune
Vit B12 def

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42
Q

Cerebellar vs vestibular nystagmus

A

Cerebellar- fast phase towards lesion
Maximal towards

Vestibular- away

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43
Q

Causes of Quadranopia

A

PITS- parietal inferior, temporal superior

Parietal superior radiation
Temporal- inferior

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44
Q

Causes of bitemporall hemianopia

A

Pituitary- superior
Craniopharyngioma- inferior

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45
Q

3rd nerve palsy sx

A

Down and out
Ptosis
Dilated pupil

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46
Q

Wernickes vs Brocas aphasia

A

Werncikes- receptive
Broca- expressive

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47
Q

Left posterior inferior cerebral artery Sx

A

Webers syndrome
Contralateral UMN of limbs
Ipsilateral CN3

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48
Q

Cluster headaches Tx

A

Oxygen
Triptan
Prophylaxis- verapamil

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49
Q

When do you need a CT for pupil sx

A

If pupil is unreactive to light and dilated
No para- meaning being compressed

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50
Q

Mx of acute MS flare up

A

IM methyprednisilone

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51
Q

Medical vs surgical 3rd nerve palsy

A

Medical- ptsosis and abducted
Surgical- dilated due to compression

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52
Q

Idiopathic intracranial hypertension sx

A

Secondary to impaired drainage
Causes raised ICP
Tinnitus
Affects young obese women

6th nerve palsy
Papiloedema

Change in acuity when changing posture- visual obscuration

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53
Q

Blood supply of Wernickes and Broca area

A

Wernickes- Inferior left MCA- superior temporal gyrus

Broca- superior left MCA- inferior frontal gyrus

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54
Q

Stroke mx after 4.5 hrs

A

Aspirin 300mg

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55
Q

Amurosis Fugax

A

Affects retinal/opthalmic artery
A temporary loss of vision in one or both eyes due to a lack of blood flow to the retin

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56
Q

Degenerative cervical myelopathy sx, dx and mx

A

Compression of spinal cord in neck

Poor coordination
Pain in neck
loss of sensory and motor
Hoffman sign- flick finger, another fingers twitches
MRI and surgery urgent

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57
Q

Nacolepsy ix

A

Multiple sleep latency EEG

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58
Q

Bells palsy Mx

A

10 day course of Pred
If no improvement after 3weeks- urgent referral to ENT

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59
Q

Main Ix of status epilepticus

A

Rule of hypoxia and hypoglycaemia
BM and ABG

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60
Q

Neuroleptic malignant syndrome sx

A

pyrexia
muscle rigidity
autonomic lability: typical features include hypertension, tachycardia and tachypnoea
agitated delirium with confusion
Elevated CK
Starts soon after starting new AP

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61
Q

Where touch and proprioception nerves travel

A

Dorsal columns

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62
Q

Where pain and temp nerves run

A

Spinothalamic columns

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63
Q

Scale that measures how stroke patients cope with ADLS

A

Barthel index

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64
Q

Tx of bells palsy

A

Prednisilone- 3w follow up- no improvement- ENT

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65
Q

Imaging of TIA

A

Diffuse weighted MR

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65
Q

SAH meds

A

Nimodipine for vasospasm

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66
Q

Epidural haemorrhage sx

A

Injury, lucid, LOC

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67
Q

Levadopa SEs

A

On off effect
Postural hypotension
Arrythmias
Psycosis
Red urine

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68
Q

When shouldn’t you do an LP in meningitis

A

Sepsis or rash
Bleeding risk
Raised ICp

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69
Q

Tx of brain mets

A

Dexamethasone

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70
Q

Syringomyelia sx

A

Fluid cavity- Chiari malformation

Cape like- neck shoulders, arms - loss of temperature and pain- spinothalamic tract - compression of anterior white commissure

Ventral horns- flaccid paralysis

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71
Q

Ix of syringomyelia

A

MRI spine

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72
Q

Tx of Parkinsons when NBM

A

Dopamine agonist patch

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73
Q

Pernicious anaemia neuro sc

A

Peripheral neuropathy- pins and needles
Subacute combined degeneration of spinal cord- progressive weakness
Psychiatric disorder

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74
Q

Sx of Guillain Barre

A

Ascending
Progressive
Symmetrical
Reflex absent
Sensory- mild

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75
Q

Normal pressure HC sx

A

Wide gait- ataxia
Urinary symptoms
Cognitive impairment

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76
Q

Wernickes sx

A

Altered mental state
Ataxic gait
Opthalmoplegia

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77
Q

Korsakoff sx

A

Wernickes
Plus confabulation and amnesia

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78
Q

Causes of vertigo

A

Viral labrythitis
Vestibular neuronitis
BPPV
Menieres
Acoustic neruoma

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79
Q

Labrynthitis vs vest neuronitis vs menieres vs BPPV

A

Recent infection- labry, neuronitis
Lab- hearing loss sometimes, not in neuro

Menieres- fullness- hearing loss, tinnitus

BPPV- short, triggered by head position

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80
Q

Parkinson tx that causes personality changes

A

Dopamine agonist
Ropinirole

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81
Q

Types of speech disorder

A

Wernickes- speech fluent, comprehension impaired, repetition imapired

Broca- speech broken

Conduction- link between 2- speech fluent but repetition is poor

Global- affecting all

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82
Q

When are you allowed to stop AED

A

If seizure free for 2 years
With AEDs stopped 2-3 months

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83
Q

Cerebellar stroke Sx

A

Ataxia
Nystagmus

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84
Q

Features of cluster headaches

A

Last 15 min-2 hours
Clusters- 4-12 weeks
Lacrimation, redness
Nasal stuffiness

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85
Q

Factors favouring true seizure over pseudo seizure

A

Raised prolactin
Tongue biting
Sudden onset

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86
Q

Sx of sinus thrombosis

A

Headache
N+V
Reduced consciousness
RF of venous thrombosis
Gradual onset

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87
Q

Ix of sinus thrombosis

A

MRI venography
Usually CT head first

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88
Q

Sign for differentiating between organic and nonorganic lower leg weakness

A

Hoover sign
Tell them to press down with weak side- will show no affect

Then next flex hip of contralateral (normal) side
If weak side extends (you fell it push down) - non organic

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89
Q

Medication for spasticity in MS

A

Baclofen or gabapentin

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90
Q

Dx to decrease relapses of MS

A

Natalizumab

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91
Q

Which drugs should be avoided in MG

A

AB- gentamicin, macrocodes
Beta blockers

Lithium
Phenytoin

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92
Q

Dx of young obese female with headache/blurred vision?

A

Idiopathic intracranial HTN

Can cause papiloedema

93
Q

Ix for suspected demyelination

A

MRI with contrast

94
Q

What should be measured for an alternative diagnosis to TIA

A

Glucose- hypo can mimic TIA

95
Q

Types of cerebellar lesions

A

Hemisphere- peripheral ataxia- finger nose

Vermis- gait ataxia

96
Q

If someone in public having a stroke, appropriate action?

A

999- -medical emergency
Only give aspirin once haemorrhage ruled out

97
Q

Efferent vs afferent defect in the eye

A

Efferent- ipsilateral doesn’t , opposite eye will react
Afferent- consensual reflex will not work

98
Q

Ix for vestibular schwannoma

A

Audiogram and gadolinium enhanced MRI head- cerebellopontine angle

99
Q

ECG if unresponsive patient with SAH

A

Torsades pe pointes

100
Q

Tx of stroke vs TIA with AF as the cause

A

Stroke- Aspirin 300mg 2 weeks then AC

TIA- AC immediately

101
Q

Mononeuropathy multiplex vs polyneuropathy

A

Both peripheral neuropathy

Poly-symmetrical
Mono- not

102
Q

Causes of injury of median, radial and ulnar nerve

A

Radial- humeral shaft
Supracondyl- ulnar and median less
Proximal humerus- axillary

103
Q

Sx of migraine more common in children

A

GI disturbance

104
Q

Sensory innervation of hand

A

Ulnar- median side of palm and dorsal
Median- lateral side of palm
Radial- dorsal side but not finger tops

105
Q

Neuropathic pain tx

A

Amitriptyline, duloxetine, gaba or pregabalin

Switch to another if not working

Tramadol used as rescue therapy

106
Q

How long do chronic subdural take to present

A

4-7 weeks

107
Q

Tx of hydrocephalus

A

VP shunt

108
Q

Saggital sinus thrombosis sx

A

Headache, diploma, bilateral papiloedema

Empty delta sign on CT venography

109
Q

Cavernous sinus syndrome

A

Opthalmoplegia
Proptosis
Periorbital oedema

110
Q

MRC power grade

A

0- no movement
1- flicker
2- between
3- against gravity
4-between
5- normal

111
Q

Raised ICP symptoms

A

Cushing triad- irregular breathing, hypertension, bradycardia

112
Q

Damage to lower brachial plexus

A

Klumpke palsy
Lower brachial palsy - forceful abduction or radiotherapy
C8-T1
Sensory loss
Hand muscle weakness

113
Q

Damage to upper brachial plexus

A

Erbs palsy
Waiter tip sign
C5-6 dermatome loss- upper arm

114
Q

Tx of trigeminal neuralgia

A

Carbmazepine

115
Q

Subacute combined degeneration of the spinal cord

A

B12 deficiency
Presents With sensory and UMN due to dorsal and cortical column degeneration

Peripheral neuropathy may be seen as a confounder with it

116
Q

Imaging of brain mets

A

MRI

117
Q

Inheritance of Charcot Marie tooth

A

AD

118
Q

Features of Charcot Marie tooth

A

Starts at puberty
Motor
Distal wasting
Pes cavus- high arch
Foot drop, leg weakness

Can get some sensory loss too

119
Q

Increase urination with lower homonymous hemianopia

A

Cranipharyngioma

120
Q

Paroxysmal hemicrania sx and tx

A

Unilateral severe headache- autonomic features

Tx with indomethacin

121
Q

Tx of stroke and TIA with and without AF

A

Aspirin 300mg daily for 2 week Then AC with AF

If TIA start immediately

Without- clopidogrel 75mg after 2 weeks

122
Q

Neurofibromatosis vs tuberous sclerosis

A

Ash leaf spots- hypo pigmented , epilepsy, retinal hamartomas, subungal fibromata - TS

Cafe au lait, phaeo, acoustic neuromas- NFM

123
Q

Neuroliptic malignant syndrome fx and tx

A

Pyrexia
Muscle rigidity
Raised CK- lead to rhabdo
High WCC

Bromocriptine

124
Q

Tx of spasticity in MS

A

Baclofen

125
Q

Tx of pain, urgency and tremor in MS

A

Pain- amitriptyline
Urgency- oxybutynin
Tremor- clonazepam

126
Q

Tx of subdural haemorrhage

A

Acute- decompressive craniectomy
Chronic- Burr hole

127
Q

HIV patient with brain lesion- ring enhancing vs homogenous

A

Homogenous- lymphoma
Ring- abscess- toxoplasmosis

128
Q

Tx of idiopathic intracranial HTN

A

Acetazolamdie

129
Q

Pontine haemorrhage sx

A

Pin point pupils
Quadraplegia

130
Q

If young and had a stroke what ix to do to try identify cause

A

AI and thrombophilia screen

131
Q

Mx of restless leg syndrome

A

Dopamine agonist
Ropinirole

132
Q

When to start anti epileptic treatment after first seizure

A

Neuro Deficit
Structure abnormality on imagine
Epileptic activity EEG

133
Q

If spinal MRI shows several lesions and too frail for surgery

A

Radiotherapy

134
Q

When can you drive after TIA

A

1 month free of sx no need to inform DVLA

135
Q

Most important causes of SE to rule out

A

Hypoxia and hypoglycaemia

136
Q

Jacksonian movememtns

A

Frontal lobe epilepsy
Clonic movements travelling proximally

137
Q

Drug for atonic/tonic seizures female

A

Lamotrigine

138
Q

Drug for myoclonic seizures females

A

Levetiracetam

139
Q

Tx of brain abscess

A

ceftriaxone and metronidazole

140
Q

If high suspicion of spinal cord compression due to bone mets what should you do

A

MRI and prescribed dexamethasone whilst waiting

141
Q

If ct done <6 hours of sx of SAH show nothing what to do next

A

Consider alternate diagnosis

142
Q

When does diffuse axonal injury happen

A

Head rapidly accelerated or decelerated
Often no signs

143
Q

If GP and Parkinson’s symptoms what do you do

A

Refer urgently to neuro

144
Q

What medication increases risk of II HTN

A

Tetracycline
Fludrocortisone
AMiodaron

145
Q

INO on examination

A

Affected side abducts
Contralateral fails to adduct

146
Q

Eye signs in MS

A

Red desaturation
INO
Painful eye with reduced acuity

147
Q

Which medication are ototoxic

A

Gentamicin
Vancomycin
Furosemide

148
Q

If CT shows nothing for acute stroke what imaging next

A

Diffuse weighted MRI- appears bright

149
Q

First seizure driving rules

A

Inform DVLA do not drive for 6 months

150
Q

Essential tremor Tx

A

Worse with intention
BB

151
Q

Charles bonnet syndrome

A

Visual loss causing hallucinations

152
Q

Atonic vs tonic falls when having a seizure

A

Atonic- loss of tension- forwards
Tonic- back spasm- backwards

153
Q

Todds paralysis

A

Paralysed after seizure for 10hrs - 1d

154
Q

SE of phenytoin

A

Gingival hypertrophy
Aplastic anaemai
Hypocalaemia

155
Q

SE of lamotrigine

A

SJS

156
Q

SE of ethosuximide

A

Night tremors

157
Q

What can intraventricular bleeds cause

A

Hydrocephalus- reducing GCS

158
Q

Raised ICP ventilation tx

A

Controlled hyperventilation
Reduces CO2 causing vasoconstriction- reducing pressure

159
Q

Nerve affected in herniation

A

CN 3- down and out

160
Q

4th CN palsy

A

Weak adduction and depression
Eye goes out and up

161
Q

6th nerve palsy

A

Weak abduction

162
Q

Acute intermittent porphyria px

A

Abdominal pain
Neuro and psych sx

163
Q

MND motor/nerve conduction studies

A

Normal

164
Q

Tx of bac meningitis >50

A

Cef and amox

165
Q

Phenytoin SE

A

Peripheral neuropathy
Gum hypertrophy
Aplastic anaemia

166
Q

When are triptans CI

A

In patents with CAD
Should avoid SSRI with them- serotonin syndrome

167
Q

Tracts affected in subacute degeneration of spinal cord and sx

A

Lateral corticospinal tracts - motor - bilateral spastic paresis

Dorsal columns - sensory- loss of proprioception, sensory and vibration- start in legs

Spinocerebellar - cerebellar - ataxia

168
Q

Tracts affected in Fredriech’s ataxia and sx

A

Lateral corticospinal tracts - motor - bilateral spastic paresis

Dorsal columns - sensory- loss of proprioception, sensory and vibration- start in legs
High arched palate, per caves, kyphoscoliosis

Spinocerebellar - cerebellar - ataxia, intention tremor

169
Q

Anterior spinal artery occlusion

A

Lateral corticospinal- spastic paresis

Lateral spinothalamic- loss of pain and temp bilaterally

170
Q

Loss of corneal reflex nerve damage

A

V1

171
Q

Mx of MND with lack of eating

A

PEG

172
Q

Pyridostigmine moa

A

Long acting ACHe Inhibitor

173
Q

Median nerve motor function

A

LOAF
Lateral lumbicals
Opponens, abductor and flexor polices

174
Q

Thoracic outlet syndrome sx

A

Tingling, muscle wasting
Cervical rib

175
Q

Types of MS

A

Relapse remitting - sx then no sx
Primary progressive - gets worse
Secondary progressive- RR and progress

176
Q

Miller Fischer variant of GBS

A

Ophthalmoplegia, areflexia and ataxia
Descending paralysis

177
Q

Transverse myelitis sx

A

Acute
Sensory and UMN below
MS or infection

178
Q

Coming off opioids and triptans

A

Wean opioids and stop Tristan abruptly

179
Q

Autonomic dyreflexia sx

A

Extreme HTN
Flushing
Sweating above cord lesion

Can cause haemorrhage stroke

180
Q

Ulnar nerve muscle innervation

A

Hypothenar- abductor, flexor digits minimi
Adductor pollicis
Interossei
Medial lumbricals

181
Q

Ix of TIA

A

BP, ECG, carotid USS< bloods- lipid profile, glucose, clotting

182
Q

Signs on CT of infarct over time

A

Hyperacute- hyper dense artery, loss of white grey interface
Acute- hypodense

183
Q

Painful 3rd nerve palsy cause

A

Posterior communicating artery rupture

184
Q

What muscles are spared in MND

A

Ocular

185
Q

Where bleed occurs in subdural haemorrhage

A

Bridging veins between cortex and venous sinus

186
Q

Headache red flags

A

Systemic- fever, cancer
Neuro signs
Onset sudden
Onset- thunder
Papilloedema

187
Q

Mx of drug induced Parkinson’s tremor

A

Procyclidine

188
Q

What can happen if you stop levodopa abruptly

A

Can cause acute dystonia

189
Q

What PD medication can cause impulse disorder

A

Dopamine agonist

190
Q

If clopidogrel not tolerate for stroke

A

Give aspirin 75mg and modified release dipyridamole

191
Q

Which medications increase mortality in dementia patients

A

AP

192
Q

How to tx on off effect of levodopa

A

Increase frequency of it

193
Q

Which sided lesions to cranial nerves cause

A

Same side as do not cross over
Apart from 4th CN

194
Q

Anti emetic for PD

A

Domperidone

195
Q

Triptan SE

A

Tight chest
Tingling
Heat

196
Q

Cause of waddling gait

A

Weak hips- myopathy
Move trunk to move hips

LEMS- affects legs first

197
Q

Saturday night palsy

A

Radial nerve compression
Unable to extend wrists

198
Q

Main way to distinguish between levy body and idiopathic PD

A

Lewy- dementia before motor
IPD- motor before

199
Q

Essential tremor sx

A

Increased with more muscle tone
Can affect vocal cords

200
Q

Tx of GBS

A

IVIG

CDIP- chronic- steroids

201
Q

Intercerebral haemorrhage after Ischameic infarct tx

A

Stop aspirin and BP control

202
Q

CN for corneal reflex and mastication muscle

A

Trigeminal

203
Q

CN causing vertical diplopia

A

Trochlear

204
Q

Valproate SE

A

Vomiting
Anorexia
Liver toxicity
Pancreatitis
Retention of weight
Oedema
Alopecia
Teratogenicity, tremor
Enzyme inhibitor

205
Q

Which epilepsy is carbmazepine CI in

A

Myoclonic and absence

206
Q

Most common form of MND

A

ALS

207
Q

Stroke and allergic to clopidogrel Mx

A

Aspirin and dipyridamole lifelong

208
Q

Posterior circulation infarcts classification

A

presents with 1 of the following:
1. cerebellar or brainstem syndromes
2. loss of consciousness
3. isolated homonymous hemianopia- can be macula sparing

209
Q

Isolated high protein in LP

A

GBS

210
Q

Only cervical nerve root to exit under vertebra

A

C8 under C7- all others on top

All other nerve roots under after

211
Q

Locked in syndrome infarct

A

Basillar artery

212
Q

AchE side effects

A

GI- N+V, diarrhoea
Fatigue, dizziness

213
Q

Most common cause of amaurosis fugax

A

Atherosclerosis of internal carotid

214
Q

Brain abcess vs tumour on MRI

A

Diffuse restricting- abscess

215
Q

Multiple ring enhancing lesions HIV patient with focal neuro signs

A

Toxoplasmosis

216
Q

Charcot marie tooth vs Fredrichs vs MND presentation

A

CMT- wasting small hands first, pet vacus, hyperkyphosis

Fredrichs- cerebellar

MND- fasciculations, no ocular, sensory or cerebellar signs, cramps and spasms

217
Q

Causes of 3rd nerve palsy

A

Vascular- stroke, CS thrombosis
Lesion- malignancy, abscess
DM

218
Q

Diplopia when looking down stairs

A

4th CN palsy

219
Q

Rigidity vs spasticity

A

Rigidity- not velocity dependent
PD

Spasticity- velocity- stroke

220
Q

Cause of cerebellar syndrome

A

MS- days, SOL- years, infection- days, stroke- minutes

221
Q

Types of ataxia

A

Cerebellar- broad gait, overshoot

Sensory- broad, stamping, Romberg +

222
Q

Level spinal cord finishes at

A

L1-2

223
Q

Driving rules with epilepsy

A

Must be seizure free for 1 year before getting licence back

If withdrawing medication- must not drive for 6 months

224
Q

When to do CT neck immediately

A

GCS <13
Intubated
Clinical suspicion and >65, neuro deficit, high impact or parasthesia

225
Q

What should you avoid with cluster headaches

A

Alcohol

226
Q

Kernig and Brudsinski sign

A

Kernig- knee extension causes pain
Brudsinski- neck flexion causes knee flexion

227
Q

If had a CT and shows intercerebrayl bleed and patient deteriorates what should you do

A

Second CT to check for hydrocephalus

228
Q

When to measure phenytoin conc

A

Before next dose

229
Q

Signs og atonic seizure in face

A

Eyelid droop or head nodding

Year 6 (28 decks)

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