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Year 6 Written > Neuro > Flashcards

Neuro Flashcards

1
Q

What is cataplexy?

A

Loss of skeletal muscle tone with strong (usually +ve) emotion

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2
Q

Features of de Quervain tendinopathy

A
  • Radial side wrist pain
  • Finkelstein test: pain worse by ulnar deviation of wrist when thumb against palm
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3
Q

Cord compression features

A
  • Short onset
  • Back pain at lumbar region
  • New onset leg weakness and urinary retention
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4
Q

Cord compression Ix

A

MR Imaging of spine

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5
Q

Extradural haemorrhage affected vessel

A

Middle meningeal artery

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6
Q

Migraine prophylaxis

A

Propranolol

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7
Q

What are the 2 sensory pathways and the 1 motor pathway? (+ where do they decussate)

A

Sensory
1. Dorsal column: fine touch, proprioception & vibration
decussates at medulla
2. Spinothalamic: (anterior - pressure, crude touch) + (lateral - pain, temp)
Decussates at level of entry

Motor
1. Corticospinal: voluntary movement
Decussates at medulla

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8
Q

Mx for encephalopathy

A

Rifaximin or lactulose
( to regulate BO)

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9
Q

What is Brown Sequard syndrome and what pattern of neuro issues does it present with?

A

Injury to one side of the spinal cord. Syx present at and below the level of injury.
- Ipsilateral loss movement and fine touch/proprioception
- Contralateral loss of pain and temp sensation

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10
Q

Myoclonus seizure

A

Sudden involuntary contraction >= 1 group muscles

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11
Q

Multiple sclerosis flare Mx

A

Methylprednisolone

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12
Q

Features of MCA stroke

A
  • Weakness arms>legs
  • Aphasia
  • Homonymous hemianopia
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13
Q

Lumbar spinal stenosis and features

A

Narrowing of area of spine that contains the nerves or spinal cord
- Intermittent weakness and numbness both legs
- May be better at rest - neurogenic claudication

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14
Q

Intrinsic handle muscle wasting - site of lesion?

A

T1 nerve root

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15
Q

Cord compression mx

A

Dexamethasone -> external beam radiotherapy

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16
Q

Most likely anatomical site of origin for impaired awareness seizures

A

Temporal lobe

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17
Q

Foot drop affected nerve

A

Common peroneal

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18
Q

Cerebellar stroke features

A

Triad of

  • Headache
  • N/V
  • Ataxia (profound imbalance)
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19
Q

Glasgow coma scale

A

Eyes
1 No response
2 To pain
3 To speech
4 Spontaneously

Voice
1 No response
2 Noises
3 Inappropriate words
4 Confused
5 Oriented TPP

Motor
1 No response
2 Abnormal extension
3 Abnormal flexion
4 Withdrawal from pain
5 Move to localised pain
6 Obey commands

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20
Q

Which part of the brains are there changes in Alzheimer’s?

A

Temporal

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21
Q

Myasthenia gravis pathophysiological process

A

Autoimmunity

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22
Q

Lower limb dermatomes

A
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23
Q

Upper limb dermatomes

A
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24
Q

Feature of hypoglossal nerve lesion

A

Tongue deviates towards side of lesion on protrusion

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25
Q

Trigeminal neuralgia and features

A

Irritation of trigeminal nerve.
- sudden and intense pain in the face, jaw, and cheek
- Triggered when brushing teeth/cold wind touching face

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26
Q

Mx for neuropathic bladder due to MS

A

If post-void >100ml: intermittent self-catheterisation

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27
Q

Bell’s palsy and features

A
  • Facial N paralysis
  • Unilateral facial weakness
  • NOT forehead sparing
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28
Q

Bell’s palsy mx

A

Prednisolone

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29
Q

Mx for parkinsonism syx(but not PD)

A

Procyclidine hydrochloride

30
Q

Akathisia v dystona v tardive dyskinesia

A

Akathisia: feeling of restlessness
Dystonia: abn muscle tone -> muscular spasm + abn positions
Tardive dyskinesia: invol movement of face and jaw

31
Q

Spinal cord compression features

A
  • Back pain
  • Bilateral leg weakness
    +/- Recent fall
32
Q

IN MS, which cells are affected?

A

Oligodendrocytes

33
Q

Trigeminal neuralgia mx

A

Carbamazepine

34
Q

GB features

A

Numbness + weakness + pain
Start distally and spreads proximally
Problems with balance and coord

35
Q

Spatial neglect issues - where is lesion?

36
Q

Horner’s and features

A

Damage to the sympathetic supply to the face
1. Ptosis (droopy upper eyelid)
2. Miosis (excessive constriction)
3. Anhidrosis

37
Q

Dx of MS and best ix

A

clinical diagnosis by consultant neurologist, 2 lesions disseminated in time and space which may be clinical or MRI with evidence of demyelination.

MRI

38
Q

Ramsay Hunt and features

A

Herpes zoster virus affecting facial N
1. Painful rash/blisters in ear canal or on outside of ear
2. Weakness/paralysis of facial muscles on affected side
3. Loss of taste sensation front two-thirds of tongue
4. Tinnitus // hearing loss
5. Vertigo//dizziness

39
Q

Cauda equina and features

A

medical emergency caused by compression or damage to the nerve roots that make up the cauda equina
- perianal anesthesia
- urinary/fecal incontinence
- lower extremity weakness/ paralysis

40
Q

Conus medullaris compression and features

A

occurs when there is pressure on the conus medullaris, the lower end of the spinal cord
- back pain ++
- perianal anaesthesia
- bladder/bowel dysfunction

41
Q

Status epilepticus mx

A

Time 0min: IV lorazepam (0.1mg/kg) or buccal midazolam or PR diazepam

Time 10 min: IV lorazepam (repeat)

Time 15 min: IV phenytoin 20mg/kg or IV levetiracetam or IV sodium valproate

Time 20-30min: Trial second agent from above or IV phenobarbital

Time >30 min: rapid induction anaesthesia

42
Q

Cluster headache mx acutely

A

Triptan ± short term O2 therapy

43
Q

Cluster headache prophylaxis

A

verapamil (alt topiramate)

44
Q

Migraine acute mx

A

paracetamol/ibuprofen + triptan
±anti-emetic drug, e.g., metoclopramide

45
Q

MS spasticity syx mx

A

1Baclofen or gabapentin
2 Try other agent
3 combo OR dantrolene

46
Q

Campylobacter, ascending polyneuropathy, anti GM1+ve

A

Guillan-barre syndrome

47
Q

Optic n/spinal cord lesion, normal MRI + anti aquaporin 4+ve

A

neuromyelitis optica

48
Q

What are the cerebellar signs?

A

Dysdiadodiskinesia
Ataxia
Nystagmus
Intention tremor
Slurred speech
Hypotonia

49
Q

Specific MS signs

A
  • Uhthoff’s phenomenon (visual syx worse with incr body temp)
  • Lhermitte’s syndrome (paraesthesia in limbs when pt flexes neck)
50
Q

what is disulfiram used for and what is its mechanism

A

Promotes alc abstinence
inhibitor of acetaldehyde dehydrogenase

51
Q

Wernicke’s encephalopathy features

A
  • nystagmus
  • ataxia
  • confusion
52
Q

Wernicke’s enceph mx

A
  1. If hypo (<4mmol/L) - treat
  2. 2 pairs IV pabrinex immediately after glucose
  3. cont for 5 days, 2 pairs TDS
  4. prophylactic thiamine indef
53
Q

cape like distribution of pain/temp loss (shoulders + upper limbs)

A

Syringeomyelia

54
Q

Sensory level L1-2 loss, upgoing plantars, absent knee reflexes (mixed UMN+LMN)

A

Conus medullaris lesion

55
Q

VDRL +ve & loss vibr/proprioception

A

Tabes dorsalis (tertiary neurosyphillis)

56
Q

Saddle anaesthesia + downgoing plantars

A

Cauda equine syndrome

57
Q

Anterior spinal artery syndrome

A

Occlusion of ant spinal artery, which supplied anterior 2/3 of spinal cord

58
Q

If high suspicion of SAH but normal CT

A

LP at 12hr for xanthochromia

58
Q

HTN + brady + kussmaul breathing

A

Cushing’s triad of raised ICP - impending herniation of brain

59
Q

SAH CT findings

A

hyperdensity within cisterns/sulci

60
Q

Extradural haemorrhage involved vessel

A

middle meningeal artery

61
Q

Extradural haemorrhage CT

A

hyperdense biconvex (lemon)

62
Q

Subdural haematoma involved vessel

A

bridging dural veins

63
Q

Subdural haematoma CT

A

Cresenteric collection (banana)

64
Q

SAH involved vessel

A

Ruptured cerebral aneurysm

65
Q

focal weakness after seizures

A

Todd’s paralysis

66
Q

Diabetic painful neuropathy mx

A

Duloxetine

67
Q

Progressive muscle weakness over days + other LMN signs (±younger pt) w/ preservation of sensation after diarrhoea

68
Q

GBS mx

A

IV immunoglobulin

69
Q

GBS LP finding

A

High protein + low cell count

70
Q

SAH RF

A

excessive alcohol

Year 6 Written (26 decks)

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