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#passmed 2023 > Neuro > Flashcards

Neuro Flashcards

1
Q

What is an example of Parkinsons Plus disorder?

A

Progressive supranuclear palsy

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2
Q

What are the CF of Progressive supranuclear palsy that make it different to normal Parkinsons? (2 things)

A
  1. Dysarthria
  2. Reduced vertical eye movements
    (but has normal TRAP Parkinsons CF as well)
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3
Q

What are the CF of a cluster headache? (4 things)

A
  1. Episodic + intense
  2. Unilateral eye pain (stabbing)
  3. Lacrimation
  4. Restless
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4
Q

What complication can Parkinsons lead to due to Autonomic failure over time?

A

Postural hypotension

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5
Q

What are the CF of Encephalitis? (5 things)

A
  1. Seizures
  2. Fever
  3. Headache
  4. Vomiting
  5. Swelling + Increased brain signal @ MRI
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6
Q

What are 95% of Encephalitis caused by?

A

HSV

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7
Q

What is the immediate Tx for Encephalitis?

A

Aciclovir

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8
Q

What will the CSF show in Lumbar puncture of Encephalitis? (2 things)

A
  1. Raised lymphocytes
  2. Raised protein
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9
Q

What is the classical triad of Normal Pressure Hydrocephalus? (3 things)

A
  1. Dementia
  2. Gait abnormality
  3. Urinary incontinence
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10
Q

Normal Pressure Hyrocephalus is a ____ cause of dementia?

A

Reversible

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11
Q

What is the Mx for Normal Pressure Hyrocephalus?

A

Ventriculoperitoneal shunting

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12
Q

What is the key CF of Myasthenia gravis?

A

Weakness that worsens throughout the day

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13
Q

What is an Eye symptom of Myasthenia gravis?

A

Blurred vision that worsens throughout the day

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14
Q

What autoantibodies do Myasthenia gravis pt have?

A

Acetylcholine receptor autoantibodies

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15
Q

What cancer is Myasthenia gravis linked to?

A

Thymoma

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16
Q

What other conditions if Myasthenia gravis linked to?

A

AI conditions like SLE

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17
Q

What investigations should you do for Myasthenia gravis? (3 things)

A
  1. Single fibre electromyography (myo like mya)
  2. Acetylcholine receptor autoantibodies
  3. CK normal
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18
Q

What is the FIRST line Mx for Myasthenia gravis?

A

Pyridostigmine (acetylcholinesterase inhibitor)

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19
Q

What is the Mx of ischaemic stroke with no signs of haemorrhage on CT?

A

Within 4.5 hours of presenting = Thrombolysis + Thrombectomy

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20
Q

What can you develop after a Lumbar puncture?

A

Iatrogenic headache

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21
Q

What is another name for Simple Partial seizure? Why is that name better?

A

Focal aware seizure
Tells you if pt is aware or not (aka LOC or not)

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22
Q

What is another name for Complex Partial seizure? Why is that name better?

A

Focal impaired awareness seizure
Tells you if pt is aware or not (aka LOC or not)

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23
Q

What is the Afferent and Efferent Nerve in the Corneal Reflex?

A
  • Afferent = V1 (ophthalmic)
  • Efferent: 7 (facial)
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24
Q

What is the Afferent and Efferent Nerve in the Jaw Jerk Reflex?

A
  • Afferent = V3 (mandibular)
  • Efferent: V3 (mandibular)
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25
Q

What is the Afferent and Efferent Nerve in the Gag Reflex?

A
  • Afferent = 9 (9lossopharyn9eal)
  • Efferent: 10 (vagal nerve)
    (same as Carotid sinus reflex)
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26
Q

What is the Afferent and Efferent Nerve in the Carotid sinus Reflex?

A
  • Afferent = 9 (9lossopharyn9eal)
  • Efferent: 10 (vagal nerve)
    (same as Gag reflex)
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27
Q

What is the Afferent and Efferent Nerve in the Pupillary light Reflex?

A
  • Afferent = 2 (optic nerve)
  • Efferent: 3 (oculomotor)
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28
Q

What is the Afferent and Efferent Nerve in the Lacrimation Reflex?

A
  • Afferent = V1 (ophthalmic)
  • Efferent: 7 (facial)
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29
Q

What should you start pt on once ischaemic stroke confirmed? (3 things)

A
  1. 300mg daily (2 weeks)
  2. 75mg Clopidogrel (forever)
  3. Offer statin if not already on one
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30
Q

What is used for the long term prophylaxis of Cluster headaches?

A

Verapamil

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31
Q

What age does MND usually present at?

A

After 40

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32
Q

What are the CF of MND? (7 things)

A
  1. Asymmetrical limb weakness
  2. Mix of UM + LM signs
  3. Small hand muscles wasting
  4. Tibialis anterior wasting
  5. Fasciculations
  6. NO sensory sings
  7. SPARING of ocular muscles (eye)
33
Q

How do you diagnose MND?

34
Q

How do you feed ppl with MND?

A

PEG (percutaneous gastrostomy tube)

35
Q

Which nerve palsy gives you Down n Out appearance of eye?

36
Q

What is the best management for Idiopathic intracranial HTN with no visual changes?

37
Q

What is the best management for Idiopathic intracranial HTN WITH visual changes?

A

WL + Acetazolamide

38
Q

What does ANTERIOR Cerebral artery stroke cause? (2 things)

A
  1. Leg weakness (contralat)
  2. Leg sensory loss (contralat)
  3. NO face weakness
  4. NO speech impairment
39
Q

What does MIDDLE Cerebral artery stroke cause? (4 things)

A
  1. Aphasia (can’t talk) (so you say MMMM)
  2. Homonymous hemianopia (contralat)
  3. Arm weakness (contralat)
  4. Arm Sensory loss (contralat)
40
Q

What does POSTERIOR Cerebral artery stroke cause? (2 things)

A
  1. Homonymous hemianopia w MACULAR sparing (contralat)
  2. Visual agnosia (can’t recognise things)
41
Q

What does ANTERIOR INFERIOR Cerebellar artery stroke cause? (2 things)

A
  1. Facial paralysis (ipsilateral)
  2. Deafness (ipsilateral)
42
Q

What does POSTERIOR INFERIOR Cerebellar artery stroke cause? (4 things)

A
  1. Facial pain + Temperature loss (ipsilateral)
  2. Nystagmus
  3. Limb / torso pain Temperature loss (contralat)
  4. Ataxia (can’t control body movements)
43
Q

What does Retinal / ophthalmic artery stroke cause? (4 things)

A

Amaurosis fugax
(aka temporary loss of vision in one / both eyes)

44
Q

In strokes how many arteries can be clarted? Wdym?

A

Several, so you can get mix of ant + middle cerebral clartation CF

45
Q

What arteries are clarted in TACI (Total Anterior Circulation Infarct)?

A

Anterior + Middle Cerebral arteries

46
Q

What Triad of CF is seen in TACI (Total Anterior Circulation Infarct)? (3 things)

A
  1. Unilateral weakness / sensory loss (face + arm + leg)
  2. Homonymous hemianopia
  3. Higher cogn dysf (dysphasia)
47
Q

What arteries are clarted in Partial Anterior Circulation Infarct (PACI)?

A

Smaller arteries in anterior circulation (upper / lower division of middle cerebral artery)

48
Q

What is seen in Partial Anterior Circulation Infarct (PACI)?

A

2/3 of Triad of TACI:
1. Unilateral weakness / sensory loss (face + arm + leg)
2. Homonymous hemianopia
3. Higher cogn dysf (dysphasia)

49
Q

When is Carotid endarterectomy indicated in TIA pt?

A

Carotid artery stenosis 70+ %

50
Q

What is the rule when Neuropathic meds are not working?

A

Switch meds, don’t add
(aka if amitriptyline not working, switch to pregabalin)

51
Q

How do you remember motor innervation of hand?

A

Rock, Paper, Scissors = Median, Radial, Ulnar (in alphabetical order)
* Rock = clench fist like rock = Median nerve
* Paper = stretch hand = Radial nerve is finger extension
* Scissors = imagine scissors made from ring + index finger = Ulnar is finger abd + add

52
Q

What are the CF of Focal seizure (originating in temporal lobe)? (3 things)

A
  1. Change in taste / smell
  2. Lip smacking
  3. Repetitive finger movements
53
Q

What did we say is unique about Focal seizure Mx?

A

Only one with FIRST line lamotrigine, all others is Sodium valproate

54
Q

What scan is FIRST line for strokes?

A

CT head WITHOUT contrast

55
Q

What meds are FIRST line for spasticity in MS? (2 things)

A
  1. Baclofen
  2. Gabapentin
56
Q

What will you see in CSF of MS pt?

A

Oligoclonal bands

57
Q

How do you remember lesions causing Homonymous Quadrantopias (aka quarter of vision in eye gone)

A

PITS
* Parietal = Inferior
* Temporal = Superior
(and obv will be contralat)

58
Q

When can you stop Anti-epileptics and how should you stop them?

A
  • If seizure free for 2 years
  • Stop over 2-3 months
59
Q

What is the Acute Tx for Migraine? (3 things)

A

Triptan + NSAID / Paracetamol

60
Q

What is used for PROPHYLAXIS of Migraines?

A

Topiramate / Propranolol

61
Q

How do you remember what the Spinothalamic tract does

A

SPinoThalamiC
1. Simple touch
1. Pain
2. Temperature
3. Crude touch

62
Q

What do you get in Syringomyelia?

A

Spinothalamic clartation (so the 4 things we mentioned clarted)

63
Q

What type of Dementia does MND increase risk of?

A

Frontotemporal dementia

64
Q

What is the most common complication of Meningitis?

65
Q

What is a side fx of Phenytoin?

A

Peripheral neuropathy (feet n hand numbness)
(P for P)

66
Q

If you have Down n Out eye (aka 3rd CN palsy) but its painful, whats the Dx?

A

Posterior communicating artery aneurysm (PCA)

67
Q

Whats important to proect in Bells palsy pt?

A

Eyes = give them night time drops n lubricants

68
Q

What is a side fx of Triptans?

A

Throat / chest Tightness
(TTT)

69
Q

What should you give pt with raised ICP bc traumatic injury while they wait for CSF drainage surgery?

A

IV mannitol
(diuretic so reduces pressure)

70
Q

What is the CSF drainage surgery done for raised ICP bc traumatic injury?

A

External ventricular drain

71
Q

What is Webers Syndrome? (2 things)

A

Midbrain stroke with:
1. CN 3 palsy (down n out, dilated pupil) (ipsilat)
2. Weakness (contralat)

72
Q

What roots is the Ankle reflex?

A

S1 – S2 button my shoe

73
Q

What roots is the Knee reflex?

A

L3 – L4 kick the door

74
Q

What roots is the Biceps reflex?

A

C5 – C6 pick up sticks

75
Q

What roots is the Triceps reflex?

A

C7 – C8 open the gate

76
Q

What is FIRST line meds for Trigeminal Neuralgia?

A

Carbamazepine

77
Q

How do you differentiate Acute vs Chronic bleeding in CT head?

A

Acute = bright (hyperdense)
Chronic = dark (hypodense)
AB CD

78
Q

What is the new FIRST line med ofr Absence seizures?

A

Ethosuximide

#passmed 2023 (39 decks)

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