Neuro 4 Flashcards
Syringomyelia presents with loss of pain and temp sensation why?
compression of the spinothalamic fibres decussating
anterior white commisure if the spine
what is ondansetron?
antagonist / agonist?
acts where?
s/e on heart?
5-HT serotonin antagonist
Chemoreceptor trigger zone
QTc prolongation
what is a risk with QTc prolongation?
ventricular tachyarrhythmias
what is the typical symptoms of Guillain Barre syndrome?
progressive symmetrical weakness
ascending fashion
immune mediated demyelination
what is co-careldopa?
levodopa
carbidopa
> decarboxylase inhibitor prevents peripheral metabolism of levodopa
Selegiline
monoamine oxidase B inhibitor
decreases the degradation of dopamine in the nigrostriatal pathway
Rotigotine
how is it given
transdermal patch
glycopyrronium bromide
can help with what s/e of parkinsons?
drooling of saliva
Dawson fingers:
hyperintense lesions penpendicular to the corpus callosum
seen in MRI for MS
miosis is?
pupil constriction
mydriasis?
pupil dilatation occurs in complete 3rd nerve palsy as unopposed radial dilator muscle
thoracic outlet syndrome
compression of brachial plexus
subclavian artery / vein
subclavian vein compression
painful diffuse arm swelling with distended veins
subclavian artery compression
painful arm claudication
ulceration
gangrene
pontine arteries radiate from?
basilar artery on brainstem
supply pons
motor tracts descend from the ____?
pons to supply limbs
bilateral paralysis
cavernous sinus thrombosis presents with?
unilateral facial oedema
photophobia
palsies CN III, IV,V,VI
topiramate and propronalol are ?
prophylactic medication for migraines
topiramate is teratogenic
propranalol is contraindicated in asthmatics
First-line treatment for neuropathic pain i
amitriptyline
duloxetine
gabapentin
pregabalin
sensation in her armpit is impaired.
Intercostobrachial21
Smiths Fracture.
median nerve
arm is hanging loose on the side
pronated and medially rotated?
brachial trunk c5 c6
Erbs palsy
lumpke’s paralysis involving brachial trunks
c8 -T1
t1 can cause horners
surgical neck of the humerus fracture
which nerve at risk?
axillary
winds around the bone of the neck of the humerus
Headache linked to Valsalva manoeuvres
raised ICP until proven otherwise
non contrast CT
phenytoin
binds to sodium channels in creasing refractory period
inducer of p450
what does intubate mean?
cuffed endotracheal tube
LP results for guillain barre syndrome?
rise in protein with normal wcc
first line imaging in neurogenic bladder dysfunction?
USS KUB
natalizumab
antagonises alpha-4 beta-1-integrin
triceps reflex
C7-C8
biceps reflex
C5,c6
supinator reflex tests
c6,c7
radial nerve
why must dopaminergic medicatio be taken on time?
prevent neuroleptic malignant syndrome
sudden decrease in dopaminergic activity
Acetazolamide
carbonic anhydrase inhibitor used to treat idiopathic intracranial htn
s/e of triptans?
tightness of throat and chest
tingling
heat
heaviness
pressure
Triptans MOA?
h-HT1b
5-ht1d
temporal lobe seizure
rising epigastric feeling
deja vu
lip smacking / grabbing / plucking
Todd’s paresis
focal seizures
vasoconstriction
bitemporal hemianopia
if it is upper quadrants?
inferior chiasmal compression
pituitary adenoma
lower quadrant defect
superior chiasmal compression
craniopharyngionma
Gait
loss of heel to toe?
ataxic gait
face blindness
temporal lobe of the brain
posterior cerebral artery stroke?
visual agnosia
contralaterall homonymous hemianopia w macular sparing
Superior homonymous quadrantanopias are caused by?
GBS is a peripheral neuropathy so would present with?
LMN signs
> weakness
>hyporeflexia
what is a myoclonic seizure?
rapid bilateral upper and lower limb muscle contraction and relaxation lasting around 10 seconds before stopping.
shaking but no loss of muscle tone / dropping / loc
should all patients with bells be given steroids?
yes
if presenting wihtin 72 hours
vitamine b1?
thiamine
essential for glial cells of the nervous system
multiple system atrophy
parkinson plus syndrome characterised postural hypotension
impotence
mx of steven johnson syndrome?
cease all medications
iV access
begin fluid hyrdation
Pituitary apoplexy mx?
bleeding / infarction
IV hydrocortisone due to loss of acth
Autonomic dysreflexia can only occur if the spinal cord injury occurs above ______
the T6 level
‘Young’ stroke blood tests
autoimmune
thrombophilia screening
ANA
APL
ACL
Lupus
ESR
homocysteine
syphylis
Tramadol MOA?
DUAL
weak opioid agonist
reuptake inhibitor of serotonin and norepinephrine
Morphine MOA?
mu opiod receptors
infantile spasms - wests syndrome
hypsarrhythmia on eeg
Benign rolandic epilepsy
paraesthesia
‘fizzy’ or ‘buzzing’
Common peroneal nerve lesion
foot dorsiflexion and foot eversion
common peroneal nerve emerges from?
sciatic nerve
tibial nerve
plantar flexors of ankle and toes
sensory loss on sole of foot
pudendal nerve palsy
muscles of perineum and genitalia
what is features of syncope rather than seizure?
rapid recovery no post ictal
presyncopal features
