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Final Year - Passmed > Neuro 5 > Flashcards

Neuro 5 Flashcards

1
Q

MG anesthetic drugs which are less successful?

A

suxamethonium

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2
Q

Rocuronium

A

neuromuscular blocking drugs

non depolarising
ppl w MG will be more sensitive to this drug

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3
Q

what is the treatment of choice for an essential tremor?

A

propranolol

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4
Q

skin on palmar aspect of thumb nerve innervation?

A

median

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5
Q

ulnar nerve provide sensation to?

A

medial aspect of the palm

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6
Q

is sodium valproate an inducer of p450?

A

No it is an inhibitor

Sodium valproate causes inhibition of the P450 system

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7
Q

sodium valproate s/e

A

A - Appetite increase –> weight gain
L - Liver failure
P - Pancreatitis
R - Reversible hair loss (alopecia)
O - Oedema
A - Ataxia
T - Teratogenic, tremor, thrombocytopaenia
E - Enzyme inducer (p450), encephalopathy (due to high ammonia)

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8
Q

MND is associated with which dementia?

A

frontotemporal dementia

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9
Q

partial strokes

A

2/3 criteria

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10
Q

complete / total anterior circulation stroke?

A

middle and anterior cerebral arteries

hemiparesis / hemisensory loss

homonymous hemianopia

higher cognitive dysfunction

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11
Q

what is the difference between multiple system atrophy and normal pressure hydrocephalus ?

A

MSA is parkinson plus condition
tremor/rigidity and bradykinesia

NPH
> gait
>urinary incontinence
>confusion

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12
Q

which abx class increases risk of Intracranial hypertension

A

lymecycline

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13
Q

drugs which increase risk of Intracranila htn?

A

COMAAR

ciclosporin
ocp
mineralocorticoids

amiodarone
antibiotics
> tetracyclines
> sulphonamides

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14
Q

colles fracture which nerve?

A

The median nerve may be injured in a Colle’s fracture

distal radius > outstretched hand

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15
Q

raised ICP mx?

A

head elevation 30 degrees

diuretic use > mannitol > osmotic diuretic

controlled hyperventilation

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16
Q

why is metoclopramide contraindicated in patients with parkinsons?

A

dopamine antagonist
crosses BBB

> worsene extrapyramidal side effects of PD

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17
Q

Domperidone

A

blocks dopamine receptors in the chemoreceptor trigger zone

does not cross BBB

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18
Q

anti emetics contraindicated in PD?

A

metoclopramide
haloperidol
prochlorperazine

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19
Q

which Parkinson drug is associated with pulmonary fibrosis?

A

cabergoline

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20
Q

Myasthenia gravis
exarcebating drugs?
why?

A

beta blockers
> not sure / look up

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21
Q

Painful third nerve palsy

where would lesion / occlusion be?

A

posterior communicating artery

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21
Q

carpal tunnel syndrome
sensory loss where?

motor function where?

A

median nerve
lateral 3.5 digits

flexor muscles of the forearm

flexion, abduction, opposition, and extension of the thumb.

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21
Q

Cubital tunnel syndrome

what nerve
what sign?

A

ulnar nerve pathology

froments test
adductor pollicis muscle
> ulnar neuropathy

22
Q

what is in pabrinex?

A

IV b/c

includes b12

replace thiamine

23
Q

C8/T1 radiculopathy

A

similar to ulnar nerve neuropathy but forearm is impacted

23
Q

What can happen if you give folate before b12?

A

worsen b12 deficiency
> subacute combined degeneration of the spinal cord

24
Q

what is wernickes triad?

A

confusion
ataxia
opthalmoplegia

24
Q

Ix signs from wernickes encephalopathy?

A

decreased red cell transketolase
MRI

25
Q

Acute seizure management?

A

ABC approach
ensure airway and o2

give benzodiazepines

25
Q

Rectal Diazepam dose?
adult

A

10-20mg

26
Q

focal seizure first line?

A

lamotrigine / levetiracetam

26
Q

focal seizures involve?

A

inappropriate electrical activity on one side of the brain

26
Q

post suspected TIA mx?

investigations

A

aspirin 300mg unless contraindicated

assessed urgently <24hours

diffusion MRI

urgent carotid doppler imaging

27
Q

post suspected TIA mx?
medical

A

antiplatelet therapy

DAPT
> clopidogrel 300mg
> aspirin 300mg

75mg for 21 days

PPI considered

27
Q

long term secondary prevention TIA?

A

clopidogrel

28
Q

how is carotid imaging conducted?

A

carotid duplex USS
CT angiography / MR angiography

28
Q

webers syndrome is characterised by?

ipsilateral ?
contralateral?

A

midbrain stroke
ipsilateral CN 3

contralateral hemiparesis

28
Q

sarcoidosis facial nerve palsy

A

lethargy
bilateral CN 7 palsy

bilateral parotid gland enlargement

28
Q

shagreen patch

A

tuberous sclerosis
rough skin over lumbar spine

28
Q

Homocystinuria

A

methionine metabolism

28
Q

when would you not be appropriate for DAPT?

A

if previous GI bleed risk

monothrerpay and ppi

28
Q

Clopidogrel moa

A

inhibits platelet aggregation
reduces risk of clot formation

29
Q

sumatriptan MOA

A

5-HT1 receptor agonist

constriction of blood vessels in the brain
> relieve headache

29
Q

radial nerve supplies what muscle group?

A

extensor muscle group

29
Q

interossei are supplied

A

ulnar nerve

30
Q

what is jacksonian movement?

A

clonic movement moving proximally

> frontal

31
Q

which antiepileptic can cause peripheral neuropathy as a side effect?

A

phenytoin

32
Q

main s/e of soidum valproate

A

GI
tremor
weight gain
hair loss

33
Q

levetiracetam main s/e

A

mood swings
aggression

34
Q

most common bleeding site in extradural haemorrhage

A

middle meningeal artery

> pterion: weakest part of the cranium

35
Q

uncal herniation causes?

A

oculamotor nerve palsy
dilated and fixed pupil

36
Q

to count as localising how high should the movement be?

A

upto clavicle

37
Q

in GBS there is decreased ______ nerve conduction velocity

A

decreased motor nerve conduction velocity

secondary to demyelination

38
Q

carotid endartectomy should be done on side?

A

contralateral to the symptoms

39
Q

miller fischer syndrome?

A

subtype of GBS

areflexia
opthalomoplegia
ataxia

40
Q
A

Final Year - Passmed (22 decks)

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