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Phase 2A HT > Neuro > Flashcards

Neuro Flashcards

1
Q

Dermatome = ?

A

= area of skin supplied by a single spinal nerve/root

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2
Q

Myotome = ?

A

= volume of muscle supplied by a single spinal motor nerve

most muscles have more than one myotome

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3
Q

What does the lateral corticospinal tract control

A

rapid, skilled, voluntary movement

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4
Q

what does the anterior corticospinal tract control

A

rapid skilled voluntary movement

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5
Q

vestibulospinal tract role?

A

facilitates extensors, inhibits flexors (controls dizziness) and balance

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6
Q

rubrospinal tract role

A

facilitates flexors and and inhibits extensors

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7
Q

tectospinal tract role

A

truncal reflexes from sigths

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8
Q

Define TIA

A

= transient and reversible episode of sudden onset neurological dysfunction caused by ischaemia without acute infarction
symps usually resolve within 24 hours

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9
Q

Where do most TIAs occur

A

in the anterior circulation (carotid territory)

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10
Q

what are the most rapid acting antihypertensives used in acute BP lowering after stroke/haemorrhage

A
  • IV labetamol (BB)

- IV GTN

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11
Q

define syncope attack

A

= paroxysmal event where changes in behaviour, sensation and cognitive processes are caused by insufficient blood/oxygen supply to the brain

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12
Q

3 causes of blackouts

A

syncope
epilepsy
non-epileptic seizures

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13
Q

precipitating factors for status epilepticus

A

alcohol abuse
abruptly stopping AEDs
intercurrent illness
poor compliance with tx

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14
Q

define myotonia

A

= delayed relaxation of muscle after contraction

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15
Q

characteristic pathology/general symptoms of MG

A

weakness and fatiguability of occular, bulbar and proximal limb muscles

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16
Q

4 conditions assoc w MG

A

RA
thyroid disease
pernicious anaemia
SLE

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17
Q

Ab involved in MG

A

anti-AChR and anti-MuSK

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18
Q

histology of MG

A

See AChR Ig and complement deposited at post synaptic membranes

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19
Q

occular symptoms of MG

A

diplopia, ptosis

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20
Q

What worsens the weakness experienced in MG

A 
pregnancy
hypokalaemia
emotion
infection
exercise
drugs
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21
Q

Mx of MG

A

PYRIDOSTIGMINE (= acetyl-cholinesterase inhibitor)
if not controlled, add steroids, gradually decrease prednis dose
if not controlled still, add MTX/azathioprine
thymectomy if difficult to control
plasmapharesis in severe exacerbation

22
Q

what is the most common form of MND and what neurones are involved

A

Amyotrophic lateral sclerosis (ALS) - UMN & LMN

23
Q

different patterns of onset in MND

A 
limb onset (most common)
bulbar onset (worse prognosis - 20%)
resp onset (least common)
24
Q

how would you distinguish MND from MS, MG and GBS

A

in MND:

  • bladder and rectal sphincters usually spared
  • no sensory symps
25
Q

MND (ALS) general symps

A

eventually weakness and atrophy of all 4 extremities, trunk and bulbar muscles

26
Q

characteristic sign in MND

A

fasciculations

27
Q

what is Guillain barre syndrome (GBS)

A

= acute inflammatory demyelinating ascending polyneuropathy of PNS

28
Q

what is GBS normally triggered by

A

an upper respt tract/GIT infection

29
Q

common causative agents of GBS

A

CAMPYLOBACTER JEJUNI, CMV,

others: mycoplasma, zoster, EBV, HIV - 40% no infectious cause found

30
Q

clinical presentation of GBS

A

1-3 wks post-inf: ascending symmetrical weakness, starting in distal muscles and progressing to more proximal ones over ~4wks
followed by recovery
see: loss of reflexes, neuropathic pain and autonomic dysfunction

31
Q

signs of autonomic dysfunction

A

sweating, tachycardia, arrhythmias

32
Q

what may lead to an ITU admission with GBS

A

involvement of resp muscles,

therefore must monitor FVC regularly in these pts

33
Q

Mx of GBS

A

IV Ig
plasmapharesis (effective but rarely used)
MONITOR VENTILATION

34
Q

3 cardinal symptoms/signs of brain tumour

A

symps of raised ICP
progressive neurological deficit
epilepsy

35
Q

signs of raised ICP

A

headache, drowsiness, N&V

36
Q

cardinal physical sign of brain tumour

A

papilloedema

37
Q

cell origin of most primary brain tumours

A

glial cell (mainly astrocytomas)

38
Q

what is dexamethasomes action

A

decreases cerebral oedema

39
Q

Mx of GBM

A

TEMOZOLOMIDE = chemo has radically improved survival in pts with MGMT mutant
other mx: surgical resection (w. post-op chemo), RT,

40
Q

mx of secondary brain tumours

A

surgery not often poss but surgery and chemo have best outcome
BSC often as effective as RT and prolongs QOL

41
Q

causes of meningitis in neonates

A

E coli, group B B-haemolytic strep

42
Q

causes of meningitis in adults

A

n. meningitidis, strep. pneumoniae, (h. influenzae)

43
Q

causes of meningitis in eldery

A

n. meningitidis, strep. pneumoniae, listeria

44
Q

causes of meningitis in immunocompromised

A

CMV, cryptococcus (stains with INDIA INK), TB

45
Q

S&S of meningitis

A 
headache
meningism = neck stiffness and photophobia
Kernig's and Brudinski sign
Non-blanching petechial rash
altered mental state (oedema)
fever
seizures
46
Q

Mx of meningitis

A

if suspect bacterial - start ABX immediately
IV cefotaxime (if community benzylpenicillin)
if >50 add ampicillin to cover for listeria
dexamethasome - decrease cerebral oedema
Notify PHE!!

47
Q

prophylaxis of meningitis

A

rifampicin/ciprofloxacin

48
Q

what is encephalitis

A

inflam of brain parenchyma

affects frontal and temporal lobes –> decreased consciousness, confusion and focal signs

49
Q

what causes encephalitis

A

viral infection - most commonly HSV1 and 2
others: varicella zoster, EBV, mumps, measles, CMV, HIV
non-viral - secondary to bacterial meningitis, TB, toxoplasma

50
Q

S&S of encephalitis

A

features of viral inf
DECREASED CONSCIOUSNESS
behavioural change, focal neurological deficit, coma, seizures

51
Q

mx of encephalitis

A

if viral URGENT ACYCLOVIR

if meningitis suspected, emergency IM benzylpenicillin

Phase 2A HT (11 decks)

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