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MedY3 > Neuro > Flashcards

Neuro Flashcards

1
Q

Wernicke’s aphasia

A

Temporal lobe affected with receptive aphasia or fluent aphasia (comprehension intact but difficulty forming words )

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2
Q

Lateral medullary syndrome or Wallenberg’s syndrome

A

Occlusion of PICA
4 S structures
Spinothalamic tract - contralateral pain and temperature, crude touch, itch
Sympathetic Nervous System -horner’s
Spinocerebellar - ataxia
Sensory nuclei of CN V- ipsi loss of facial sensation

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3
Q

4 midline structure at medulla

A

Motor nuclei of CN 3,4,6,12
Motor tract - corticospinal tract
Medial lemniscus tract - proprioception?
MEDIAL LONGITuDinaL FASCICULUS —-> intranuclear opthalmoplegia

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4
Q

Fatiguable ptosis/ fatigue on climbing stairs/ teacher with sloppy handwriting towards the end of the day

A

Myasthenia gravis

Autoantibodies against ACh receptors?

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5
Q

Paraneoplastic NMJ manifestation ?

A

Arising from small cell Lung carcinoma

Ease of movement improves with more motion

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6
Q

Wernicke’s encephalopathy classic triad

A
  1. Confusion
  2. Ataxia - wide based gait
  3. Opthalmoplegia ( nystagmus, LR or conjugate palsy. Supranuclear opthalmoplegia)

Due to thiamine B1 deficiency

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7
Q

Korsakoff’s syndrome

A

Hypothalamic damage and cerebral atrophy due to thiamine (B1) deficiency.

Decrease ability to form new memories, confabulation (inventing memories) lack of insight and apathy.

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8
Q

Broca’s aphasia

A

Frontal lobe affected with expressive aphasia or non fluent aphasia (difficulty comprehending but formation of non logical sentences)

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9
Q

Down and out gaze with ptosis

A

Cranial Nerve III palsy

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10
Q

Multiple sclerosis is associated with

A

Intranuclear opthalmoplegia
Optic neuritis
Patchy neurological symptoms

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11
Q

Investigations for Stroke

A

Bedside:
ECG and holter
Bloods: FBE, ESR, Coags, Troponin,
Non contrast CT, Echo

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12
Q

Mx of Stroke

A

Ischaemic Stroke: O2 control, BSL, alteplase, Maintain BP, DVT prophylaxis, aspirin

Haemorrhagic Stroke: reverse , refer to Nsx, decrease BP, manage seizure

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13
Q 
Pathology of Brain Infarcts 
<24 hours
1-3 days (S-L-O)
3-5 days (Liq-M -G)
Long term
A

<24 hours - no change
1-3 days - soft swollen pale/ loss of grey white differentiation/ oedema
3-5 days - liquefactive necrosis, macrophage infiltrate, gliosis
Long term - fluid filled cystic change

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14
Q

Cause/location of extradural haemorrhage

A

B/w dura and skull

rupture of middle meningeal artery

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15
Q

Typical presentation of extradural haemorrhage

A

Head trauma, unconscious lucid interval coma

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16
Q

CT finding of extradural hx

A

Biconvex finding, adherance to sutures

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17
Q

Subdural haematoma

  • rupture
  • CT
  • presentation
A
  • bridging emissary vein (b/w dura and arachnoid)
  • elderly pt from fall (brain atrophy, rattle in skull)
  • crosses sutures, crescent shape
18
Q

Subarachnoid hx

  • presentation
  • location
  • Ix
  • Management
A

-Gradually increasing neuro symtom - thunderclap headache, meningism, preceded by sentinel headache ‘warning leak’
-Rupture of berry aneurysm
- Ix - CT and LP (xanthochromia, blood in CSF)
- Clip and coil. Increase volume, increase BP, decrease Hct
induce hypertension, hypervolaemia, haemodilution (Triple H)

19
Q

What are common causes of coma?

COMA

A

CO2 narcosis: COPD, asthma, GBS, respiratory depression
Overdose: alcohol, opiates, benzo, antidepressants,
Metabolic: Hypo/hyperglycaemia, hypo/hypernatraemia, uraemia, hypothyroid, adrenal failure
Apoplexy: stroke, head trauma, encephalitis, epilepsy,

20
Q

Mx of decrease consciousness

A

First aid: DRSABCD- immobilise C spine, O2, 2 large bore IV cannula
Examination: Vital BSL,
Ix:
Manage underlying cause:

21
Q

Causes of headache x 4

A 
Tension headache 
migraine 
Cluster headache 
Trigeminal neuralgia 
OR ( meningitis, sinusitis, temporal arteritis, raise ICP)

Don’t forget rebound headaches - caffeine or med withdrawal

22
Q

Tension Headache

  • Epi
  • Rx
A

Most common in adults, tight band like sensation

Paracetamol, NSAID, amitriptyline

23
Q

Migraine Headache

  • presentation
  • Rx
A 
Common in females, and ED presentation 
Prodrome: photophobia --> prodrome:aura --> severe unilateral throbbing headache 4-7 hours --> nausea, vomiting -->postdrome: lethargy
Rule out others with MRI 
Acute: Paracetamol, NSAID
Dark room, avoid triggers
24
Q

MIGRAINE triggers: CHOCOLATE

A 
Chocolate cheese 
Hydration 
OCP, menstruation 
Caffeine withdrawal 
Odours 
Light loud noise 
alcohol red wine 
Travel 
Eating poorly 
Sleep deprivatoin 
Stress
25
Q

Cluster headaches

  • presentation
  • rx
A
  • most common in males, triggered by alcohol
  • severe consecutive unilateral headaches alternating with headache free period
  • pain behind eyes, lacrimation, rhinorrhoea (sinusitis ddx)

triptan, verapamil, HIGH flow oxygen for 15 minutes.

26
Q

Trigeminal neuralgia

A

Treat with carbamazepine (antiepileptic)
Extreme pain with trigger points
‘suicide disease’

27
Q

Temporal arteritis

  • classic presentation
  • rx
A

> 50 year old with high ESR
Scalp tenderness, jaw claudication, amaurosis fugax,
Treat with : high dose prednisolone, then temporal artery biopsy.

28
Q

What is associated with PMR

A

Temporal arteritis

Due to inflammation of medium and large vessel arteries in body containing elastin

29
Q

Benign intracranial hypertension

- presentation

A

Overweight female with daily headaches worse in the morning.
Assoc with vomiting, diplopia and tinnitus

30
Q

Indications for CT

A
  • First or worst severe headache
  • Change in pattern
  • Neurological signs
  • Over 50
  • Fever (consider LP)
  • Occipital headache (seizure syndrome)
31
Q

Occipital headache can be associated with:

A

Subarachnoid haemorrhage

32
Q

Triad for brain abscess

Presentation and treatment

A

Fever
Headache
Focal neurology

fluclox
metro
ceftaz

33
Q

Encephalitis

  • cause
  • rx
A

Commonest cause: viral
HSV, EBV, varicella, adenovirus
Empirical: acyclovir

34
Q

Commonest primary brain tumours

A

Meningiomas (good prognosis) 36%
Gliomas - 2nd commonest (good prognosis except GBM)
Pituitary adenomas
schwannomas

35
Q

CT MRI findings of

  • abscess
  • metastases
  • primary
A
  • Abscess and metastases found at corticomedullary junction
  • A: central necrosis, reactive edge
  • M: small, multiple, rounded satelite
  • P: solid tissue, single large
36
Q

5 causes of peripheral neuropathy

A 
DEBUT
Diabetes
ETOH
B12 deficiency 
Uraemia (kidney failure) 
Thyroid (hypo)
37
Q

Charcot Marie tooth has what typical gait

A

Flat footed - crane like?

High arched foot

38
Q

Most common bacterial pathogens for bacterial meningitis

A 
Strep pneumoniae 
Neisseria meningitides
Haemophillus influenzae 
Listeria monocytogenes 
Mycoplasma tuberculosis
39
Q

Most common viral causes of viral meningitis

A

Herpes simplex virus HSV
Coxsackie virus
Echovirus

40
Q

Causes of SeizuresL TIMED P

A 
Trauma 
Infection 
Metabolic glucose 
Mass 
Epilepsy 
DRugs 
Pseudoseizure
41
Q

Triggers for Seizures IFSSAD

A 
Illness 
Flashing lights 
stress 
sleep deprivation 
alcohol withdrawal 
drugs (illicit/noncompliance)
42
Q

If icp is raised, first cranial nerve to be affected ?

A

CNVI

MedY3 (16 decks)

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