Neuro Flashcards
benign tumour, affects children, surgery is curative
astrocytoma
brain tumour affecting the frontal lobe, 25-45 year olds, presenting with seizures
oligodendral tumours
what viruses target neurones
herpes, polio, rabies
how do viruses infect neurones
exploit retrograde transport in the axon
sensory fibres leave what horn
dorsal
motor fibres leave what horn
ventral
name the substrate and receptor involved in excitatory nerve impulses
glutamate, cation selective inotropic
name the substrates and receptor involved in inhibitory nerve impulses
gamma-aminobutyric acid, GABA, glycine, target post synaptic anion inotropics
when is glutamate inhibitory
when it acts on metatropic glutamate receptors
what cells line the ventricles
ependymal cells
what cells are the phagocytes of the NS
microglia
what cells produce myelin in the CNS
oligodendrites
what cells produce myelin in the PNS
Schwann cells
what cells maintain the BBB in the CNS
astrocytes
what is spatial summation
many neurones combine to reach threshold
inheritance pattern of DMD
x-linked recessive
inheritance pattern of Huntington
autosomal dominant
pathophysiology behind hunting tons
excess glutamine, CAG repeats = abnormal huntingtin gene
most common dementia
alxhiemers
molecular changes seen in alzheimers
cortical neurone loss, neurofibrillary tangles, senile plaques
treatment of tics
clonidine, tetrabenzamine and CBT
CSF result in tuberculous meningitis
clear, lymphocytes, increased protein, decreased glucose
onset of MS
30-40 years
where is the problem in internuclear ophthalmoplegia
medial longitudinal fasiculus
describe CSf result in MS
clear, increased oligoclonal bands
treatment of MS fatigue
amantadine
treatment of MS exacerbation
symptomatic treatment, steroids: methylprednisolone 500mg OD
first line disease slowing drugs in MS
interferon beta
second line disease slowing drugs in MS
monoclonal antibodies
third line disease slowing drugs in MS
mitoxantrone (relapsing progressive)
first line drug for relapsing remitting
tecfedira
describe UMN lesions in MND
increased tone, hyperreflexia, extensor plantar response, spastic gait, increased jaw jerk, bradykinesia
describe LMN in MND
wasting, fatigue, fasciculations, absent/reduced reflexes
what is the most common type of MND
amyotrophic lateral sclerosis
what features does ALS have
UMN and LMN
what features does primary lateral sclerosis have
only UMN
what disorders tend to precede parkinson
REM parasomnias
in what syndrome are antibodies produced against presynaptic calcium terminals
Lambert Eaton syndrome
what is the problem in myasthenia gravis
antibodies produced against acetylcholine receptors
how do you manage myasthenia gravis
give acetylcholinesterase inhibitors
release of what chemical produces aura in migraine
substance P
what can you give as migraine prophylaxis
propranolol, tropiramate, amitryptiline
what headaches come under trigeminal autonomic cephalgias
cluster, hemicranias, SUNCT
prophylactic treatment of cluster headaches
verapamil
general management of cluster headaches
sumatriptan, steroids
gold standard confirmation of SAH
angiography
csf appearance in SAH
xanthochromic
management of SAH
endovascular treatment or surgical clipping
explain cord transection
a complete lesion affecting all motor and sensory components
explain cord hemisection
ipsilateral motor and sensory loss (not pain and temp) and contralateral pain and temp loss
explain central cord syndrome
cape like sensory loss and distal upper limb weakness
extradural masses are typically
metastases
brain abcesses in the UK are typically caused by
staph
imaging of choice in brain abscesses
ct with contrast
management of brain abscess
drain. give ceftriaxone and metronidazole
management of gillian barre
immunoglobulin infusion/plasma exchange
management of generalised seizures
sodium valproate/lamotrigine
management of partial seizures
carbamazepine/lamotrigine
3 second spike and wave pattern on EEG
petit mal
what kind of stroke:
- contralateral hemiparesis + sensory loss
- lower limbs affected over upper
anterior cerebral
what kind of stroke:
- contralateral hemiparesis + sensory loss
- contralateral homonymous hemianopia
- upper limbs affected over lower
middle cerebral
what kind of stroke:
- contralateral homonymous hemianopia with macular sparing
- visual agnosia
posterior cerebral
what kind of stroke:
- ipsilateral facial pain and temperature loss
- contralateral limb/torse pain and temperature loss
- ataxia, nystagmus, vertigo and dysarthria
Posterior inferior cerebellar artery (lateral medullary syndrome)
what kind of stroke:
- locked in syndrome
Basilar artery
what kind of stroke:
- either:
hemiparesis, hemisensory loss or hemiparesis with limb ataxia
lacunar stroke
what sites can lacunar stroke effect
basal ganglia, thalamus, internal capsule
name the pathogens of meningitis in the following age groups:
- neonates
- kids
- 10-21
- 21+
- Listeria, E.Coli
- H.Influezae
- meningococcal
- pneumococcal
treatment of bacterial meningitis
ceftriaxone IV 2g BD include amoxicillin if listeria cover needed.
give IV dexamethasone 10mg QDS
pen allergic: chloramphenicol
describe various CSF results
- bacterial
- viral
- fungal
- cloudy in colour, low in glucose, high in protein, polymorphs
- clear/cloudy, 60-80% of plasma glucose, normal/raised protein, lymphocytes
- cloudy/ fibrin web, low glucose, high protein, lymphocytes
what causes parkinson’s
degeneration of dopaminergic neurones in the substantia nigra
parkinsonism triad
bradykinesia, resting tremor, rigidity
treatment of parkinson’s
young: ropinirole
older: selegiline/cabergoline
tremor and rigidity: procylidine
