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Revision Year 2 > Neuro > Flashcards

Neuro Flashcards

1
Q

Lumbar Puncture Indications

A 
Meningitis
Meningoencephalitis
Subarachnoid hemorrhage
Malignancy – Diagnosis and Treatment
Idiopathic Intracranial Hypertension
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2
Q

Contraindications for Lumbar Puncture

A

Cardiovascular or Respiratory instability
Localized skin/soft tissue infection over puncture site
Unstable bleeding disorder
Platelets < 50,000 or clotting factor deficiency

Increased intracranial pressure

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3
Q

MCA Occlusion

A 
Contra-lateral 
- Paralysis of face/arm/leg
- sensory loss face/arm/leg
Homonymous hemianopia
Gaze paralysis to the opposite side

Aphasia if stroke on dominant (left) side of brain
Dysarthria, Dysphasia
Unilateral neglect and agnosia for half of external space if non-dominant stroke (usually right side).

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4
Q

ACA Occlusion

A

Contra-lateral
Paralysis of foot and leg
Sensory loss over foot and leg
Impairment of gait and stance.

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5
Q

PCA Occlusion

A

Syncope
Vertigo
Diplopia

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6
Q

Stroke Causes

A

Thromboembolism
Raptured Aneurysm
Thrombosis, Atheroma

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7
Q

Total Anterior Circulation Stroke (TACS)

A

= / - Sensory and Motor Loss
Hemianopia + Dysphasia
Or Hemianopia + Neglect

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8
Q

Partial Anterior Circulation Stroke (PACS)

A

+ / - Sensory and Motor Loss
Hemianopia
Or Dysphasia
Or Neglect

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9
Q

Commonest Place for Thrombus

A

Left Atrium

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10
Q

Stroke Teratment

A

Aspirin, Clopidogrel - AntiPlatelet
Warfarin - Anti Coagulant
IV TPA - Thrombolysis (<= 4 Hours)

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11
Q

Hemiplegia

A

paralysis of one side of the body

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12
Q

Multiple Sclerosis

A

Autoimmune - Type 4 Hypersensitivity Reaction

Risk Factors:
Female, Away from equator, Younger, HLA-DR2

Signs: Cerebellar + Sensory Signs, Nystagmus
Internuclear Ophalmoplegia

Symptoms: Diplopia, Limb Weakness, Sensory Weakness, Lhermittes’s Sign (electric sensation down spine)

Lumbar Puncture, (High Protein, ImG, Oligoclonal Bands
White Plaques on MRI

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13
Q

Optic Neuritis

A

Colour Vision Disturbed
Initial Swelling of Optic Disc
Sub-acute
Pain on moving eye

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14
Q

Inter-nuclear Opthalmoplegia

A

Pons

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15
Q

Bad Prognosis of MS

A

Male, Older, Multifocal, Motor Symptoms

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16
Q

MS Treatment

A

Steroids
Interferon-B
Tremor, Pain and Urinary Incontinence Drugs

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17
Q

Alzheimer’s

A

B amyloid plaques and tangles

Progressive memory loss

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18
Q

Vascular Dementia

A

Stepwise Progression

19
Q

Parkinson’s

A

Dopaminergic neurons degeneration substantia Nigran

Risk Factors - Males, Family History, Rural Living

TRAP - Resting Tremor, Rigidity, Akinesia/Bradykinisia, 
Postural Instability (>2of these), Pill Rolling

Sleep Disturbance, Bladder, Bowel Distraction

20
Q

Parkinson’s Treatment

A

Levodopa + Carpidopa Targeted to Brain
If only 1 given it would target peripherally
Dopamine cannot cross the blood brain barrier

Dopamine Agonist - rotigotine

Catechol O Methyl Transferase Inhibitor
Mono Amine Oxidase B Inhibitors
- Protect Dopamine from being Degraded

Deep Brain Stimulation

21
Q

Huntingtons Disease

A

Hundingtin (HTT) on Chromosome 4,

Motor, Cognitive, Saccadic Eye Movements

22
Q

Muscle Disease Investigation

A

EMG
CK
Muscle Biopsy

23
Q

AntiEpileptic Drugs

A

Lorazepam
Carbamazepine
Sodium Valproate

24
Q

Seizure Risk

A 
Missed medications
Sleep disturbance, fatigue
Hormonal changes
Drug/Alcohol use, Drug interactions
Stress/Anxiety
Photosensitivity
25
Status Epilepticus
Prolonged or recurrent tonic-clonic seizures persisting for more than 30 minutes with no recovery period between seizures
26
Syncope
Reflex (neuro-cardiogenic) Taking blood/medical situations Cough, Micturation Orthostatic Dehydration, medication related (anti-hypertensive) Endocrine, autonomic nervous system Cardiogenic Arrhythmia, aortic stenosis
27
Common Sides of Metastasis to Brain
``` Skin Melanoma Lung Breast Kidneys Colon ```
28
Cauda Equina Syndrome
Bilateral Sciatica Urinary Retention Saddle Paraesthesia
29
Hydrocephalus Types
Non-Communicating - Obstruction Tumour, Congenital Communicating - CSF Reabsorption Failure Meningitis, Subarachnoid Haemorrhage
30
Sciatica
LA-L5, S1-S3 | Compression of nerve root by prolapsed IV Disc caused leg pain, decreased sensation, muscle weakness
31
Amygdala
Processing Memory and Emotional Reactions | Damage can lead to erratic behaviour
32
Dilation of the pupil caused by?
Cocaine Brain Death Dim Light 3rd Nerve Palsy
33
Coning
Cerebellum moves inferiorly into foramen magnum
34
Uncal herniation
Cerebrum moves inferiorly over edge of tentorium
35
Subfalcine herniation
midline shift, anterior cerebral artery compressed Cingulate gyrus is pushed over to side and herniates underneath falx Lateral ventricle is crushed flat and displaced downwards
36
Commonest Cancer in Children
Meduloblastoma | causes non communicationg hydrocephalous after compression of 4th ventricle
37
Commonest Cancer in Children
Meduloblastoma | causes non communicating hydrocephalous after compression of 4th ventricle
38
Cerebellar tonsillar herniation
Tonsils move inwards and downwards and crush brainstem - urgent
39
Lacunar Stroke
Basal Ganglia affected Pure motor stroke Pure sensory stroke Dysarthria - unclear articulation of speech Ataxic hemiparesis (weakness, clumsiness of the legs more than arms)
40
Posterior Stroke
Pure Motor + / - Pure Sensory + / - Brainstem + Cerebellar Signs Hemianopia / Dysphasia / Neglect + / -
41
Precursor of the transmitter Interference with the storage of transmitter in vesicles within the pre-synaptic neuron Binding to the post-synaptic receptor site Binding to the receptor-modulating site
Levodopa Tetrabenazine Bromocriptine Benzodiazepines
42
Interference with the breakdown of neurotransmitter within the synaptic cleft Reduce reuptake of transmitter from synaptic cleft into pre-synaptic cell reuptake inhibitors Binding to presynaptic autoreceptors.
Acetylcholinesterase inhibitors; Monoamine oxidase inhibitors—MAOIS Selective serotonin reuptake inhibitors—SSRIS, eg fluoxetine, or serotonin and noradrenaline There are 3 kinds of autoreceptors: Neurotransmitter release modulators, synthesis Modulators, and Impulse modulators. eg. Augmenting antidepressant therapy with 5HT autoreceptor antagonists such as pindolol
43
Benzodiazepine medication eg. Lorazemap
Anxiety disorders, Trouble sleeping, Active seizures such as status epilepticus and alcohol withdrawal

Revision Year 2 (14 decks)

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