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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
Q

Status Epilepticus

A

Prolonged or recurrent tonic-clonic seizures persisting for more than 30 minutes with no recovery period between seizures

26
Q

Syncope

A

Reflex (neuro-cardiogenic)
Taking blood/medical situations
Cough, Micturation

Orthostatic
Dehydration, medication related (anti-hypertensive)
Endocrine, autonomic nervous system

Cardiogenic
Arrhythmia, aortic stenosis

27
Q

Common Sides of Metastasis to Brain

A 
Skin Melanoma
Lung
Breast
Kidneys
Colon
28
Q

Cauda Equina Syndrome

A

Bilateral Sciatica
Urinary Retention
Saddle Paraesthesia

29
Q

Hydrocephalus Types

A

Non-Communicating - Obstruction
Tumour, Congenital

Communicating - CSF Reabsorption Failure
Meningitis, Subarachnoid Haemorrhage

30
Q

Sciatica

A

LA-L5, S1-S3

Compression of nerve root by prolapsed IV Disc caused leg pain, decreased sensation, muscle weakness

31
Q

Amygdala

A

Processing Memory and Emotional Reactions

Damage can lead to erratic behaviour

32
Q

Dilation of the pupil caused by?

A

Cocaine
Brain Death
Dim Light
3rd Nerve Palsy

33
Q

Coning

A

Cerebellum moves inferiorly into foramen magnum

34
Q

Uncal herniation

A

Cerebrum moves inferiorly over edge of tentorium

35
Q

Subfalcine herniation

A

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
Q

Commonest Cancer in Children

A

Meduloblastoma

causes non communicationg hydrocephalous after compression of 4th ventricle

37
Q

Commonest Cancer in Children

A

Meduloblastoma

causes non communicating hydrocephalous after compression of 4th ventricle

38
Q

Cerebellar tonsillar herniation

A

Tonsils move inwards and downwards and crush brainstem - urgent

39
Q

Lacunar Stroke

A

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
Q

Posterior Stroke

A

Pure Motor + / -
Pure Sensory + / -
Brainstem + Cerebellar Signs
Hemianopia / Dysphasia / Neglect + / -

41
Q

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

A

Levodopa

Tetrabenazine

Bromocriptine

Benzodiazepines

42
Q

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.

A

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
Q

Benzodiazepine medication eg. Lorazemap

A

Anxiety disorders,
Trouble sleeping,

Active seizures such as status epilepticus and
alcohol withdrawal

Revision Year 2 (14 decks)

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