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Finals > Neuro > Flashcards

Neuro Flashcards

1
Q

list the types of MS

A

relapsing-remitting, primary progressive, secondary progressive

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2
Q

which areas are most commonly affected by MS

A

optic nerve, cervical cord, periventricular areas

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3
Q

2 signs in MS

A

Lhermitte’s - neck flexion = paresthesia

uthoff’s - worse in heat

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4
Q

investigations in MS

A

MRI - demyelinating plaques
LP - oligoclonal bands
evoked potentials

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5
Q

diagnosis of anterior stroke (ie symptoms) and arteries affected

A

need 3/3 for total and 2/3 for partial
unilateral hemiparesis, hemianopia, dysphasia
middle cerebral (arm), anterior cerebral (leg)

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6
Q

diagnosis of poterior stroke (ie symptoms) and arteries affected

A 
one of;
homonymous hemianopia
loss of consciousness
cerebellar syndrome 
vertebrobasilar arteries
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7
Q

diagnosis of lacunar stroke (ie symptoms) and arteries affected

A 
1 of; 
unilateral weakness
ataxic hemiparesis
sensory change 
perforating arteries
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8
Q

long term management of stroke

A

aspirin for 2/52 then clopidogrel

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9
Q

management of TIA

A

do ABCDE2

warfarin if AF or clopidogrel if no AF

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10
Q

explain CHADS2Vasc

A

risk of stroke in AF

give warfarin

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11
Q

describe the presentation and CT findings of an extradural and vessel affected

A

lucid period then reduced LOC following temporal bone fracture
fixed dilated pupil due to CN III compression
biconvex lesion with midline shift
middle meningeal

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12
Q

describe the presentation and CT findings of a sub dural

A

fluctuating consciousness. can be chronic.
crescent shaped not limited by suture lines (bright/hyperdense in acute, dark/hypodense in chronic)
bridging veins

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13
Q

describe the presentation and CT findings of subarachnoid

A

sudden onset thunder clap headache, meningism, N&V
star sign, follows suture lines
circle of willis

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14
Q

investigations and management in subarachnoid

A

CT
Lp 12 hrs after onset - xanthochromia
nimodipine

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15
Q

presentation of parkinsons

A

rigidity, bradykinesia (slow intention, shuffling gait), tremor (resting, pill rolling, unilateral)

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16
Q

name the parkinson’s plus syndromes

A

multiple system atrophy - autonomic dysfunction
progressive supranuclear palsy - vertical gaze palsy, postural instability
lewey body dementia - visual hallucinations
vascular - risk factors
corticobasal degeneration - alien limb, sensory loss

trial of levodopa doesn’t help

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17
Q

what drugs are used in parkinsons

A 
MAOi's (selegiline)
dopamine agonists (ropinirole) - domperidone as antiemetic is nausea and vomiting
l-dopa and madopar (decarboxylase inhibitor)
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18
Q

acute and chronic treatment of tension headache

A

short term analgesia/ amitriptyline

10 sessions acupuncture over 5-8 weeks

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19
Q

acute and chronic treatment of cluster headache

A

100% oxygen and SC/sublingual triptan

verapimil

20
Q

acute and chronic treatment of migraine

A

oral triptan and analgesia

if get >2 attacks a month give topiramate (can give propranolol)

21
Q

investigations in seizures

A

EEG, CT, glucose , U&E’s

22
Q

management of epilepsy

A 
sodium valproate (generalised)
carbamazepine (focal)
23
Q

driving advice in seizures

A

cant drive for 6 months after seizure and cant drive for 1 year seizure free in epilepsy

24
Q

driving advice in TIA

A

at least 1 month off driving

25
Q

management of status epilepticus

A

buccal midaz , repeat benzo, phenytoin, phenobarbital

26
Q

signs in spinal cord compression

A

UMN signs BELOW level
LMN signs at level of lesion
contralateral loss of pain and temperature sensation
sphincter disturbance

27
Q

neuro deficits in brown sequard

A

ipsilateral loss of vibration, proprioception, and fine touch (dorsal columns) and motor function at the level of lesion

contralateral loss of pain and temperature 1-2 levels below the lesion

28
Q

management of MS

A

alemtuzumab
beta interferon
methylpred in flare up

29
Q

criteria for MND

A

El escorial criteria
UMN and LMN signs
no sensory signs
progressive course

30
Q

investigations and management of MND

A

EMG
creatinine kinase high
riluzole and baclofen for spacisity

31
Q

presentation of myasthenia gravis

A 
diplopia/ptosis
speech change
peek sign
snarl
swallowing and breathing difficulties
32
Q

investigations in myasthenia gravis

A

Ab’s: anti Ach, anti-musk
CT thorax for thymus hyperplasia
EMG

33
Q

management of myasthenia gravis (chronic and acute)

A

pyridostigmine, immunosuppression, thymectomy

acute: plasma exchange and IVIg

34
Q

triad in normal pressure hydrocephalus

A

gait abnormality
dementia
urinary incontinence

35
Q

signs in a c5/6 radiculopathy

A

loss of biceps reflex (6 letters)

altered thumb sensation

36
Q

signs in C7 radiculopathy

A

loss of triceps reflex (7 letters)

middle finger sensation

37
Q

signs in L5 radiculopathy

A

cant stand on heels (dorsiflexion)

big toe sensation

38
Q

signs in s1 radiculopathy

A

cant stand on toes

absent ankle reflex

39
Q

what does a negative rinne’s test mean

A

bone conduction = better than air conduction

conductive deafness

40
Q

weber’s test lateralized to left ear means?

A

conductive problem in left ear (if rinnes negative)

or sensorineural deafness in right ear (if rinnes positive .- ie. normal rinne’s)

41
Q

describe grading of muscle weakness (MRC)

A

0: no contraction
1: flicker
2: some active movement
3: active movement against gravity
4: active movement against some resistance
5: normal power

42
Q

investigations in memory loss

A

AMT (out of 10)
MMSE (out of 30. <24 = demantia)
bloods: B12/folate, FBC, ESR, U&E, calcium, syphilis
CT

43
Q

management in dementia

A

psychosocial

anticholinesterase i’s : donepezil, rivastigmine, memantine

44
Q

causes of facial nerve palsy

A 
bells (diagnosis of exclusion)
ramsay hunt
infection
stroke
tumour
diabetes
GBS
parotid tumour
45
Q

what is bells palsy

A

one half of face paralysed (LMN)
CN VII palsy
give prednisilone

46
Q

what mononeuropathy gives you foot drop?

A

common peroneal

47
Q

causes of polyneuropathy

A 
diabetes
Gbs
b12/folate deficiency 
RA
polyarteritis nodosa
GPA
polycythaemia 
HIV
syphilis
lymes disease
charcot marie tooth
drugs (alcohol, isoniazid, phenytoin, metronidazole, nitrofurantoin)

Finals (18 decks)

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