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2020 phase 3a newer > neuro > Flashcards

neuro Flashcards

1
Q

how is angina treated>

A

GTN
bisoprolol
aspirin 75
atorvastatin - can cause leg cramps and myositis?

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2
Q

a patient with a fever is given amoxicillin. they develop a maculopapular rash. what is this?

A

EBV

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3
Q

how is essential tremor treated?

A

propranolol or primidone

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4
Q

what are the dermato parts of dermatomyositis?

A

gottron’s papules and (bony prominences?)

heliotrope rash and myopathy ofc

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5
Q

where is interferon beta used?

A

relapsing remitting MS

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6
Q

how is acute ms treated?

A

IV steroids for 3 days?

if no improvement plasma exchange

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7
Q

how is tremor treated in ms?

A

clonazepam

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8
Q

what can cause a surgical 3rd nerve palsy?

A

pcoma aneurysm - painful, no symptoms assoc. with below

cavernous sinus syndrome

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9
Q

how does cavernous sinus syndrome present?

A

ophthalmoplegia
horner’s syndrome
trigeminal sensory loss
and surgical third nerve palsy

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10
Q

what is hoffman’s sign and why useful

A

flick tip of middle finger cause flexion of thumb exaggerated

umn lesion
differentiate between simple carpal tunnel and dcm

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11
Q

what does emg show in mnd?

A

diffuse denervation

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12
Q

what do you use for agitated patients?

A

haloperidol/antipsychotics + procyclidine

lorazepam if PD

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13
Q

pick’s disease investigation?

A

focal gyral atrophy with knife

pick bodies - tau bodies on silver staining

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14
Q

what are symptoms of picks?

A

increased appetite
personality change
hyperorality
perseveration

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15
Q

how might gbm look on ct?

A

frontal mass crossing midline

seizure
aka grade 4 astrocytoma

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16
Q

why does phenytoin need ecg monitoring?

A

arrhythmogenic

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17
Q

what drugs can cause stevenns johnson

A

carbemazepine

lamotrigine

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18
Q

which part of cerebellum is affected in gait ataxia?

A

no limbs

just vermis

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19
Q

which part of cerebellum affected with limb ataxia?

A

cerebellar hemisphere

finger-nose impaired

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20
Q

what criteria is used for complex regional pain syndrome?

A

budapest

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21
Q

when does complex regional pain syndrome happen?

A

weeks to months

treat with amitriptyline and other neuropathic pain

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22
Q

what happens in autonomic dysreflexia?

A

htn bradycardia
sweating flushing above level of injury

at or above T6 level

following cervical injury?

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23
Q

what causes diffuse axonal injury

A

acceleration deceleration etc

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24
Q

which type of bitemporal does craniopharyngioma cause?

A

craniopharyngioma causes lower bitemporal heminopia

pituitary adenoma causes upper bitemporal hemianopia

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25
Q

how are migraines accutely managed?

A

nsaid and triptan

or paracetamol and triptan

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26
Q

what is first line prophylaxis of migraine in women

A

propranolol

topiramate is antiepileptic and ?teratogenic

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27
Q

how is pd treated?

A

if affecting qol - levodopa

if not, dopamine agonists or MAOB

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28
Q

what side effects of dopamine agonists?

A

impulse control disorders
sleepiness
hallucinations

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29
Q

how does pontine haemorrhage present?

A

life threatening

quadriplegia and absence of horizontal eye movements, reduced gcs, miosis!

commonly secondary to htn

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30
Q

how would trigeminal nerve palsy present?

A

loss of sensation duh
loss of corneal reflex
jaw deviation towards affected side (weaker side idk)

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31
Q

how would trochlear nerve palsy present?

A

vertical diplopia

worse when looking down

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32
Q

how would vagal palsy present?

A

uvula deviating AWAY from the lesion!!!!

absent gag reflex

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33
Q

uvula deviates to the right where is the lesion

A

left vagus?

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34
Q

how is nausea treated in pd

A

domperidone

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35
Q

which antiemetics can’t you use in pd?

A

metoclopramide
cyclizine
prochlorperazine

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36
Q

how does syringomyelia present?

A

neck and arms - loss of pain and temp sense
spinothalamic tracts in anterior commisure?
associated with arnold chiari malformation

patients can burn themselves without noticing

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37
Q

what causes homonymous hemianopia with macular sparing

A

posterior cerebral artery infarct

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38
Q

how does progressive supranuclear palsy present

A 
parkinsonism
vertical diplopia
falls
slurred speech
cognitive impairment
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39
Q

how does acoustic neuroma present?

A 
absent corneal reflex
facial palsy
vertigo
hearing loss
tinnitus
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40
Q

what condition can increase risk of bilateral acoustic neuroma

A

nf2

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41
Q

what type of dementia is associated with mnd?

A

frontotemporal

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42
Q

how does wernickes present?

A

ataxia
confusion
opthalmoplegia

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43
Q

how do you treat wernickes?

A

glucose first then thiamine

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44
Q

which nerve is injured if surgical neck of humerus is broken or dislocation of shoulder?

A

axillary - sergeant patch loss of sensation and weakness in 15-90 abduction of arm

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45
Q

what is klumpke?

A 
c8-t1
horners
intrinsic hand muscles lost
dermatome sensory loss
due to traction injuries or delivery?
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46
Q

what is erb’s?

A

c5-6

winged scapula
waiters tip

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47
Q

do you have to tell DVLA if you have tia?

A

no

can drive if 1 month symptom free

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48
Q

how do you tell if optic nerve lesion from light shining?

A

pupil constricts if light shone in the opposite eye

will stay the same (/lesser degree of constriction) if shone in the affected eye

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49
Q

how do you treat headache caused by lumbar puncture?

A

Caffeine and fluids

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50
Q

how is stroke prevented?

A

clopidogrel

if not tolerated aspirin + dipyridamole lifelong

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51
Q

does levodopa cause galactorrhoea?

A

no!

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52
Q

where is wernicke’s region?

A

left superior temporal gyrus

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53
Q

where is broca’s region?

A

left inferior frontal gyrus

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54
Q

what is the treatment for adhesive capsulitis?

A

physio

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55
Q

what side of paresis is homonymous hemianopia on?

A

ipsilateral!

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56
Q

how is stroke treated?

A

aspirin 300mg for 2 weeks then clopidogrel for life

if no clopidogrel - aspirin 75 and dipyridamol

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57
Q

what nerve is damaged in a mid shaft humerus fracture:?

A

radial nerve - wrist drop

no extension of fingers

58
Q

how is acoustic neuroma investigated?

A

audiogram
gadolinium enhanced mri cerebellopontine angle

vertigo
tinnitus
hearing loss
absent corneal reflex, loss of trigem sensation
facial palsy also
59
Q

what would a t1 nerve lesion cause

A

weakness of finger abduction

60
Q

what can happen if levodopa stopped too quickly?

A

neuroleptic malignant syndrome

61
Q

when are triptans contraindicated

A

cardiovascular disease

62
Q

what disease can affect dorsal columns?

A

neurosyphilis

63
Q

what sensation travels in dorsal columns?

A

fine touch
proprioception
vibration

64
Q

what abx can precipitate raised icp idiopathic?

A

tetracyclines! (chlamydia and acne?)

65
Q

what class of abx includes azithromycin erythromycin etc?

A

macrolides

66
Q

what class of drugs includes doxycycline?

A

tetracyclines?

67
Q

what side effects of phenytoin and carbemazepine cerebellar?

A

danish and negative romberg’s

68
Q

when would rombergs be positive

instability when eyes closed

A

dorsal column dysfuntion (loss of proprioception)

69
Q

what does hyperattenuation on ct mean

A

haemorrhagic

70
Q

what is furosemide and how does it affect ears:/

A

loop diuretic

may cause ototoxicity

71
Q

what are the symptoms of intracavernous venous thrombosis?

A

nausea vomiting
headache

saggital venous sinus - seizures and hemiplegia

72
Q

what can cause subacute combined degeneration of cord?

A

b12 deficiency (megaloblastic anaemia )

73
Q

what are symptoms of subacute combined degeneraiton of cord?

A

dosral and lateral columns affected

joint position and vibration sense lost first then distal paraesthesia

UMN signs in legs (babinski, brisk knee, absent ankle)

stiffness and weakness if untreated

74
Q

how to reduce oedema in metastatic brain cancer?

A

iv hypertonic saline

75
Q

what is jugular foramen syndrome

A

cn ix, x and xi (and xii)

weakness of sternocleidomastoid trapezius uvula (deviates away from lesion)
absent gag reflex
hoarse voice

76
Q

what can branchial cyst surgery cause?

A

injured hypoglossal nerve (tongue deviates towards lesion)

77
Q

what is writer’s cramp

A

focal dystonia
when doing one action
cramps stays in the same position

78
Q

what type of cancer causes sclerotic bone mets?

A

prostate

79
Q

lesion in which lobe causes visual neglect/inattention?

A

parietal lobe!

80
Q

what is the most common cause of intracerebral haemorrhage?

A

hypertension

81
Q

can valsalva cause haemorrhage

A

yes = increased htn

82
Q

what can cause subarachnoid hameorrhage?

A

berry aneurysm

83
Q

how to reduce disability in cord compression?

A

surgical decompression and steroids!

84
Q

what nerve root supplies knee?

A

L3

85
Q

hep c can cause cryoglobulinaemia can cause mononeuritis multiplex in ivdu

A

that’s it

86
Q

what can cause haemorrhagic stroke?

A

amyloid disease

87
Q

how does lumbar spinal stenosis present

A

crampy leg pain idk need to learn1!!

88
Q

what causes diabetic third nerve palsy

A

mononeuritis

89
Q

what can cause subdural haemorrhage?

A

anticoagulant use
epidural injections??
LOOK OVER THIS

90
Q

how does encephalitis look on mri

A

bilateral medial temporal lobe on mri

91
Q

https://en.wikipedia.org/wiki/Air_bronchogram

A

https://litfl.com/brainstem-rules-of-4/

92
Q

what is brown sequard?

A
  • ipsilateral hemiparesis
  • ipsilateral loss of proprioception and vibration
  • contralateral loss of pain and temperature (2/3 segments below lesion)
93
Q

what are the csf findings of viral meningitis?

A
  • CSF glucose more than half plasma glucose (high)
  • less than 1g protein (low)
  • predominantly mononuclear cells

-

94
Q

what are the features of congenital toxoplasmosis?

A

hydrocephalus (tense fontanelle)
chorioretinitis (posterior uveitis)
intracranial calcifications

95
Q

what is cervical spondylosis?

A
  • causes falls
  • UMN signs in legs
  • LMN signs in arms
  • lhermitte’s sign
96
Q

what is progressive multifocal leukoencephalopathy

A

hypodense area in basal ganglia

choreiform movements

jc virus

hiv/ms immunosuppression

97
Q

what spinal cord root does knee extension?

A

l3

reduced sensation over medial thigh!!!!

98
Q

what are the symptoms of myotonic dystrophy?

A
  • balding, ptosis
  • slow relaxing grip
  • dysarthria
  • weakness gradually worsening

insulin resistance
cardiomyopathy
testicular atrophy

99
Q

how is myotonic dystrophy inherited?

A

AD

trinucleotide repeat

100
Q

how to treat migraine?

A

nsaid
then nsaid and triptan

always metoclopramide - antiemetic

101
Q

what are the side effects of levodopa?

A
  • dyskinesias
  • restlessness
  • psychosis
    gi upset
    hypotension
102
Q

what are the side effects of topiramate?

A 
weight loss (valproate -gain) 
renal stones
cognitive/behaviour changes
103
Q

internuclear opthalmoplegia

A

DO THIS

104
Q

why postural hypotension in parkinson?

A

autonomic failure

105
Q

which antibiotic can you not use in myasthenia gravis?

A

tetracyclines

106
Q

person with cad and cluster. what medication

A

just high flow o2. no sumatriptan

107
Q

what antiepileptic can cause nystagmus?

A

phenytoin

108
Q

csf findings for viral encephalitis?

A

Raised protein + raised lymphocytes + normal glucose

109
Q

gag reflex: palate elevated because?

A

cranial nerve 10

110
Q

gag reflex: afferent nerve?

A

cn9

111
Q

clasp knife phenomenon. what?

A

umn

112
Q

subthalamic nucleus infarct. what signs

A

involuntary movements contralateral

113
Q

what is first step managing patients with cord compression suspected mets?

A

dexamethasone to reduce swelling around it and reduce decompression and buy time for surgical plan

114
Q

anterior horn cell degeneration. what symptoms

A

fasciculaitons

115
Q

can cataracts cause rapd?

A

no

116
Q

what supplies the thalamus?

A

posterior cerebral artery

117
Q

thalamus lesion causes what

A

reduced pain and temp on contralateral side

118
Q

what are symptoms of subacute combined degeneration?

A

dorsal and lateral columns affected

loss of vibration and proprioception

THEN distal paraesthesia

umn signs in legs
absent ankle jerks

119
Q

pt with absent ankle reflexes, no vibration/proprioception. what?

A

subacute combined degeneration

120
Q

what causes subacute combined degeneration?

A

b12 deficienvy

121
Q

should you use metoclopramide in children with migraine?

A

no

122
Q

isolated raised protein in csf. what is this?

A

gbs

123
Q

how much glucose is normal in csf?

A

> 0.5 of plasma glucose

124
Q

how is stevens johnson treated?

A

iv fluids

125
Q

what anaesthetic is mg pt resistant to?

A

suxamethonium `

126
Q

what nerve responsible for thumb abduction?

A

median`

127
Q

which type of epilepsy has todd’s paresis?

A

frontal lobe

partial seizure

128
Q

which type of MND has worse prognosis?

A

progressive bulbar palsy

129
Q

what are the features of bulbar palsy?

A

CN 9, 10, and 12 affected

absent gag reflex
flaccid fasciculating tongue
nasal quiet speech

130
Q

what are the features of pseudobulbar palsy?

A

upper motor neuron lesion of speech and swallow

spastic tongue
hot potato speech
brisk jaw jerk reflex
emotional lability?

131
Q

what are the features of brown sequard?

A

ipsilateral hemiparesis
ipsilateral loss of vibration and proprioception
contralateral loss of pain and temp

132
Q

what is lateral medullary syndrome caused by?

A

Posterior inferior cerebellar artery

133
Q

what are the symptoms of lateral medullary syndrome?

A 
ipsilateral:
ataxia
horner's
nystagmus
dysphagia
facial numbness

contralateral:
limb sensory loss

134
Q

what causes weber’s syndrome?

A

paramedian branches of posterior cerebral artery

135
Q

what are the symptoms of weber’s syndrome?

A

ipsilateral 3rd nerve palsy

contralateral hemiparesis

136
Q

if patient on levodopa daily stops taking it, what could happen?

A

acute dystonia

137
Q

how to prevent acute dystonia in patient on levodopa?

A

dopamine agonist

138
Q

what medications can precipitate myasthenic crises?

A

bisoprolol and other beta blockers

139
Q

which headaches respond to indomethacin?

A

paroxysmal hemicrania

140
Q

would hoffman’s sign be positive in MS?

A

yes

ms has umn signs

2020 phase 3a newer (11 decks)

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