neuro Flashcards
1
Q
how is angina treated>
A
GTN
bisoprolol
aspirin 75
atorvastatin - can cause leg cramps and myositis?
2
Q
a patient with a fever is given amoxicillin. they develop a maculopapular rash. what is this?
A
EBV
3
Q
how is essential tremor treated?
A
propranolol or primidone
4
Q
what are the dermato parts of dermatomyositis?
A
gottron’s papules and (bony prominences?)
heliotrope rash and myopathy ofc
5
Q
where is interferon beta used?
A
relapsing remitting MS
6
Q
how is acute ms treated?
A
IV steroids for 3 days?
if no improvement plasma exchange
7
Q
how is tremor treated in ms?
A
clonazepam
8
Q
what can cause a surgical 3rd nerve palsy?
A
pcoma aneurysm - painful, no symptoms assoc. with below
cavernous sinus syndrome
9
Q
how does cavernous sinus syndrome present?
A
ophthalmoplegia
horner’s syndrome
trigeminal sensory loss
and surgical third nerve palsy
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
11
Q
what does emg show in mnd?
A
diffuse denervation
12
Q
what do you use for agitated patients?
A
haloperidol/antipsychotics + procyclidine
lorazepam if PD
13
Q
pick’s disease investigation?
A
focal gyral atrophy with knife
pick bodies - tau bodies on silver staining
14
Q
what are symptoms of picks?
A
increased appetite
personality change
hyperorality
perseveration
15
Q
how might gbm look on ct?
A
frontal mass crossing midline
seizure
aka grade 4 astrocytoma
16
Q
why does phenytoin need ecg monitoring?
A
arrhythmogenic
17
Q
what drugs can cause stevenns johnson
A
carbemazepine
lamotrigine
18
Q
which part of cerebellum is affected in gait ataxia?
A
no limbs
just vermis
19
Q
which part of cerebellum affected with limb ataxia?
A
cerebellar hemisphere
finger-nose impaired
20
Q
what criteria is used for complex regional pain syndrome?
A
budapest
21
Q
when does complex regional pain syndrome happen?
A
weeks to months
treat with amitriptyline and other neuropathic pain
22
Q
what happens in autonomic dysreflexia?
A
htn bradycardia
sweating flushing above level of injury
at or above T6 level
following cervical injury?
23
Q
what causes diffuse axonal injury
A
acceleration deceleration etc
24
Q
which type of bitemporal does craniopharyngioma cause?
A
craniopharyngioma causes lower bitemporal heminopia
pituitary adenoma causes upper bitemporal hemianopia
25
how are migraines accutely managed?
nsaid and triptan
| or paracetamol and triptan
26
what is first line prophylaxis of migraine in women
propranolol
topiramate is antiepileptic and ?teratogenic
27
how is pd treated?
if affecting qol - levodopa
| if not, dopamine agonists or MAOB
28
what side effects of dopamine agonists?
impulse control disorders
sleepiness
hallucinations
29
how does pontine haemorrhage present?
life threatening
quadriplegia and absence of horizontal eye movements, reduced gcs, miosis!
commonly secondary to htn
30
how would trigeminal nerve palsy present?
loss of sensation duh
loss of corneal reflex
jaw deviation towards affected side (weaker side idk)
31
how would trochlear nerve palsy present?
vertical diplopia
| worse when looking down
32
how would vagal palsy present?
uvula deviating AWAY from the lesion!!!!
| absent gag reflex
33
uvula deviates to the right where is the lesion
left vagus?
34
how is nausea treated in pd
domperidone
35
which antiemetics can't you use in pd?
metoclopramide
cyclizine
prochlorperazine
36
how does syringomyelia present?
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
37
what causes homonymous hemianopia with macular sparing
posterior cerebral artery infarct
38
how does progressive supranuclear palsy present
```
parkinsonism
vertical diplopia
falls
slurred speech
cognitive impairment
```
39
how does acoustic neuroma present?
```
absent corneal reflex
facial palsy
vertigo
hearing loss
tinnitus
```
40
what condition can increase risk of bilateral acoustic neuroma
nf2
41
what type of dementia is associated with mnd?
frontotemporal
42
how does wernickes present?
ataxia
confusion
opthalmoplegia
43
how do you treat wernickes?
glucose first then thiamine
44
which nerve is injured if surgical neck of humerus is broken or dislocation of shoulder?
axillary - sergeant patch loss of sensation and weakness in 15-90 abduction of arm
45
what is klumpke?
```
c8-t1
horners
intrinsic hand muscles lost
dermatome sensory loss
due to traction injuries or delivery?
```
46
what is erb's?
c5-6
winged scapula
waiters tip
47
do you have to tell DVLA if you have tia?
no
| can drive if 1 month symptom free
48
how do you tell if optic nerve lesion from light shining?
pupil constricts if light shone in the opposite eye
will stay the same (/lesser degree of constriction) if shone in the affected eye
49
how do you treat headache caused by lumbar puncture?
Caffeine and fluids
50
how is stroke prevented?
clopidogrel
if not tolerated aspirin + dipyridamole lifelong
51
does levodopa cause galactorrhoea?
no!
52
where is wernicke's region?
left superior temporal gyrus
53
where is broca's region?
left inferior frontal gyrus
54
what is the treatment for adhesive capsulitis?
physio
55
what side of paresis is homonymous hemianopia on?
ipsilateral!
56
how is stroke treated?
aspirin 300mg for 2 weeks then clopidogrel for life
if no clopidogrel - aspirin 75 and dipyridamol
57
what nerve is damaged in a mid shaft humerus fracture:?
radial nerve - wrist drop
| no extension of fingers
58
how is acoustic neuroma investigated?
audiogram
gadolinium enhanced mri cerebellopontine angle
```
vertigo
tinnitus
hearing loss
absent corneal reflex, loss of trigem sensation
facial palsy also
```
59
what would a t1 nerve lesion cause
weakness of finger abduction
60
what can happen if levodopa stopped too quickly?
neuroleptic malignant syndrome
61
when are triptans contraindicated
cardiovascular disease
62
what disease can affect dorsal columns?
neurosyphilis
63
what sensation travels in dorsal columns?
fine touch
proprioception
vibration
64
what abx can precipitate raised icp idiopathic?
tetracyclines! (chlamydia and acne?)
65
what class of abx includes azithromycin erythromycin etc?
macrolides
66
what class of drugs includes doxycycline?
tetracyclines?
67
what side effects of phenytoin and carbemazepine cerebellar?
danish and negative romberg's
68
when would rombergs be positive
| instability when eyes closed
dorsal column dysfuntion (loss of proprioception)
69
what does hyperattenuation on ct mean
haemorrhagic
70
what is furosemide and how does it affect ears:/
loop diuretic
| may cause ototoxicity
71
what are the symptoms of intracavernous venous thrombosis?
nausea vomiting
headache
saggital venous sinus - seizures and hemiplegia
72
what can cause subacute combined degeneration of cord?
b12 deficiency (megaloblastic anaemia )
73
what are symptoms of subacute combined degeneraiton of cord?
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
how to reduce oedema in metastatic brain cancer?
iv hypertonic saline
75
what is jugular foramen syndrome
cn ix, x and xi (and xii)
weakness of sternocleidomastoid trapezius uvula (deviates away from lesion)
absent gag reflex
hoarse voice
76
what can branchial cyst surgery cause?
injured hypoglossal nerve (tongue deviates towards lesion)
77
what is writer's cramp
focal dystonia
when doing one action
cramps stays in the same position
78
what type of cancer causes sclerotic bone mets?
prostate
79
lesion in which lobe causes visual neglect/inattention?
parietal lobe!
80
what is the most common cause of intracerebral haemorrhage?
hypertension
81
can valsalva cause haemorrhage
yes = increased htn
82
what can cause subarachnoid hameorrhage?
berry aneurysm
83
how to reduce disability in cord compression?
surgical decompression and steroids!
84
what nerve root supplies knee?
L3
85
hep c can cause cryoglobulinaemia can cause mononeuritis multiplex in ivdu
that's it
86
what can cause haemorrhagic stroke?
amyloid disease
87
how does lumbar spinal stenosis present
crampy leg pain idk need to learn1!!
88
what causes diabetic third nerve palsy
mononeuritis
89
what can cause subdural haemorrhage?
anticoagulant use
epidural injections??
LOOK OVER THIS
90
how does encephalitis look on mri
bilateral medial temporal lobe on mri
91
https://en.wikipedia.org/wiki/Air_bronchogram
https://litfl.com/brainstem-rules-of-4/
92
what is brown sequard?
- ipsilateral hemiparesis
- ipsilateral loss of proprioception and vibration
- contralateral loss of pain and temperature (2/3 segments below lesion)
93
what are the csf findings of viral meningitis?
- CSF glucose more than half plasma glucose (high)
- less than 1g protein (low)
- predominantly mononuclear cells
-
94
what are the features of congenital toxoplasmosis?
hydrocephalus (tense fontanelle)
chorioretinitis (posterior uveitis)
intracranial calcifications
95
what is cervical spondylosis?
- causes falls
- UMN signs in legs
- LMN signs in arms
- lhermitte's sign
96
what is progressive multifocal leukoencephalopathy
hypodense area in basal ganglia
choreiform movements
jc virus
hiv/ms immunosuppression
97
what spinal cord root does knee extension?
l3
| reduced sensation over medial thigh!!!!
98
what are the symptoms of myotonic dystrophy?
- balding, ptosis
- slow relaxing grip
- dysarthria
- weakness gradually worsening
insulin resistance
cardiomyopathy
testicular atrophy
99
how is myotonic dystrophy inherited?
AD
| trinucleotide repeat
100
how to treat migraine?
nsaid
then nsaid and triptan
always metoclopramide - antiemetic
101
what are the side effects of levodopa?
- dyskinesias
- restlessness
- psychosis
gi upset
hypotension
102
what are the side effects of topiramate?
```
weight loss (valproate -gain)
renal stones
cognitive/behaviour changes
```
103
internuclear opthalmoplegia
DO THIS
104
why postural hypotension in parkinson?
autonomic failure
105
which antibiotic can you not use in myasthenia gravis?
tetracyclines
106
person with cad and cluster. what medication
just high flow o2. no sumatriptan
107
what antiepileptic can cause nystagmus?
phenytoin
108
csf findings for viral encephalitis?
Raised protein + raised lymphocytes + normal glucose
109
gag reflex: palate elevated because?
cranial nerve 10
110
gag reflex: afferent nerve?
cn9
111
clasp knife phenomenon. what?
umn
112
subthalamic nucleus infarct. what signs
involuntary movements contralateral
113
what is first step managing patients with cord compression suspected mets?
dexamethasone to reduce swelling around it and reduce decompression and buy time for surgical plan
114
anterior horn cell degeneration. what symptoms
fasciculaitons
115
can cataracts cause rapd?
no
116
what supplies the thalamus?
posterior cerebral artery
117
thalamus lesion causes what
reduced pain and temp on contralateral side
118
what are symptoms of subacute combined degeneration?
dorsal and lateral columns affected
loss of vibration and proprioception
THEN distal paraesthesia
umn signs in legs
absent ankle jerks
119
pt with absent ankle reflexes, no vibration/proprioception. what?
subacute combined degeneration
120
what causes subacute combined degeneration?
b12 deficienvy
121
should you use metoclopramide in children with migraine?
no
122
isolated raised protein in csf. what is this?
gbs
123
how much glucose is normal in csf?
>0.5 of plasma glucose
124
how is stevens johnson treated?
iv fluids
125
what anaesthetic is mg pt resistant to?
suxamethonium `
126
what nerve responsible for thumb abduction?
median`
127
which type of epilepsy has todd's paresis?
frontal lobe
| partial seizure
128
which type of MND has worse prognosis?
progressive bulbar palsy
129
what are the features of bulbar palsy?
CN 9, 10, and 12 affected
absent gag reflex
flaccid fasciculating tongue
nasal quiet speech
130
what are the features of pseudobulbar palsy?
upper motor neuron lesion of speech and swallow
spastic tongue
hot potato speech
brisk jaw jerk reflex
emotional lability?
131
what are the features of brown sequard?
ipsilateral hemiparesis
ipsilateral loss of vibration and proprioception
contralateral loss of pain and temp
132
what is lateral medullary syndrome caused by?
Posterior inferior cerebellar artery
133
what are the symptoms of lateral medullary syndrome?
```
ipsilateral:
ataxia
horner's
nystagmus
dysphagia
facial numbness
```
contralateral:
limb sensory loss
134
what causes weber's syndrome?
paramedian branches of posterior cerebral artery
135
what are the symptoms of weber's syndrome?
ipsilateral 3rd nerve palsy
| contralateral hemiparesis
136
if patient on levodopa daily stops taking it, what could happen?
acute dystonia
137
how to prevent acute dystonia in patient on levodopa?
dopamine agonist
138
what medications can precipitate myasthenic crises?
bisoprolol and other beta blockers
139
which headaches respond to indomethacin?
paroxysmal hemicrania
140
would hoffman's sign be positive in MS?
yes
| ms has umn signs
