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Lottie's Question Books > Neuro > Flashcards

Neuro Flashcards

1
Q

What is the main risk factor of stroke?

A

HTN

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2
Q

List factors that convey a better prognosis for MS?

A

Under 25

Optic neuritis or sensory disturbance as primary complaint

Greater than 1 year between events

Few lesions on MRI

Female

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3
Q

What is amaurosis fugax?

A

Painless unilateral vision loss of short duration.

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4
Q

What causes amaurosis fugax?

A

Retain artery emboli due to AF

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5
Q

What is the immediate Tx of stroke? Why?

A

1st = nil by mouth –> prevent aspiration pneumoia

2nd = CT head –> can tell between ischaemic and haemorrhagic better

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6
Q

List complete contraindications to thrombolysis in stroke Tx

A

Onset more than 3hrs ago

Current seizure

BP > 180/110

Surgery less than 2 weeks ago

Bleeding

Previous intracranial bleed

LP less than 7 days ago

Stroke less than 3 months ago

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7
Q

Spine claudication, lumbar pain, sciatica on moving. Better when walking uphill vs down. Dx?

A

Spinal stenosis

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8
Q

Ascending polyneuropathy and associated motor loss. Dx?

A

GBS

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9
Q

What causes GBS?

A

Inflammation of peripheral nerves

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10
Q

List Sx of PD

A

TRAID = bradykinesia, tremor, rigidity

ALSO: narrow based gait, hypomimia, micrographia, kicking/yelling in sleep, autonomic dysfunction, postural instability

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11
Q

Pt fitting for 20 mins. Had 2 x rectal diazepam and still fitting. What is going on?

A

Status epilepticus

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12
Q

Woman w bad migraines taking co-codamol and ibuprofen. Headaches getting worse. Mx? Why?

A

Stop all Tx

Medication over use headache now

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13
Q

What is Tx for status epilepticus?

A

Phenytoin loading

Call ITU

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14
Q

What is the indication for requesting phenytoin levels?

A

Dose adjustment

Patient compliance

Toxicity - if Sx suggestive of this

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15
Q

Woman stares blankly for 1 minute then starts picking at clothes. Returns back to reality feeling tired. Dx?

A

Complex partial seizures

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16
Q

What feature differntiaties compelx and simple partial seixures?

A

Complex = dont remember event

SImple = retain conciousness, so remeber event

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17
Q

What feature is indicative of compelx partial seizures?

A

Pts carry out repetitive and purposeless motions such as chewing / lip smacking / picking at clothes

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18
Q

What feature is indicative of absence seizures?

A

In KIDS

Stare blankly for a few seconds

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19
Q

Traid of Wernicke’s ?

A
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20
Q

What is Korsakoff’s?

A

Anterograde amnesia (forget new information)

Post alcoholic

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21
Q

Signs of Wernicke/Korsakoff’s?

A

Broad gait but clumsy

Diplopia

Low MMSE - can’t register new info

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22
Q

Pt has 5/5 power upper limbs but 0/5 power lower limbs. Where is the lesion?

A

Spinal cord

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23
Q

What is the dermatomal level of the shoulders?

A

C4

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24
Q

What is the dermatomal level of the nipples?

A

T4

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25
Q

What is the dermatomal level of the umbillicus?

A

T10

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26
Q

What is the dermatomal level of pockets?

A

L1

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27
Q

What is the dermatomal level of the knee?

A

L3

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28
Q

Crossed signs (eg L arm but R face) indicate that the lesion is where?

A

Brainstem

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29
Q

R arms and legs affected but also L face. Where is the lesion?

A

Left brainstem - R motor tract but L cranial nervee

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30
Q

In the swinging torch test, which cranial nerve is efferent and which is afferent?

A

A = CN 2

E = CN 3

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31
Q

What is the name of a failed swinging torch test lesion?

A

Relative afferent pupillary defect

32
Q

What feature distinguishes myopathy from MG?

A

Fatiguability

33
Q

Why are MG muscles fatiguable?

A

Use up the ACh to exhaustion therefore fatigued

34
Q

How does MG differ from Lambert-Easton syndrome?

A

LE = increased repeition leads to increased strength

MG = increased repetion leads to decreased strength

35
Q

What causes Lambert Easton?

A

Auto AB against VGCC

36
Q

Which condition is Lambert Easton most associated with?

A

Small cell lung cancer

37
Q

What conditions is MG associated with?

A

Thyrotoxocosis, haemolytic anaemia, pernicious anaemia, connective tissue disease

38
Q

Is Bells palsy UMN or LMN?

A

LMN

39
Q

What is Mx of Bells palsy?

A

Lubricating eye drops & taping eye shut at night

Steroids and acyclovir if PC <48hrs

40
Q

What is the most common cause of UMN facial palsy?

A

Stroke

41
Q

What causes intranuclear opthalmoplegia?

A

Problem with communication between CN VI of right eye and CN III of left eye - often a lesion in the medial longitudinal fasciculus

42
Q

Name a common cause of opthalmoplegia

A

MS

43
Q

Flick distal phalynx of middle finger and thumb will contract. What sign is this?

A

Hoffman’s sign

44
Q

What does Hoffamn’s reflex indicate?

A

UMN lesion

45
Q

What features are classic of Lewy-Body dementia?

A

extra-pyramidal (parkinsonian)

46
Q

Pt has disinhibition and problems finding words. Dx?

A

Fronto-temporal dementia

47
Q

Causes of absent ankle jerk with upgoing plantars?

A

Cord compression

Cord degeneration

MND

Freidrich’s ataxia

48
Q

Is MS UMN, LMN or mixed?

A

UMN only - never has LMN signs

49
Q

Unsteady gait, difficulty raising right leg which he swings round in an arc on walking. R arm and wrist are flexed. Dx?

A

Hemiplegic gait

50
Q

Which conditions have a scissoring gait?

A

MS and cerebral palsy

51
Q

Which condition has a high stepping gait?

A

Foot drop

52
Q

Which condition has a stomping gait?

A

Diabetic neuropathy

53
Q

R lower quadrantoptia. Where is the lesion?

A

L parietal lobe

54
Q

R upper quadrantopia. Where is the lesion?

A

L temporal lobe

55
Q

Dizziness on moving head. Dx?

A

BPPV

56
Q

Dizziness, tinnitus, hearing loss and sensation of increased ear pressure. Dx?

A

Menieres

57
Q

Where does Meneires affect?

A

Inner ear

58
Q

How do you differentiate Menieres from vestibular neuronitis?

A

VN does not affect hearing but Menieres does

59
Q

Cafe au lait spots, axillary freckling and neurofibromas. Dx?

A

Neurofibromatosis type 1

60
Q

Bilateral acoustic neuromas leading to deafness. Less cutaneous manifestations. Dx?

A

Neurofibromatosis type 2

61
Q

Telangectasia, epistaxis, vascualr disorders. Dx?

A

Hereditary haemorrhagic telangectasia

62
Q

What is evident on CT of extradural haematoma?

A

Lenticular (convex) shaped haematomas

63
Q

Who gets subdural haematomas?

A

Elderly and alcoholics

64
Q

Thunderclap headache. What does CT head show?

A

Blood along sulci and fissures (SAH)

65
Q

Stroke w visual problems, dizziness, nystagmus and dysdiadokinesis. Where is lesion?

A

Posterior circulation - occipital lobe

66
Q

Aphasia, agnosia, agraphia. Where is the lesion?

A

Left parietal lobe

67
Q

Memory probelms with upper quadrantopia. Dx?

A

BILATERAL temporal lobe lesions

68
Q

Visual / sensory / motor neglect. Dx?

A

RIGHT parietal lobe

69
Q

5 day Hx of numbness and tingling in hands and feet, getting worse and worse. Complete resolution after 1 weeks. Dx?

A

GBS

70
Q

What is Kernig’s sign?

A

Patients leg is held flexed at hip and knee and there is pain and resistance on susequent knee extension

71
Q

Meningism with LP results of:

normal glucose

low protein

high lymphocytes

Dx?

A

Viral meningitis

72
Q

Meningism with LP results of:

low glucose

normal/raised protein

high neutrophils

Dx?

A

Bacterial meningitis

73
Q

Meningism with LP results of:

low glucose

high/normal protein

high lymphocytes

Dx?

A

TB/fungal meningitis

74
Q

LP results of:

high glucose

very high protein

high RBC

Dx?

A

SAH

75
Q

Patient stands with feet together and closes her eyes. Unable to keep still. What test is this?

A

Rombergs

76
Q

What does positive Rombergs show?

A

Proprioceptive loss

Lottie's Question Books (15 decks)

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