Neuro Formative Flashcards
An 80 yearold man presents to his GP with a gradual onset of walking difficulties, urinary incontinence and cognitive decline. He has no headache. What are these symptoms most typical of?
Normal pressure hydrocephalus
wet, wacky and wobbly
Treatment of normal pressure hydrocephalus
Ventriculoperitoneal (VP) shunt
Types of hydrocephalus
Communicating (normal pressure) - difference in CSF production:drainage ratio
Non-communicating (obstruction)
A 50 year old right handed barman presents with cognitive language dysfunction. He has difficulty expressing what he wishes to say and difficulty reading emails. What is the most likely explanation for these findings?
Lesion in left temporo-parietal area
A 69 year old man with left sided neglect. which structure is most likely to be affected?
Right parietal lobe
Oligodendrocytes
Form myelin sheaths in CNS
Schwann cells
Myelination of PNS
What organism is responsible for syphilis?
Treponema pallidum
Borrelia burgdorferi
Lyme disease
Features of an UMN lesion
Spasticity
Hypertonia
Sustained clonus
Hyperreflexia
Which artery supplies the left internal capsule?
Left middle cerebral artery
What suggests a vascular aetiology of dementia?
Stepwise progression
A 47 year old woman presents to A&E with severe back pain and urinary retention. She is numb around her perineum and has absent ankle jerks. What is the likely diagnosis?
Cauda Equina syndrome
How is Gerstmann’s syndrome characterised?
Dysgraphia/agraphia (deficiency in the ability to write)
Dyscalculia/acalculia (difficulty in learning or comprehending mathematics)
Finger agnosia (inability to distinguish the fingers on the hand)
Left-right disorientation
Cause of Gerstmann’s syndrome
Lesion in dominant (usually left) hemisphere, near temporo-parietal junction
Guillain Barre syndrome
Immune system attacks healthy nerve cells of the PNS, leading to weakness, numbness, and tingling, and can eventually cause paralysis
Lumbar radiculopathy
Normally caused by compression of spinal nerve root manifesting as pain, numbness, or weakness of the buttock and leg (sciatica)
A 47 year old man was referred to a neurosurgeon with a spinal cord tumour. The tumour was compressing his posterior (dorsal) columns on the right hand side. There is likely to be loss of ___ sensation below the level of the lesion on the ___ side
Vibration and proprioception
Ipsilateral
Up which tract do pain and temperature travel?
Lateral spinothalamic
What is erythrocyte sedimentation rate?
The rate at which red blood cells in whole blood descend in a standardized tube in a period of one hour.
Increased in inflammation
A 55 year old woman presents to her GP with a headache which is associated with scalp tenderness over the right temporal artery. The GP diagnoses giant cell arteritis and commences treatment. What laboratory result would be expected with this condition? (ESR)
Elevated ESR
Which neurotransmitter is affected in Parkinson’s?
Dopamine
Differential diagnosis of three previous episodes of loss of consciousness
Epileptic fit
Syncope
Hypoglycaemia
Cardiac arrhythmia
Symptoms of epilepsy
Aura/warning symptoms Witness account of tonic/clonic seizure Tongue biting Urinary incontinence Slow recovery Family history
Tonic stage of seizure
You lose consciousness, your body goes stiff, and you may fall to the floor
Clonic stage of seizure
Your limbs jerk about, you may lose control of your bladder or bowel, you may bite your tongue or the inside of your cheek, and you might have difficulty breathing
Dysphagia
Difficulty swallowing
Dysarthria
Slurred speech
Myasthenia gravis
Interruption of nerve impulses at NMJ
Signs on examination of Guillain Barre but not myasthenia gravis
Areflexia
Sensory loss
Muscle wasting
Signs on examination of myasthenia gravis but not motor neuron disease
Ptosis
Opthalmoplegia
Fatiguability (varying in severity from hour to hour)
What is the most likely cause of Guillain Barre syndrome?
Post infectious immune response
With damage to the pyramidal tract at the right internal capsule, which side of the body would be affected? Would there be sensory or motor loss?
Left side
Motor
Where does the pyramidal tract originate from?
Precentral gyrus
Name two areas that deal with language and speech
Broca’s area (language processing, frontal lobe)
Wernicke’s area (comprehension of speech, temporal lobe)
Name two areas that deal with language and speech
Broca’s area (production of speech, frontal lobe)
Wernicke’s area (comprehension of speech, temporal lobe)
Causes of subarachnoid haemorrhage
Life threatening type of stroke
Ruptured aneurysm
Arteriovenous malformation
Head injury
CT of head with convex lens shaped bleed
Extradural haematoma
CT of head with bleed within the brain (discrete)
Subarachnoid haemorrhage
CT of head with kinda wonky bleed lining the skull
Subdural haematoma
CT of head with large bleed within the brain
Intracerebral haemorrhage
