Neuro Formative Assessment Key Points Flashcards
Which treatment would not improve tremor in Benign Essential Tremor?
Levodopa –> Parkinsons and replace functional dopamine deficiency
What scan would be used to differentiate a Benign Essential Tremor from early PD?
DAT Scan - radioactive tracer to bind to dopamine transporters and show if nigrostriatal degeneration
What is the most important initial test in a myasthenic crisis?
Bedside forced vital capacity assessment –> Respiratory weakness is biggest concern
What would the most likely diagnosis be with high CSF pressure, significant lymphocyte elevated, and very low glucose levels?
Tuberculous Meningitis –> Raised temperature and absence of concurrent pulmonary TB
What causes peripheral neuropathy as seen in Friedrich’s ataxia?
Atrophy of DRG and thinning of dorsal roots
What disorder is seen with impairment of tandem walk?
Cerebellar Dysfunction
How is papillitis differentiated from papilloedema of raised intracranial pressure?
Papillitis has significant characteristic visual loss
If a patient who is injured loses sensation in middle fingers, ulnar half of forearm, inside of upper arm etc. where will the site of injury be?
C7
Myelopathy is the clinical syndrome associated with a disease process of what
structure?
Spinal cord
A fixed dilated pupil caused by a squeeze on the parasympathetic fibres of the third
nerve can be differentiated from a blind eye by?
Testing for indirect (consensual) pupillary reflex
The following phrases, which might be described by a patient in lay terms, match the
clinical condition:
a) ‘Struggling with both hands for buttons, zips, and phone keypad’
b) ‘Difficulty opening food jars in the kitchen’
c) ‘Legs stiff and not doing what I tell them to do’
a) Myelopathy
b) Carpal Tunnel syndrome thenar muscle weakness associated
c) Myelopathy
What are the main criteria for use and guidelines in an MRI
1) Is the relevant imaging investigation to exclude demyelination/MS
2) Is the primary imaging work-up for patients suspected of having a spinal problem
(vertebral pain syndrome, radiculopathy, myelopathy)
3) Requires completion of a patient safety questionnaire
Which pattern of weakness is typically associated with myopathies?
Proximal, asymmetrical
Nerve conduction studies can help diagnose?
Carpal Tunnel Syndrome
When nerves get squashed e.g. in an ulnar neuropathy at the elbow, which of the
following describes the general sequence of damage to the nerve?
Sensory demyelination, sensory axon loss, motor demyelination, motor axon
loss.
Where will compression be to cause wrist drop?
Compression of the radial nerve at the spiral groove of the humerus
Foot drop can occur with compression of?
the peroneal nerve at the neck of the fibular OR L4/5
radiculopathy
Which of the following are common causes of generalised axonal neuropathy
in the UK?
1) Diabetes
2) Alcohol
Fasciculation potentials and normal motor unit potentials may indicate which
following condition?
Benign cramp fasciculation potentials
Proximal muscle weakness and muscle pain are most associated with?
Polymyositis
Amyotrophic lateral sclerosis is characterised by?
Combined upper and lower motor neurone signs
Hand paraesthesia that wakes the patient at night is associated with?
Carpal Tunnel Syndrome
What are the following lateralising signs in the context of the ‘mini-neurologic examination’
in the patient with impairment of level of consciousness?
1) A gaze paresis
2) Right arm extending where the left arm is flexing (best motor response = flexing)
