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Ned's PassMed notes 2019/20 > Neuro PassMed > Flashcards

Neuro PassMed Flashcards

1
Q

treatment of idiopathic inter cranial hypertension

A

acetazolamide (carbonic anhydrase inhibitor)

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2
Q

which antiemetic can be prescribed to Parkinson’s patients and why is it favoured

A

domperidone - doesn’t cross the BBB so doesn’t cause EP side effects

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3
Q

is a resting parkinsons tremor bilateral or unilateral

A

unilateral

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4
Q

bells palsy treatment

A

prednisolone for 10 days - prescribed within 72hrs of onset

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5
Q

encephalitis treatment

A

IV acyclovir to cover HSV1

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6
Q

essential tremor- what is its inheritance, when is it worst and how do you treat

A

AD
worst when arms outstretched
tx = propranolol

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7
Q

what medication is used in thrombolysis if patient presents within 4.5hrs

A

alteplase

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8
Q

what is used in secondary prevention of stroke

A

clopidogrel is now preferred over aspirin

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9
Q

name one contraindication to triptan use in migraine management

A

a history of CVD

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10
Q

name the acute management of migrane

A

triptan+NSAID+ paracetamol

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11
Q

name the prophylactic management of migrane

A

topiramate or propranolol

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12
Q

what neurocutaneous syndrome are bilateral vestibuloschwannomas associated with

A

NFB2

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13
Q

what does the presence of thymoma on CT in a tired girl suggest

A

myasthenia gravis

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14
Q

which antiepileptic has peripheral neuropathy as a side effect

A

phenytoin

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15
Q

describe the mechanism of action of phenytoin

A

binds to Na channels to increase the refractory period

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16
Q

how is the weakness in Lambert eaton syndrome different from MG

A

weakness in Lambert eaton IMPROVES after exercise

weakness in MG WORSENS after exercise

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17
Q

which antibodies are associated with MG

A

ACh receptor antibodies

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18
Q

which antibodies are associated with lamber eaton syndrome

A

voltage gated calcium channel antibodies

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19
Q

what visual field defect will occur if there is a L temporal lobe infarct?

A

R superior quadranopia (remember PITS)

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20
Q

what visual field defect will occur if there is a L parietal lobe infarct?

A

R inferior quadranopia (PITS!)

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21
Q

which type of stroke affects the upper limb more than the lower limb

A

middle cerebral artery infarct

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22
Q

which type of stroke affects the lower limb more than the upper limb

A

anterior cerebral artery infarct

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23
Q

which stroke presents with 2 of:

  1. contralateral hemiparesis and sensory loss
  2. homonyms hemianopia
  3. aphasia
A

partial anterior circulation infarct

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24
Q

which type of stroke has all 3 of:

  1. contralateral hemiparesis +/- sensory loss
  2. aphasia
  3. contralateral homonymous hemianopia
A

total anterior circulation infarcts

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25
Q

what is used for long term prophylaxis of cluster headaches

A

verapamil

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26
Q

what is used as acute therapy for cluster headaches

A

sumatriptan and high flow oxygen

27
Q

what would be signs of a problem in the basal ganglia

A

hypERkinetic (Huntington’s)
or
hyPOkinetic (Parkinson’s)

28
Q

what is the acute treatment and prophylactic treatment of an ischaemic stroke

A

acute- 300mg aspirin. if present within 4.5hrs of symptom onset, thrombolysis (using alteplase)

prophylactic - clopidogrel

29
Q

what is the Cushing reflex in response to

A

a physiological response to ICP

30
Q

what is the Cushing reflex

A

hypertension and bradycardia

31
Q

what should you orescribe to patients with N&V associated with chemotherapy

A

ondansetron (5HT antagonist)

32
Q

what is required before starting phenytoin and why

A

cardiac monitoring- it has pro-arrhythmogenic side effects

33
Q

what is the most common hereditary sensorimotor neuropathy? which nerves does it affect

A

Charcot-marie-tooth disease

peripheral nerves

34
Q

name 4 features of Charcot Marie tooth disease

A

foot drop
high arched feet
distal muscle weakness and atrophy
hyporeflexia

35
Q

what is the 1st line investigation for suspected stroke

A

non-contrast CT head

36
Q

what are contrast-enhanced CT scans more useful for

A

detecting cerebral mets and abscesses

37
Q

in detecting ismchaemic changes, is T1 or T2 imaging more sensitive

A

T2 weighted imaging is more sensitive

38
Q

where is Broca’s speech area located

A

inferior frontal gyrus

39
Q

describe the characteristics of Broca’s aphasia

A

expressive aphasia

non fluent, laboured and halting speech

comprehension normal

40
Q

where is wernicke’s area located

A

superior temporal gyrus

41
Q

describe the characteristics of wernicke’s aphasia

A

receptive aphasia

speech remains fluent but sentences make no sense

comprehension is impaired

42
Q

where does the facial nerve supply sensation to on the tongue

A

the anterior 2/3

43
Q

name one of the signs of bulbar onset MND

A

tongue fasciculations

44
Q

name 3 areas that are NOT affected in MND

A
  1. external ocular muscles (no nystagmus or diplopia) (allows it to be differentiated from MG)
  2. No cerebellar signs
  3. sphincter function preserved
45
Q

when a patient presents with mixed UMN and LMN signs, what else must you consider other than MND?

A

subacute combined degeneration of the cord

occurs due to vit B12 deficiency

can be precipitated if patients are given folate supplements without B12

46
Q

which drug is used to manage tremor in drug induced parkisnson’s

A

procyclizine

47
Q

which Parkinson’s drug has been associated with pulmonary fibrosis

A

cabergoline

48
Q

why is compliance so important in Parkinson’s medication

A

risk of acute akinesia or neuroleptic malignant syndrome if medication isn’t taken

49
Q

what is dystonia

A

involuntary muscle spasms and sustained muscle contractions

50
Q

name 2 drugs that can cause drug induced dystonia

A

levodopa and other dopamine agonists used in Parkinson’s treatment

typical antipsychotics - dystonia is one of the EP side effects they can cause

51
Q

how do you treat drug induced dystonia

A

procyclidine

52
Q

treatment for neuroleptic malignant syndrome

A

bromocriptine

53
Q

which arteries does a lacunar infarct affects

A

the perforating arteries around the internal capsule, thalamus and basal ganglia

54
Q

which arteries does a posterior circulation infarct affect

A

vertebrobasilar arteries

55
Q

what are the 3 features of normal pressure hydrocephalus

A

walking wet, wacky

ataxia
urinary incontinence
dementia

56
Q

what is the 1st line treatment for neuropathic pain

A

amitriptyline (TCA)
duloxetine (SNRI)
gabapentin (anticonvulsant)

57
Q

pathology of Parkinson’s

A

loss of dopaminergic neurones in substantia nigra

58
Q

what disorder do antiaprkinsonian medications have a risk of

A

impulse control disorders

dopamine agonists are the worst for it

59
Q

a stroke in what area of the brain would cause quadriplegia and ‘locked in’ syndrome

A

brainstem stroke

60
Q

which brachial plexus palsy causes a ‘waiters tip’ appearance

A

erb’s palsy

61
Q

which nerve roots are damaged in erb’s palsy -

how does it present?

A

C5, C6

internally rotated shoulder with extended elbow

62
Q

which brachial nerve palsy causes a ‘claw hand’

A

klumpke’s palsy

63
Q

which nerve roots are damaged in klumpke’s palsy

A

C8, T1

Ned's PassMed notes 2019/20 (17 decks)

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