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

Neuro PassMed Flashcards

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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
what is used for long term prophylaxis of cluster headaches
verapamil
26
what is used as acute therapy for cluster headaches
sumatriptan and high flow oxygen
27
what would be signs of a problem in the basal ganglia
hypERkinetic (Huntington's) or hyPOkinetic (Parkinson's)
28
what is the acute treatment and prophylactic treatment of an ischaemic stroke
acute- 300mg aspirin. if present within 4.5hrs of symptom onset, thrombolysis (using alteplase) prophylactic - clopidogrel
29
what is the Cushing reflex in response to
a physiological response to ICP
30
what is the Cushing reflex
hypertension and bradycardia
31
what should you orescribe to patients with N&V associated with chemotherapy
ondansetron (5HT antagonist)
32
what is required before starting phenytoin and why
cardiac monitoring- it has pro-arrhythmogenic side effects
33
what is the most common hereditary sensorimotor neuropathy? which nerves does it affect
Charcot-marie-tooth disease peripheral nerves
34
name 4 features of Charcot Marie tooth disease
foot drop high arched feet distal muscle weakness and atrophy hyporeflexia
35
what is the 1st line investigation for suspected stroke
non-contrast CT head
36
what are contrast-enhanced CT scans more useful for
detecting cerebral mets and abscesses
37
in detecting ismchaemic changes, is T1 or T2 imaging more sensitive
T2 weighted imaging is more sensitive
38
where is Broca's speech area located
inferior frontal gyrus
39
describe the characteristics of Broca's aphasia
expressive aphasia non fluent, laboured and halting speech comprehension normal
40
where is wernicke's area located
superior temporal gyrus
41
describe the characteristics of wernicke's aphasia
receptive aphasia speech remains fluent but sentences make no sense comprehension is impaired
42
where does the facial nerve supply sensation to on the tongue
the anterior 2/3
43
name one of the signs of bulbar onset MND
tongue fasciculations
44
name 3 areas that are NOT affected in MND
1. external ocular muscles (no nystagmus or diplopia) (allows it to be differentiated from MG) 2. No cerebellar signs 3. sphincter function preserved
45
when a patient presents with mixed UMN and LMN signs, what else must you consider other than MND?
subacute combined degeneration of the cord occurs due to vit B12 deficiency can be precipitated if patients are given folate supplements without B12
46
which drug is used to manage tremor in drug induced parkisnson's
procyclizine
47
which Parkinson's drug has been associated with pulmonary fibrosis
cabergoline
48
why is compliance so important in Parkinson's medication
risk of acute akinesia or neuroleptic malignant syndrome if medication isn't taken
49
what is dystonia
involuntary muscle spasms and sustained muscle contractions
50
name 2 drugs that can cause drug induced dystonia
levodopa and other dopamine agonists used in Parkinson's treatment typical antipsychotics - dystonia is one of the EP side effects they can cause
51
how do you treat drug induced dystonia
procyclidine
52
treatment for neuroleptic malignant syndrome
bromocriptine
53
which arteries does a lacunar infarct affects
the perforating arteries around the internal capsule, thalamus and basal ganglia
54
which arteries does a posterior circulation infarct affect
vertebrobasilar arteries
55
what are the 3 features of normal pressure hydrocephalus
walking wet, wacky ataxia urinary incontinence dementia
56
what is the 1st line treatment for neuropathic pain
amitriptyline (TCA) duloxetine (SNRI) gabapentin (anticonvulsant)
57
pathology of Parkinson's
loss of dopaminergic neurones in substantia nigra
58
what disorder do antiaprkinsonian medications have a risk of
impulse control disorders dopamine agonists are the worst for it
59
a stroke in what area of the brain would cause quadriplegia and 'locked in' syndrome
brainstem stroke
60
which brachial plexus palsy causes a 'waiters tip' appearance
erb's palsy
61
which nerve roots are damaged in erb's palsy - how does it present?
C5, C6 internally rotated shoulder with extended elbow
62
which brachial nerve palsy causes a 'claw hand'
klumpke's palsy
63
which nerve roots are damaged in klumpke's palsy
C8, T1

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

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