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Mccqe1 Red Star Questions > Neuro Qs > Flashcards

Neuro Qs Flashcards

1
Q

Steppage gait is caused by:

A

L5 radiculopathy

Neuropathy of common peroneal nerve

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2
Q

Peroneal neuropathy Vs sensory neuropathy

A

Peroneal neuropathy: steppage gait
Sensory neuropathy: wide based gait
Also have slap gait

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3
Q

Function of circle of Willis

A

If there is vascular occlusion,it helps maintain blood flow and cerebral pressure by alternate channels

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4
Q

Venous supply of brain

A

Superficial : superficial,middle,inferior
Deep: great cerebral v,basal v

Connect to dural venous sinus

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5
Q

Feature of lacunar infarct

A

U/L motor impairment only

Mainly in the posterior limb of internal capsule

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6
Q

Headache plus pain b/l face and eyes + unable to move the orbit s/o

A

Cavernous sinus thrombosis

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7
Q

Risk factors of epidural abscess (5)

A 
Iv drug use
Alcohol
Dm
Immunosuppressions 
Invasive procedure-removal of epidural catheter
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8
Q

Median medullary syndrome is due to…..

A

Injury to paramedian branches of ASA

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9
Q

C/f of medial medullary syndrome (3)

A

C/l hemiparesis
Loss of propriception
I/L cn 12 palsy

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10
Q

C/f of median midbrain syndrome

A

Aka weber syndrome
I/L CN 3 palsy
Lateral gaze weakness

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11
Q

M.c injured nerve by compression of posterior fossa tumor is

A

Glossopharyngeal nerve (CN9)

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12
Q

C/f of CN9 lesion (4)

A
  1. Loss of gag reflex
  2. Loss of pharyngeal sensation
  3. Loss of taste and sensation to posterior 1/3 of the tongue
  4. Dysfunction of carotid sinus reflex-> increased risk of syncope
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13
Q

Nerve affected by lesion in medulla

A

CN 11- accessory nerve

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14
Q

Artery affected by lesion in medulla

A

PICA

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15
Q

C/f of CN11 palsy

A

I/L SCM and trapezius muscle injury

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16
Q

Previously healthy kid now having muscle weakness u/l and problem with swallowing s/o

A

Myotonic dystrophy

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17
Q

DNA repeats seen in myotonic dystrophy is ….

A

CTG repeats in DMPK gene

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18
Q

Myotonic muscular dystrophy is aka

A

Steinert disease

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19
Q

EBV DNA in CNS S/o

A

Primary CNS lymphoma

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20
Q

Lesions of progressive multifocal leukoencephalopathy are…..

A

Non-enhancing

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21
Q

Lesion of primary CNS LYMPHOMA are….

A

Weakly ring enhancing, solitary periventricular mass

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22
Q

C/f of GC induced myopathy

A

No pain or tenderness
Myopathy of LL
ESR,CK normal

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23
Q

ESR and CK in polymyalgia rheumatica

A

ESR: increased
Ck: normal

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24
Q

Esr and CK in statin induced myopathy

A

ESR: normal
Ck: increased

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25
Q

Another condition that behaves like statin induced myopathy

A

Hypothyroid myopathy

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26
Q

Cerebral Ring enhancing lesions seen with ……… conditions

A 
MAGIC DR 
Mets
Abscess
Glioma
Infarction 
Contusion
Demyelinating diseases
Radiation necrosis
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27
Q

Rx for myasthenia gravis

A

Intubation

Iv Ig+ plasmapheresis + GC

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28
Q

Medications causing myasthenic crisis (2)

A

Azithromycin

Beta blockers

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29
Q

Associated feature of Broca’s aphasia

A

Right hemiparesis (face & U/L)

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30
Q

Associated feature of wernicke’s aphasia

A

Right superior visual field defect

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31
Q

Lesions of frontal lobe dominant vs non dominant

A

Dominant:
Broca’s aphasia, c/l hemiparesis of face and u/l
Wernicke’s aphasia, right superior visual field defect
Conjugate gaze-towards side of lesion

Non-dominant:
Apraxia

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32
Q

Lesions of parietal lobe: dominant vs non-dominant

A

Dominant:
C/l inferior homonymous quadrantanopsia

C/l sensory loss: pain,temp,vib,agraphesthesia,asterognosis

Non-dominant:
Hemineglect

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33
Q

Lesion in temporal lobe: dominant vs non-dominant

A

Dominant:
C/l superior homonymous quadrantanopsia
Receptive and conductive aphasia

Non-dominant:
Sensory aprosodia

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34
Q

Patient with increased arm:height ratio who is having downward displacement of lens s/o……

Complications…..(2)

Genetics of the disease is…

A

Homocysteinuria

Fair skin-thrombosis and megaloblastic anemia

Autosomal recessive

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35
Q

Marfan’s syndrome genetics is …

Complications

A

Autosomal dominant

Aortic root dilation

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36
Q

Features of fabry’s disease (4)

A

Alpha galactosemia

Renal,heart failure
Angiokeratoma
Peripheral neuropathy
Corneal dystrophy

37
Q

C/f of krabbe’s disease

A

Blind, deaf paralysed idiot with seizures

Galactocerebrosidase def

38
Q

Loss of DTR in elderly is s/o….

A

Paraneoplastic

Eaten lambert syndrome

39
Q

Muscle weakness with esophageal dysmotility s/o

A

Polymyositis

40
Q

Mallory bodies seen with (2)

A

Alcoholic liver injury

Wilson’s disease

41
Q

Rx of MS

A

Acute : GC-if refractory,plasmapheresis

Chronic DMARDS, if no use-IF BETA and glatiramer acetate

42
Q

In metabolic encephalopathy….. is not seen

A

No FND

but there is bradykinesia,asterixis

43
Q

Presynaptic Ach release is impaired by….

A

Botulinum toxin

44
Q

Pathophysiology of tetanus

A

Toxin induced NM blockage

45
Q

C/f of infantile vs foodborne botulism

A

Infantile:
Constipation,drooling,poor gag reflex/suck reflex,ptosis

Foodborne:
N/V/ab pain

46
Q

When to give iv lorazepam/rectal diazepam in seizure?

A

If seizure lasts for more than 5mins/

Recurrent seizures in 24hrs

47
Q

Iv alteplase should not be given for Bp of…..

A

> 185/110mmhg

48
Q

Eye manifestations of optic neuritis (6)

A
  1. Acute-peaks within 2 weeks
  2. Mono ocular Vision loss
  3. Eye pain with movement
  4. “ washed out” color vision
  5. Afferent pupillary defect
49
Q

Mgt of GBS

A

Spirometry to access FVC
If FVC<20ml/kg- Intubate

Intubate also when respiratory distress
Dysautonomia-HR,Bp instability
Wide pulse pressure

50
Q

What is FVC and FRC formula?

A

FVC: IRV+ ERV+TV

FRC: ERV+ RV

51
Q

Meds causing angle closure glaucoma (3)

A

Sympathomimetics
Anticholinergics-tolterodine
Decongestants

52
Q

“Halos” around lights s/o

A

Angle closure glaucoma

53
Q

Common sites of hge secondary to HTN

A

Basal ganglia > cerebellar nuclei > thalamus> putamen> cerebral cortex

54
Q

C/f of cerebellar hge (4)

A
  1. I/L hemiataxia of trunks-vermis
    I/L hemiataxia of limbs-hemispheres
  2. N/V/ nystagmus
  3. Occipital headache- radiate to neck and shoulders
  4. Neck stiffness-blood in 4th ventricle
55
Q

How to manage backache in CA patients?

A

Mild: NSAIDS+ acetaminophen

Moderate: weak opioids+ nonopioids
Codeine,tramadol

Severe: strong short acting- morphine,hydroxymorphine

Calculate the total dose and give long acting: fentanyl patch, oxycodone
+ short acting opioid for breakthrough pain

56
Q

Areas affected by vitb12 def

A

Dorsal column
SCT- ataxia
CST- spastic paresis

57
Q

Dx test for CRAO

A

Carotid Doppler of neck

58
Q

Wide based gait with impaired heel shin test

A

Alcoholic cerebellar degeneration

59
Q

Diabetic neuropathy causes degeneration of

A

Small fibers-pain,temp loss
Large fibers-vibration, proprioception
Gait is normal

60
Q

Cause of alcoholic cerebellar degeneration

A

Damage to purkinje fibers in the vermis

61
Q

CN 3 palsy types

A

Tumor- pupil-mydriasis

Dm- pupil- normal

62
Q

Nerve in medial thigh is…..

Nerve in anteromedial thigh is…

A

Obturator nerve

Femoral nerve

63
Q

Tumor of the submandibular salivary gland causes injury to….

A

Hypoglossal nerve

64
Q

Tic douloureux is due to …..

A

Trigeminal nerve injury

65
Q

How does V3 get damaged?

A

Very deep dissection of muscles of mastication

66
Q

Strabismus causes injury to…..

A

CN 3,4,6

67
Q

GBS occurs more commonly with conditions such as….(3)

A

Lymphoma,sarcoidosis,SLE

68
Q

High plantar arches,scoliosis,progressive weakness s/o…..

A

Friedrich’s ataxia (GAA)

69
Q

Areas affected in friedrich’s ataxia are…..

A

Dorsal column-loss of pain,vibration,proprioception

SCT- ataxia

Lateral CST- spastic weakness

70
Q

Cardiac problem with friedrich’s ataxia is….

A

Hypertrophic CMP

71
Q

Friedrich’s ataxia is a …..condition with…… in adolescence

A

Autosomal recessive condition

Progressive ataxia

72
Q

Peripheral facial nerve palsy refers to…..

A

Lesion below pons

73
Q

Dysarthria in Bell’s palsy occurs at…..

A

Above the pons-central lesion

74
Q

Cranial nerve nuclei in medulla are…

A

CN 9,10,12

75
Q

CN nuclei of midbrain

A

CN 3,4,6,12

76
Q

CN nuclei of pons

A

CN 5,6,7,8

77
Q

Nucleus of CN 11 is in…

A

Spinal cord

78
Q

Clinical features of PICA syndrome(6)

A
  1. I/L dysphagia,decreased gag reflex,hoarseness—nucleus ambiguous
  2. Ataxia,dysmetria,dysdiadokinesia—inferior CP
  3. Horner’s syndrome, uncontrolled hiccups—sympathetic fibers
  4. Nystagmus+ vertigo+ fall to side of lesion—vestibular nuclei
  5. Loss of pain +temp in face—TN nuclei
  6. C/L loss of pain+temp in limbs—lateral STT
79
Q

C/f of lateral pontine syndrome (3)

A

I/L TN#:
: #muscles of mastication
Decreased jaw jerk reflex
Impaired tactile and position sensation over the face.

80
Q

Management of Alzheimer’s disease

A

Mild-moderate: donepezil,galantamine,rivastigmine

Moderate to severe:
Memantine

81
Q

Sign when dorsal root is affected….

A

Romberg sign-impaired proprioception

82
Q

Migraine abortive Rx (5)

A

NSAIDS, acetaminophen
Sumatriptan
Ergotamine
Antiemetics

83
Q

Preventive treatment for migraine (3)

A

Topiramate
Beta blockers
Amitryptilline

84
Q

Define post concussion syndrome? (7)

A

Headaches,confusion, amnesia,difficulty conc,
vertigo,sleep disturbance
Anxiety

No flashbacks/nightmares of the incident

85
Q

What is dystonic gait?

A

Involuntary sustained twisting motion of limbs and trunk.

86
Q

C/f of shy dager syndrome (3)

A

Multisystem atrophy
—-Parkinson’s disease
—-Autonomic dysfunction
——Cerebellar,pyramidal,LMN signs

87
Q

What is autonomic dysfunction?

A

Abnormal bladder,bowel control
Salivation, lacrimation
Postural hypotension

88
Q

C/f of Riley day syndrome (3)

A

Ashkenazi jews at birth with:

  1. decreased feeding, decreased muscle tone
  2. Severe orthostatic hypotension
  3. No tears

Mccqe1 Red Star Questions (7 decks)

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