Neuro - Useful facts Flashcards
What motor deficiency effects do you see in common peroneal nerve lesion and tibial nerve palsy?
TIPPED
Tibial Inversion Plantarflexion
Peroneal Eversion Dorsiflexion
So inversion, plantarflexion affected in tibial nerve palsy, and eversion and dorsiflexion in common peroneal nerve lesion
What indicates a L5 nerve lesion and not a common peroneal nerve lesion?
Weakened dorsiflexion, eversion, AND INVERSION of the ankle indicates an L5 nerve lesion not a common peroneal nerve lesion
Broca’s and Wernicke’s aphasia, way to remember
Broca’s = broken speech (can’t articulate words), also frontal lobe
Wernicke’s = wer de ficke are you talking about (doesn’t make sense), also temporal lobe
What is the management for patients with raised ICP?
- investigate and treat the underlying cause
- head elevation to 30º
- IV mannitol may be used as an osmotic diuretic
- controlled hyperventilation
Mnemonic to help remember Wernicke and Korsakoff’s clinical features
COAT RACK
Wernicke’s:
Confusion
Opthamoplegia
Ataxia
Thiamine Deficiency
Also nystagmus in Wernicke’s
Korsakoff’s:
- *R**etrograde amnesia
- *A**nterograde amnesia
- *C**onfabulation =
- *K**orsakoff’s
Also Psychosis in Korsakoff’s
Why are extradural haematomas limited by suture lines whereas subdural haematomas are not limited?
Extradural haematomas are between the skull and the dura mater, therefore they can move anywhere within those planes of section
However, at suture lines this is where the dura attaches to the skull, therefore they cannot cross it.
Meningitis complications SHAPED mnemonic
Meningitis complications = ‘SHAPED’
Sepsis
Hydrocephalus; Herniation of brain
Abscess (intracerebral)
Paralysis
Epilepsy
Deafness
Drugs for nausea in which scenario
- Ondansetron for chemotherapy-induced nausea
- Haloperidol for intracranial causes (raised ICP, direct effect of tumour)
- Prochlorperazine for vestibular causes
- Metoclopramide for gastrointestinal causes
OR, good way to help remember
- Ondansetron**from youO***ncologist
- Haloperidol**for causes in yourH***ead
- Prochlorperazine**for when you feelP***eculiar (i.e. dizzy)
- Metoclopramide**for things attached to theM***esentry
What component in a blood test would help differentiate between a true seizure and a pseudoseizure?
Prolactin can be used to differentiate between a true seizure and a pseudoseizure
What are the features of a 3rd nerve palsy?
- eye is deviated ‘down and out’
- ptosis
- pupil may be dilated (sometimes called a ‘surgical’ third nerve palsy)
If there was ptosis + constricted pupil, then Horner’s
What is the best anti-emetic to prescribe in Parkinson’s to someone who is nauseous on co-careldopa? Which two anti-emetic drugs should you not give in Parkinson’s for nausea?
Give Domperidone
Cyclizine is an antihistamine which, like prochlorperazine, may exacerbate Parkinson’s disease, so don’t prescribe
Bitemporal hemianopia UP LOC
UP LOC
Upper - Pitiutary (upper quadrant defect)
LOwer - Craniopharyngioma (lower quadrant defect)
Key complication of meningitis once a patient has recovered (zerotofinals)
Hearing loss is a key complication of meningitis
All patients with meningitis are offered audiology assessment as soon as they are recovered to assess for hearing impairment.
This complication comes up often in exams and is worth remembering
What is discitis?
Discitis is an infection in the intervertebral disc space
It can lead to serious complications such as sepsis or an epidural abscess
Assess the patient for endocarditis e.g. with transthoracic echo or transesophageal echo
Antiplatelets you give for TIA and Ischameic stroke?
Clopidogrel for both
Tretament of acute subdural and chronic subdural?
Acute - decompressive craniectomy
Chronic - surgical decompression with burr holes if they’re confused of symptomatic
Drugs that increase the risk of Idiopathic Intracranial HTN?
COMAAR – ciclosporin, oral contraceptives, mineralocorticoids, amiodarone, antibiotics (tetracyclines, sulphonamides), retinoic acid
4 features of a vestibular schwannoma (acoustic neuroma)
The classical history of vestibular schwannoma includes a combination of vertigo, hearing loss, tinnitus and an absent corneal reflex
Which antiepileptic drug is most associated with weight gain?
Sodium Valproate
Causes of cerebellar injury? PASTRIES
P - Posterior fossa tumour
A - Alcohol
S - Multiple sclerosis
T - Trauma
R - Rare causes
I - Inherited (e.g. Friedreich’s ataxia)
E - Epilepsy treatments
S - Stroke
Involvement fo which spinal level could give a patient Horner’s syndrome?
Horner’s makes it harder to see playing golf, you’d never be able to get it in on the first shot.
You can’t Tee 1 (T1)
Nerve root for ankle, knee, biceps, triceps reflexes?
S1-S2 button my shoe
L3-L4 kick the door
C5-C6 pick up sticks
C7-C8 open the gate
OR
biceps = 6 letters so c5-6 triceps = 7 letters so c7-8 knee = 4 letters so l3-4
OR
S1-S2 Put on my shoe,
L3-L4 My knee’s on the floor,
C5-C6 Impress the chicks,
C7-C8 Arm is straight
Reflex Root
Ankle S1-S2
Knee L3-L4
Biceps C5-C6
Triceps C7-C8
Hypersensitivity reactions
Hypersensitivity reactions - ACID
Type 1 Allergic - IgE-mediated (e.g. bee stings, latex, meds)
Type 2 Cytotoxic/antibody-mediated (e.g. hyperacute graft reaction, haemolytic reaction)
Type 3 Immune-complex deposition (e.g. SLE, polyarteritis nodosa)
Type 4 Delayed/cell mediated (e.g. chronic graft reactions, poison ivy, nickel)
Mnemonic for motor nerves that supply the hand?
try the mnemonic: Rock, Paper, Scissors –> Median, Radial, Ulnar (both in alphabetical order)
- Rock –> Clenching your fist in rock formation. The median nerve supplies muscles of finger flexion
- Paper –> Stretching out your hand. The radial nerve supplies muscles of finger extension
- Scissors –> Pretend you’re using scissors made out of ring and index fingers. The ulnar nerve supplies the small muscles of finger abduction and adduction.
(Extra: Anterior interosseous (AIN) nerve supply) –> Make an OK sign with your fingers. Thumb flexion at IP joint and finger flexion of index finger at DIP joint)
