neuro wrong

Question 1

encephalitis: cerebrospinal fluid constituents

Answer 1

lymphocytosis (inc wcc) and elevated protein

Question 2

signs/symptoms of stroke of lateral medullary sydrome

Answer 2

ipsilateral: Dysphagia (Nucleus ambiguous) , facial numbness, horners (hypothalamic tract)

contralateral: limb sensory loss
cerebellar features: ataxia (spinocerebellar tract) & nystagmus & Vertigo (vestibular nucleus)

Question 3

signs/symptoms of pons stroke

Answer 3

locked in syndrome
quadraplegia (corticospinal tract)
cant speak (corticobulbar tract)
bilateral damage to abducens = restricts horizontal gaze (abducens nuclei)

No loss of consciousness

Question 4

signs/ symptoms of midbrain stroke
what is it also known as

Answer 4

contralateral weakness (corticospinal tract)
ipsilateral occulmotor palsy (CN3 nuclei)

aka webers

Question 5

signs/symptoms of lateral pontine syndrome (also medulla affected)

Answer 5

same as wallenbergs syndrome except also ipsilateral deafness

wallenbergs (ataxia, nystagmus
ipsilateral: dysphagia, facial numbness, cranial nerve palsy e.g. Horner’s
contralateral: limb sensory loss)

Question 6

lesion where results in lateral medullary syndrome

Answer 6

PICA (posterior inferior cerebellar artery)

Question 7

what arteries supply the medulla

Answer 7

• vertebral arteries & pica (Posterior Inferior Cerebellar Arteries) (branches of vertebral arteries)

Question 8

what arteries supply the pons

Answer 8

AICA (anterior inferior cerebellar artery)
pontine arteries
superior cerebellar arteries

^^ all branches of basilar artery

Question 9

midbrain blood supply

Answer 9

posterior cerebRAL arteries ( branch of basilar)

Question 10

drug induced parkinsonsim occurs when/how

Answer 10

tends to occur a few weeks after starting antipsychotics or dopamine antagonists

(chlorpromazine, haloperidol, lithium, valproic acid, metoclopramide)

Question 11

progressive supranuclear palsy features

Answer 11

impairment of vertical gaze,
symmetrical parkinsonism,
cognitive impairment
postural instability/falls

poor response to l-dopa

Question 12

vascular parkinonism features

Answer 12

primarily affect gait in the lower limbs and comes on slowly, and
there is a lack of autonomic dysfunction. It is caused by small strokes and
infarcts

Question 13

what are some extrapyramidal side effects which occur from typical antipsychotics

Answer 13

Acute dystonic reaction, akathisia, parkinsonism, and tardive
dyskinesia

Question 14

what does a painful nerve palsy suggest

Answer 14

that the nerve is compressed

Question 15

common cause of a painful third nerve palsy

Answer 15

compression from posterior communicating artery anyuerysm

Question 16

crutzfold-jakob disease
pathophysio and key features

Answer 16

prion proteins>amyloid folds= tightly packed beta sheets resistant to proteases

rapid onset dementia and myoclonus- uncontrollabe twitching

Question 17

what is apraxia

Answer 17

inability to perform a movement spontaneously on command

Question 18

what anti-emetic can be given to parkinsons patients

Answer 18

domiperidone- dopamine antagonist (used as it does not cross blood brain barrier)

Question 19

syringomelia presentation

Answer 19

pain and temperature loss in neck arms and shoulders. as diseases progresses can cause weakness and spasticity in lower limbs

classically burn hands without realisng

Question 20

subacute degenration of the cord symptoms

Answer 20

dorsal and lateral corticospinal tracts are affected therefore, weakness and loss of fine touch, propioception and vibration occurs

Question 21

what nerve innervates adductor pollicis

Answer 21

ulnar

Question 22

wernickes enceohalopathy symptoms

Answer 22

confusion, ataxia, nystagmus, opthalmoplegia

(+ history of acoholo misuse)

Question 23

Where are lower motor neurones cell bodies

Answer 23

Anterior horn!

Question 24

why is COCP contrindicated in thos with mirgraine with aura

Answer 24

significantly increased risk of ischaemic stroke

Question 25

what palsy is caused by arm being pulled in abducted position. eg trying to grab a branch when falling or pulling a baby out the womb by arm

Answer 25

klumpkes palsy- causes damage to C8 and T1, so median nerve and ulnar nerves are damaged.- claw hand

Question 26

ondenaston moa and action site

Answer 26

. Ondansetron is a selective 5-HT3 receptor antagonist. It works by blocking serotonin, both peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone (CTZ) located in the area postrema of the medulla oblongata.

Question 27

what condition is associated witj vestibular shwannomas

Answer 27

Neurofibromatosis type 2

Question 28

What is cushings triad and why is it bad

Answer 28

Widened pulse pressure
Bradyxhardia
Irregular respiration

Indicates increased intracranial pressure-last stop before brain herniation and death

Question 29

Left homonomous hemaniopia, where is the lesion

Answer 29

Right optic tract

Question 30

What are triptans and contraindications

Answer 30

5ht agonists
Contraindicated in ischaemic heart disease or cerebrovascular disease

Question 31

Bppv ix and yx

Answer 31

Ix - dix halpike

Tx - epley

Question 32

risk factors for raised intracranial hypertension

Answer 32

moon faced young obese woman trying to treat her acne

moon= steroids

young obese woman

treating acne- isotretinoin, tetracyclines, COCP

Question 33

absent ankle and plantar reflex but knee jerk intact- what nerve has a defect

Answer 33

sciatic- innervates hamstrings down back of leg