Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

AKT > Neurology 1 > Flashcards

Neurology 1 Flashcards

1
Q

Name an example of a 5-HT3 antagonist

Adverse effects (2)

A

Ondansetron

Prolonged QT
Constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Absence seizure
Typical age range
Gender
Provoked by (2)

A

3-10yo
F>M
Stress, hyperventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Absence seizure
EEG:

A

Bilateral, symmetrical spikes and wave pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a positive Babinski?

A

Suggestive of upper motor neuron disease
Dorsiflexion of big toe and fanning out of the others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Lesions that can cause both absent ankle jerks and extensor plantars (Babinski) (6)

A

Upper and lower motor neuron disease

Subacute combined degeneration of the cord
Motor neuron disease
Friedreich’s ataxia
Synringomelia
Tabparesis (syphillis)
Conus medullaris lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Friedreich’s ataxia?
AD/AR
Age
Features other than ataxia (2)
Later features (3)

A

AR mitochondrial disease, trinucleotide repeat
Usually causing ataxia, HOCM and DM
Upper and lower motor neuron, absent ankle jerks, extensor plantar, optic atrophy
10-15yo
Later - heart failure, loss of vision and hearing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Receptive aphasia
Broca/Wernicke?

A

Where you lack comprehension, but can speak well, but none of what you’re saying makes sense because you can’t comprehend. i.e word salad

Wernicke’s aphasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Expressive aphasia
Broca/Wernicke?

A

When you understand what people are saying but struggle to get the words out, speech is non fluent, repetitive and laboured.

Broca’s aphasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is conduction aphasia?

A

Usually secondary to a stroke to the arcuate fasiculus - connection between Broca’s and Wernicke’s

Comprehension is normal, aware of the errors
Repetition is poor
Speech is fluent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Global aphasia

A

Results in both receptive and expressive aphasia, may still be able to communicate with gestures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is ataxia telangiectasia?
AD/AR
Age of onset
Features (3)
Increased risk of which two cancers?

A

AR
1-5yo

  1. Cerebellar ataxia
  2. Telangiectasia
  3. Recurrent chest infections secondary to IgA deficiency
  4. Increased risk of lymphoma and leukaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Explain autonomic dysreflexia

A

Occurs in patients who have a spinal cord injury at or above T6

Triggered by faecal impaction or urinary retention causes a sympathetic spinal reflex up the spinal cord. But due to lesion/ injury at T6 or above it is unable to deliver it all the way to the brain. This results in sympathetic activation below T6 and parasympathetic response above T6 leading to:

HTN
Bradycardia
Sweating
Flushing
Agitation
Haemorrhagic stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Bell’s palsy
Age range
Common in which type of patient?
Forehead or no forehead sparing?

A

20-40yo
Pregnant women
No forehead sparing due to lower motor neuron facial nerve palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Bell’s palsy features (5)

A

Paralysis of one side of the face including forehead
Post-auricular pain
Altered taste
Dry eyes
Hyperacusis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Bell’s palsy
Mx (2)

When to refer to ENT?
Prognosis?

A
  1. Prednisolone PO if within 72 hours of onset of symptoms
  2. Artifical tears and eye lubricants

If no improvement after 3 weeks
Full recovery within 3-4 months
15% have permanent weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What situations may cannabis based medicinal products be used?

A

Chemotherapy induced N&V (nabilone)
Spasticity in adults with MS (sativex nasal spray)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Partial seizures
1st line mx

A

Carbamazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

SE carbamazepine (3)

What is autoinduction?

A

Leucopenia and agranulocytosis
Hyponatraemia secondary to SIADH
Visual disturbances

May see a return of seizures after 3-4 weeks of treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is cataplexy?
What condition is it associated with?

A

Sudden and transient loss of muscular tone caused by a strong emotion

2/3 of patients with narcolepsy have cataplexy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Charcot-Marie-Tooth disease?
Features (6)

A

Most common form of hereditary peripheral neuropathy
AD

Features:
Foot drop (frequently sprained ankles)
Pes cavus (high arched feet)
Hammer toes
Stork leg deformity
Hyporeflexia
Distal muscle weakness and atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Cluster headaches
Trigger (1)
Mx acute (2)
Chronic (1)

A

ETOH

Mx
Acute 1. 100% oxygen, 2. SC triptan

Chronic 1. Verapamil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Foot drop is secondary to which nerve lesion?
Other features for this nerve lesion (3)

A

Common peroneal

Loss of dorsiflexion
Loss of eversion
Sensory loss of dorsum of the foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Type I and Type II complex regional pain syndrome

Complex regional syndrome pain syndrome mx (3)

A

Type I - no demonstratable lesion to a major nerve
Type 2 there is a lesion to a major nerve

Physiotherapy
Neuropathic analgesia
Pain team

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

CN
I
II
V

A

I smell
II sight
V (trigeminal) facial sensation, muscles of masticatio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

CN
III occulomotor
IV trochlear
VI abducens

A

Eye movement
III - MR, IO, SR, IR, constriction, accommodation, eyelid opening
IV - SO
VI - LR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Clinical signs with lesions on

Trigeminal (2)
Occulomotor (2)
Abducens (1)
Trochlear (2)

A

Trigeminal neuralgia, loss of corneal reflex
Occulomotor down and out eye, dilated fixed pupil
Abducens Horizontal diplopia
Trochlear downward gaze, vertical diplopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

CN
VII
VIII
IX
Function

A

Facial anterior 2/3 of tongue, lacrimation, salivation
Vestibulocochlear hearing balance
Glossopharyngeal posterior 1/3, swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

CN 10-12 function

A

X vagus gag reflex
XI accessory head and shoulder movement
XII hypoglossal tongue movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Clinical signs
CN 7 (3)
CN 8 (2)
CN 9 (1)

A

7 loss of corneal reflex, taste, hyperacusis
8 hearing loss, vertigo
9 loss of gag reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Clinical signs 10-12

A

10 uvula deviates away from site
11 weakness turning head to contralateral side
12 tongue deviates towards side of lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Corneal + Lacrimation reflex afferent efferent

A

v1 trigeminal ophthalmic VII facial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Jaw jerk afferent efferent

A

V3 mandibular mandibular

33
Q

Gag + glossopharyngeal afferent efferent

A

In on 9 out on 10

34
Q

Pupillary light reflex

A

In on 2 out on 3

35
Q

What is Hoffman’s sign?

A

Reflex test for cervical myelopathy
Hand resting, flick one finger, +ve test = if other fingers on the same hand also flex

36
Q

Gold standard Ix for degenerative cervical myelopathy (1)
Mx (2)

A

MR
Urgently refer to neurosurgery or ortho spinal surgery

37
Q

Dermatome
Thumb and index finger =
Middle finger and palm =
Ring and little finger =
Nipples

A

C6
C7
C8
T4

38
Q

Dermatome
Umbilicus
Knee caps
Big toe + dorsum
Lateral foot and small toe

A

T10
L4
L5
S1

39
Q

Name five drugs that can cause peripheral neuropathy
HINT NAVIM

A

Nitrofurantoin
Amiodarone
Vincristine
Isoniazid
Metronidazole

40
Q

DVLA seizures
First unprovoked seizure

A

6 months unless abnormalities on imaging or EEG in which case 12 months

41
Q

DVLA
Epilepsy/ multiple unprovoked siezures

A

Need to have been free from seizures for 12 months
If no seizures in last 5 years then licence restored (until 70)

42
Q

DVLA
Withdrawal of epilepsy medication

A

No driving whilst it is being withdrawn and for six months after the last dose

43
Q

DVLA
Single episode syncope, explained and treated
=

A

4 weeks

44
Q

DVLA single episode syncope unexplained

A

= 6 months

45
Q

DVLA two or more episodes of syncope

A

12 months

46
Q

DVLA
Stroke/ TIA
Multiple TIAs

A

1 month do not need to inform DVLA
3 months inform DVLA

47
Q

DVLA
Craniotomy
Pituitary tumour

A

= 1 year off driving
= 6 months

48
Q

Difference between Duchenne muscular dystrophy and Becker muscular dystrophy
Age of onset

A

5yo and >10yo
Intellectual impairment in Duchenne No intellectual impairment in Becker’s

49
Q

What is Gower’s sign?

A

Uses arms to stand up from squatted position

50
Q

Infantile spasms
Occur at what age?
Describe the seizure
AKA
EEG

A

First few months of life
Flexion of head, trunk, arms then extension of arms
Salaam attack
EEG: hypsarrhythmia (high amplitude waves with irregular spikes)

51
Q

Lennox Gastaut syndrome
Age
EEG
Mx

Features (4)

A

Extension of infantile spasms
Aged 1-5yo
EEG slow spike
Mx ketogenic diet

Atypical absences, falls, jerks
Moderate to severe handicap

52
Q

Benign rolandic epilepsy
Most common in
Gender
Features (2)
EEG

A

Childhood, males
Paraesthesia (unilateral face)
Characteristic partial seizures at night
Centro temporal spikes

53
Q

Juvenile myoclonic epilepsy
AKA
Age of onset
Gender

Type of seizures
Usually when? caused by what?
Other features (2)
Mx (1)

A

Janz syndrome
Teenage
F>M

Infrequent generalised seizures
Often in the morning/ following sleep deprivation
Daytime absences
Shock like myoclonic seizures

Mx sodium valproate

54
Q

When do you start anti-epileptics following the first seizure? (4)

A

Neurological deficit
Structural abnormality on imaging
EEG unequivocal epileptic activity
Patient/ family wishes

55
Q

Mx
Generalised tonic clonic seizures
M (1)
F (2)

A

Males SV
Females lamotrigine or levetiracetam

56
Q

Mx
Focal seizures
1st line
2nd line

A

1st line Lamotrigine or levetiracetam
2nd line carbamezapine, oxcarbazepine or zonisamide

57
Q

Absence seizures
Mx
1st line
2nd line

A

Ethosuximide
M SV
F lamotrigine or levetiracetam

58
Q

What medication can exacerbate absence seizures?

A

Carbamazepine

59
Q

Myoclonic seizures mx

Tonic or atonic seizures mx

A

M SV
F Levetiracetam

M SV
SV Lamotrogine

60
Q

Essential tremor
Worse when?
Improved by?
Mx 1st line 2nd line

A

Arms outstretched
ETOH and rest
Propranolol
Primidone

61
Q

Vertical diplopia
Subjective tilting of objects
Head tilting
Affected eye may deviate upwards and rotate outwards =

A

Fourth nerve palsy (trochlear)

62
Q

GCS explained

A

M6V5E4

M 1 none, 2 extend to pain, 3 abnormal flexion, 4 withdraws to pain, localises pain, obeys commands

V 1 none, 2 sounds, 3 words, 4 confused, 5 orientated

E 1 none, 2 open to pain, 3 open to voice, 4 spontaneous

63
Q

Guillain Barre syndrome

Commonly which bacteria triggers it?
Antibodies present in 25% of pts

A

Immune mediated demyelination of the peripheral nervous system triggered by infection
Campylobacter jejuni
Anti-GM1 antibodies

64
Q

What is Miller Fisher syndrome?
Antibodies present in 90% of cases
Ascending or descending
Features (3)

A

Similar to GBS however associated with ophthalmoplegia, areflexia and ataxia
Descending paralysis
Anti-GQ1b antibodies

65
Q

Guillian Barre
Features (3)

LP findings (2)

A

Ascending paralysis
Reflexes absent or reduced
Mild/ few sensory signs

Raised protein
Normal WCC

66
Q

Huntington’s
AD/AR
Age of onset
Features (4)

A

AD
Trinucleotide repeat disorder CAG
35yo

Chorea, personality changes, dystonia, saccadic eye movements

67
Q

Idiopathic intracranial hypertension
RF (4)

A

Obesity
COCP
Female
Pregnancy

68
Q

Name five drugs than can cause IIH

A

COCP
Tetracyclines
Steroids
Vitamin A
Lithium

69
Q

IIH features (4)

A

Headache
Papilloedema
6th nerve palsy (abducens)
Enlarged blind spot

70
Q

Mx IIH (3)

A
  1. Weight loss
  2. Acetazolamide
  3. Topiramate
71
Q

Lamotrogine adverse effect
MOA

A

Steven Johnson syndrome
Sodium channel blocker

72
Q

Leg cramps mx (3)

A
  1. Stretching exercises for calves
  2. Quinine - stop if no benefit
  3. Referral to secondary care
73
Q

Migraine diagnostic criteria:

A

At least x5 attacks of criteria B-E

B Headache lasting 4-72 hours

AND

C x2 of:
- unilat
- pulsating
- mod to severe pain
- avoidance of routine activity

AND

D x1 of
nausea/vomiting
photophobia + phonophobia

AND

E not attributed to any other disorder

74
Q

Migraine Mx
Acute
1st line (2)
If aged 12-17 consider
2nd line (2)
3rd line (2)

A
  1. Combi therapy with PO triptan + NSAID/paracet
    If aged 12-17 nasal triptan instead

If not effective then for:
2nd line: non PO metoclopramide/ prochlorperazine

3rd line +/- non oral NSAID/triptan

75
Q

Migraine prophylaxis
When should it be given?

Mx 1st line (2)
2nd line (1)
Recommendation

A

If 2 or more attacks per month

1st line Topiramate or propranolol
2nd line 5-8 session of acupuncture

Recommend riboflavin 400mg OD

76
Q

Mx for menstrual migrane (2)

A

Frovatriptan 2.5mg BD or zolmitriptan

77
Q

Migraine during pregnancy
Mx (2)

A
  1. Paracetamol
  2. NSAIDs (first and second trimester)
78
Q

Migraine in children more typically have which symptoms? (3)

A

Bilateral
Shorter lasting
GI symptoms have more prominence

AKT (52 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions