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MRCP 1 > Neurology > Flashcards

Neurology Flashcards

1
Q

What is Miller-Fisher syndrome?

A

Variant of GBS

Ophthalmoplegia, areflexia and ataxia

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2
Q

Anti-bodies in Miller-Fisher

A

anti-GQ1b

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3
Q

GBS: poor prognostic features

A 
Age >40
Poor muscle strength 
Previous diarrhoeal illness
High anti-GM1 antibody 
Ventilation
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4
Q

Ipsilateral spastic paresis
Ipsilateral loss of proprioception and vibration
Contralateral loss of pain and temperature

A

Brown-Sequard syndrome

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5
Q

Injury in Brown-Sequard syndrome

A

Spinal cord hemisection

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6
Q

Bilateral spastic paresis
Bilateral loss of proprioception and vibration
Bilateral limb ataxia

A

Subacute degeneration of spinal cord

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7
Q

Bilateral spastic paresis
Bilateral loss of proprioception and vibration
Bilateral limb ataxia
+ cerebellar signs

A

Friedrich’s ataxia

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8
Q

Bilateral spastic paresis

Bilateral loss of pain and temperature

A

Anterior spinal artery occlusion

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9
Q 
Flacid paresis (intrinsic muscles of hand)
Loss of pain and temperature
A

Syringomyelia

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10
Q

Combination of motor, sensory and ataxia

A

MS

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11
Q

Loss of proprioception and vibration

A

Neurosyphilis (tabes dorsalis)

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12
Q

Non fluent speech with comprehension intact

A

Broca’s aphasia

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13
Q

Non fluent speech with impaired comprehension

A

Global aphasia

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14
Q

Fluent speech with comprehension in tact

A

Conduction aphasia

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15
Q

Fluent speech and impaired comprehension

A

Wernicke’s aphasia

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16
Q

Wernicke’s aphasia: lesion

A

Superior temporal gyrus - MCA

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17
Q

Broca’s aphasia: lesion

A

Inferior frontal gyrus - MCA

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18
Q

Conduction aphasia: lesion

A

Arcuate fasiculus (connects Wernicke’s and Broca’s)

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19
Q

Parietal lobe lesion

A 
Sensory inattention
Apraxia
Astereognosis (inability to identify)
Inferior homonymous quadrantanopia 
Alexia, acalculia, agnosia
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20
Q

Occipital lobe lesion

A

Homonymous hemianopia (with macula sparing)
Cortical blindess
Visual agnosia

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21
Q

Temporal lobe lesion

A

Wenicke’s aphasia
Superior homonymous quadrantanopia
Auditory agnosia
Difficulty recalling faces

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22
Q

Frontal lobe lesion

A 
Broca's aphasia
Disinhibition 
Perseveration
Anosmia
Inability to generate list
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23
Q

Midline cerebellum lesion

A

Gait and truncal ataxia

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24
Q

Hemisphere cerebellar lesion

A

Intention tremor
Past pointing
Dysdiadokinesis
Nystagmus

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25
Q

Associations: medial thalamus and mammillary bodies

A

Wernicke and Korsakoff syndrome

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26
Q

Associations: subthalamic nucleus of basal ganglia

A

hemiballism

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27
Q

Striatum of basal ganglia

A

Huntington’s chorea

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28
Q

Substantia nigra of basal ganglia

A

Parkinson’s disease

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29
Q

‘Ash leaf spots’
Roughened patches skin over L spine
Adenoma sebaceum
Cafe-au-lait spots

A

Cutaneous features of TS

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30
Q

TS: inheiritance

A

AD

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31
Q

Developmental delay
Epilepsy
Intellectual impairment

A

Neurological features of TS

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32
Q

Retinal hamartomas (white spots on retina)
Rhabdomyomas of heart
PCKD
Renal angiomyolipomata

A

Features of TS

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33
Q

Von Hippel Lindau Inheirtiance

A

AD

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34
Q

VHL features

A

Vitreous haemorrhages
Haematomas (cerebellar and retinal)
Lousy cancers (clear cell carcinoma, endolymphatic)

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35
Q

Meniere’s disease: features

A

Recurrent vertigo, tinnitus and hearing loss
Aural fullness
Nystagmus and positive Romberg’s

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36
Q

Left homonymous hemianopia

A

Lesion of right optic tract

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37
Q

Homonymous superior quadrantanopia

A

Contralateral temporal lobe

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38
Q

Homonymous inferior quadrantanopia

A

Contralateral parietal lobe

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39
Q

What is Ramsay Hunt syndrome?

A

Reactivation of VZV in seventh CN

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40
Q

Ramsay Hunt: features

A

auricular pain
CN7 palsy
Vesicular rash around ear

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41
Q

Causes of horizontal disconjugate eye movement

A

internuclear ophthalmoplegia

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42
Q

Internuclear ophthalmoplegia: lesion

A

medial longitudinal fasciculus

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43
Q

Where is the medial longitudinal fasciculus?

A

Paramedian area of midbrain and pons

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44
Q

Internuclear ophthalmoplegia: features

A

Impaired adduction on same side of lesion

Horizontal nystagmus on contralateral side

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45
Q

Lateral medullary syndrome: lesion

A

Posterior inferior cerebellar artery

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46
Q

LMS: features

A

Ataxia

Nystagmus

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47
Q

LMS: ipsilateral features

A

Dysphagia
Facial numbness
CN palsy

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48
Q

LMS: contralateral features

A

Limb sensory loss

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49
Q

Levodopa: SE

A 
Dyskinesia
Dry mouth
Anorexia
Palpitations
Postural hypotension
Psychosis
50
Q

Bromocriptine, ropinirole, cabergoline and apomorphine are..

A

dopamine receptor agonists

51
Q

Selegiline is..

A

MAO-B inhibitor

52
Q

Procyclidine, benzotropine, benzhexol are..

A

antimuscarinics

53
Q

Treatment of drug induced Parkinsonism

A

anti-muscarinics

54
Q

Multiple system atrophy: features

A

Parkinsonism
Autonomic disturbance
Cerebellar signs

55
Q

Lambert-Eaton myasthenic syndrome

A

Associated with small cell lung cancer

56
Q

Anti-Hu associations

A

lung cancer and neuroblastoma

57
Q

Anti-Hu features

A

Sensory neuropathy
Cerebellar syndrome
Encephalomyelitis

58
Q

Anti-Yo associations

A

Ovarian and breast cancer

59
Q

Anti-Yo features

A

cerebellar syndrome

60
Q

Anti-GAD antibody associations

A

Breast, CRC and SCLC

61
Q

AntiGAD antibody features

A

Stiff person’s syndrome

Diffuse hypertonia

62
Q

Anti Ri asociations

A

Breast and SCLC

63
Q

Anti-Ri features

A

Ocular opsoclonus-myoclonus

64
Q

Ataxic telangiectasia: inheiritance

A

AR

65
Q

Ataxic telangiectasia: features

A

Cerebellar ataxia
Teleangiectasia
IgA deficiency

66
Q

Bell’s palsy: features

A

LMN CN7 palsy

Forehead affected

67
Q

Bell’s palsy: Mx

A

Prednisolone

Eye care

68
Q

Erb’s Palsy

A

Damage to C5-6

Winged scapula

69
Q

Klumpke’s palsy

A

Damage to T1
Loss of intrinsic hand muscles
Due to traction

70
Q

HSV: CT

A

Medial temporal and inferior frontal changes

71
Q

Sumitriptan: MoA

A

5HT-1 antagonist

72
Q

Multiple System Atrophy: features

A

Parkinsonism
Autonomic (erectile dysfunction, postural hypotension, atonic bladder)
Cerebellar signs

73
Q

Neuroleptic malignant syndrome: cause

A

Antipsychotic medications

74
Q

Neuroleptic malignant syndrome: features

A

Pyrexia
Muscle rigidity
Autonomic lability (HTN, tachycardia/pnoea)
Agitation

75
Q

Neuroleptic malignant syndrome: Mx

A

Stop causative medication
IV fluids
Dantrolene
Bromocriptine

76
Q

Neuromyelitis optica: diagnostic criteria

A

Optic neuritis, myelitis and 2 of;

  1. spinal cord lesion at 3+ levels
  2. normal MRI brain
  3. aquaporin 4 positive serum antibody
77
Q

Parkinson’s: features

A

Asymmetrical
Bradykinesia
Resting tremor
Rigidity

78
Q

Drug induced Parkinson’s: features

A

Rapid onset motor symptoms and bilateral

79
Q

Peripheral neuropathy: motor loss

A 
GBS
Porphyria
Lead poisoing 
Charcot-Marie Tooth
Chronic inflammatory demyelinating polyneuropathy
Diphtheria
80
Q

Peripheral neuropathy: sensory loss

A 
Diabetes
Uraemia
Leprosy
Alcoholism
B12 deficiency
Amyloidosis
81
Q

Tuberous sclerosis: inheiritance

A

Autosomal dominant

82
Q

Tuberous sclerosis: cutaneous features

A 
Ash-leaf spots
Roughened patches over lumbar spine
Adenoma sebaceum
Subungual fibromata
Cafe-au-lait spots
83
Q

Tuberous sclerosis: neurological features

A

Developmental delay
Epilepsy
Intellectual impairment

84
Q

Tuberous sclerosis: additional features

A 
Retinal hamartomas
Rhabdomyomas of heart
Gliomatous changes in brain
PCKD
Renal angiomyolipomata
Lung cysts
85
Q

Generalised tonic clonic seizures: Mx

A

Sodium valproate

Lamotrigine, carbamazepine

86
Q

Absence seizures: Mx

A

Sodium valproate or ethosuximide

87
Q

Myoclonic seizures: Mx

A

Sodium valproate

Clonazepam, lamotrigine

88
Q

Focal seizures: Mx

A

Carbamazepine or lamotrigine

Levetiracetam, oxcarbazepine or sodium valproate

89
Q

Hemiballism: lesion

A

Damage to subthalamic nucleus

90
Q

Hemiballism: features

A

Involuntary sudden jerking movements on contralateral side to lesion

91
Q

Lambert Eaton syndrome: damage

A

Antibody directed against pre-synaptic voltage gated calcium channel

92
Q

MS: spasticity Mx

A

Baclofen and gabapentin

93
Q

MS: bladder dysfunction

A

USS for bladder emptying
Residual volume –> intermittent self catheterisation
No residual volume –> anticholingeric

94
Q

Myasthenia gravis: Mx

A

Long acting acetylcholinesterase inhibitors (pyridostigmine)

Immunosuppression

95
Q

Myasthenia crisis: Mx

A

Plasmapheresis

IV IG

96
Q

Myasthenia gravis: exacerbating factors (6)

A 
Pencilliamine
Quinidine, procainamide
BB
Lithium
Phenytoin
Antibiotics (gent, macrolides, quinolones, tetracyclines)
97
Q

Myotonic dystrophy: features

A

Distal weakness
AD inheiritance
DM
Dysarthria

98
Q

Nacrolepsy has low levels of..

A

Orexin

99
Q

NF1: chromosome

A

17

100
Q

NF2: chromosome

A

22

101
Q

Causes of Parkinsonism

A 
Parkinson's
Anti-psychotic
PSP
Multiple system atrophy
Wilson's
Post-encephalitis
Dementia pugilistica
Toxins
102
Q

PSP: features

A

Postural instability and falls
Impairment of vertical gaze
Parkinsonism
Cognitive impairment

103
Q

Spastic paraperesis: causes (8)

A 
Demyelination
Cord compression
Parasagittal meningioma
Tropical spastic paraperesis
Transverse myelitis (HIV)
Syringomyelia
Hereditary
OA
104
Q

Subacute degeneration of spinal cord affects…

A

Dorsal columns and lateral corticospinal tract

105
Q

Chorea: lesion

A

Basal ganglia (caudate nucleus)

106
Q

Chorea: causes

A 
Huntington's, Wilson's, ataxic telangiectasia
SLE, anti-phospholipid
Rheumatic fever
OCP, L-dopa, anti-psychotics
Neuroancanthocytosis
Pregnancy
Thyroidtoxicosis
Polycythaemia rubra vera
CO poisoning
107
Q

Idiopathic intracranial HTN: RF

A

Obesity
Female
Pregnancy
COCP, steroids, tetracyclines, vitamin A, lithium

108
Q

Riluzole

A

Used in MND

109
Q

Transverse myelitis: causes

A

Viral infection
Bacterial infection
Post-infectious
MS

110
Q

CSF: Normal pressure

A

60-150mm

111
Q

CSF: Normal protein

A

0.2 - 0.4 g/l

112
Q

CSF: Normal glucose

A

> 2/3 BM

113
Q

CSF: Raised protein

A

GBS
TB, fungal and bacterial meningitis
Froin’s
Viral encephalitis

114
Q

Weakened foot dorsiflexion and eversion
Weakened extensor hallucis longus
Sensory loss over foot dorsum

A

Common peroneal nerve lesion

115
Q

Upbeat nystagmus

A

Cerebellar vermis lesion

116
Q

Downbeat nystagmus

A

Arnold-Chiari malformation

117
Q

Normal hearing

A

AC > BC

118
Q

Conductive hearing loss

A

BC > AC (affected ear)

Weber’s lateralises to affected ear

119
Q

Sensorineural hearing loss

A

AC > BC

Weber’s lateralises to unaffected ear

120
Q

Wernicke’s encephalopathy: features

A 
Nystagmus
Ophthalmoplegia
Ataxia
Confusion, altered GCS
Peipherial sensory neuropathy

MRCP 1 (16 decks)

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