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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
Associations: medial thalamus and mammillary bodies
Wernicke and Korsakoff syndrome
26
Associations: subthalamic nucleus of basal ganglia
hemiballism
27
Striatum of basal ganglia
Huntington's chorea
28
Substantia nigra of basal ganglia
Parkinson's disease
29
'Ash leaf spots' Roughened patches skin over L spine Adenoma sebaceum Cafe-au-lait spots
Cutaneous features of TS
30
TS: inheiritance
AD
31
Developmental delay Epilepsy Intellectual impairment
Neurological features of TS
32
Retinal hamartomas (white spots on retina) Rhabdomyomas of heart PCKD Renal angiomyolipomata
Features of TS
33
Von Hippel Lindau Inheirtiance
AD
34
VHL features
Vitreous haemorrhages Haematomas (cerebellar and retinal) Lousy cancers (clear cell carcinoma, endolymphatic)
35
Meniere's disease: features
Recurrent vertigo, tinnitus and hearing loss Aural fullness Nystagmus and positive Romberg's
36
Left homonymous hemianopia
Lesion of right optic tract
37
Homonymous superior quadrantanopia
Contralateral temporal lobe
38
Homonymous inferior quadrantanopia
Contralateral parietal lobe
39
What is Ramsay Hunt syndrome?
Reactivation of VZV in seventh CN
40
Ramsay Hunt: features
auricular pain CN7 palsy Vesicular rash around ear
41
Causes of horizontal disconjugate eye movement
internuclear ophthalmoplegia
42
Internuclear ophthalmoplegia: lesion
medial longitudinal fasciculus
43
Where is the medial longitudinal fasciculus?
Paramedian area of midbrain and pons
44
Internuclear ophthalmoplegia: features
Impaired adduction on same side of lesion | Horizontal nystagmus on contralateral side
45
Lateral medullary syndrome: lesion
Posterior inferior cerebellar artery
46
LMS: features
Ataxia | Nystagmus
47
LMS: ipsilateral features
Dysphagia Facial numbness CN palsy
48
LMS: contralateral features
Limb sensory loss
49
Levodopa: SE
``` Dyskinesia Dry mouth Anorexia Palpitations Postural hypotension Psychosis ```
50
Bromocriptine, ropinirole, cabergoline and apomorphine are..
dopamine receptor agonists
51
Selegiline is..
MAO-B inhibitor
52
Procyclidine, benzotropine, benzhexol are..
antimuscarinics
53
Treatment of drug induced Parkinsonism
anti-muscarinics
54
Multiple system atrophy: features
Parkinsonism Autonomic disturbance Cerebellar signs
55
Lambert-Eaton myasthenic syndrome
Associated with small cell lung cancer
56
Anti-Hu associations
lung cancer and neuroblastoma
57
Anti-Hu features
Sensory neuropathy Cerebellar syndrome Encephalomyelitis
58
Anti-Yo associations
Ovarian and breast cancer
59
Anti-Yo features
cerebellar syndrome
60
Anti-GAD antibody associations
Breast, CRC and SCLC
61
AntiGAD antibody features
Stiff person's syndrome | Diffuse hypertonia
62
Anti Ri asociations
Breast and SCLC
63
Anti-Ri features
Ocular opsoclonus-myoclonus
64
Ataxic telangiectasia: inheiritance
AR
65
Ataxic telangiectasia: features
Cerebellar ataxia Teleangiectasia IgA deficiency
66
Bell's palsy: features
LMN CN7 palsy | Forehead affected
67
Bell's palsy: Mx
Prednisolone | Eye care
68
Erb's Palsy
Damage to C5-6 | Winged scapula
69
Klumpke's palsy
Damage to T1 Loss of intrinsic hand muscles Due to traction
70
HSV: CT
Medial temporal and inferior frontal changes
71
Sumitriptan: MoA
5HT-1 antagonist
72
Multiple System Atrophy: features
Parkinsonism Autonomic (erectile dysfunction, postural hypotension, atonic bladder) Cerebellar signs
73
Neuroleptic malignant syndrome: cause
Antipsychotic medications
74
Neuroleptic malignant syndrome: features
Pyrexia Muscle rigidity Autonomic lability (HTN, tachycardia/pnoea) Agitation
75
Neuroleptic malignant syndrome: Mx
Stop causative medication IV fluids Dantrolene Bromocriptine
76
Neuromyelitis optica: diagnostic criteria
Optic neuritis, myelitis and 2 of; 1. spinal cord lesion at 3+ levels 2. normal MRI brain 3. aquaporin 4 positive serum antibody
77
Parkinson's: features
Asymmetrical Bradykinesia Resting tremor Rigidity
78
Drug induced Parkinson's: features
Rapid onset motor symptoms and bilateral
79
Peripheral neuropathy: motor loss
``` GBS Porphyria Lead poisoing Charcot-Marie Tooth Chronic inflammatory demyelinating polyneuropathy Diphtheria ```
80
Peripheral neuropathy: sensory loss
``` Diabetes Uraemia Leprosy Alcoholism B12 deficiency Amyloidosis ```
81
Tuberous sclerosis: inheiritance
Autosomal dominant
82
Tuberous sclerosis: cutaneous features
``` Ash-leaf spots Roughened patches over lumbar spine Adenoma sebaceum Subungual fibromata Cafe-au-lait spots ```
83
Tuberous sclerosis: neurological features
Developmental delay Epilepsy Intellectual impairment
84
Tuberous sclerosis: additional features
``` Retinal hamartomas Rhabdomyomas of heart Gliomatous changes in brain PCKD Renal angiomyolipomata Lung cysts ```
85
Generalised tonic clonic seizures: Mx
Sodium valproate | Lamotrigine, carbamazepine
86
Absence seizures: Mx
Sodium valproate or ethosuximide
87
Myoclonic seizures: Mx
Sodium valproate | Clonazepam, lamotrigine
88
Focal seizures: Mx
Carbamazepine or lamotrigine | Levetiracetam, oxcarbazepine or sodium valproate
89
Hemiballism: lesion
Damage to subthalamic nucleus
90
Hemiballism: features
Involuntary sudden jerking movements on contralateral side to lesion
91
Lambert Eaton syndrome: damage
Antibody directed against pre-synaptic voltage gated calcium channel
92
MS: spasticity Mx
Baclofen and gabapentin
93
MS: bladder dysfunction
USS for bladder emptying Residual volume --> intermittent self catheterisation No residual volume --> anticholingeric
94
Myasthenia gravis: Mx
Long acting acetylcholinesterase inhibitors (pyridostigmine) | Immunosuppression
95
Myasthenia crisis: Mx
Plasmapheresis | IV IG
96
Myasthenia gravis: exacerbating factors (6)
``` Pencilliamine Quinidine, procainamide BB Lithium Phenytoin Antibiotics (gent, macrolides, quinolones, tetracyclines) ```
97
Myotonic dystrophy: features
Distal weakness AD inheiritance DM Dysarthria
98
Nacrolepsy has low levels of..
Orexin
99
NF1: chromosome
17
100
NF2: chromosome
22
101
Causes of Parkinsonism
``` Parkinson's Anti-psychotic PSP Multiple system atrophy Wilson's Post-encephalitis Dementia pugilistica Toxins ```
102
PSP: features
Postural instability and falls Impairment of vertical gaze Parkinsonism Cognitive impairment
103
Spastic paraperesis: causes (8)
``` Demyelination Cord compression Parasagittal meningioma Tropical spastic paraperesis Transverse myelitis (HIV) Syringomyelia Hereditary OA ```
104
Subacute degeneration of spinal cord affects...
Dorsal columns and lateral corticospinal tract
105
Chorea: lesion
Basal ganglia (caudate nucleus)
106
Chorea: causes
``` 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
Idiopathic intracranial HTN: RF
Obesity Female Pregnancy COCP, steroids, tetracyclines, vitamin A, lithium
108
Riluzole
Used in MND
109
Transverse myelitis: causes
Viral infection Bacterial infection Post-infectious MS
110
CSF: Normal pressure
60-150mm
111
CSF: Normal protein
0.2 - 0.4 g/l
112
CSF: Normal glucose
>2/3 BM
113
CSF: Raised protein
GBS TB, fungal and bacterial meningitis Froin's Viral encephalitis
114
Weakened foot dorsiflexion and eversion Weakened extensor hallucis longus Sensory loss over foot dorsum
Common peroneal nerve lesion
115
Upbeat nystagmus
Cerebellar vermis lesion
116
Downbeat nystagmus
Arnold-Chiari malformation
117
Normal hearing
AC > BC
118
Conductive hearing loss
BC > AC (affected ear) | Weber's lateralises to affected ear
119
Sensorineural hearing loss
AC > BC | Weber's lateralises to unaffected ear
120
Wernicke's encephalopathy: features
``` Nystagmus Ophthalmoplegia Ataxia Confusion, altered GCS Peipherial sensory neuropathy ```

MRCP 1 (16 decks)

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