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MRCP Part 2 > Neurology > Flashcards

Neurology Flashcards

1
Q

Treatment for migraine prevention

A

Topiramate

Propanolol

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2
Q

Acute management of cluster headaches

A

Oxygen

SC triptan

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3
Q

Prophylaxis of cluster headaches

A

Verapami

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4
Q

What drugs cause peripheral neuropathy?

A 
Amiodarone 
Isoniazid 
Vincristine 
Nitrofurantoin 
Metronidazole
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5
Q

Features of multi system atrophy

A 
Parkinsonism 
Autonomic disturbance 
Erectile dysfunction 
Postural hypotension 
Atonic bladder 
Cerebellar signs
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6
Q

What is friedreichs ataxia?

A

Autosomal recessive condition that develops around age 10 - 15.

  • Gait ataxia and kyphoscolliosis
  • Absent ankle jerks
  • Cerebellar ataxia
  • Optic atrophy
  • Spinocerebellar tract degeneration
  • HOCM
  • Diabetes
  • High arched palate
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7
Q

Most common cause of death in friedreichs ataxia

A

HOCM

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8
Q

Subacute combined degeneration of the spinal cord.

A
  1. Bilateral spastic paresis
  2. Bilateral loss of prorioception and vibration
  3. Bilateral limb ataxia
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9
Q

Treatment of primary open angle gluacoma

A
  1. Prostoglandin analogue eye drop

2. Beta blocker, carbonic anhydrase inhibitor

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10
Q

Subthalamic nucleua of the basal ganglia

A

Hemibalism

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11
Q

Striatum (caudate nucleaus) of the basal ganglia

A

Huntingtons corea

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12
Q

What is von hippel lindau syndrome?

A 
Autosomal dominant condition predisposing to neoplasia.
- Cerebella haemangiomas 
Retinal haemangiomas 
Renal cysts 
Phaeochromocytoma 
Extra renal cysts 
Endolymphatic sac tumours 
Clear cell renal cell carcinoma
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13
Q

Best form on imaging for a TIA

A

MRI (with diffusion weighted imaging)

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14
Q

Treatment for glioblastoma multiforme?

A

Chemoradiotherapy with temozolamide (they have a synergistic effect on killing tumour cells.

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15
Q

Antibodies in myaesthenia gravis

A

Antibodies to acetylcholine receptors

ANti muscle specific tyrosine kinase antibodies

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16
Q

Treatment for myasthenia gravis

A

Pyridostigmine
Immunosupression may be needed in addition (initially prednisolone then azathioprine, cyclosporin or mycophenolate)
Thymectomy

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17
Q

Treatment of trigeminal neuralgia

A

Carbamazapeine

Microvascular secompression

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18
Q

Treatment of guillain barre

A

IV IG or Plasma exchange

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19
Q

Drugs that can exacerbate myaesthenia gravis

A 
Penicillamine 
Quinidine 
Procanamide 
Beta blocker
Lithium 
Ohenytoin 
Gentamicin, maclorlide, quinolones, tetracyclines
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20
Q

Symptoms of sporadic CJD

A

rapidly progressive dementia
Depression, apathy, euphoria, anxiety and emotional lability
Myoclonus, ataxia, nystagmus and hyperreflexia

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21
Q

MRI findings in CJD

A

Hypertintense signals in the basal ganglia and thalamus

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22
Q

Treatment for tics?

A

Clonidine

Atypical antipsychotics

23
Q

Features of myotonic dystrophy

A
  • features occur at age 20 - 30.
  • Myotonia (tonic spasm of muscle)
  • Mental impairment
  • Diabetes
  • Testicular atrophy
  • Cardiac involvment (heart block, cardiomyopathy)
    Dysphagia
24
Q

Treatment for paroxysmal hemicrania

A

Indomethacin

25
Q

Treatment for neuroleptic malignant syndrome

A

IV fluids
Dantrolene
Bromocriptine

26
Q

What is facioscapulohumeral muscular dystrophy?

A

Autosomal dominant muscular dystrophy that affects the face, scapula and upper arms first (symptoms tend to present by age 20)

27
Q

How do you test for friedrichs ataxia?

A

Serum genetic testing of the GAA trinucleotide repeat

28
Q

What is neuromyelitis optics (devics disease)

A 
Demyelinating CNS disorder. 
- Bilateral optic neuritis
- Myelitis 
- Spinal cord lesion invloving 3 or more spinal levels 
- Normal M~RI brain 
Aquaporin 4 positive serum antibody
29
Q

Treatment of neuromyelitis optica

A

Immunosupressants (eg rituximab)

30
Q

Which type of lunch cancer is associate with sensory neuropathy?

A

Small cell lung cancer (Anti Hu antibodies) Also causes cerebellar synndrome and enchephalomyelitis

31
Q

What is the treatment of valproate induced hyperammonaemic encephalopathy

A

L Carnitine

32
Q

What do you see in the CSF of patients with guillan barre syndrome

A

High protein

33
Q

What medications increase the risk of idiopathic intracranial hypertension?

A 
COCP
Steroids
Tetracyclines 
Vitamin A 
Lithium
34
Q

Medications used in idiopathic intracranial hypertension

A

Acetazolamide

Topiramte

35
Q

Treatment ladder in parkinsons disease

A
  1. Levodopa (if symptoms impact on quality of life)
  2. Dopamine agonist of MAOB inhibitors if symptoms not impacting on quality of life
  3. MAO B inhibitor on COMT inhibiitors as an adjunct to people on levodopa who are having fluctiatioms despite optimal therapy
36
Q

What does entacapone do?

A

COMT inhibitor that reduced the breakdown on L dopa (can be used as ad adjunt to levo dopa if ongoing motor symptoms)

37
Q

What medication can be used to help daytime sleepiness in parkinsons disease?

A

Modafinil

38
Q

What medication can be used to help REM sleep behaviour disorder in parkinsons?

A

Clonazepam or melatonin

39
Q

What medication can be used for postural hypotension in parkinsons disease?

A

Midodrine

40
Q

What medicatin can be used to help with drooling in people with parkinsons disease>

A

Glycopyrronium bromide

41
Q

Investigations in myaesthenia gravis?

A

Single fibre electromyography
CT Thorax (to exclude thymoma)
CK (normal)
Autoantibodies- Acetylcholine receptor, anti muscle specific tyrosine kinase antibodies)
Tensilon test (edrophonium reduced muscle weakness temporarily

42
Q

Management of myasthenic crisis?

A

Plasmapheresis

IVIG

43
Q

Nerve conduction tests - normal velocity but reduced amplitude

A 
Axonal pathology 
- Diabetes 
- B12 
- Paraneoplastic 
HIV
44
Q

Nerve conduction tests - reduced velocity and normal amplitude

A

Demyelination
- MS
- Guillan barre
CIDP

45
Q

What do glioblastoma look like on imaging?

A

Solid tumours with central necrosis and a rim that enhances with contrast.. Also associated with vasogenic oedema.

46
Q

What do meningioma look like on imaging?

A

Contrast enhancing lesion

47
Q

Total anterior circulation infarcts

A

All of…
1. Unilateral hemiparesis/hemisensory loss of the face arm and leg
2. Homonymous hemianopia
3. Higher cognitive dysfunction eg dysphasia
Middle and anterior cerebral arteries

48
Q

Partial anterior circulation infarcts

A

2 of
1. Unilateral hemiparesis/hemisensory loss of the face arm and leg
2. Homonymous hemianopia
3. Higher cognitive dysfunction eg dysphasia
Involves the smaller arteries of the anterior circulation.

49
Q

Lacunar infarcts

A 
1 of the following 
1. Unilateral weakness 
2. Pure sensory stroke 
3. Ataxis hemiparesis 
Involves perforating arteries of the unternal capsule, thalamus and basal ganglia
50
Q

Posterior circulation infarcts

A

1 of the following

  1. Cerebellar or brainstem syndrome
  2. Loss of consciousness
  3. Isolated homonymous hemianopia
51
Q

What is the criteria for needing ventilatory support in guillan barre syndrome?

A

FVC of less than 15 - 20.

52
Q

What is miller fisher syndrome?

A

Variant of guillan barre syndrome associated with opthlmoplegia, areflexia an ataxia. The eye muscles are affected first and it usually presents with a descendng paralysis rather than ascending.
Anti GQ1b antibodies are present in 90% of cases.

53
Q

Drug used after levodopa for tremor predmiant parksinons disease?

A

Anticholinergics such as procyclidine

MRCP Part 2 (11 decks)

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