Brainscape's Knowledge GenomeTM

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


See full index

Sophie’s Flash Cards > Neurology > Flashcards

Neurology Flashcards

1
Q

Cause of unilateral spatial neglect and dressing apraxia

A

Non-dominant inferior parietal lesion
- MCA infarct

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

DWI-FLAIR mismatch

A

Acute ischaemic lesion detect with DWI but not FLAIR - > within time window for thrombolysis

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

Lamotrigine toxicity

A

Sodium valproate
- Lamotrigine is extensively metabolised by N-glucoronidation
Sodum valproate inhibit its glucoronidation

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

Major concern of increased use of keppra

A
  • Mood disorders e.g. suicidality
  • Psychiatric disorder: aggression, abnormal behavior, suicide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Triad of meniere disease

A
  • Episodic vertigo, sensisorineural hearing loss and tinnitus
  • Dx only if episodic vertigo + sensorineural hearing loss
  • Aural fullness + nausea might be seen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

HINTS exam

A

Head impulse: 20 degree sudden rotation of head with eyes fixed on distance
- Normal: eye will rotate in the opposite direction
- Peripheral: abnormal - unable to maintain fixation
- Central - eye will rotate in opposite direction
Nystagmus (central: bidirectional; peripheral: unidirectional)
Skew deviation - cover and uncover eyes alternatively
- Peripheral: no deviation
- Central: vertical skew deviation (uncovered eye quickly shift from central to abnormal skew position)

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

Deep brain stimulation for PD
- Specific sites targeting
- Symptoms most likely improve on

A

Two specific sites target: subthalamic nucleus and internal segment of globus pallidus
Helps to improve
- Levodopa responsive symptoms, tremor, on-off fluctuations and dyskinesia

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

Stroke mimic > stroke

A
  • Known cognitive impairment
  • LOC or seizure at onset
  • Migration of symptoms
  • Positive symptoms: paraesthesia, jerks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Stroke > stroke mimic

A
  • Exact time of onset
  • Patient could recall exactly what they were doing at sx onset
  • Well in the week
  • Focal symptoms or signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Management timing for acute stroke

A

Thrombolysis within 4.5h after onset
Thrombectomy: within 24h

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

Fridrich’s ataxia presentation

A
  • limb ataxia
  • Early loss of position and vibration (posterior column spinal cord dysfunction)
  • Dorsal root and peripheral, primarily sensory, axonal neuropathy
  • Affect autonomic -> bladder dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Rubrospinal tract

A

Red nucleus in midbrain -> decussate near point of origin and descend contralaterally in lateral funiculus of the cord

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

Rubrospinal tract

A

Red nucleus in midbrain -> decussate near point of origin and descend contralaterally in lateral funiculus of the cord

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

Transverse myelitis presentation

A
  • Sensory, motor or autonomic dysfunction attributable to the spinal cord
  • Bilateral
  • Clearly defined sensory level
  • No evidence of compressive cord lesion
  • Inflammation defined by CSF pleocytosis or elevated IgG or gadolinium enhancement
  • Progression to nadir 4h - 21 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Ddx of optic neuritis

A
  • MS
  • Neuromyelitis optica
  • Drugs ethambutol, alcohol
  • Vit B12 def
  • Ischaemic secondary to DM, temporal arteritis
  • Familial e.g. Leber’s disease
  • Infective: EBV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Features suggestive for MS

A

Suggestive
- Relapse and remissions
- Onset between 15-50
- Optic neuritis
- Lhermitte sign
- Internuclear ophthalmoplegia
- Fatigue
- Heat sensitivity (Uhthoff phenomenon)

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

Use for ocrelizumab

A
  • Deplete CD20 expressing B cell
  • For primary progressive MS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Complications of levodopa

A
  • Motor fluctuations
  • Involuntary movements (dyskinesia)
  • Abnormal cramps
  • Dystonia
  • NOT Gait disturbances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Diagnosis criteria of essential tremor

A
  • Bilateral action tremor of the hands and forearms (but not resting)
  • Absence of other neuro signs, wth exception of cogwheel phenomenon
  • Isolated head tremor with no signs of dystonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Steroid use in bell’s palsy

A

Who has poor prognosis
- Severe complete paralysis
- Age > 60
- EMG: axonal degeneration
- Hyperacusis
- Altered taste

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

Association of PRES

A
  • HTN (53%)
  • Kidney disease (45%)
  • Malignancy (32%)
  • Dialysis dependency (21%)
  • Transplantation (24%)
  • AI disorders (11%)
  • Eclampsia (11%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Clinical presentation of PRES

A
  • Seizure (85%)
  • Headache (50%)
  • Amaurosis/hemianopsia (blindness in nearly 50%)
  • Altered mental status/coma (40%)
  • N+V (30%)
  • Transient motor defect (10%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Triad of normal pressure hydrocephalus

A
  • Gait impairment (specifically gait apraxia)
  • Dementia
  • Urinary incontinence
    Treatment
  • Potentially reversible
  • CSF drainage (VP shunt)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Wallenberg syndrome (Lateral medullary syndrome)

A

Occlusion of PICA
- Ipsilateral loss of facial pain and temp (trigeminal spinal nucleus and tract involvement)
- Contralateral loss of pain and temp (spinothalamic tract)
- Ipsilateral palatal, pharyngeal, vocal cord paralysis with dysphagia and dysarthria (nucleus ambigus)
- Ipsilateral horner syndrome (descending sympathetic fibres)
- Ipsilateral cerebellar syndrome
- Vertigo, N+V (vestibular nuclei)
- Hiccups (middle medulla)
- Diplopia (lower pons)

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

Foster Kennedy syndrome

A

Inferior frontal lobe tumor
- Optic atrophy in one eye
- Papilloedema of others

26
Q

Gerstamann syndrome

A
  • Agraphia, acalculia, finger agnosia, L right disorientation
27
Q

Cluster vs migraine

A
  • Cluster a/w unilateral phonophobia and photophobia
  • Cluster: move around
  • Migraine: motionless
28
Q

CT head before LP

A
  • Presence of papilledema
  • History of recent head trauma
  • Known or suspected intracranial lesion
  • Focal neuro signs
  • Depressed LOC
29
Q

Features of EMG of MND

A
  • Chronic partial denervation with preserved motor conduction velocity
30
Q

Kennedy syndrome

A
  • X-linked disorder
  • Gynaecomastia and infertility
  • LMN signs - progressive weakness in limb and bulbar muscle
  • Male, mid-adult life
31
Q

Treatment that prolong survival for MND

A
  • NIV
  • Riluzole only slow progression
  • PEG only improves QoL
32
Q

MOA of riluzole

A
  • Na channel blocker that inhibits glutamate release
33
Q

Conditions of purely UMN signs and purely LMN signs

A

Purely UMN - primary lateral sclerosis
Purely LMN - primary muscular atrophy

34
Q

Drugs change level of carbamezapine

A

Increase
- Macrolides
- Isoniazid
- Chloramphenicol
- Ca blockers
Reduce
- Phenobarbitone
- Phenytoin
- Primidone
- St john wart

35
Q

S/E of phenytoin

A
  • Osteoporosis
  • Ataxia, nystagmus
  • Gingival hyperplasia
  • Coarsening of facial features
  • Loss of libido
  • Hormone dysfunction
  • BM hypoplasia
36
Q

S/E of vigabatrin

A
  • Drowsiness (most common)
  • Neuropsychiatric symptoms
  • Weight gain
  • Visual field changes
37
Q

AED that can weight gain

A
  • Vigabatrin
  • Pregablin
  • Valproate
38
Q

Features of posterior communicating aneurysm

A
  • Painful 3rd nerve palsy
39
Q

MOA of COMT inhibitors

A
  • Tolcapone and entacapone
  • Prolong and potentiate levodopa effect when given with levodopa
  • Reduce the peripheral (entacapaone) and central (tolcapone) methylataion of levodopa and dopamine
40
Q

Feature of 3rd nerve palsy

A
  • Eye is deviate down and out
  • Ptosis
  • Pupil may be dilated
41
Q

Weber syndrome - midbrain infarct

A
  • Ipsilateral 3rd nerve palsy with contralateral hemiplegia
42
Q

AED that affect OCP

A
  • Enzyme inducer e.g. carbamazepine, phenytoin, phenobarbital
  • SODIUM valproate does not affect
43
Q

AED that most likely cause SJS

A
  • Lamotrigine
44
Q

AED to avoid in juvenile myoclonic epilepsy

A
  • Carbamazepine
    Important to uncover any hx of jerking, esp in the morning, before starting drugs
45
Q

AED increase half life of lamotrigine

A
  • Na valproate
46
Q

Treatment of Essential tremor

A
  • Propranolol
  • Primidone
  • Alprazolam
  • Alcohol
47
Q

Most common immediate symptoms of excess levodopa

A
  • N+V
48
Q

MOA of amantadine

A
  • Enhance dopamine release
  • Peripheral s/e: livedo reticularis, ankle oedema
  • Other S/E: confusion, hallucination, nightmares
49
Q

S/E of COMT Inhibitors

A
  • Tolcapone: dyskinesia, hallucination, confusion, nausea, orthostatic hypotension
  • Diarrhea, orange discoloration of urine, rarely hepatoxicity
  • Lower the dose of levodopa either before or after addition of tolcapone
  • Entacapone: not been a/w hepatoxicity
50
Q

Pathologic gambling with PD

A
  • Cuased by Pramipexole
  • Dysregulation of dopaminergic tone
51
Q

Clinical presentation of progressive supranuclear palsy

A
  • Disturbance of gait -> fall
  • Ophthalmoparesis or ophthalmoplegia (hallmark)
  • Dysarthria, dysphagia, rigidity, frontal cognitive abnormalities, sleep disturbances
    Poor response to levodopa
52
Q

Upper trunk branchial plexopathy (C5, C6)

A
  • Loss of shoulder movement and elbow flexion
  • Sensory loss over lateral aspect of arm and forearm
53
Q

Lower trunk brachial plexopathy (C8, T1)

A
  • Claw hand
  • Horner syndrome
  • Sensory loss over (ulnar) side hand and forearm
54
Q

Complete brachial plexopathy

A
  • Horner
  • LMN signs
  • Sensory loss over whole limb
55
Q

Foot drop

A
  • Common peroneal nerve, L5, sciatic nerve
  • If reflex intact -> common peroneal nerve or L5
56
Q

Complete brachial plexopathy

A
  • Horner
  • LMN signs
  • Sensory loss over whole limb
57
Q

Femoral nerve

A
  • usually seen in haemophilia patient with haematoma in iliacus muscle
  • Weak knee extension (quadriceps), absent knee jerk, loss of sensory inner aspect of thigh and leg
58
Q

Antibiotics reduce therapeutic effect of sodium valproate

A
  • Carbapenum (meropenum, entapenum, imipenum)
59
Q

S1 lesions

A

Sensory loss of posterolateral leg and lateral foot
Weakness in plantar flexion
Reduced ankle reflex
Positive sciatic nerve stretch test

60
Q

L3 nerve root

A

Sensory loss over anterior high
Weak knee extension
Reduced patellar reflex

61
Q

L4 nerve root

A

Sensory loss over the knee
Weak ankle dorsiflexion
Reduced patellar reflex

Sophie’s Flash Cards (9 decks)

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