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MRCP Part 1 > Neurology > Flashcards

Neurology Flashcards

1
Q

Features of PSP

A
  • Parkinsons
  • Vertical gaze palsy (downwards is worse)
  • Postural instability
  • Cognitive dysfunction

Poor response to L-dopa

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2
Q

Features of MSA

A

MSA-P: mostly Parkinsons
MSA-C: mostly cerebellar signs

  • Parkinsons
  • Autonomic dysfunction e.g. erectile dysfunction, atonic bladder
  • Cerebellar signs
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3
Q

Features of DLB

A
  • Parkinsons
  • Visual hallucinations
  • Progressive cognitive impairment including executive function and attention
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4
Q

Anterior cerebral artery infarct presentation

A

Contralateral hemiparesis and sensory loss, leg > arm

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5
Q

Middle cerebral artery infarct presentation

A

Contralateral hemiparesis and sensory loss
Contralateral homonymous hemianopia
Aphasia

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6
Q

Posterior cerebral artery infarct

A

Visual changes:

  • Contralateral homonymous hemianopia with macula sparing
  • Visual agnosia
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7
Q

Oxford-Bamford: Total Anterior Circulation Stroke

A

Affects areas supplied by anterior and middle cerebral arteries

Need all 3 of:

  • Unilateral motor or sensory deficit
  • Homonymous hemianopia
  • Higher cerebral dysfunction e.g. aphasia
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8
Q

Oxford-Bamford: Partial anterior cerebral stroke

A

Need 2 of:

  • Unilateral motor or sensory weakness
  • Homonymous hemianopia
  • Higher dysfunction e.g. dysphasia
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9
Q

Oxford-Bamford: Posterior circulation stroke

A

Affects brainstem and cerebellum

Any of the following:

  • Cerebellar dysfunction
  • BILATERAL motor/sensory deficit
  • Cranial nerve palsy
  • Eye movement disorder
  • Isolated homonymous hemianopia
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10
Q

Oxford-Bamford: Lacunar syndrome

A

No loss of higher cerebral function
Pure sensory or pure motor stroke
Ataxic hemiparesis

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11
Q

Mono-ocular vision loss: lesion is at…

A

Ipsilateral optic nerve

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12
Q

Bitemporal hemianopia: lesion is at…

A

OPTIC CHIASM

Upper > lower quadrant: inferior optic chiasm compression (PIT TUMOUR)

Lower > upper quadrant: superior optic chiasm compression (CRANIOPHARYNGOMA)

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13
Q

Homonymous hemianopia: lesion is at…

A

CONTRALATERAL optic tract

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14
Q

Quadrantanopia: lesion is at…

A

PITS

Parietal radiation lesion = Inferior quadrantanopia

Temporal radiation lesion = Superior quadrantanopia

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15
Q

Scotoma: lesion is at…

A

Contralateral occipital pole

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16
Q

Eye signs in Neurofibromatosis versus Tuberous Sclerosis

A

NF:

TS: Retinal

17
Q

Who should triptans be avoided in

A

Ischaemic heart disease

Cerebrovascular disease

18
Q

Who qualifies for migraine prevention

A

Getting 2+ migraines per month

19
Q

Migraine prevention drugs

A

1st line: Propranolol or topiramate

2nd line: 10 weeks acupuncture

20
Q

Trigeminal neuralgia management

A

1st line: carbamazepine

2nd line: refer to neurology!!!

21
Q

Trigeminal neuralgia management

A

1st line: carbamazepine

2nd line: refer to neurology!!!

22
Q

Transerve myelitis treatment

A

1) IV steroids

2) Plasmapheresis

23
Q

Transverse myelitis investigations

A

LP - isolated neutrophilia

24
Q

Treatment of valproate encephalopathy

A

L-carnitine

25
Q

Posterior inferior cerebellar artery stroke

A

“Lateral medullary syndrome”

  • Vertigo, ataxia and nystagmus
  • Loss of pain and temperature in IPSILATERAL face and CONTRALATERAL body
  • Horner’s syndrome
  • Chewing and swallowing difficulties

Think PICA - EATING weird stuff

26
Q

Anterior inferior cerebellar artery stroke

A

“Lateral pontine syndrome”

  • Ataxia, vertigo and nystagmus
  • FACIAL PARALYSIS (IPSILATERAL) and DEAFNESS
  • Horner’s syndrome
  • Pain and temperature loss in IPSILATERAL face and CONTRALATERAL body

Think AICA; fAICAl nerve

27
Q

Midbrain stroke (Weber’s syndrome)

A

Ipsilateral CN III palsy (down and out + ptosis)

Contralateral hemiparesis

28
Q

Locked in syndrome is due to an infarct in…

A

Basilar artery

29
Q

Amaurosis fugax is due to an infarct in…

A

Ophthalmic artery

30
Q

Absolute contraindications to thrombolysis

A 
Stroke in past 3 months 
Seizure
Brain tumour
Recent bleeding
Raised ICH
31
Q

Which anti-epileptics do not work on sodium channels?

A

Valproate: GABA agonist

Ethosuximide: blocks Ca channels on thalamic T-neurons

32
Q

Which anti-epileptics act on sodium channels?

A

Carbamazepine: block sodium channels

Lamotrigine: blocks sodium channels

Phenytoin: blocks sodium channels

Topiramate: blocks sodium channels and increases GABA

MRCP Part 1 (8 decks)

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