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phase 3a > Neurology > Flashcards

Neurology Flashcards

1
Q

Describe the pattern of weakness in GBS?

A

symmetrical ascending weakness

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2
Q

Describe the reflexes in someone with GBS

A

reduced

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3
Q

What investigations can be done in someone with suspected GBS?

A

nerve conduction studies and lumbar puncture

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4
Q

What is the time frame between the preceding infection and onset of symptoms in GBS?

A

within 4 weeks

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5
Q

How can we treat GBS?

A

intravenous immunoglobulins

plasmapheresis

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6
Q

What is the first line diagnostic investigation in SAH?

A

CT head

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7
Q

What should you do at least 12 hours after onset of symptoms in a patient with suspected SAH?

A

lumbar puncture

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8
Q

What is the most common thing to present with in SAH?

A

thunderclap headache- sudden onset and severe

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9
Q

What is xanthochromia ?

A

yellow discolouration indicating presence of bilirubin in the CSF

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10
Q

What are the things are looked at in the Glasgow coma scale?

A

eye opening
motor response
verbal response

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11
Q

Which nerve palsy can you get in SAH?

A

third cranial nerve palsy

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12
Q

A patient has two seizures and does not regain consciousness between them. What is the diagnosis?

A

status epilepticus

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13
Q

A patient has a tonic-clonic seizure that lasts more than 5 minutes- what is the diagnosis ?

A

status epilepticus

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14
Q

Which group of inherited conditions damage the peripheral nerves, with symptoms usually appearing between the ages of 5 and 15?

A

Charcot-Marie-Tooth disease

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15
Q

What does CIDP stand for?

A

chronic inflammatory demyelinating polyneuropathy

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16
Q

In which disease are there antibodies against nicotinic acetylcholine receptors?

A

myasthenia gravis

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17
Q

What is the most common type of mononeuropathy?

A

carpal tunnel syndrome

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18
Q

Which part of the nervous system does MS affect?

A

the CNS

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19
Q

What is the most common presentation of MS?

A

optic neuritis

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20
Q

What is the most common pattern of MS at initial diagnosis?

A

relapsing remitting

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21
Q

How should MS relapses be treated?

A

methyprednisolone

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22
Q

What kind of imaging could you do on someone with suspected MS?

A

MRI

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23
Q

What is the most common type of motor neurone disease?

A

amylotrophic lateral sclerosis

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24
Q

What is the second most common MND?

A

progressive bulbar palsy

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25
Q

Which disease involves the progressive degeneration of both upper and lower motor neurones?

A

MND

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26
Q

In parkinsons disease there is a progressive reduction of what chemical in the basal ganglia?

A

dopamine

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27
Q

What is the classic triad of features in parkinsons disease

A

resting tremor
rigidity
bradykinesia

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28
Q

What may happen to a persons handwriting in parkinsons disease

A

may get smaller

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29
Q

What is the typical gait of a person with parkinsons ?

A

shuffling

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30
Q

How does rest affect tremor in someone with parkinsons?

A

tremor is worse at rest

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31
Q

What medication is given in parkinsons disease to mimic dopamine ?

A

levodopa

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32
Q

What type of drug does levodopa have to be combined with to prevent it from being broken down?

A

peripheral decarboxylase inhibitors

33
Q

What affect does alcohol have on a benign essential tremor?

A

improves tremor

34
Q

What can make a benign essential tremor worse?

A

coffee, stress, fatigue and voluntary movement

35
Q

What might you see if you perform fundoscopy on a patient with raised ICP?

A

papillodema

36
Q

What is papilloedema?

A

swelling of the optic disc secondary to raised ICP

37
Q

What type of cancer may result in the development of lambert-eaton myasthenic syndrome ?

A

small-cell lung cancer

38
Q

What type of migraine may mimic a stroke ?

A

hemiplegic migraine

39
Q

What is the name for a headache caused by long term analgesic use ?

A

analgesic headache

40
Q

What does a headache that is worse when coughing indicate?

A

raised ICP

41
Q

What does a postural headache suggest?

A

raised ICP

42
Q

What may a headache during pregnancy indicate ?

A

pre-eclampsia

43
Q

In what type of seizure is there a muscle tensing then muscle jerking epidode?

A

tonic-clonic

44
Q

What is the period after a seizure called where the person may be drowsy and confused?

A

post-ictal

45
Q

What is the first line management of tonic-clonic seizures in men?

A

sodium valproate

46
Q

In which part of the brain do focal seizures start?

A

temporal lobes

47
Q

What is the first line treatment for focal seizures ?

A

carbamazapine or lamotrigine

48
Q

How long do absence seizures typically last?

A

10-20 seconds

49
Q

If a patient has had a stroke and they now have aphasia- which artery was most likely to be the one blocked?

A

Middle cerebral artery- supplies both wenickes and brocas areas

50
Q

A young overweight female presents with headache and blurred vision and sixth nerve palsy. On fundoscopy there is papilloedema. What is the most likely diagnosis?

A

Idiopathic intracranial hypertension

51
Q

Describe the inheritance pattern of tuberous sclerosis

A

Autosomal dominant

52
Q

A patient presents with depigmented ‘ash leaf spots’, fibromata beneath their nails and epilepsy. What is the most likely diagnosis?

A

Tuberous sclerosis

53
Q

A neurologist places the base of a struck tuning fork on a patient’s forehead. What test is this?

A

Weber’s test

54
Q

A neurologist performs Rinne’s test by placing a struck tuning fork onto the mastoid process and then moving the tuning fork next to the ear when the patient says they can no longer hear the sound. The patient reports that now the tuning fork has been moved they can hear it vibrating. Is this a normal result?

A

This is normal as in healthy individuals air conduction should be better than bone.

55
Q

What is a rinnes positive result?

A

A rinnes positive result is when air conduction is louder than bone- this is a normal result

56
Q

What is a normal Weber’s test result?

A

Sound heard equally in both ears

57
Q

Webers test is performed on a patient with conductive hearing loss. Which ear will hear the sound loudest?

A

The affected ear

58
Q

Vestibular schwannomas are also sometimes referred to as……?

A

Acoustic Neuromas

59
Q

Where would you find a vestibular schwannoma?

A

The cerebellopontine angle

60
Q

A tumour is found at the cerebellopontine angle. What type of tumour is this most likely to be?

A

Vestibular schwannoma AKA acoustic neuroma

61
Q

A patient presents with vertigo, hearing loss and tinitis. O/E patient has absent corneal reflex. What tumour would you want to investigate for?

A

vestibular schwannoma (acoustic neuroma)

62
Q

Which nerve is affected in cubital tunnel syndrome?

A

Ulnar

63
Q

Which nerve gives sensation to the little finger on both the front and back of the hand?

A

Ulnar

64
Q

What should be given to a patient presenting who is presenting with Bell’s palsy?

A

Prednisolone and lubricating eye drops

65
Q

Apart from prednisolone, what should be given to a patient with Bell’s palsy?

A

lubricating eye drops

66
Q

How can you tell stroke apart from Bell’s palsy?

A

In stroke the lesion is an upper motor neurone lesion thus the forehead will be spared

67
Q

Which nerve palsy results in ptosis and down and out deviation of the eye?

A

third nerve palsy

68
Q

what does mydriasis mean?

A

dilation of the pupil

69
Q

What does miosis of the pupil mean?

A

constriction

70
Q

In a third nerve palsy, how may the pupil be affected?

A

pupil may be dilated (mydriasis)

71
Q

Which class of drugs have the strongest evidence base for reducing the number of relapses in MS? Clue: Natalizumab

A

Monoclonal antibodies

72
Q

Which two drugs are first-line for MS spasticity?

A

baclofen and gabapentin

73
Q

A 75 year old man presents with gait abnormality, urinary incontinence and dementia- what is the diagnosis?

A

Normal pressure hydrocephalus

74
Q

In males, what is the first line treatment for focal seizures?

A

lamotrigine or levetiracetam

75
Q

A patient is diagnosed with a disorder where the brachial plexus is compressed at the site of the thoracic outlet. They have generalised numbness and some hand weakness. What is the diagnosis?

A

Thoracic outlet syndrome

76
Q

What is the most likely cause of a painful third nerve palsy?

A

posterior communicating artery aneurysm

77
Q

A patient presents with double vision. O/E their right eye is deviated upwards and outwards. The doctor diagnoses a fourth nerve palsy. Which muscle is innervated by CN IV?

A

superior oblique

78
Q

Which nerve innervates the skin on the palmar aspect of the thumb?

A

median nerve

79
Q
A

phase 3a (6 decks)

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