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OSCE finals > Neurology > Flashcards

Neurology Flashcards

1
Q

Visual inattention to one side?

A

Contralateral parietal defect

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2
Q

How far should you sit from patient when testing for visual fields

A

1m

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3
Q

In reflexes response
-Afferent vs efferent defects

A

Afferent: CN II
- when light is shone into affected eye- neither eye will constrict

Efferent CN III
- Affected eye is contantly partially dilated
- Contralateral eye will constrict when eye is shone into affected eye.

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4
Q

What is a relative afferent defect

A

Swinging light test.
When light is shone into the affected eye then the pupils this will contrict less/ dilate more

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5
Q

Horizontal vs vertical nystagmus

A

Vertical: Central pathology
Horizontal: cerebellar

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6
Q

Fatigue on staring upwards?

A

Myasthenia gravis

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7
Q

Which nerve is affected?
- Eye cannot move laterally?
- Eye cannot move down when looking medially?
- Cannot move in most directions
- Complex opthalmoplegia

A
  • CN6- Abducens - lateral rectus
  • CN4- trochlear - superior oblique
  • CN3
  • Myasthenia or graves disease or brainstem lesion
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8
Q

Corneal reflex afferent and efferent nerves?

A

Afferent? CN 5
Efferent? CN 7

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9
Q

Jaw reflex afferent and efferent?

A

CN5

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10
Q

Why is the forehead spared in an UMN lesion?

A

the nucleus supplying the upper part of the face has a bilateral UMN innervation.

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11
Q

Which way does the uvula deviate in a CN 10 lesion?

A

TOWARDS from the lesion

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12
Q

What might cause Unilateral UMN weakness?

A

Brain: Stroke/ SOL
Brainstem: stroke/ SOL
Spinal cord: MS, SOL, Trauma, Haemorrhage, Syringomyelia

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13
Q

What might cause bilateral UMN weakness?

A

MS
Motor Neurone N.B. would have normal sensation
Myelopathy e.g. cord compression/ trauma/ transverse myelitis/ syringomyelia
OR
brainstem stroke OR Cerebral palsy

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14
Q

What cause bilateral LMN DISTAL weakness with abnormal sensation?

A

Alcohol
B12/ thiamine deficiency
Charcot-Marie Tooth/ Carcinomas
Diabetes/ Drugs (e.g. TB drugs/ metronidazole)
Every vasculitis (SLE/ RA/ polyarteritis nodosa)
And some infections e.g. HIV/ Leprosy/ herpes

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15
Q

What causes bilateral DISTAL LMN

A

Lead poisoning
Chronic inflammatory demyelinating polyneuropathy
Inclusion body myositis
Porphyria

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16
Q

What causes bilateral DISTAL LMN with acute flaccid paralysis?

A

Guillan- Barre
Cauda equina
Acute transverse myelitis

17
Q

What can cause unilateral LMN

A

Radiculopathy- pinching of the nerve at the root
Plexopathy
Peripheral neuropathy: pinching of the nerve further down. ( including mono neuritis multiplex)

18
Q

What causes LMN proximal weakness with normal sensation?

A

DENIM
Dystrophies e.g. Beckers/ Duchenne
Endocrinological e.g. Cushing’s/ Hypo-hyperthyroid
Neuromuscular e.g. myasthenia gravy/ Lambert-Eatin
Inflammatory
Metabolic/ mitochondrial

19
Q

What vision abnormalities might you expect in someone who has a cerebellar pathology?

A
  • Horizontal nystagmus
  • Saccadic Demetria ( difficulty focusing on one target)
  • Hypometric saccades (slow eye movements)
20
Q

CT of a subdural?

A

Looks like a banana

21
Q

CT of an extradural?

A

Looks like a circle

22
Q

CT of subarachnoid?

A

Bleeding at the sulci

23
Q

Presentation of an extradural bleed?

Management?

A

Trauma at the Period
Losses consciousness
Followed by LUCID period

Craniotomy + evacuation of haematoma

24
Q

Presentation of a subdural and management

A

Due to trauma or shredding of the veins in the head

  • Fluctuating consciousness

If acute: craniotomy
If chronic and large: burr holes

25
Q

Subarachnoid CT

Management

A

Bleeding surrounding the sulci

Nimodipine to prevent vasospasm

26
Q

Hypodense vs hyperdense for ischaemic stroke?

A

Hyperdense: early- as early as 90 mins
Hypodense: Late- >6 hours

OSCE finals (14 decks)

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