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1MRCP Part 1 > Neurology > Flashcards

Neurology Flashcards

1
Q

Horizontal Nystagmus
- When appears?
- Area of cortex affected

A

On horizontal gaze
Medial longitudinal fasciculus - integration of CN III and CN VI

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2
Q

Internuclear Ophthalmoplegia =
Associated with

A

= affected eye shows impairment of adduction.
When an attempt is made to gaze contralaterally (relative to the affected eye), the affected eye adducts minimally, if at all
Can abduct, will have nystagmus
Assoc: MS

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3
Q

Asymmetrical Muscular Dystrophy

A

= fascioscapulohumeral MD

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4
Q

Indication for Carotid Endartectomy

A

Stenosis of >70%-99%

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5
Q

Descending paralysis
Ataxia
Ophthalmoplegia
Post Infection

A

= MF variant of GBS
Different to ascending paralysis usually seen

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6
Q

Thrombolysis Window in Acute Stroke

A

4.5 hours

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7
Q

Thrombectomy Window in Acute Stroke

A

6 hours

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8
Q

CNIII nerve palsy
- Painful
- Not painful

A

Painful = posterior communicating artery aneurysm
Not painful = oculomotor nucleus

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9
Q

Diagnosis of Multiple Sclerosis

A

MRI FLAIR

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10
Q

Why can switching to carbamazepine cause a return of seizures?

A

= autoinduction
Carbamazepine induces its own metabolism, this decreases the half life
= reduction in carbamazepine levels after several weeks of treatment
> seizures
- Need to increase carbamazepine every 2 weeks to keep levels high

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11
Q

Asymptomatic rash
Skin folds, male
Pink or brown well defined patches with scaling

A

Erythasma
= superficial skin infection caused by corynebacterium

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12
Q

First line - myoclonic seizures, male

A

Sodium valproate

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13
Q

Treatment of IIH

A

Acetazolamide

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14
Q

Life prolonging treatment in MND

A

NIV - better than riluzole

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15
Q

Where in the hypothalamus control satiety?

A

Ventromedial area
Because not even a MEDIUM meal will do

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16
Q

Area responsible for chorea

A

Caudate nucleus

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17
Q

Genetic mutation in CADASIL

A

NOTCH3

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18
Q

Antibiotics MOST associated with myaesthenic crisis

A

Gentamicin (aminoglycosides)

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19
Q

What is apomorphine?

A

Dopamine agonist
Used in Parkinson’s disease

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20
Q

Bone conduction > air conduction

A

Conductive hearing loss
Weber’s lateralises to that side (sound travels from forehead through bone)

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21
Q

What is tabes dorsalis?
How can it present?

A

= complication of neurosyphilis
Neuropathic pain, cerebellar signs, urge incontinence

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22
Q

NF2
- key presentation
- genetic abnormality

A

= bilateral acoustic neuromas
Chromosome 22

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23
Q

DAT scan =

A

SPECT scan

24
Q

Management of spasticity in MS

A

Baclofen
Gabapentin - both first line

25
Q

Management of TIA acronym

A

HALTSS
HTN
Antiplatelet/anticoagulation
Lipid therapy
Tobacco
Sugar - diabetes
Surgery

26
Q

Painful Horner’s Syndrome
- why?

A

Carotid dissection until proven otherwise
= sympathetic overlie carotid, lost in dissection = Horner’s syndrome

27
Q

Assessment of function in stroke scoring system

A

Modified Rankin

28
Q

Mechanism of action of alteplase

A

Tissue plasminogen activator

29
Q

Cortical haemorrhage cause
Lobar haemorrhage cause

A

Cortical = HTN most likely
Lobar = AVM, amyloid, tumour

30
Q

Side effects of phenytoin (3)

A

Gum hyperplasia
Hirsutism
Megaloblastic anaemia

31
Q

Features of MSA (3)

A

Symmetrical distribution
Progresses quickly
Responds poorly to levodopa

32
Q

Features of Corticobasal degeneration (5)

A

Apraxia
Aphasia
Cognitive impairment
Alien Hand syndrome
Symmetrical distribution

33
Q

Mechanism of levodopa

A

Precursor to dopamine - metabolised to give dopamine

34
Q

Ophthalmoplegia
- differentiation

A

= involvement of the pupil
Medical causes e.g. diabetes, vascular don’t usually involve the pupil

34
Q

Internuclear Ophthalmoplegia
- definition
- causes (3)

A

= nystagmus and failure of adduction
Indicates lesion in the medial fasciculus longitudinus
e.g. MS, stroke, malignancy

35
Q

Management of optic neuritis

A

IV methylprednisolone

36
Q

Assessment of MS
CSF findings

A

McDonald’s criteria
Oligoclonal bands in CSF

37
Q

Miller-Fisher
- association
- presentation

A

Association = GQ1b ganglioside
Ophthalmoplegia including peripheral neuropathy

38
Q

CSF findings in GBS (2)

A

Elevated CSF protein
Normal CSF cell count

39
Q

Two types of autoimmune encephalitis

A

NMDA encephalitis
CASPR2 encephalitis

40
Q

Association with NMDA encephalitis

A

NMDA receptor antibodies - ovarian teratoma

41
Q

Association with CASPR encephalitis

A

Sleep disorder

42
Q

Causes of mixed LMN/UMN presentation (5)

A

MND
Syringomyelia
Cervical Spondylopathy
Tabes Dorsalis
Freiderich’s Ataxia

43
Q

Gene associated with Charcot Marie Tooth

A

PMP22 gene

43
Q

MRI finding in sporadic CJD

A

Cortical ribboning

44
Q

Neurocysticerosis investigation finding =

A

= multiple calcifications
Poorly heated pork

45
Q

Avoid doing in acute stroke

A

Correcting hypertension - allows the use of collateral blood vessels to supply the brain

46
Q

CN III palsy - what to consider?

A

Pupil - if fixed need urgent neuroimaging ?carotid artery aneurysm

47
Q

Where is responsible for hemiballismus?

A

Subthalamic nucleus

48
Q

Amyloid is associated with…

A

Autonomic neuropathy

49
Q

When can you rule out SAH?

A

If CTH within 6 hours of onset of headache can confidently rule out

50
Q

Signs in CSF in MS (2)

A

IgG intrathecal synthesis
Oligoclonal bands

51
Q

Side effects of topiramate (2)

A

Weight loss
Renal stones

52
Q

Management of Tourette’s Syndrome

A

Risperidone

53
Q

Mechanism of Ropinirole

A

Dopamine receptor agonist

54
Q

Brachial neuritis =

A

= neuralgic amyotrophy

1MRCP Part 1 (20 decks)

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